Sufferers of rheumatoid arthritis in Britain have been warned that their access to a particularly effective class of drug will in future be limited.
Rheumatoid arthritis is an auto-immune disease which attacks the joints; it is a debilitating disease which causes pain and swelling.
The joints most commonly affected are those in the hands, wrists, knees and feet with the joints becoming stiff and hard to move, especially early in the morning; sufferers often feel tired and unwell - sometimes lumps appear under the skin near the joints called rheumatoid nodules.
Anti-TNF (anti-tumour necrosis factor alpha) therapy drugs such as adalimunab, etanercept, and infliximab, have been found to be particularly effective for severe cases as they can slow the progress of the disease and help to reduce symptoms such as joint pain, swelling, mobility and fatigue; each drug works and is administered in slightly different ways, but they are very expensive.
As the disease progresses, the muscles around the joint waste away, the cartilage in the joint and the bone underneath become eroded and eventually the whole joint is filled with fibrous scar tissue and completely freezes and other parts of the body such as the skin, eyes, lungs, heart, blood and kidneys can also be affected.
Rheumatoid arthritis affects about one per cent of the population and is more common in women; it usually appears in women between 25-45 years of age and often runs in families - it can strike suddenly, but is more likely to begin gradually - it can go into remission, never to reappear again in some cases - but as a rule it flares up repeatedly.
While there is no cure for rheumatoid arthritis the progression of the disease can be slowed and the symptoms treated with rest, 'physio' and occupational therapy, alternative treatments such as acupuncture and a variety of drugs.