Rheumatology and Clinical Immunology

UPMC Rheumatoid Arthritis Center

The UPMC Rheumatoid Arthritis Center is dedicated to treating patients with rheumatoid arthritis. Because rheumatoid arthritis (RA) is a chronic disease of the immune system – and can affect joints and organs – it requires ongoing care from a multidisciplinary team of highly trained physicians.

At UPMC, our team utilizes the full array of diagnostic tools and treatments for RA, and creates an individualized care plan for each patient, based on symptoms, physical exam, lab results, and imaging studies. The goals of RA treatment are to reduce pain and stiffness, limit permanent joint damage, slow or halt disease progression, and improve the quality of life for each patient.

About Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the person’s own immune system attacks normal tissues, resulting in inflammation, stiffness, pain, and possible permanent damage to joints and internal organs. While the exact cause isn’t known, RA is believed to be triggered by a combination of genetic and environmental factors. While anyone can develop rheumatoid arthritis, nearly three-quarters of RA patients are women, and most are diagnosed between the ages of 30 and 60.

Rheumatoid arthritis typically affects the same joints on both sides of the body, most commonly the:

• Hands
• Wrists
• Fingers
• Knees
• Ankles
• Feet

Rheumatoid arthritis is a chronic condition that requires regular follow-up care throughout the patient’s life. In advanced cases, the inflammation caused by RA can damage the patient’s lungs, blood vessels, heart, and spine.

Diagnosing Rheumatoid Arthritis

The UPMC Rheumatoid Arthritis Center offers a comprehensive approach to diagnosing RA. Our physicians check for symptoms and perform an array of tests related to rheumatoid arthritis to ensure a correct diagnosis and appropriate treatment plan.

Signs and symptoms of rheumatoid arthritis

To be diagnosed with rheumatoid arthritis, patients typically have one or more of the following symptoms:

• Joint pain and stiffness – with prominent morning stiffness lasting more than one hour
• Swelling in three or more joint areas – including the hands, wrists, fingers, knees, ankles, and feet
• Arthritis that is symmetric – the same joints on both sides of the body are similarly affected
• Rheumatoid nodules – lumps under the skin near affected joints
• Positive rheumatoid factor test – a blood test that measures levels of an antibody in the blood that is commonly found in patients with RA
• Positive anti-CCP2 test – a blood test that measures an auto-or self-antibody that is usually only found in RA patients
• X-rays showing joint damage
• Elevated C-reactive protein (CRP) and sedimentation rate (ESR) – these blood tests measure inflammation that is due to rheumatoid arthritis

Other lab and imaging tests may also be used in identifying rheumatoid arthritis.

Rheumatoid Arthritis Treatments

Specialists at the UPMC Rheumatoid Arthritis Center utilize the latest knowledge and research to find the best course of treatment for each patient. A number of medications are available to reduce symptoms, slow the disease, and limit permanent damage to joints. These medications may be used individually or in combination:

Type of Medication	Drug
Anti-inflammatory medications – reduce pain and inflammation	Aspirin Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen COX-2 inhibitors (Celebrex)
Corticosteroids – act quickly to reduce inflammation	Prednisone Prednisolone Methylprednisolone
DMARDS – disease-modifying anti-rheumatic drugs that slowly change the course of the disease	Methotrexate (Rheumatrex) Azathioprine (Imuran) Hydroxychloroquine (Plaquenil) Leflunomide (Arava) Sulfasalazine (Azulfidine)
Biologic Agents – block steps in the inflammation process and act as DMARDs to change the course of the disease process	Abatacept (Orencia) Adalimumab (Humira) Anakinra (Kineret) Certolizumab (Cimzia) Etanercept (Enbrel) Golimumab (Simponi) Infliximab (Remicade) Rituximab (Rituxan) Tocilizumab (Actemra)