Research Organizations and Foundations Supporting RA

Rheumatoid arthritis (RA) is a type of inflammatory arthritis in which the immune system attacks the tissues lining the joints on both sides of the body. RA can also affect other body parts, including the skin, eyes, lungs, and heart. The exact cause of RA is unknown.

In the United States, RA affects around 1.3 million adults. It is a lifelong condition without a cure. Fortunately, RA is treatable and manageable. While there is no cure for RA, many research organizations and foundations are taking the initiative to improve treatment and patient quality of life.  

This article will cover what science knows about RA, its current treatment options, the latest research efforts, clinical trials, advocacy efforts, and more.  

What RA Researchers Know

RA is an autoimmune disease in which the body's immune system attacks its own healthy tissues leading to systemic (body-wide) inflammation and fluid buildup in the joints. Treatments for RA can put a stop to the immune system's overactive response, and treatments have come a long way in the last 25 years.

Researchers continue to look for new ways to get relief from RA symptoms and prevent joint damage or disability.

Chronic Nature of RA

RA is a chronic disease that will progress and have long-term effects. The term "chronic" refers to a disease that lasts more than three months. Chronic diseases are conditions that can be controlled but not cured.

People with RA often need to deal with daily symptoms that affect their quality of life. They might experience additional health problems that lead to disease complications and a shortened life expectancy.  

Effect of Inflammation 

The progression of RA is closely linked to the severity of inflammation.  With RA, the body fights itself, and the inflammatory response rages. If the inflammation goes unchecked, joint damage will likely occur. The same chronic inflammation can also affect body parts such as the skin, eyes, lungs, and heart.

A 2014 Annals of Rheumatic Disease study found people with RA had high levels of C-reactive protein (CRP), markers of inflammation. CRP levels doubled the risk for heart attack. In addition, up to 80% of RA had lung involvement due to severe and prolonged inflammation.

Theories About Cause 

The immune system typically makes antibodies that attack bacteria and viruses. However, in RA, it mistakenly produces antibodies that attack the lining of the joints (joint synovium), leading to damage of bones, cartilage, tendons, and ligaments. If RA is not treated, it will gradually cause joints to be misshapen and misaligned.

Researchers have some theories as to why some people get RA and others do not. The following risk factors may contribute:

• Genetics: Genetics has a significant influence on the development of RA. There also appears to be an increased occurrence in families.
• Hormones: RA is more common in women than in men, and research suggests estrogen might play a role. Estrogen is important to female sexual and reproductive development.
• Smoking: Some evidence suggests that people who smoke have an increased risk of developing RA.

Treatment Options

The main goal of RA treatment is to achieve the lowest possible level of disease activity or even remission. Remission means that RA symptoms disappear for a period of time.  

Additional treatment goals for RA are:

• Minimizing joint damage
• Enhancing physical function
• Maintaining quality of life
• Participation in social and professional life

RA joint damage typically occurs within the first two years of diagnosis in 80% to 85% of people. Untreated RA doubles a person's risk of mortality compared to others of the same age. 

Treatments for RA include medications, physical therapy and occupational therapy, lifestyle changes, and surgery. In determining your treatment options, your healthcare provider, specifically a rheumatologist, will consider your age, overall health, medical history, and the severity of RA symptoms. 

Medications that treat RA and its symptoms include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs can decrease pain and inflammation. Examples of NSAIDs are Advil (ibuprofen), Aleve (naproxen), and aspirin.
• Corticosteroids: Available as a pill or injection, a corticosteroid can help manage pain and reduce inflammation.
• Disease-modifying antirheumatic drugs (DMARDs): These drugs can slow down the disease process by modifying your immune system's response. DMARDs can be prescribed alone or other corticosteroids and other RA medicines. Commonly prescribed DMARDs for treating RA are Rheumatrex (methotrexate), Plaquenil (hydroxychloroquine), and Azulfidine (sulfasalazine).
• Biologic DMARDs: Biologics are a type of DMARD that works by targeting particular chemicals in the blood that activate the immune system and attack the joints. They are given by injection or IV infusion. Examples of biologic DMARDs are Enbrel (etanercept), Remicade (infliximab), Orencia (abatacept), Cimzia (certolizumab pegol), and Simponi (golimumab).
• Janus kinase (JAK) inhibitors: JAK inhibitors are the newest class of drugs used to treat RA. Like biologics, these drugs are targeted therapies that affect how the immune system responds. Unlike biologics, they are given in pill form. Xeljanz (tofacitinib), Olumiant (baricitinib), and Rinvoq (upadacitinib) are approved to treat RA.

Latest Research Efforts

Researchers are continually looking for ways to determine what causes RA. For example, they want to understand the interaction of genes and inflammation. Researchers are also looking at better treatment options in hopes of putting more people in clinical remission.  

The 2021 American College of Rheumatology Convergence, an annual meeting of rheumatology experts worldwide, revealed new research on RA, including the following: 

Cycling of JAK Inhibitors in Difficult to Treat RA

This study looked at 708 people with RA who had previously failed a first JAK inhibitor and were treated either with a second JAK inhibitor (cycling) or a biologic DMARD (switching) in their routine care—154 were cycled, and 554 switched.

The study results showed cycling and switching strategies offered the same drug survival rates. The researchers concluded that even after failing a first JAK inhibitor, trying a second JAK inhibitor could equal success rates similar to switching to a biologic DMARD. 

