- Risk Factors for RA
- Preventing RA
- RA and COVID-19
- Is The Vaccine Safe for RA?
Rheumatoid arthritis (RA) tends to run in families. Your likelihood of getting RA, however, is not determined by your family history of the disease alone. It is also influenced by environmental factors such as age, obesity, and smoking.
- Inherited: Genes that are passed down from your parents to you
- Environmental: Things you are exposed to in your environment such as cigarette smoke
Who is at risk of developing rheumatoid arthritis?
Genetic risk factors
If you have relatives with RA, you are at a higher risk of developing the disease. And if they are first-degree relatives, you are more than twice as likely to develop RA. Scientists have identified over 100 genetic changes that occur more commonly in people with RA.
Family history of other autoimmune diseases substantially increases the risk of RA as well. These include:
- Thyroid disorders (hypothyroidism and hyperthyroidism)
- Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
Other risk factors
Apart from heredity, other risk factors for RA may include:
- Age: The disease mostly occurs in people between 40-60 years of age.
- Hormones: RA affects women more than it affects men.
- Smoking: You are more likely to develop RA if you smoke.
- Obesity: Excess weight, especially if you are under 55 years of age, can increase your risk of RA.
Can I do anything to prevent RA?
Although there is no definitive way to prevent RA, you may be able to lower your risk by:
- Quitting smoking: After hereditary factors, smoking is the next biggest factor that increases your odds of developing RA. It can also worsen disease progression and lead to more joint damage, especially if you are 55 years of age or older.
- Taking care of your gums: New research suggests that there is a connection between RA and gum disease. So brushing your teeth twice a day, flossing regularly, and maintaining regular visits to the dentist may help.
- Managing your weight: Being overweight increases the risk of wear and tear on your joints. Maintaining a healthy weight can therefore lower your risk of arthritis, including RA.
Early treatment can help delay the progression of the disease, making your joints less painful and prone to damage. Ideally, you should begin the treatment within 3-6 months of developing initial symptoms.
Are people with rheumatoid arthritis higher risk for COVID-19?
Rheumatoid arthritis (RA) is chronic (long-term) multisystem disorder that affects various joints, particularly of the hands and feet, causing severe pain and deformities. Advanced RA can also attack the eyes, heart, lungs, kidneys, and nerves, resulting in severe disability and distress.
- Individuals with RA have poor immune responses because of the disease itself and the medications they are on. This puts them at higher-than-average risk of COVID-19 infection and complications.
- COVID-19 complications in these individuals may include acute respiratory distress syndrome (ARDS; a type of severe dysfunction of the lungs), myocarditis (swelling of the heart muscles), and secondary bacterial sepsis (a severe infection).
Although there is much about the COVID-19 virus that we do not know, doctors all over the world agree that vaccination against the virus is an important measure to stay safe in this pandemic.
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Are COVID-19 vaccines safe in individuals with RA?
Most inactivated or non-live vaccines (vaccines that do not carry a living virus) can be administered to individuals with rheumatoid arthritis (RA) and are highly recommended. Based on current research, two non-live vaccines by Moderna and Pfizer appear to be safe in individuals with RA. The active content of these vaccines is mRNA that poses little to no risk to the affected individual.
The only contraindications to these vaccines are as follows:
- If you have a history of severe allergies to any vaccine in the past
- If you are pregnant
- If you are less than 18 years of age.
- If you are on blood thinners such as Acitrom or have any bleeding disorders, you must talk to your doctor before going for the shot.
The vaccine may be less effective in individuals with RA compared with the general population because of drugs against rheumatoid arthritis (DMARDs) administered to these patients. Still, some protection is better than no protection. The potential for benefit from a complete dose of vaccination likely outweighs most vaccine uncertainties.
Other preventive measures such as wearing a mask, maintaining social distancing, frequent hand washing, avoiding unwanted traveling, and social distancing must be practiced even after the vaccine is administered.
The degree to which the vaccine is effective depends upon your RA medication schedule and the type of medicines you take.
- Riabni, Rituxan, Ruxience, and Truxima (rituximab) are associated with the greatest decline in response to vaccinations followed by Otrexup, Rasuvo, Rheumatrex, and Trexall (methotrexate), and Orencia (abatacept).
- However, even this slightly less effective vaccine may help prevent the severe disease that otherwise requires hospitalization or intensive care unit (ICU) admission.
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Kronzer VL, Crowson CS, Sparks JA, et al. Family history of rheumatic, autoimmune, and nonautoimmune diseases and risk of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2021 Feb;73(2):180-187.
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