Matthew Ezerioha, MD

Doctor of Medicine (M.D.) in 2016 from Medical University of South Carolina, Expert Medical Consultant & Entrepreneur

Oct 7, 2018 4 min read

RA Prognosis: Can I Live a Long Life with Rheumatoid Arthritis?

Today’s modern treatment options and medical technology means a much more positive prognosis for rheumatoid arthritis than in the past. Thus many patients with rheumatoid arthritis are able to maintain a healthy quality of life and continue with work, school, physical and social activities.

life expectancy

However, an accurate prognosis is very difficult for doctors to predict. This is because the course of rheumatoid arthritis varies greatly among patients. In addition, the fact the cause of rheumatoid arthritis is still unclear also adds to the challenge.

It is important to note that a  lot of factors contribute to disease outcome with severity ranging from mild discomfort to very severe and debilitating disease. 

Also, different technologies abound that assist in disease monitoring and in the provision of targeted treatments. Hence, if patients continue with personalized treatment plans the likelihood of symptom control increases tremendously.

Potential Outcomes for Rheumatoid Arthritis Patients

Potential outcomes that can develop in the course of rheumatoid arthritis include frequent flare-ups, decreased life expectancy, and numerous prognostic possibilities. While some patients may experience chronic active states of disease while others may have long periods of remission in which symptoms are not active.

Some common prognosis possibilities for rheumatoid arthritis patients will include:

  • Persistent joint inflammation
  • Progressive, multiple joint destruction  as the inflammation continues
  • A decline in mobility and range of motion
  • Pain and stiffness that fails to improve with treatment

In addition to the joints, RA also has complications that manifest in various organs around the body. Possible complications that may be experienced outside of the regular joint-related symptoms include:

  • Skin conditions such as psoriasis
  • Heart disease & high blood pressure
  • Eye inflammation
  • Osteoporosis
  • Anemia
  • Depression and anxiety
  • Increased risk of contracting infections
  • Cancer – especially lymphoma
  • Respiratory conditions caused by nodules and scarring of the lungs

If symptoms progress rapidly through the four main stages of rheumatoid arthritis the condition can turn into progressive rheumatoid arthritis. This means symptoms continue to worsen over time with no reversal.

Ultimately, patients with rheumatoid arthritis need constant medical care, hence seeing a primary care physician, as well as a rheumatologist on a regular basis, will help to alleviate symptoms and make monitoring for signs of progression easier and timely.

Factors that Determine Rheumatoid Arthritis Prognosis

As previously stated, many factors can influence disease progression and prognosis. Some of these factors include:

  • Positive or negative blood tests for markers of the disease such as rheumatoid factor or anti-CCP. (You may hear terms like seropositive and seronegative)
  • Patient’s age at diagnosis
  • How early treatment was initiated after the appearance of symptoms
  • Patient’s lifestyle including diet, exercise, and smoking habits
  • The presence or absence of complications during the course of the disease
  • Patient’s personalized treatment plan
  • Patient’s response to treatment
  • How active the condition has been including the frequency of flare-ups and remission periods

As a rule of thumb, patients who are seropositive, meaning they’ve tested positive for rheumatoid factor and/or anti-CCP, may experience more severe and aggressive symptoms. Adult patients who are diagnosed at a younger age may also experience a more serious disease course as well. This does not include patients with juvenile rheumatoid arthritis, who can have a different prognosis altogether.

Meanwhile, patients with healthy lifestyles like abstaining from smoking can also manage their symptoms better. It is thought that there is a direct link between smoking and rheumatoid arthritis symptoms in patients.

Over time, rheumatoid arthritis symptoms can affect bone health and cause erosions and even deformity of the joints. They can also impact the health of other organs such as the lungs and heart which could be fatal.

Therefore, an early and aggressive personalized treatment plan will improve the outlook for most rheumatoid arthritis patients. The primary objective of treatment is to achieve remission and reduce pain. Remission occurs when inflammation or progressive joint damage is halted and ideally the patient will no longer experience chronic pain.

Imaging Tests Used in Prognosis

Several imaging tests like X-rays, MRIs, and ultrasound, can help doctors detect the degree of inflammation and joint deterioration in patients. While these don’t conclusively give a prognosis, they assist in monitoring symptoms and adjusting treatments along the way to ensure the best possible outcome.

Ways to Improve Prognosis

Despite the unpredictability of rheumatoid arthritis progression, patients can ensure a positive outlook by doing the following:

  • Maintaining a  healthy lifestyle including diet
  • Quit  smoking and other poor lifestyle habits like drugs and alcohol
  • exercising regularly  including walking, cycling, and swimming
  • Engaging in physical and occupational therapy to help adapt daily routines to any mobility challenges
  • Adhering to a personalized medical treatment plan which can include taking DMARDs and other medications

All of these methods are aimed at improving or maintaining the patient’s quality of life, managing disease symptoms, reducing pain, and very importantly, establishing a positive outlook for the patient.

In some cases, doctors may recommend surgery to completely replace joints or to rebuild them. This can alleviate pain and improve mobility in some cases. While surgery is a viable option, the rates of surgical joint replacements in rheumatoid arthritis patients are declining. This is largely due to the massive improvements in other treatment options, and early detection rates in modern times.