Rheumatoid Arthritis, Pathophysiology and Management

Abstract

Introduction: Rheumatoid arthritis is considered one of the most common, and particularly attacks the joint causing significant individual and community burden, and present with articular as well as extra articular manifestation. Treatment modalities of rheumatoid arthritis have dramatically improved in recent years, significantly decreasing long-term auricular and extra-auricular complications. Aim of the work: this review was aimed to study the pathophysiology, clinical picture, and management of rheumatoid arthritis, with focus on the newer modalities. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: rheumatoid arthritis, chronic inflammatory disorders, genetic of rheumatoid arthritis, management of rheumatoid arthritis, DMARD, biological agents Conclusion: The newer modality of treatment must include disease-modifying antirheumatic drug (DMARDs) which must be started as early as possible. Combining DMARDs with corticosteroids will result in significantly better outcomes than monotherapy with any DMARD, and decrease long term morbidity associated with this condition.

Hyaluronic Acid-Based Nanosystems for CD44 Mediated Anti-Inflammatory and Antinociceptive Activity

“…This leads to an increase in inflammation due to the active presence of pro-inflammatory cytokines. This has further led to the increased targeting of CD44 as a therapy for OA using HA, a well-known CD44 ligand [ 102 , 103 , 104 , 105 ].…”

CD44 receptor-targeted novel drug delivery strategies for rheumatoid arthritis therapy

“…Among the receptors that have been discussed earlier, CD44 has been reported to be over-expressed in the sites of inflammation in RA proportionate to the inflammation intensity [4]. The levels of CD44 in the synovium of patients with RA are 3.5-fold and 10.7-fold higher than that of patients with osteoarthritis and joint trauma, respectively.…”