The Three Types Of RA | Arthritis Information

The Three Types Of Rheumatoid Arthritis

Type 1

Type 2

Type 3

Progression

Spontaneous remission

Minimal disease progress

Serious disease progress

Percentage of people with type

5-20%

60-90%

How is it distinguished?

Negative rheumatoid factor

Lasts more than six months; positive lab findings

Last more than six months; positive lab findings

Also called

Inflammatory arthritis, reactive arthritis, post-viral arthritis

Mild rheumatoid arthritis; symmetrical arthritis

Persistent inflammatory symmetrical arthritis (PISA)

Type 1 Disease:

In the late 1960’s, researchers conducted large studies involving the entire population of certain areas to see how many people met the criteria for RA. As it turned out, about two percent of the study population met the criteria. Yep, about 75% of those did not show evidence of RA three to five years later. And apparently many never say a doctor about their symptoms.

It now seems likely that if a person has symptoms of RA for less than six months, chances are good that the condition will go away on its own. Doctors now better understand the early stages of RA and can better recognise this Type 1 RA that does not tend to progress. In fact, they may call it something other than rheumatoid arthritis – such as inflammatory polyarthritis. The terms rheumatoid arthritis is now usually reserved for a more severe case of the disease.

Type 2 Disease:

Most people who meet the criteria for rheumatoid arthritis and have experience arthritis in symmetrical joints – both wrists, both hands, and so on – for longer than six months do not experience a spontaneous remission of their symptoms. A minority – from five to 20 percent – maybe have a mild disease course that can be controlled with less aggressive therapy (such as NSAIDS or anti inflammatory drugs) than more severe RA. Although Type 2 disease is progressive it tends to cause less severe damage to joints and often does not affect other parts of the body.

Type 3 Disease or PISA:

Most people who have symptoms of RA for longer than six months will have what is know as persistent inflammatory symmetrical arthritis (PISA) or Type 3 disease. The most severe type of RA, it affects 60 to 90 percent of people whose disease is monitored by a doctor. The symptoms usually cannot be controlled with NSAID’s along; stronger disease modifying antirheumatic drugs (DMARD’s) are needed as well to control inflammation and prevent damage.

Yes, Type 3 rheumatoid arthritis can have long term consequences and require years of taking medications and monitoring by a physician. However, new information and drugs, and more aggressive treatment strategies now greatly improve the long term outlook of this population. Because of these advances and others on the horizon, doctors believe that the joint damage that was common 20 years ago will soon be a thing of the past. People with RA now have treatment options with fewer side effects than ever before.

Cordelia2008-03-02 19:17:37Now that looks familiar ... Good Living with RA, I believe! That was A LOT to type in. I think lots of folks will find this info helpful. Your a peach Cordelia! BTW, the part I hold onto is that last paragraph and "will soon be a thing of the past." Looking forward to the day this disease is talked about in the past tense only! Good on ya Cords, sometimes it's good to have a reminder of exactly what we are dealing with. Cheers Janie. Hows the meals on wheels and any other assistance panning out? Any news on housing nearer to facilities? Love Janie. Yep, Good Living With RA. I actually have not been able to find this information anywhere but that book, so I got the book out of the library again to copy it out as several people had asked me about it as I had mentioned it now and then.

That's why I had to type it all out as I couldn't find another source on the net or anywhere that had it.

Yeah, I think it is useful information too. Janie, I will send you an update email this week. Things are happening and for the good.

It is good to remember what we are dealing with. Of course, most of us here are Type 2's and 3's. Isn't it interesting the percentage of Type 3's, so much higher than the other two categories.
Hi Cords, yes very interesting, the difference in numbers!!!

I have just been for a walk, however I was in bad shape this am due to walking yesterday, but I refuse to stop as I think overall, it can only improve my whole being. I really enjoy exercise and this disease is cruel as it stopped me participating in mostly all sports that I used to play, distance running, golf, badminton, tennis, weight training, power walking, cricket with tha kids, all sorts! I was too chicken to take my MTX this morning due to terrible mouth, tongue and lip problems, so I shall ask for the injections again, then the tummy probs will be back, between a rock and a hard place, did I hear you all say?????

Awaiting more test results due to MTX liver, if positive then I have to come off of it again. Then it will just be pain relief on its own again. Never mind, think positive, onwards and upwards and I am thankful for all the good things in life. Cheers Janie.
"I refuse to stop" Very powerful Janie. AH believe I am a type Dos. Si? Si. Oh but I don't have any positive tests? It's not gospel, Katie, just a guide, darl.

Good on you, Janie!!! Aye aye cap'in! I'm a bit confused at those 'types,' although it does confirm some of my own research around the 'spontaneous remission' that happens in some cases of RA, which turn out not to be RA at all. Question - Where does seronegative RA fit in? It usually has negative lab findings (RF-, CRP-, ESR-), but is certainly an erosive disease. Well, I am seroneg and I am definitely a Type 3. In fact, if there was a 4, I would be it. I have no RF factor with very high ESR and C-reactive. Many on this board are similar to me. Raging RA and seroneg. ;) Oh, ok. That's the problem with defining a heterogeneous disease, there are always people outside the box! So where do they then put people who are RF-, CRP-, ESR-, but still have erosive disease? I know it doesn't happen often, if you are CRP- and ESR-, you generally don't have severe erosive disease, but it can happen. In the type 2 box? Sorry, just curious!
Don't be sorry, there are no stupid questions here. Okay, let me get this straight, you are talking RF - negative, ESR & CRP negative also???

Yeah, I would say Type Two, for sure.
^ Yeah. Hmm... OK, thought so. I was under the assumption that positive labs meant bloods, but positive labs can also mean x-rays. *No need for alarm! It's just fibrofog!* _popupControl();
It doesn't really say a lot, does it? It sounds like anyone who isn't helped by NSAIDS alone and has had symptoms longer than 6 months, is type 3. Is that right? What constitutes disease progression?
Interesting I'm a 3 wishing I could say I was a 2! It has taken 30 years to really wreck me, but I'm wrecked. Even so I have had remissions. Never had a positive RF. No longer positive for csr or sed no matter how bad the swelling and inflammation is. Basically, yes, kweenb, that's what I understood also. Most people here are going to be 3's because we need to manage and cope with the long term chronic nature of the disease.

I would say that disease progression would be anything from damage, joint replacement, the duration it takes to get the disease under control, inflammation levels etc.

My mother has a friend who is a Type 2 and you can really see the difference between her and I. Her disease areas are pretty much confined to her hands and feet, the disease has barely slowed her down. Whereas with me, three years after dx they are still trying to find a medication to get mine under control and most of that time I have spent housebound and bedridden.
Cordy,

Ty for posting that info - most useful!
lorrie2008-11-23 23:54:34No problems, Lorrie. Glad you have had a good time with your sis. Look forward to catching up on Yahoo. I am doing not too badly at the moment.
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