Active Monitoring of TNF Inhibitors to Control RA Disease Effects

This study suggests that therapeutic drug monitoring, with regular blood work to adjust medication dosage and intervals, could make tumor necrosis factor (TNF) inhibitor drug therapy more effective.

In this randomized, controlled, open-label multicenter trial, participants were monitored for their infliximab dose and treatment intervals within a range of 3 to 7 milligrams per liter (mg/L). The standard group had their dosing and intervals adjusted based on their doctor's recommendation.  

During the 52-week follow-up, sustained disease control occurred in 73.6% of the control group participants and 55% in the standard group. The study's authors concluded keeping drug levels within the therapeutic range and not below helped control disease activity and prevent anti-drug antibodies that would reduce drug effectiveness.

List of Research Organizations and Foundations

RA research efforts continue to emerge through various research organizations and health and educational institutions. 

Rheumatic Disease Biorepository 

The Rheumatology Department at Virginia Mason Medical Center has a Rheumatic Disease Biorepository led by rheumatologist Jeffrey S. Carlin.

The registry is a confidential list of people willing to donate blood samples and provide health information to researchers investigating the causes of RA and long-term health effects of the condition in an effort to improve treatments and patient care.

Johns Hopkins Arthritis Center 

Researchers at Johns Hopkins Medicine's Arthritis Center lead a lab that focuses on biomarker identification to define RA risk factors and subtypes better. Biomarkers are objective measurements, such as blood tests for specific chemicals or cell proteins.

They are also studying imaging modalities and their use in RA diagnosis and progression. They have clinical programs that cover a wide range of RA-related issues from diagnosis to treatment and to reducing disease complications. 

Rheumatology Research Foundation 

The Rheumatology Research Foundation is continually working with health institutions to research more advanced treatment options for people with rheumatic diseases and help them to live longer and healthier lives.  

The National Institute of Arthritis and Musculoskeletal and Skin Diseases

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) supports research on causes, treatment, and prevention of arthritis, musculoskeletal, and skin diseases. They also work towards better training for scientists who carry out research and share information on research efforts with the public and professionals.

Recent NIAMS rheumatoid arthritis efforts include studies on:

• Molecular and genetic basis for identifying future therapies
• Natural history of RA in children and adults to determine progression and life quality
• RA remission in people taking TNF inhibitors
• RA inflammation and its effect on blood vessels and heart tissue

Rheumatoid Arthritis Support

Nonprofit organizations can be excellent resources for learning more about RA, including treatment, and getting support for various aspects of the condition.

Such organizations include: 

• Arthritis Foundation: The Arthritis Foundation is dedicated to improving people's lives with arthritis. It also hosts online support communities. 
• American College of Rheumatology (ACR): ACR offers resources and information for people living with rheumatic diseases and their caregivers and loved ones. It provides a diverse resource center and search tool links to advocates, doctors, and treatments. 
• Global Healthy Living Foundation (GHLF): GHLF is a nonprofit whose mission is to improve people's lives with chronic diseases, including rheumatoid arthritis. Its Creaky Joints digital community is an essential resource for people with arthritis and their caregivers to seek education and support and learn about advocacy and research efforts. 

Where to Enroll in an RA Clinical Trial

Clinical trials are research studies to show how well a medical strategy or treatment works on people. They are a vital part of getting the Food and Drug Administration (FDA) to approve a treatment to become available to the general public.

It is sometimes hard to find people to participate in trials, either because people are unaware that trials exist or because they fear the safety of trials. There are many resources available for finding a local study. Patient safety protections for clinical trials include review board monitoring to protect participant rights and well-being. 

Many websites help you search for a clinical trial near you. You should consult with your healthcare provider about trials that may interest you. Your healthcare provider and office staff might also have information about local research taking place within their medical institutions. 

Websites that can help you locate an RA clinical trial include: 

• American College of Rheumatology
• Arthritis Foundation
• Clincaltrials.gov
• Center Watch
• Mayo Clinic
• National Institute of Arthritis and Musculoskeletal and Skin Diseases 

Reasons to Join RA Advocacy Efforts

There are many benefits to getting involved in RA advocacy efforts. You can get involved in your community and work toward legislative change efforts. It can also help you connect with new friends, learn new skills, and further your career. 

Getting involved in the RA effort can improve your mental and physical health. Making a difference and being involved with others can keep you mentally stimulated, give you a sense of purpose, reduce stress, and combat feelings of anxiety and depression.  

You can become involved in many different ways, including through non-profit organizations and state and federal efforts. Many wonderful organizations like those referenced above can help you get started. 

Summary

Rheumatoid arthritis is a type of inflammatory arthritis that attacks the lining of the joints. Its exact cause is unknown. While there is no cure for RA, the condition is manageable and treatable with medications, lifestyle changes, physical and occupational therapies, and surgical treatment.

In addition, many organizations and medical institutions are working to improve treatment and quality of life for people with the condition. 

A Word From Verywell

It is difficult to predict the exact effect of RA on a person's life and outlook because disease course will vary person-to-person. Continuing advances in RA treatment mean that outlook with RA is better than it has been before. Many people live healthy and active lives despite RA with mild symptoms and minor day-to-day limitations. 

If you are worried about the effects of RA or if you continue to experience severe symptoms, let your healthcare provider know. With the right treatment approach, it is possible to experience an improved disease status or even remission.