Rheumatoid arthritis (RA) is a chronic autoimmune condition. In RA, the body's immune system actually attacks the joints. Inflammation in the synovium or joint lining occurs. This causes the symptoms of pain, swelling, and difficulty with movement. Most people also have symptoms affecting the rest of their bodies. For example, fever and body aches. Over time permanent joint damage may occur. That is why early treatment is so important. Treatment, not only includes medications, but also:
- Lifestyle changes. Weight management and exercise, including range of motion to keep your joints moving
- Joint protection. Changing the way you do things to protect your joints from damage
- Natural and alternative treatments. Use of heat and cold, acupuncture, and massage are just some of the therapies
- Learning to deal with RA. Relaxation techniques and counseling
There are many different medications used to treat RA. Because RA can be complicated, it is best managed by rheumatologists or specialists in arthritis and other conditions. The medications that may be prescribed include the following:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs help to lessen pain and inflammation. They are available over-the-counter and by prescription. Ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) are common over-the counter NSAIDs. There are also several prescription NSAIDs. NSAIDs can cause stomach problems, including bleeding, as well as other side effects. One, celecoxib (Celebrex) is safer for the stomach. But, it may cause other side effects. Make sure you talk with your health care provider before taking these medications.
Corticosteroids or steroids are strong anti-inflammatory medications. They can quickly control inflammation. Prednisone, prednisolone and methyprednisolone are commonly used steroid medications. They are used short term because of serious side effects.
Disease-modifying antirheumatic drugs (DMARDs)
DMARDs change the course of RA. They are usually started soon after diagnosis to prevent joint damage. Methotrexate is used most often.
Biologic agents or biologics also change the course of RA. Each of the drugs slows inflammation and prevents damage to the joints. There are several biologics used to treat RA. Biologics may help some people with RA who haven't responded to other medications.
DMARDs and biologics
The American College of Rheumatology, made up of experts in arthritis treatment, have set guidelines for using DMARDs and biologic agents. The recommendations help doctors know which medications to use as well as how and when to makes changes. And because these medications increase the chance of serious infections, they also guide doctors about when to screen for tuberculosis and what vaccinations to take.
Work with your rheumatologist to find the medications that work best for you. Your provider may try different medications or combinations of them. In order to get the most benefit and lessen the chance of side effects, make sure you go to all appointments, get all recommended tests and vaccines, and carefully follow all instructions.
March 27, 2020
ollaway, Beth, RN, M.Ed, MMI board-certified, academically affiliated clinician