Addressing rising cases, burden of rheumatoid arthritis in Nigeria
• Pfizer introduces Project Afya, patient assistance programme to improve access to life- saving medications, RA management
WORRIED about the rising cases and burden of rheumatoid arthritis ( RA) in Nigeria, healthcare professionals have called for massive awareness and management of the condition to prevent disease progression, stating that early diagnosis and initiation of effective treatment improve clinical outcomes for patients with the disease.
They, however, said untreated RA may cause disability, job loss and people with condition are seen to have lower functional status, and that the disability can lead to a loss of career and sources of income.
Arthritis is an inflammatory disorder affecting one or more joints of the body with varying causal factors, including trauma, infections, autoimmune disorders, idiopathic causes, and ageing. Irrespective of the cause, the underlying pathophysiology involves the breakdown of cartilage, which protects the end surfaces of bones at the joints, leading to the loss of smooth glide at the joint during movement; this frictional rubbing results in pain, swelling and stiffness at the joint and eventual muscle strain due to difficulty moving the joint.
According to a study published in the journal PLOS ONE and titled ‘ Prevalence of Arthritis in Africa: A Systematic Review and Meta- Analysis’, there are six main types of arthritis. RA is a systemic autoimmune disease that presents as a symmetrical inflammatory polyarthritis, which affects the smaller joints such as hands and feet first, before affecting larger joints. Osteoarthritis ( OA) is characterised by degeneration of the joints such as the knee and the hip. Juvenile arthritis comprises a range of arthritic disorders affecting children and adolescents below the age of 16 years. Psoriatic arthritis is a form of arthritis affecting people with psoriasis, a skin disorder. Gouty arthritis, or simply gout, is associated with the deposition of monosodium urate crystals in the tissues and joints. Ankylosing spondylitis is an axial arthritis, which affects the vertebra causing inflammatory spinal pain and limited spinal and chest wall movements.
RA is a disabling disease that affects the joints with pain, swelling, and stiffness. RA is a systemic disease, which means it can have an impact on a person’s entire body and may even impact one’s sense of well- being.
More than 350 million people have arthritis globally, more than 22 per cent of adults around the world who are older than 40 have knee osteoarthritis, and up to 14 million people around the world have rheumatoid arthritis, according to recent reports by the World Health Organisation ( WHO), Global RA Network, and Eclinicalmedicine.
Also, according to the United States Centres for Disease Control ( CDC), 60 per cent of people who have arthritis are between the ages of 18 and 64, and 29 per cent of people between the ages of 45 and 64 have arthritis.
Several studies have shown that disability due to musculoskeletal disorders has increased by 45 per cent and RA and OA are listed as the fastest increasing major health conditions and ranked joint second as cause of disability by WHO.
As part of efforts to address the menace, Pfizer has intensified efforts at raising awareness about as well as enlightening the public about the management of rheumatoid arthritis. Pfizer has in recent times organised hybrid media roundtables to highlight the disease’s burden in Nigeria.
A rheumatologist and was the Inflammation/ Immunology Group Lead for North America Medical Affairs during his time at Pfizer, Incorporation, Dr. Andrew Koenig, said: “RA often results in a gradual limitation of normal activities because the joint damage and symptoms that occur with it usually progress slowly over time. When those who don’t know they have RA feel pain or stiffness, they naturally try to avoid what makes them hurt. They may first start by changing their schedules ( such as stopping early morning exercise or getting to work later), changing what they do ( reducing physical activity, switching chores to lower impact ones, or avoiding activities they enjoy because it makes them hurt), or reducing activities because they may not want to ask for help. Eventually, people with RA may start to withdraw, cut back on social activities, and even reduce their work hours. Some patients, with or without appropriate intervention, may even feel the need to quit their job due to limited mobility. This effect can have emotional, social, and economic consequences for patients and their families.”
Country Medical Director, Pfizer East and West Africa, Dr. Kodjo Soroh, said RA remains one of the most common rheumatic and musculoskeletal diseases in the region.
According to him, there is hope as Pfizer is committed to raising awareness around the treatments available. “We want to work closely with the healthcare community to ensure early diagnosis, increased patient access and medication adherence. There is Project Afya, a patient assistance programme aimed at improving access to life- saving medications and boosting cancer care and autoimmune disease management.