There may be a new treatment for rheumatoid arthritis. Rheumatoid arthritis (RA) is an autoimmune condition that starts between the ages of 30-60. It is a chronic inflammatory disease that effects mostly women with a female/male ratio of 3:1. If you have RA, your immune system attacks your joints in addition to all tissues in the body. It can release inflammatory compounds called cytokines that damage tissues and causes pain and swelling. A meta-analysis involving over 39,000 patients found a 41% increase in the risk of stroke among patients with RA. Strokes often affect people over the age of 65. But with RA, your risk goes up before age 50.
The cytokines that damage your joints can also damage blood vessels, form clots and build plaque in the walls of arteries raising the risk of cardiovascular disease. RA also damages heart valves and increases the risk of an irregular heart rhythm known as arterial fibrillation that makes you 3-5 times more likely to have a stroke.
First line treatment tends to be medications to bring down inflammation, such as Methotrexate or tumor necrosis factor (TNF) alpha inhibitor drugs that help to lower the risk of heart disease. But these don’t come without their side effects such as nausea, abdominal discomfort, low white blood cells and increased risk for infection. Some of the medications that treat the pain and inflammation that comes with RA can also be a problem. Many people commonly use non-steroidal anti-inflammatory drugs (NSAIDS) such as over the counter Ibuprofen, Aleeve, and diclofenac. These medications also increase the risk for heart disease soon after taking them and the risk continues to rise the longer you are on them.
A matched cohort study looked at another option for treatment of RA that has been around for centuries. Acupuncture. The study looked at the effects of acupuncture therapy on stroke risk among patients with RA. Those patients who received acupuncture had significantly lower rates of ischemic stroke (from blood clots) than those who did not, even after controlling for risk factors, demographics and medication use. Acupuncture therapy can also relieve the pain, stress and inflammation that is associated with the risk for stroke among those with RA.
References: Overton, T. Effect of Acupuncture on Ischemic Stroke in Patients with Rheumatoid Arthritis. Practice Update: Primary care, April 12, 2024.
Ola A. Al-Ewaidat, Moawiah, M. Naffaa. Stroke risk in rheumatoid arthritis patients: exploring connections and implications in patient care. Clin Exp Med, 1/31/2024.
Watson, S. Rheumatoid Arthritis and Stroke: What’s the Link? WebMD, March 30, 2022.