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Understanding Rheumatoid Arthritis -- Treatment

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The main treatment goals with rheumatoid arthritis are to control inflammation and slow or stop down RA.

Treatment usually includes medications, occupational or physical therapy, and regular exercise. Some people need surgery to correct joint damage. Early, aggressive treatment is key to good results. And with today’s treatments, joint damage can be slowed or stopped in many cases.

Drugs for Rheumatoid Arthritis

NSAIDs

As part of rheumatoid arthritis treatment, your doctor will probably prescribe a nonsteroidal anti-inflammatory drug (NSAID). These medications reduce pain and inflammation but do not slow down RA. So if you have moderate to severe RA, you’ll probably also need to take other drugs to prevent further joint damage.

Over-the-counter NSAIDs include ibuprofen and naproxen. Most people with RA need a prescription NSAID as they offer a higher dose with longer-lasting results and require fewer doses throughout the day.

There are many prescription NSAIDs that your doctor will consider. All of them carry a warning about the increased risk of heart attack and stroke. NSAIDs can also raise blood pressure and can cause stomach irritation, ulcers, and bleeding.

You and your doctor can weigh the benefits of NSAIDs against the potential risks. You may have to try a few different ones to find the one that’s right for you.

DMARDs

“DMARDs” stands for disease-modifying antirheumatic drugs. They help slow or stop RA from getting worse.

Doctors usually first prescribe methotrexate to treat rheumatoid arthritis. If that alone doesn’t calm the inflammation, doctors may try a different type of DMARD. Other DMARDs include hydroxychloroquine (Plaquenil), leflunomide (Arava) and sulfasalazine (Azulfidine).

In rheumatoid arthritis, an overactive immune system targets joints and other areas of the body. DMARDs curb the immune system, but they aren’t selective in their targets. They can lead to infection and a wide variety of other side effects.

DMARDs, particularly methotrexate, have made dramatic improvements in severe rheumatoid arthritis and can help save your joints.

Tofacitinib (Xeljanz) is a different type of DMARD. Because it affects a specific part of the immune system involved in RA, it also has a risk of serious infection.

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