Rheumatic pain eased with close monitoring

Kitty Kwok Yan
Associate Consultant (Medicine)
Queen Elizabeth Hospital

Rheumatic diseases develop when the immune system turns against and attacks its own. This in turn causes inflammation in different body systems like joints, kidneys, gut, lung, heart or brain. Dr Kitty Kwok believes that early diagnosis of rheumatoid arthritis (RA) and prompt treatment with tight control of symptoms can increase the chance of remission and reduce damage to joints, resulting in chronic disability.

Inspired by overseas models, Dr Kwok pioneered an objective assessment method at RA clinic in her hospital in 2008 to assess and closely monitor patients by seeing patients once every six to eight weeks. Employing a protocol-driven method, objective scores are used to measure the patient’s disease activity based on joint pain, swelling of joint and blood tests. Medications will be stepped up if treatment targets are not met. This approach helps achieve remission without using expensive biologic therapy.

Dr Kwok has collaborated with 13 hospitals in Hong Kong to set up an RA patient registry in 2013, building up a database of 300 patients so far. Due to genetic differences of Asians and Caucasians, she believes that the database can contribute to improvement of RA treatment protocols with substantial local evidence.

While prescribing the right medications is important, Dr Kwok said one also needs to listen to patients’ concerns with a big heart in order to communicate well. Only by doing so can patients understand what is going on in their body and what to expect if they receive treatment. Besides, support for family and caregiver are also vital. No matter patients are getting better or worse, Dr Kwok is committed to standing by them.