Although there is no cure for RA, the goal of treatment is to minimize patients' symptoms and disability by introducing appropriate medical therapy as soon as possible, before the joints are permanently damaged. No single therapy is effective for all patients, and many will need to change treatment strategies during the course of their lifetime.
Successful management of RA requires early diagnosis and, at times, aggressive treatment. Patients with an established diagnosis of rheumatoid arthritis should begin treatment with disease-modifying anti-rheumatic drugs, or DMARDs. DMARDs are often used in conjunction with non-steroidal anti-inflammatory drugs and/or low dose corticosteroids.
Gary S. Firestein, MD
Neural Regulation of Synovial Inflammation
Much of the therapies currently available to treat rheumatoid arthritis focus on the role of the immune system and its regulation of synovial A joint affected by rheumatoid arthritis has swelling of the
synovium, or synovial fluid, that can lead to damage to cartilage and bone. inflammation and joint destruction. Dr. Firestein's project focuses on how the central nervous system can control inflammation. The study is the first to identify a new pathway that allows the spinal cord and brain to decrease joint inflammation and joint destruction. Now that this pathway is identified, new therapies can be developed to utilize it and mimic the anti-inflammatory effects of the central nervous system.
S. Louis Bridges, Jr., MD, PhD
Genetics and Ethic Differences in C-Reactive Protein as a Biomarker of Radiographic Severity in Rheumatoid Arthritis
This project seeks to obtain new information on the genetic basis for severity of the disease. Dr. Bridges hopes to identify genetic markers that influence the severity of disease in different ethnic groups. If successful, this will help physicians individualize treatment based on the patient's genes.
Cornelia M. Weyand, MD, PhD
Defects of Hematopoietic Stem Cell Function in Rheumatoid Arthritis
This project focuses on cells that are the precursor to bone marrow. Bone marrow is primarily responsible for shaping the immune system and tissue repair. The precursor cells to bone marrow are defective in all RA patients. Dr. Weyand will be investigating the effects of various treatments on these cells with the idea that restoring these bone marrow cells will improve immune function.
Edward Yelin, PhD
Disparities in Utilization and Outcomes in Rheumatoid Arthritis
This study compares standard measures of disease activity such as degree of joint damage, with assessments of socioeconomic status such as income, education level and employment status, race/ethnicity of the patient and the language spoken at home to explain disparities in care and treatment of RA.