Study and Management of Rheumatoid Arthritis and Its Comorbidities in Patients at Tertiary Care Hospital

Introduction: Rheumatoid arthritis (RA) is a multifactorial autoimmune disease of unknown etiology, primarily affecting the joints, then extra-articular manifestations can occur. Due to its complexity, which is based on an incompletely elucidated pathophysiological mechanism, good RA management requires a multidisciplinary approach. The clinical status of RA patients has improved in recent years due to medical advances in diagnosis and treatment, that have made it possible to reduce disease activity and prevent systemic complications. The most promising results were obtained by developing disease-modifying anti-rheumatic drugs (DMARDs), the class to which conventional synthetic, biologic, and targeted synthetic drugs belong. Furthermore, ongoing drug development has led to obtaining molecules with improved efficacy and safety profiles, but further research is needed until RA turns into a curable pathology. In the present work, we offer a comprehensive perspective on the management of RA, by centralizing the existing data provided by significant literature, emphasizing the importance of an early and accurate diagnosis associated with optimal personalized treatment in order to achieve better outcomes for RA patients. In addition, this study suggests future research perspectives in the treatment of RA that could lead to higher efficacy and safety profiles and lower financial costs. Aims & Objectives:  To study the associated significant patient’s complications, this can be Exacerbated by Management of Rheumatoid Arthritis.  The main aim of the study is to determine the Management of Rheumatoid Arthritis which includes pharmacological and non- pharmacological treatment at Tertiary care hospital, Andhra Pradesh, Vaidya Vidhana Parishad (APVVP), Proddatur.  To identify the typical treatment options for Rheumatoid Arthritis including pharmacological, and lifestyle modifications. To discuss about the disease conditions in patients.  To summarize current evidence on effective treatments for Management of Rheumatoid Arthritis. Material and Method: A Prospective observational study was carried out for a period of six months. Patients diagnosed with Management of Rheumatoid Arthritis were included. Relevant data regarding the drug prescription and drug usage collected from the patients were analyzed for the pattern of drug usage in patients. Results: Out of 120 Patients Rheumatoid arthritis was mostly seen in between the age of 35-70yrs, mainly due to their family history, obesity and it is more seen in females. Hypertension, Cardiovascular disease, Interstitial Lung disease, Gastrointestinal disease and Osteoporosis are the comorbidities observed in the study. The most frequently prescribed drugs before going to surgery are Methotrexate, Tramadol (Analgesic), and Azathioprine. A total number of 120 cases collected in Orthopedic department, in this department the given medications are 30(25%) are prescribed with DMARDs, 15 (12.5%) are prescribed with Analgesics, 12(10%) are prescribed with Glucocorticoids, 25(20.83%) are prescribed with Anti-TNF agents, 13(10.83%) are prescribed with vitamin supplements, 08(6.66%) are prescribed with Steroids, 10(8.33%) are prescribed with Biological Response Modifiers and 07(5.83%) are prescribed with Immunosuppressive agents. Conclusion: Selection of appropriate and doses may result in minimizing the DRPs in the patients, helps in improving quality of life of patients. Prescribing of drugs by generic named helps in minimizing the errors in prescription writing and even in dispensing. High numbers of drugs wereused for prescription in the study. This may increase the possibility of DIs, AE, ADRs, and DRPs. Hence there is a need for further studies in comorbidity of Rheumatoid Arthritis patients with special consideration for the above - mentioned issues.