Rheumatoid Arthritis Health Center

Treating Rheumatoid Arthritis With Disease-Modifying Drugs (DMARDs)

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DMARDs slow down rheumatoid arthritis and improve quality of life for most people. Some will even achieve a remission while taking them. More commonly, the disease activity continues, but at a slower, less intense pace.

While taking one or more DMARDs, you may have longer symptom-free periods, or flare ups that are less painful or stressful. Your joints may take less time to loosen up in the morning. At a check-up, your rheumatologist may end up telling you that your most recent X-rays are free of any new damage. Taking a DMARD regularly makes you less likely to have long-term damage to your joints, too.

Are DMARDs safe? The FDA has approved all DMARDs. Many people take them without ever having problems.

But because they work throughout the body to fight rheumatoid arthritis, their powerful action typically does cause some side effects. The DMARDs share several potential side effects in common:

• Stomach upset. DMARDs often cause nausea, sometimes with vomiting, or diarrhea. Other medicines can help treat these symptoms, or they often improve as you get used to the drug. If the symptoms are too uncomfortable to tolerate, your rheumatologist will try a different medication.
• Liver problems. These are less common than stomach upset. Your doctor will check blood tests on a regular basis to make sure your liver is not being harmed.
• Blood issues. DMARDs can affect the immune system and raise the risk of infection. Infection-fighting white blood cells may also be decreased. Low red blood cells (anemia) can make you tired more easily. A simple blood test by your doctor every so often will make sure your blood counts are high enough.

You should learn about possible side effects of any medicine you are taking and discuss them with your doctor until you feel comfortable.

To minimize side effects, DMARDs are usually started one at a time and increased gradually. The goal is to minimize both rheumatoid arthritis disease activity and medication side effects. Sometimes it takes more than one DMARD to get control of active rheumatoid arthritis.

How do you know you're on the "right" regimen? There's no easy way. Rheumatologists use all their training and experience to determine what's right for you.

Though DMARDs can have side effects, there is a good reason to take them -- they're proven to work against rheumatoid arthritis. Even if you are in a remission, many rheumatologists believe you should keep taking a DMARD, just to keep rheumatoid arthritis at bay.