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17 - Pharmacogenetics of Rheumatology: Focus on Rheumatoid Arthritis

from II - Therapeutic Areas

Published online by Cambridge University Press:  05 June 2012

Russ B. Altman
Affiliation:
Stanford University, California
David Flockhart
Affiliation:
Indiana University
David B. Goldstein
Affiliation:
Duke University, North Carolina
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Summary

Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease, with a population prevalence of 2 percent to 3 percent and an annual incidence rate of 0.5 percent to 1.0 percent. Like many autoimmune conditions, it affects women more commonly than men (4:1). The prevalence of RA increases from the third decade through the eighth. Because it is the most common inflammatory rheumatic disease, most pharmacogenetic studies in adult rheumatology have concentrated on treatments for RA, and this will be the focus of the chapter.

Clinically, RA is a painful condition associated with significant disability. It primarily affects the joints, resulting in pain, swelling, and loss of musculoskeletal function. Because of its chronic nature, small changes accumulate and many patients experience substantial disability over the decades that they live with the condition. Although classical extraarticular manifestations (e.g., vasculitis, Felty's syndrome, spine disease) have diminished in frequency, there is an increasing awareness that the inflammation of RA places patients at increased risk for common conditions, such as cardiovascular disease, osteoporosis, and insulin resistance. These chronic comorbidities also contribute to the disability associated with RA.

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Publisher: Cambridge University Press
Print publication year: 2012

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