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WebMD 5: Rheumatoid Arthritis

Our expert explains rheumatoid arthritis and what's ahead for treatment.


2. Can it be cured?

Right now there is no cure for RA, but we have effective treatments for the majority of patients. Some people will have very mild disease, but others have a waxing and waning course with exacerbations and remissions that go on over time.

The general rule for all the therapies is the rule of thirds: a third of patients will get much better with a particular therapy, a third will get somewhat better, and a third will not improve at all. A new class of medications called biologics can be very effective. These drugs block certain proteins in the body that cause inflammation.

3. Besides medication, what else works?

In almost any pain or arthritis study, about 20% to 30% of patients have a modest response to a placebo, which means the expectation of improvement can lead to changes in disease activity. And there actually is physical and laboratory evidence that people are improving, so there must be a biology to it that we don't understand.

It's really important to maintain range of motion and stay physically active if you have any chronic disease and especially a disease of the joints such as RA. Swimming is a great exercise. Using elliptical machines rather than running and pounding the pavement is another example of getting a good aerobic workout without having high impact on inflamed joints.

4. Is it possible to get pregnant with RA? Can I pass RA on to my child?

Women with RA can certainly become pregnant, and pregnancy can induce remission in a large percentage of women -- about half to three-quarters. Subsequently, about one to two months after delivery, those women almost always have a return of the disease or a flare. Nobody really understands why. There are some theories about how the immune system in pregnant women gets modified to prevent rejection of a fetus, and maybe that's responsible for putting the disease into remission.

We always try to minimize drug exposure during pregnancy. There can be some risks related to certain RA medications (such as methotrexate) during pregnancy, so we usually recommend that women be off these medications for six months or so before conceiving.

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