Rheumatoid Arthritis and Biologics (रह्युमेटोइड आर्थराइटिस | जैविक दवाइयां)

Rheumatoid Arthritis and Biologics (रह्युमेटोइड आर्थराइटिस | जैविक दवाइयां)


Namaste,
I’m Ailsa Bosworth. I’m the founder and chief executive of
the National Rheumatoid Arthritis Society. NRAS has been established
for 16 years and is the leading patient organisation
in the U.K. for people with rheumatoid arthritis
and juvenile idiopathic arthritis. We’re an evidence based
health charity which means that any information
we produce must be backed up by clinical evidence and aligned
with national standards and guidance laid down by the regulatory authorities
in this country such as NICE which is the National Institute
for Health and Care Excellence and professional bodies such as
the British Society for Rheumatology. I’ve lived with severe RA myself
for over 35 years and I understand only too well the challenges of living
with this difficult condition. We’re making this video today
with Dr Kanta Kumar, a lecturer
at the University of Manchester who’s a researcher into the issues
of ethnicity in RA practice. Dr Shirish Dubey,
Consultant rheumatologist and Joti, a young woman
who has RA and is currently receiving
a biologic drug to help control her disease. The reason that we’re doing this now
is because Dr Kumar has recently conducted research
into the views of South Asian people with RA on their experience of moving on
to a biologic drug when the standard disease modifying drugs
no longer work well for them. I’m on the biologic drugs as well.
I also take Methotrexate. It’s the combination
of these two treatments which enables me to enjoy
a good quality of life and to work between
50 and 60 hours a week. Without this medication,
I would be in a wheelchair and I wouldn’t be able to work at all. So, it’s very clear to me
that the value of taking my medication
every week is critical. So, we’re going to hear today
from Dr Dubey, Dr Kumar and Joti and I hope that the information and views expressed in this video will help you to understand more
about the benefits of moving on to a biologic drug
if and when you need to. WHAT IS RHEUMATOID ARTHRITIS? What is rheumatoid arthritis? Rheumatoid arthritis is an autoimmune disease that causes swelling in the joints. It affects small and big joints and the swelling generally happens in small joints. The joints also feel stiff. Sometimes this disease starts slowly
and sometimes it starts suddenly. Autoimmune disease can attack various parts of body. They may affect different organs like heart, lungs etc. There are many other
autoimmune conditions like diabetes, which is known as sugar disease. Vitiligo, lupus, thyroid. There is no cure but they can be kept
in check through treatment. Nowadays our knowledge has improved a lot, so we can keep
these disease under control. There are many new drugs
available to control this disease and taking medication is necessary. SYMPTOMS What are the symptoms of RA? They are joint pain,
stiffness, swelling, weakness, constant fatigue, irritation,
anemia, weight loss, perspiration, lumps on the body. This disease generally affects
hands, legs, wrists, knees, shoulders. What happens
during rheumatoid arthritis? Joints especially the lining of the joints get swollen that causes problems like
redness, effusion, warmth, pain. The nerves in the joint capsule
get stretched causing pain. Long-term swelling
is called chronic inflammation. It may damage cartilage and weaken joints. DIAGNOSIS How to diagnose
rheumatoid arthritis? There isn’t a specific test
to diagnose rheumatoid arthritis. To diagnose the disease, the experts
like consultant rheumatologist record the description,
run blood tests like ESR, CRP, rheumatoid factor, CCP antibodies. They examine the joints. They may also conduct
X-ray, ultrasound or MRI. TREATMENT Many medicines are used for treatment. We use paracetamol
or naproxen for pain. Steroids can be used
to reduce swelling. There are drugs for long term treatment like methotrexate, sulfasalazine,
hydroxychloroquine, leflunomide. They are called DMARDs. If these drugs don’t work, we can also use biologics or biological DMARDs. Where do these drugs come from? They have many sources. Hydroxychloroquine came from trees. Sulfasalazine is a chemical substance. Methotrexate was used in large
doses in the treatment of cancer. Methotrexate drug is
very important to us. It can also be used
in combination with other drugs. We’ve been using it
for the past 3-4 decades. It was created
by Dr. Subbarao in 1940. Steroid is an internal juice
which also generates in body. It reduces swelling. Biologics target a specific molecule. All the drugs can have side-effects. In particular steroids, if taken
in large doses for a long term, they may cause problems. When we start medication,
we also talk about side-effects. What is new here? In the earlier decades, we used to
intensify the treatment gradually, which would damage
the joints of the patients and the joints would
stop functioning properly. Nowadays we intensify
the treatment sooner to save the joints. Many new drugs are available
now which are very effective. Sometime we start with 2
or 3 drugs at the same time because it is very beneficial. There is no cure of this disease
in complimentary treatments. Therefore, our drugs
are very necessary. You should adapt a healthy lifestyle. Exercise and balanced food is required. You should stay away from cigarettes, If you smoke, quit. Smoking cigarette increases
the possibility of rheumatoid arthritis and reduces the possibility
of controlling it if you are already suffering
from rheumatoid arthritis. For more information, please visit
the website of National Rheumatoid Arthritis Society, www.nras.org.uk/apnijung Biologics is an effective
