When the burly, 45-year-old construction worker and heavy equipment operator first came to see rheumatologist Eric Matteson, MD, at the Mayo Clinic in the summer of 2006, he didn't look like the strong, vigorous man he'd once been. He had been suffering from rheumatoid arthritis for about three months. It had gotten so bad that he was no longer able to work, and he needed rheumatoid arthritis medication badly.
Matteson noted the man's rheumatoid arthritis (RA) was particularly aggressive, with more than 20 joints involved. Matteson started the construction worker on several rheumatoid arthritis medications, including six weeks of steroid treatment followed by a combination of disease-modifying antirheumatic drugs (DMARDs).
Rheumatoid arthritis (RA) is perhaps the most common inflammatory arthritis in the world, says Gary S. Firestein, MD, professor of medicine, dean and associate vice chancellor of translational medicine at the University of California, San Diego School of Medicine. In the United States, an estimated 1.3 million people have the disease, and it affects two to three times as many women as men. And RA may be on the rise in women, according to a 2010 Mayo Clinic study. After decades of decline, the incidence...
Within three weeks, the 45-year-old was back at work. A few months later, the man stopped showing improvement and Matteson changed his rheumatoid arthritis medications to include a tumor necrosis factor (TNF) blocker -- a drug that helps prevent inflammation and preserve joint health. "Now, he has virtually no disease activity at all, he's working full time, and he's doing everything he needs to do," Matteson says.
As recently as 1990, a person diagnosed with rheumatoid arthritis may have been put on Motrin or a pain reliever and sent home. A common notion then was to wait until X-rays showed evidence of joint damage before starting aggressive treatment with rheumatoid arthritis medication. But over the past 15 years, experts have learned that early aggressive treatment is essential to help prevent long-term damage and disability from rheumatoid arthritis.
Rheumatoid Arthritis Medication: Live Longer, Live Better
Many people think of rheumatoid arthritis as a debilitating chronic disease, but not necessarily a deadly one. Yet, people with RA have been found to have a life expectancy that's shorter than people without the disease. That's largely because they're at increased risk for other conditions, like heart disease, renal disease, infections, and respiratory problems.
Disease-modifiying medications such as DMARDs and TNF blockers can do more than just keep you from being disabled; they may add years to your life.
"Disease-modifying treatment early on has led to a lessening of disability from rheumatoid arthritis, and even an improvement in patients' life expectancy," Matteson says. "When you begin these treatments early on, you are less likely to develop erosive disease in the joints, and less likely to develop other, related conditions such as lung disease, vasculitis, and pericarditis, all of which are major contributors to early mortality in people with rheumatoid arthritis."
Several major studies have documented the dramatic benefits of early treatment with rheumatoid arthritis medication. Research presented at the 2006 American College of Rheumatology Annual Scientific Meeting found that early, intensive treatment with a combination of rheumatoid arthritis medication offers a chance of remission.
And a study by Matteson and his colleagues, published in Arthritis Care and Research, found that patients who developed RA more recently, and are receiving more aggressive treatment, require as much as 35% fewer joint replacement surgeries than people diagnosed 20 years ago, Matteson tells WebMD.