Rheumatoid arthritis (RA): Prognosis
Rheumatoid arthritis (RA) is a common form of arthritis that affects more than 1.3 million people in the United States alone. It can develop in anyone, but it is more common in women than men and is most likely to present in people aged 60–69 years.
RA is an autoimmune disease in which the immune system mistakenly attacks healthy tissue in the joints. It causes inflammation, pain, swelling, stiffness, and reduced joint mobility.
People usually experience the symptoms of RA in multiple joints, and the condition typically affects both sides of the body symmetrically. The symptoms tend to occur in cycles, so people have flare-ups and periods of remission. Over time, RA can lead to permanent joint damage.
In this article, we look at the prognosis for RA, factors that can influence it, and tips for improving the quality of life with this condition.
What is the outlook for people with RA?
A person with rheumatoid arthritis may find that joint pain and mobility worsen over time.
RA is a chronic condition for which there is currently no cure.
However, treatment can slow down the progression of the disease. It can also help reduce pain, make symptoms manageable, and prevent joint damage.
Continuing advances in RA treatment mean that the outlook for people with RA is better than ever before. Many people can live a healthy, active life with RA.
It is difficult to predict the exact impact that RA will have on a person's life expectancy because the course of the disease differs significantly between people.
In general, it is possible for RA to reduce life expectancy by around 10 to 15 years. However, many people continue to live with their symptoms past the age of 80 or even 90 years.
With appropriate treatment, many people with RA experience only relatively mild symptoms for many years, and it places few limitations on their everyday life.
For example, disease-modifying antirheumatic drugs (DMARDs) have become an effective and widely available medication for people with RA. These drugs work by suppressing the immune system and minimizing the damage that it does to joint tissue.
Over time, people with RA often experience some of the following issues:
- worsening joint pain and swelling
- more persistent symptoms during flare-ups
- permanent joint damage
- inflammation spreading to new joints
- an increasingly restricted range of motion in affected joints
- decreased mobility
- treatment having less effect than it did initially
In comparison with other forms of arthritis, RA is particularly challenging to treat because it involves the immune system. As a result, it can cause widespread complications throughout the body, not just in the joints. These complications can contribute significantly to people's outlook. Some people may also have systemic symptoms.
The systemic symptoms of RA include:
It is also possible for people with RA to experience complications, including:
- inflammation in other parts of the body, such as the eyes
- heart disease
- high blood pressure
- skin conditions
- respiratory conditions
These complications are relatively uncommon, but they occur more often in advanced forms of RA. For this reason, people with advanced RA have a significantly lower life expectancy than those whose RA is less active.
What factors can influence outlook?
While the outlook for people with RA is difficult to predict, several factors can have an influence.
Factors likely to affect the prognosis of RA include:
- the presence of complications and systemic symptoms
- a person's age
- the progression of the condition at diagnosis
- being overweight or obese
- lifestyle factors, such as smoking and exercise
- the success of treatment
- genetic factors
We discuss some of these factors in more detail below:
Smoking tobacco can adversely affect the progression of RA. A study in people with a genetic predisposition for RA found that smoking was a significant risk factor for the development of this disease.
Smoking causes further inflammation, which can worsen the progression of RA. It also increases the risk of complications, such as respiratory conditions and heart disease.
As with many conditions, an early diagnosis of RA can lead to a significant difference in a person's outlook.
The early stages of the condition tend to involve less inflammation, which is easier to control with anti-inflammatory drugs. Receiving appropriate treatment at this stage can prevent permanent joint damage and minimize the impact of RA on quality of life.
Later diagnosis carries the risk of inflammation already being chronic, which can be difficult to treat. There is also an increased risk of permanent joint damage.
RA usually develops in older adults, but it can affect people of any age.
When the onset of RA occurs at a younger age, there is more time for it to progress. Consequently, it may cause more severe symptoms over time, and it is more likely to lead to complications.
Receiving appropriate treatment is key to improving a person's outlook.
RA is a lifelong condition, meaning that ongoing treatment and monitoring is necessary to limit its impact on the body.
Doctors recommend getting regular blood tests and scans to detect any signs of disease progression or complications.
Where possible, regular visits to a physical therapist can help keep the joints and surrounding tissues healthy.
Tips for improving quality of life with RA
Eating an anti-inflammatory diet can help slow down the progression of rheumatoid arthritis.
People with RA can improve their outlook and slow down the progression of the condition by adopting a healthful lifestyle and actively managing the disease.
Doing this may involve:
- exercising regularly
- eating an anti-inflammatory diet
- using equipment, such as straps, to support affected joints when necessary
- losing weight, if overweight
- avoiding high-intensity sports or other activities that put excessive pressure on affected joints
- adhering to any treatments that a doctor advises, even when symptoms have not flared up
- quitting smoking, if relevant
It is difficult to predict the course of RA, and the prognosis varies greatly.
RA can reduce a person's life expectancy by as much as 10 to 15 years, although many people live with their symptoms beyond the age of 80 or even 90 years.
Factors affecting RA prognosis include a person's age, disease progression, and lifestyle factors, such as smoking and being overweight.
Due to advances in medications and other treatments, the prognosis for RA is better than ever before.