and targeted therapy. The journey from disease-modifying
anti-rheumatic drugs or DMARDs to biologics can be decided
between you and your doctor. Before starting biologics treatment, doctors see if your DMARDs can be changed. If changes can not be made, the doctors measure
your RA using a score. It is called DAS or disease activity score. If your DAS level is high like blood sugar level, the doctors take action. It is important to understand that even though biologics
may be successful in some cases it is not necessary that
it would work on everyone. It may also cause some side-effects. In this process, health professionals
take decisions with you and advise you regarding treatment. We encourage you to complete
this journey with your health professional. It is our pleasure to have
a patient with us today. She has been suffering
from rheumatoid arthritis and has been taking
biologics for many years. Can you tell us
what you were feeling when your consultant
told you to start biologics? I have had rheumatoid arthritis
since the past 18 years and I have been taking biologics
treatment since the past 11 years. I was taking many drugs before but
they didn’t have any effect on me. When I was offered biologics,
my consultants told me I had to take injections. I was afraid of it. I was afraid that I
had to take injections. I wasn’t thinking about its benefits. If I had not undergone biologics,
I would have never felt better. It has worked well for me. In the research we found that South Asians think
that biologics is very harmful. They consult their families or other doctors in India
for a second opinion. What is your opinion on biologics? What do you get
from rheumatology team? Biologics treatment has been
very beneficial for me. Before biologics I
had also gone to India for treatment, but there I was constantly worried
about what was in the drugs. In this regard, I have great trust in UK’s medicines. Biologics treatments have been
in use for the last 17 years. Apart from research, there is also
National Biologics Register in UK. They have proved that these drugs
are effective as well as safe. I am lucky that my doctors
help and also understand me. Joti, our research shows that a lot of people are
unaware of rheumatoid arthritis and some patients take
the prescribed medications and some don’t. Do you think this video will be
informative for our patients? There are many people in UK
who do not understand or speak English and the information about rheumatoid
arthritis does not reach them often. I think such videos are very important
as the information is provided in Hindi. I hope all South Asians who
understand Hindi, Urdu or Punjabi can profit from this video. Joti, our research also shows that patients are concerned
why they did not get biologics before. It may be because they don’t know that we have to follow guidelines. Do you think we should tell
everything to the patient beforehand? I think doctors and consultants
should inform the patient about all the treatments
from the very beginning. We are also lucky that we can get
a lot of information on the internet like the website of NRAS where you can get information on all drugs
for rheumatoid arthritis in a booklet. This booklet describes what is
DAS score, how to calculate it. Joti, were you worried about side-effects when you started biologics? When doctors told
me about biologics, I was not so worried
about side-effects. I was only worried about injections. That also went away slowly. I am lucky that I had
very few side-effects after biologics. My family supports me a lot and can
see how biologics has helped me. Were you satisfied with
the information we provided you? This information
has benefited me a lot. I’d like to thank Joti,
Dr Kanta Kumar and Dr Shirish Dubey for their collaboration
in making this video. Dr Kumar’s research showed
that some people valued getting information
through group discussion, whilst others suggested
that getting information about RA and biologics through video
would be valued. We responded to that request
in the making of this video and we really hope
that you have found that the information to
be useful and helpful and thinking about your own treatment
or that of a loved one. We intend to build on this
in providing relevant information for the South Asian population
affected by rheumatoid arthritis on our Apni Jung web area. If you have any ideas
about the kind of things that you would like us to cover
or publish information on, please do get in touch with us. Thank you for watching. Help us to spread the word
about Apni Jung. Tell your family and friends
who might be living with RA. We’re here to help you
and share the journey. Thank you. Apni Jung
For more information about Apni Jung, visit www.nras.org.uk/apnijung or email us at [email protected]

3 comments on “Rheumatoid Arthritis and Biologics (रह्युमेटोइड आर्थराइटिस | जैविक दवाइयां)

  1. S S Post author

    Can you video on the VSH, CRP and and all those technical terms and what they mean by the numbers and % of those. They are confusing for some patients to understand and cause worries.

    Reply
  2. Eden Aquino Post author

    Hello my name is Eden Aquino from the Philippines. I also suffer so much RA my arms, thighs, legs & feet. Tried to eat Veges & fruits as always recommended here internet listening to different opinions of doctors all around the world but until now no change in me. Am still suffering the pain following all the instructions of my doctors prescriptions. By the way my RA started last year just a year ago. Please Help me & send some advice to minimize my pain. Thanks you.

    Reply

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