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RA Treatments: What Are Your Options?

By Susan Bernstein
WebMD Feature
Reviewed by David Zelman, MD

When you have rheumatoid arthritis (RA), your body’s immune system attacks your joints and organs. Not only could it cause serious joint damage, it might also raise your risk of other problems like heart disease. That’s why it’s important to diagnose your RA early so you can begin treatment as soon as possible.

“The earlier a patient with RA is identified, the earlier they are likely to receive disease-modifying treatments,” says Bella Fradlis, MD, a rheumatologist at Montefiore Medical Center. Treating RA inflammation quickly will keep you and your joints healthy.

Susan Goodman, MD, a rheumatologist at the Hospital for Special Surgery in New York, identifies two short-term treatment goals:

  1. Ease pain, stiffness, and fatigue.
  2. Prevent more damage to the joints from happening.

But the long-term goal for your RA treatment is remission. This means your disease is well controlled and you have no tenderness or swelling. Your doctor will examine you to see if your joints are tender or swollen and test your blood for signs of inflammation. The results will show if your RA is in remission.

How do you get to that point? You and your rheumatologist work together to find a treatment that leads to remission, Fradlis says.

Treatment Options

Your doctor will choose drugs from these groups to treat your inflammation:

  1. DMARDs
  2. Biologics
  3. Corticosteroids
  4. NSAIDs
  5. Analgesics

The first drugs you’ll use to treat inflammation are disease-modifying antirheumatic drugs, or DMARDs, Goodman says. If they don’t work, you may need stronger drugs called biologics.

Your doctor may also suggest you take nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids to ease inflammation, Goodman says. Some people with RA also take an analgesic like acetaminophen to help ease their pain.

DMARDs

You’ll probably start with a DMARD like azathioprine, hydroxychloroquine, leflunomide, or methotrexate to treat your inflammation, Fradlis says. Most people begin with methotrexate. It comes in a pill or a shot you give yourself at home.

Methotrexate is the first choice in RA because it works and it's safe, Fradlis says. “It is also relatively inexpensive.”

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