Knowledge library

Systemic Lupus Erythematosus (SLE), commonly referred to as Lupus, is an auto-immune disease that affects approximately one in every 200 Canadians. A normal functioning immune system produces antibodies that defend the body from infections and invaders such as viruses and bacteria. In patients with Lupus, the antibodies produced by the immune system start to attack the body itself. This causes tissue to become inflamed, resulting in pain and tissue damage.  

While Lupus can be difficult to diagnose as symptoms can vary from individual to individual, once diagnosed it can be managed using a combination of exercise, lifestyle adjustments and drug therapy. With successful adherence to treatment, most people with Lupus can lead a high quality of life.  

Where can I go for more information? 

Lupus Canada has a robust website that includes comprehensive information, resources and support for patients living with Lupus.  

Arthritis can affect children and young adults. Juvenile arthritis refers to arthritis that occurs in children under aged 16; while Adolescent arthritis refers the disease occurring in patients 16-18 years old. Oftentimes, the symptoms and presentation of this disease are similar to when it appears in adults. However, younger patients living with the disease can face unique challenges that can impact many aspects of their lives, from schooling to social activities.  

Many health care professionals offer support to young adults living with arthritis as they enter their adult years. Through our Young Adults with Rheumatic Diseases, we help patients successfully transition from adolescent to adult care by offering integrated care that addresses the medical, social and lifestyle impacts of this adjustment. 

Where can I go for more information? 

The Arthritis Society provides information for patients and caregivers. 

Rheumatoid arthritis is a type of autoimmune disease characterized by inflammation of the joints, causing swelling, pain and loss of mobility. While the disease can affect any joint in the body, it most often affects joints in the hands. The disease is a type of autoimmune disorder that causes the body’s antibodies to attack healthy tissues in the joints.  

Approximately one in every 100 adult Canadians suffer from RA, and it can occur at any age. Diagnosis often occurs using physical examination, blood test and imaging. There is no cure for RA, so treatment typically focuses on using medications to manage symptoms and slow disease progression. Physical therapy and exercise are also useful to help manage the disease. When properly managed, patients living with RA can often enjoy a high quality of life. 

Where can I go for more information? 

The Arthritis Society is a Canadian organization that offers numerous resources for patients living with Rheumatoid Arthritis. Their website also includes information on advocacy and patient support options.

Scleroderma is a disease that causes inflammation of the body’s connective tissue. This results in symptoms that can include swelling, pain and reduced mobility.  

The body’s connective tissue holds together important structures within the body – the muscles, tendons, organs and other tissues. In patients with Scleroderma, the immune system begins to attack the body itself, causing inflammation within this connective tissue that results in the formation of collagen. As a result, normal, flexible connect tissue becomes hard and rigid.  

There is no cure for Scleroderma. Your doctor will work with you to create a customized treatment plan that typically involves taking medications such as corticosteroids to reduce inflammation. Patients may also be prescribed medications that suppress the activity of the immune system. 

Where can I go for more information? 

The Scleroderma Canada website is an excellent resource for patients that contains information on the disease, treatments and more.  

Spondyloarthropathy refers to a collection of various types of arthritis that affect specific parts of the body: 

• Ankylosing spondylitis – which normally affects the spine. 

• psoriatic arthritis – which affects the skin, causing psoriasis. 

• reactive arthritis – arthritis that results from an infection. 

Treatments typically involve addressing symptoms caused by the disease. Medications used include analgesics, NSAIDs, biologics and corticosteroids. Oftentimes, physical therapy (in Ankylosing spondylitis) can help reduce pain and increase range of motion. 

Where can I go for more information? 

The Canadian Spondylitis Association is an excellent resource for patients.  

Vasculitis is an autoimmune disease in which the immune system begins to attack the body’s own healthy tissue, causing inflammation of the blood vessels. This can reduce blood flow as vessels narrow and swell. If not properly treated, vasculitis can cause permanent damage to the tissues and organs.  

Physicians diagnose vasculitis using a variety of methods, including lab and imaging tests, but only a biopsy can confirm a diagnosis. There is no cure for vasculitis, so treatment focuses on reducing symptoms. The most common treatments include medications that reduce inflammation and others that help support the immune system. 

