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Rheumatoid Arthritis (RA)

What is Rheumatoid Arthritis? Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. It affects 1% of the population in the United States and can cause significant joint damage and disability. If treated early, joint damage may be slowed significantly.

What Causes Rheumatoid Arthritis?

Rheumatoid arthritis is caused by inflammation of joint structures in response to several types of antibodies, including rheumatoid factor (RH) and anti-citrullinated protein antibody (ACPA). The etiology of this autoimmunity is thought to be the result of interactions between several internal and external factors. There is evidence of genetic susceptibility to abnormalities in the innate and adaptive immune systems that may be triggered by environmental factors, such as:

  • Cigarette smoke
  • Dust exposure
  • Chronic stress
  • Infection or altered microbiome of the mouth or gut

The onset of RA may occur at any time. However, the risk increases with age until the age of 50. Having a relative diagnosed with RA and being female also increase the risk of developing the disease.

Symptoms of Rheumatoid Arthritis

The onset of RA is insidious and often manifests with extra-articular symptoms. Characteristic symptoms of rheumatoid arthritis include:

  • Symmetrical involvement of joints.
  • Small joints affected first.
  • Morning stiffness that can last over 30 minutes.
  • Carpal tunnel syndrome.
  • Swan-neck deformity of the fingers.

Extra-articular manifestations can include:

  • Rheumatoid nodules on the skin
  • Muscle weakness
  • Inflammation and dryness of the eyes.
  • Pericarditis
  • Vasculitis.
  • Increased risk of heart disease

Source: Scherer, H. U., Häupl, T., & Burmester, G. R. (2020). The etiology of rheumatoid arthritis. Journal of Autoimmunity, 110, 102400. https://doi.org/10.1016/j.jaut.2019.102400