Rheumatoid arthritis: a primer for pharmacists

The epidemiology of rheumatoid arthritis (RA), its pathophysiology and immune mechanisms, and its clinical manifestations are reviewed. The signs, symptoms, and radiographic and biochemical changes noted in mild, moderate, and severe disease are discussed and the systemic nature of RA and its adverse impact on survival are addressed. Traditional and newer scoring instruments to measure disease severity, progression, disability, and response to therapy are reviewed and introduced, respectively. The impact of RA on disability and quality of life (QOL) is also explored.

RA, a chronic inflammatory autoimmune disease that involves the synovial membrane and extraarticular sites, affects approximately 1-2% of the population, with women 2-3 times as likely to be affected as men. If RA is not treated aggressively, its clinical course is characterized by progressive physical disability and reduced QOL.

Increased knowledge of the cellular and immune mechanisms involved in RA has identified new drug targets.