BANGKOK, April 6 /PRNewswire/ -- Rheumatoid arthritis (RA) is a systemic disease or an autoimmune disorder in which the body's defense system attacks the joints through the thin layer of cells called the synovium that lines and lubricates the joints. The most visible symptoms of RA are swollen joints and crippling stiffness, particularly of the hands and feet. It can cause fatigue, fever, loss of appetite and also impedes mobility and quality of life. RA cannot be confirmed or excluded by one single test. The diagnosis of RA is based on clinical examination of symptoms, patient history, blood tests, rheumatoid factor (RF), anti-cyclic citrullinated peptide (Anti-CCP), and X-ray.
Rheumatoid arthritis (RA) is a relatively less common inflammatory arthritis, affecting about 4 per 1,000 individuals in Thailand. About four times as many women as men have the disease. Most of the patients fall between 30 to 40 years of age. In 2008, it is estimated that about 300,000 people with RA have been diagnosed and treated. In the absence of readily available studies to evaluate the prevalence and incidence of RA in Thailand, the prevalence is estimated to be approximately 0.4 percent. Incidence is assumed to be fairly close to the prevalence figures, as the disease is not common and new cases are not likely to impact the prevalence significantly. The incidence is likely to increase with the increase in awareness of the disease among both physicians as well as the population, and with the early diagnosis of the disease. Currently, physicians see more of moderate to severe cases, and in the future expect to tap patients in early stages, so as to prevent disability.
Frost & Sullivan, Research Analyst Sushma Rajan says, "The diagnosis of RA is based on clinical examination of symptoms, patient history, as well as some blood tests. RA cannot be confirmed or excluded by any one test. The most common test is rheumatoid factor (RF). The other supporting tests are: anticyclic citrullinated peptide (Anti-CCP), erythrocyte sedimentation rate (ESR), and X-ray."
"Recent work productivity studies have confirmed that better disease awareness and availability of treatment options have resulted in fewer patients ceasing to work and more patients reporting lower impact of their disease on work as well as family and social activities," she further elaborates.
Methotrexate (MTX), a DMARD (disease-modifying anti-rheumatic drugs) has been traditionally used to treat RA. It is also the most used form of treatment in rheumatoid arthritis, especially with generic forms available. Currently, combination therapies between DMARDs and NSAIDs (non-steroidal antiinflammatory drugs) are commonly practiced.
DMARDs capture the majority of the RA therapeutics market owing to the availability of reimbursement for treatment with these drugs and their easy availability over the counter. DMARDs are expected to retain majority share in the forecast period as well.
According to Rajan, "Biologics are used in combination with DMARDs for moderate to severe RA patients. Some biologic drugs are currently reimbursed, if treated in government hospitals. Physicians opine that with more drugs brought into the hospital formularies, the usage of biologics would increase for treatment earlier in the disease."
Physicians consider the efficacy of medication and minimum side effects to be the key factors while considering the choice of treatment for RA patients.
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