Rheumatoid arthritis is an autoimmune disease of unknown origin which is characterized by damage to the joints and internal organs. It often causes serious consequences: vascular changes, joint deformities, osteoporosis and bone fractures. In Germany, during the treatment of this disease, doctors successfully use new drug therapy regimens. To combat the complications of rheumatoid arthritis, sparing surgical interventions and specialized rehabilitation are provided here.
Content
- Conservative Therapy
- Management of Musculoskeletal Complications
- Treatment of Cardiovascular Complications
- Organization of Treatment Abroad
Rheumatoid arthritis can be treated with conservative methods: with the help of systemic drugs and intra-articular injections. However, with the development of complications, operations on the joints (arthroscopy, arthroplasty), as well as on the heart and large vessels, may be required.
The best clinics for the treatment of rheumatoid arthritis are University Hospital of Ludwig, Maximilian University of Munich, University Hospital Rechts der Isar in Munich and University Hospital Ulm.
You are welcome to leave your request on the Booking Health website and we will help you receive treatment in Germany as soon as possible. The specialists at the Booking Health company will recommend a clinic with the highest treatment success rates, draw up a preliminary medical program, book airline tickets and apartments for the patient and his accompanying person and provide medical insurance for the period of treatment and recovery. You will also receive a personal interpreter and a medical coordinator for the entire period of treatment.
Conservative Therapy
Most patients are prescribed nonsteroidal anti-inflammatory drugs. These are used to relieve joint pain. The drugs are usually used in minimal dosages. It is undesirable to use these drugs at a high dose due to the risk of cardiovascular complications.
Here are some other drugs for the conservative treatment of rheumatoid arthritis:
- folic acid analogues;
- anti-inflammatory drugs;
- selective immunosuppressants;
- tumor necrosis factor-alpha inhibitors;
- interleukin inhibitors;
- antimalarial medications;
- cytostatics;
- glucocorticoids;
- monoclonal antibodies.
The more severe the disease, the more intensive the therapy. Risk factors for the development of complications are considered to be early joint erosions, high activity of inflammatory markers in the blood and long-term preservation of high pathology activity against the background of ongoing therapy.
During the period of exacerbation of arthritis (joint inflammation), the severity of symptoms can be quickly relieved with the help of an intra-articular injection of glucocorticoids. These can also be injected into the area of periarticular tissues, inflamed tendons and tendon bags. However, the frequency of injections should not exceed 1 time in 3 months, since glucocorticoids can adversely affect the metabolism of cartilage tissue in the joint.
Some clinics use stem cells for rheumatoid arthritis treatment. At the moment, stem cells are not part of the standard treatment but they have already proven themselves well in clinical trials. This method was first studied in 2004 and by 2018, the number of clinical trials had reached a peak. Doctors use autologous mesenchymal stem cells, which are injected intravenously. They are used for rheumatoid arthritis which is resistant to standard pharmacological treatment.
Management of Musculoskeletal Complications
Many patients with rheumatoid arthritis develop osteoporosis. Its risk is much higher after the long-term use of glucocorticoids. To prevent osteoporosis, calcium and vitamin D preparations are prescribed and bisphosphonates can also be used for treatment.
Frequent and severe inflammation can lead to significant damage to large joints, most often the knee joints. Such patients will require surgical treatment in the following cases:
- with persistent and drug-resistant synovitis, arthroscopic synovectomy is performed (minimally invasive excision of the synovial membrane);
- with severe functional disorders and pain syndrome, joint arthroplasty is performed – the joint is replaced with an artificial prosthesis.
Treatment of Cardiovascular Complications
Rheumatoid arthritis accelerates the progression of atherosclerosis. As a result, patients are 4 times more likely to develop coronary heart disease and myocardial infarction, as well as have a 50% increased risk of stroke.
In the case of a coronary heart disease, doctors will perform procedures and operations to revascularize (restore blood supply) to the myocardium. Whenever possible, the problem of poor blood supply to the heart muscle is solved with the help of a minimally invasive procedure: angioplasty and stenting, which is performed through an incision in the groin. Doctors deliver a balloon to the blood vessels of the heart, this expands the stenosed sections of the arteries. They then place a stent inside, which is a frame that keeps the lumen of the blood vessel open. With severe atherosclerotic lesions of the coronary vessels, coronary artery bypass grafting is performed. In Germany, this surgery is often performed on a beating heart in order to reduce the risk of complications. Some clinics perform a totally endoscopic coronary artery bypass grafting, using a robotic surgical system.
In some patients with rheumatoid arthritis, the heart valves are affected. Such patients undergo surgery for their reconstruction or prosthetic repair. In some cases, German doctors resort to minimally invasive procedures that are performed from inside the blood vessels.
Organization of Treatment Abroad
With the Booking Health company, you can get diagnostics and any type of rheumatoid arthritis treatment, in Germany. On the Booking Health website you can find out the cost of different types of treatment and you will be able to compare the prices for medical services in specialized clinics in Germany. The qualified medical advisors will select the most suitable clinic for you and fully organize your trip to Germany for treatment at the best possible price. With the Booking Health company, you can entrust the restoration of your health to world-famous specialists.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
The Journal of Rheumatology
MedicineNet
Web MD
