Understanding Rheumatoid Arthritis -- Treatment
The main treatment goals with rheumatoid arthritis are to control inflammation and slow or stop the progression of RA.
Treatment is usually a multifaceted program that consists of medications, occupational or physical therapy, and regular exercise. Sometimes, surgery is used 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
As part of rheumatoid arthritis treatment, your doctor will probably prescribe a nonsteroidal anti-inflammatory drug (NSAID). These drugs reduce pain and inflammation but do not slow progression of RA. Therefore, people with moderate to severe RA often require additional drugs to prevent further joint damage.
Over-the-counter NSAIDs include ibuprofen (Advil or Motrin) and naproxen sodium (Aleve). Most people with RA require 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 to choose from.
All prescription NSAIDs carry a warning regarding the increased risk of heart attack and stroke. NSAIDs can also raise blood pressure. In addition, NSAIDs 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.
Disease-modifying antirheumatic drugs (DMARDs) help slow or stop progression of RA. Methotrexate is usually the first DMARD used to treat rheumatoid arthritis. If methotrexate alone doesn’t calm the inflammation, doctors may try a different type of DMARD. Other DMARDs include Arava, Azulfidine, and Plaquenil.
In rheumatoid arthritis, an overactive immune system targets joints and other areas of the body. DMARDs work to suppress the immune system. However, they aren't selective in their targets. Thus, while they can increase the risk of infections, they also cause a wide variety of other side effects.
DMARDs, particularly methotrexate, have produced dramatic improvements in severe rheumatoid arthritis and can help preserve joint function.
Xeljanz is a different type of DMARD. Because it affects a specific part of the immune system involved in RA, it also increases the chance of a serious infection.