Extra Articular Manifestations and its management in Rheumatoid Arthritis: An Overview

Rheumatoid Arthritis (RA), an immune-mediated illness, results in ongoing, low-grade inflammation that can eventually destroy joints and result in deformity, disability, and even death. Although periarticular and osteoarticular symptoms are the primary RA symptoms, RA is a systemic disorder that appears with cutaneous and organ-specific extra-articular manifestations (EAM). Extra-articular symptoms are known to cause a number of potentially detrimental long-term consequences. High disease activity in RA has been associated with an increased risk of these characteristics. However, because these extra-articular symptoms are frequently associated with more severe and active RA and because these patients have a poor prognosis, an aggressive treatment strategy is usually adopted. Since the effectiveness of medication therapy for EAM has not been well investigated in randomized clinical research, practitioners still find it difficult to comprehend the complexity of EAM and how to manage them. The fact that there is no clear understanding among rheumatologists about how to categorize these EAMs or that there are no standardized methods for treating them makes it difficult to evaluate and much harder to treat these EAMs. In our initial categorization effort, we divided EAM into cutaneous and visceral subtypes, both severe and not severe, and classified them accordingly. In light of this background, the current study focuses on the various EAMs of RA, their classification, clinical characteristics, and general management overview.