Despite the latest treatment option with disease-modifying antirheumatic drugs (DMARDs) which is a combination of tablets and injections to slow down progression of Rheumatoid Arthritis (RA), the issue of poor awareness among patients and doctors makes rheumatologists to treat the condition with growing challenges.

There is a misconception among general practitioners and patients that RA can be treated with painkillers. Adding further despair is the serious shortage of trained specialists who comprehend the debilitating consequences.

India has only 250 rheumatologists to treat the 10 million RA cases. Although, major advances have been achieved to treat the RA which is a chronic, debilitating inflammatory joint disease, the shortage of specialists to diagnose early and prevent the disease progression is a challenge. The country has only three centres: Nizam Institute of Medical Sciences, Hyderabad, Medical College, Chennai and Sanjay Gandhi Post Graduate Institute of Medical Sciences(SGPGI), Lucknow which offer the specialization in Rheumatology, Dr Ramesh Jois, consultant, rheumatologist, Wockhardt Hospital told Pharmabiz

The Indian Rheumatology Association (IRA) has 250 registered specialists to treat 10 million cases in India. Many metros have no rheumatologists. Karnataka has 10 rheumatologists, of which eight are in Bangalore and two in Belgaum. The situation is grave as the condition does not spare any age-group. It could affect in childhood from the age of three and is pre-dominant in mid-life. The ratio of women to men is 3:1. Early diagnosis is the key for successful administration of DMARDs, he added.

The West is well established and way ahead in RA's early diagnosis, treatment and care. In order to emphasise early diagnosis, IRA has teamed up European League Against Rheumatism (EULAR). Through the 'Let's Work Together' campaign, it is creating an awareness about RA on the World Arthritis Day observed annually on October 12.

The Karnataka Chapter of IRA has been aggressively working to educate the medical professionals about RA. These include specialists and general practitioners from the primary health centres across the State, government and private hospitals including nursing homes. The cause of RA is unknown. However, genetic and environmental factors are known to aggravate the disease which results in inflammation, swelling, difficulty in movement and pain affecting joints of hands and feet. Other symptoms like loss of appetite, fever, loss of energy and anaemia affect the quality of life.

The key objective is to highlight the symptoms and the need to refer such cases to the specialists. Most patients unaware of the criticality of RA and therefore do not deem it necessary to get a correct diagnosis. This is because in India chronic pain is neglected and not considered life threatening like cardiovascular diseases or diabetes, said Dr Jois.

Apart from RA, other serious disease conditions which can be treated by rheumatologists are ankylosing spondylitis, osteoarthritis and gout.