Where can I go for more information? 

The Vasculitis Foundation Canada website contains thorough information for patients and caregivers.  

Corticosteroids, sometimes referred to as Glucocorticoids, are synthetic hormones that mimic the role of cortisol in the body. Cortisol is a hormone in your body that helps to regulate numerous body activities. It is also a “fight or flight” hormone hormone that is meant to be protective, ensuring there is enough energy to get through stressful situations.  

In higher than normal body amounts, it is both anti-inflammatory and immunosuppressive and is used to treat many types of diseases and syndromes, such as autoimmune diseases, asthma, cancer and many others.  

They do have many side effects as well, increased blood sugar and blood pressure, increased fat deposits and muscle breakdown, cataracts and glaucoma, osteoporosis and psychiatric symptoms.  They should be used in the lowest dose for the shortest amount of time possible to help decrease the side effects. 

Commonly in Rheumatology, systemic glucocorticoids are given by injection into the muscle of triamcinolone or methylprednisolone, or orally as prednisone. Injections directly into the joint are also commonly used as treatment of inflamed joints.

Where can I go for more information?

The Alberta Rheumatology website contains information for patients regarding corticosteroids.

NSAIDs are medications that decrease inflammation and relieve pain.   While they make you feel better, they do not prevent damage from inflammation. With the exception of some patients with spondyloarthropathy, they do not treat the disease and instead only mask the symptoms. They should be used in the lowest effective dose for the shortest amount of time possible due to a high risk of side effects, such as bleeding, stomach and intestine ulceration, kidney and liver problems, high blood pressure, heart attacks and stroke.

Where can I go for more information?

The Alberta Rheumatology website contains thorough information regarding NSAIDs.

DMARDs are medications that come in many forms and are each very different. The common denominator is that they modify the immune response that is responsible for creating inflammation and damage. There are now 3 classes of DMARDs; the older or “conventional” DMARDs, frequently associated with the term, and Advanced Therapies which include Biologic DMARDs (bDMARDs or just “biologics”) and Targeted small molecule DMARDs like apremilast or the JAK inhibitors. Combinations of disease modifying agents are used to maximize disease control and minimize side effects.

csDMARDS (Conventional Synthetic Disease Modifying Anti-Rheumatic Drugs DMARDs)

CsDMARDS are frequently what comes to mind when DMARD is used. These are chemical medications, taken orally or by injection and most of them have been used in treating inflammatory arthritis for many decades. Methotrexate is the most commonly used of the DMARDs and is frequently used in combination with other traditional DMARDs or advanced therapies.

Where can I go for more information?

The Arthritis Foundation website contains detailed information on DMARDs.

Biologics are medications that are made in live cells, such as animal stem cells, yeasts or fungi,  they are made by introducing DNA that will create a protein that blocks production or activity of inflammatory components that cause inflammation and damage. Often these are antibodies against cells or proteins or proteins with similar mechanisms. The end product has all traces of the cells removed and is a purified protein. These medications must be injected because they are easily broken down by the enzymes and acids in saliva and stomach acid. Biosimilar medications are copies of the original branded biologic. They are called biosimilar because cells producing these drugs cannot be controlled like chemical reactions and there will be slight differences from company to company but they have all been proven equally effective to the original biologic and are not considered inferior in any way.

Where can I go for more information?

The Arthritis Society website contains detailed information on Biologic DMARDS.

Immunosuppressants are medications that non-selectively suppress the immune system. Many of these are also used in transplant patients in order to prevent the immune system from attacking the new organ/tissue. Immunosuppressants in autoimmune diseases work the same way- they prevent the immune system from attacking its own tissue and causing symptoms. These are used in Rheumatic diseases that affect a lot of systems in the body such as SLE, myositis, vasculitis and scleroderma.  

Typical examples commonly used in Rheumatic Disease include mycophenolate, cyclophosphamide and azathioprine. Corticosteroids in high doses are also considered immunosuppressants.

Where can I go for more information?

The John Hopkins website contains detailed information on immunosuppressants.