New study shows obesity and smoking likely to undermine rheumatoid arthritis treatment

Rheumatoid arthritis (RA) is an autoimmune condition that causes inflammation in the joints, resulting in joint pain and swelling. There are estimated to be approximately 20,000 cases of rheumatoid arthritisdiagnosed in the UK every year, affecting 700,000 adults in all. The first few weeks and months after the onset of rheumatoid arthritis is commonly known as the ‘window of opportunity’, as treatment at an early stage can prevent some of the damage that is inflicted on the joints, meaning a greater chance of achieving remission or avoiding many of the long-term problems associated with rheumatoid arthritis.

However, a new study presented at the recent European League Against Rheumatism Annual Congress indicated that the chance of achieving remission in early rheumatoid arthritis is greatly reduced in those that smoke or who are obese.

How does rheumatoid arthritis affect the joints?

Our joints are where two bones meet. The ends of our bones are covered with the flexible connective tissue called cartilage that allows our joints to move easily against each other without friction. The joint is surrounded by the synovium membrane, another type of connective tissue, that produces synovial fluid which lubricates the cartilage and joint.

Rheumatoid arthritis causes an inflammation of the synovium membrane, so it swells, produces extra synovial fluid and goes red as there is increased blood flow which accounts for the feeling of heat in an affected joint. Pain and stiffness is the result of the nerve ending becoming irritated by the inflammation and the capsule that surrounds the joint becoming stretched by swelling.

Treatment for rheumatoid arthritis

The aim of rheumatoid arthritis treatment is to achieve remission, where the disease is not affecting your ability to perform normal everyday activities or continue in employment. Yet it is estimated that, within ten years of onset of the disease, half of all sufferers are unable to maintain a full-time job. In the UK, in a survey carried out by the National Rheumatoid Arthritis Society in 2010, only 17.8% of respondents felt that the condition had not affected their employment.

The study’s lead investigator Dr Susan Barlett of McGill University, Canada, found that a non-smoking male with a healthy BMI would have a 41% chance of achieving sustained remission compared to 15% for an obese male smoker. For women, the probability is 27% compared to 10%. Dr Bartlett commented: “Our findings show that not smoking and a healthy body weight – lifestyle factors which can be modified by patients – can have a significant impact on becoming symptom-free.”

Cambridge-based Rheumatologist Professor Cathy Speed believes in a holistic approach to healthcare which in practical terms means addressing your general health, nutrition and lifestyle factors to produce optimal results. For a consultation with Professor Speed call 01223 200 595.