Rheumatoid Arthritis

We will be focusing on rheumatoid

arthritis.

>> In this presentation, we'll be doing a

full analysis on rheumatoid arthritis,

beginning with a descriptive

epidemiology of the disease, including

the prevalence, incidence, and mortality

rates. We'll then go more in depth on

the main characteristics of the disease,

including the signs, symptoms, and

biological complexity of it. And then

we'll end off by covering a

rehabilitation program for rheumatoid

arthritis, which will include a

description on what the program is, how

the program works, and how it helps with

rheumatoid arthritis. Rheumatoid

arthritis is a chronic autoimmune

condition that causes pain, swelling,

and inflammation of the joints of those

who are affected. It can also lead to

joint damage, bone erosion, and possible

deformity over time. Although modern

treatments have improved disease

management and patient outcomes,

rheumatoid arthritis may still lead to

long-term damage and an increased risk

of heart disease. So before we dive

deeper into rheumatoid arthritis, it's

important to first understand what

actually makes a disease chronic.

According to the CDC and the World

Health Organization, chronic diseases

are defined as conditions that last one

year or more and requiring ongoing

medical attention or limit activities of

daily living or both. Uh they're of long

duration, generally slow progression and

importantly they cannot be cured only

managed. There are six key

characteristics that define a chronic

disease. First, long duration. They

persist for months to a lifetime,

typically beyond three months. Second,

slow progression. They develop gradually

and worsen over time if left untreated.

Third, there is no known cure. Uh they

cannot be prevented by vaccines or cured

by medication. Uh fourth, they involve

complex causality, meaning they're

caused by multiple interacting genetic,

environmental, and behavioral factors.

Fifth, they require ongoing medical

care, continuous treatment, monitoring

and lifestyle management. And sixth,

they limit daily living, reducing

quality of life, functional mobility,

and participation in everyday

activities. RA as a chronic disease.

When we apply each of these defining

criteria to rheumatoid arthritis, we can

see that RA clearly satisfies every

single one. Starting with long duration,

RA is a lifelong condition. Once

diagnosis, once diagnosed, it persists

indefinitely uh cycling between active

flare stages and periods of remission

throughout a patient's entire life. In

terms of progression, RA develops

gradually and if left untreated, it

progressively destroys cartilage and

bone leading to joint deformity and dis

uh disability over months to years.

Um, regarding a cure, there is currently

no cure for RA. Treatment is focused on

reducing pain, controlling inflammation,

slowing disease progression, and

maintaining joint function. Uh, for

complex causality, AR arises from the

interaction of genetic predisposition.

For example, the HLA DR4 gene along with

hormonal factors and environmental

triggers such as smoking and infections.

RA also requires uh ongoing care

demanding continuous pharmacological

management with drugs like demarts

and bi bi biologics

uh physiootherapy

um regular monitoring of disease

activity and lifestyle modifications.

And finally, RA limits daily living um

causes chronic pain, fatigue, joint

stiffness and reduce mobility. all of

which significantly impair a person's

workability uh independence and overall

quality of life. So in conclusion,

rheumatoid arthritis uh clearly meets

all established criteria for a chronic

disease. It is uh lifelong progressive

incurable multiffactorial requires

ongoing care and limits daily function.

>> So to start off I'll I'll discuss the

the descriptive epidemiology of

rheumatoid arthritis. So, I'm going to

divide up divide up into the Canadian

perspective and worldwide perspect

perspective just to give us a better

insight of what uh rheumatoid arthritis

looks like in Canada. Let's start off uh

in Canada about 334,000 Canadians or

1.2% have been diagnosed with rheumatoid

arthritis and this is between the ages

of 16 and 90 plus. So overall what the

trends is that we're noticing an

increased private incidence in

conjunction with increasing age. So as

people get older the rates are a bit

higher. um it is higher in women than in

men. So 1.7 versus 0.8%. And from the

years 2007 to 2017 the prevalence rate

of rheumatoid arthritis uh and this is

the rates according to standardized uh

the age groups. It grew in females from

1.3 to 1.5%. It remains stable for

males. So it's leveling off for men. And

the incidence rates have also decreased

in men and women. And this is the data

from the public health agency of Canada

from a report that was published in

2020. So here I provided uh some some

graphs that show the prev the prevalence

and incidence rate from the same

publication. So from the public health

agency of Canada from the 2020 report.

So you can see that the orange bars this

is representing women and the blue are

representing men and you can see that it

is increasing with increasing age. So

the the x-axis just showing that the

ages as they're increasing the farthest

on the far right is at 90 plus. So you

can see that it is increasing with age

and the same with incidents and is

higher in women significantly higher in

women than in men. So that is a trend

that we're noticing. I just want to note

that the incidence rate is leveling off

and decreasing um as reported by the

same publication uh public health agency

of Canada from the 2020 report. So I

just want to briefly point out the

mortality rates from the same report

from the public health agency of Canada

2020 and it state from 2007 to 2017 that

the mortality rates actually decreased

in both sexes. So both men and women and

this is standardized according to age

rates. uh but they did find that the

mortality rates was higher in males and

females as compared to the actual

incidence of prevalence rates being

higher in women. The death rates are

higher actually in men. And I also want

to point out the prevalence of

arthritis. U so this one study by the

public health agency of Canada 2017 um

looked at all types of arthritis. So

this includes rheumatoid arthritis but

also osteoarthritis and other types. And

they found that the highest the highest

rates are in the east coast. So in Nova

Scotia, Newfoundland, Labrador, New

Brunswick, Prince Island, as low as

Quebec, British Columbia, the

territories. So it is highest in Nova

Scotia. And I just pulled this report

because there's a limited amount of data

related to arthritis in between

provinces. So I thought that this

provided a good perspective. I just want

to point out that the prevalence of all

arthritis stayed by the same report from

2017 and may reach 20% by 2031. So this

is an alarming statistic that needs to

be taken seriously.

>> So I'll now move on to a relevant study

that was conducted in Alberta. And this

study measured the prevalence rate for

rheumatoid arthritis within the entire

province. And what they did find is that

the is that the rural rates of

rheumatoid arthritis were a lot higher

than uh urban areas. You can see that in

this picture um here the lighter areas

are where there's less cases and the

darker areas there were more cases. So

as a result there's less um cases in

Calgary and Edmonton. And this stud is

relevant because similar findings were

found Ontario, BC, Quebec where the race