Rheumatoid arthritis epidemiology

Knekt P, Heliovaara M, Aho K, Alfthan G, Marniemi J, Aromaa A (2000) Serum selenium, serum alpha-tocopherol, and the risk of rheumatoid arthritis. Epidemiology, 11 402—405. 

For some autoimmune diseases, little is known about environmental factors involved in the initiation or progression of the disease. For other diseases, however, considerable research has been conducted on one or more types of exposures. Most epidemiologic studies of environmental influences have focused on multiple sclerosis, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and small vessel vasculitis, but experimental studies using murine models of these diseases is limited (Table 25.1). 

Many epidemiologic studies of scleroderma, lupus, rheumatoid arthritis with fairly consistent and strong associations seen adjuvant- pro-inflammatory properties. Limited mechanistic research in MRL +/+ lupus mice... 

Slow viruses are becoming increasingly suspect in the instances of much more common diseases, particularly the autoimmune diseases. An autoimmune disease may be defined as a disease wheiein the immune system of the body does not direct its attack on an invading foreign substance, but instead at the body s own tissue. Many authorities consider rheumatoid arthritis and multiple sclerosis as autoimmune diseases. The precise causes of these diseases have remained obscure. Multiple sclerosis is a demyelinating disease and has variously been described as an autoimmune disease, a viral disease, or an autoimmune disease provoked by a virus. Epidemiological studies indicate that from 3 to 23 years may elapse between the time of exposure to the virus and the onset of symptoms. Further evidence points to involvement of a myxovirus. Measles virus is of this kind. 

Spector TD, Hochberg MC. The protective effect of the oral contraceptive pill on rheumatoid arthritis an overview of the analytic epidemiological studies using meta-analysis. J Clin Epidemiol 1990 43(ll) 1221-30. 

Gabriel SE. The epidemiology of rheumatoid arthritis. Rheum Dis Clin North Am. 2001 27 269-281. 

Kvien TK. Epidemiology and burden of illness of rheumatoid arthritis. Pharmacoeconomics. 2004 22 (suppl 2) 1—12. 

Symmons DP. Epidemiology of rheumatoid arthritis determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol. 2002 16 707-722. 

Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res 2002 4(suppl 3) S265-S272. 

A comprehensive review discusses the therapeutic management of RA (Turesson and Matteson, 2004). Epidemiological studies link extra-articular rheumatoid arthritis manifestations with premature mortality and support aggressive anti rheumatoid therapies for those patients. Cyclophosphamide is favored in patients with systemic rheumatoid vasculitis and methotrexate in those cases with other manifestations of extra-articular rheumatoid arthritis (Turesson and Matteson, 2004). Cyclophosphamide and TNFa inhibitors such as infliximab have some positive success in treatment resistant vasculitis associated with RA (Unger et al., 2003). However, TNFa inhibitors have also been associated with the opposite effect, an induction of extra articular rheumatoid arthritis so their use should be used only in specific cases when close monitoring is in place. 

Some of the mechanisms and risk factors of methotrexate-associated non-Hodgkin s lymphoma in patients with rheumatoid arthritis have been reviewed, including an analysis of the characteristic features of 25 detailed published cases (122). Although the epidemiological evidence is limited, several reports of spontaneous remission of lymphomas after methotrexate withdrawal strongly support a cause-and-effect relation. 

Anonymous. Neoplasms in rheumatoid arthritis update on clinical and epidemiologic data. Am J Med 1985 78(lA) l-83. 

Furtheron, a broad range of other clinical and epidemiological observations is in support with the previous results. For single analgesics, abuse is only poorly documented and the nephrotoxic potency of single analgesics can be considered as minimal. Even in patients with rheumatoid arthritis in which high... 

Generally, autoimmune diseases are perceived to be rare however, when all autoimmune diseases are combined, the estimated prevalence of 3-5% is not rare, which underlines their importance in the public health sector. Because of problems in designing and standardizing epidemiological studies and because of the fact that only limited data are available, this prevalence may be underestimated (Jacobson et al., 1997). There is epidemiological evidence of increasing prevalence of some autoimmune diseases (e.g. diabetes mellitus type 1, multiple sclerosis), although the rates for other diseases (specifically, rheumatoid arthritis, or RA) appear to be... 

Compelling support for the involvement of free radicals in disease development comes from epidemiological studies showing that an enhanced antioxidant status is associated with reduced risk of several diseases. Vitamin E and prevention of cardiovascular disease is a notable example. Elevated antioxidant status is also associated with decreased incidence of cataracts and cancer, and some recent reports have suggested an inverse correlation between antioxidant status and occurrence of rheumatoid arthritis and diabetes... 

Demmer RT, Molitor JA, Jacobs Jr. DR, Michalowicz BS. Periodontal disease, tooth loss and incident rheumatoid arthritis results from the First National Health and Nutrition Examination Survey and its epidemiological follow-up study. J Clin Periodontal. 2011 38(11) 998—1006. Alvarez-Lafuente R, Fernandez-Gutierrez B. Potential relationship between herpes viruses and rheumatoid arthritis analysis with quantitative real time polymerase chain reaction. Ann Rheum Dis. 2005 64(9) 1357—1359. 

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