Skip to content
My WebMD Sign In, Sign Up
Select An Article
Font Size

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.

Recommended Related to Rheumatoid Arthritis

Diagnosing Rheumatoid Arthritis

Diagnosing rheumatoid arthritis (RA) in the early stages can be difficult. There is no single test that can clearly identify rheumatoid arthritis. Instead, doctors diagnose rheumatoid arthritis based on factors that are strongly associated with the disease. The American College of Rheumatology uses this list of criteria: Morning stiffness in and around the joints for at least one hour. Swelling or fluid around three or more joints simultaneously. At least one swollen area in the wrist,...

Read the Diagnosing Rheumatoid Arthritis article > >

Drugs for Rheumatoid Arthritis

NSAIDs

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.

DMARDs

Disease-modifying antirheumatic drugs (DMARDs) help slow or stop progression of RA. The most common DMARD used to treat rheumatoid arthritis is methotrexate. Other DMARDs include Arava, Azulfidine, Cytoxan, Imuran, Neoral, P laquenil, and Xeljanz.

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, they decrease the immune system overall and increase the likelihood of catching some infections.

DMARDs, particularly methotrexate, have produced dramatic improvements in severe rheumatoid arthritis and can help preserve joint function.

Biologics

The newest and most effective treatments for rheumatoid arthritis are biologics. Biologics are genetically engineered proteins. They are designed to inhibit specific components of the immune system that play a pivotal role in inflammation, a key component in rheumatoid arthritis.

Biologics are usually used when other drugs have failed to stop the inflammation of rheumatoid arthritis. Biologics may slow or even stop RA progression.

TNF blockers help to reduce pain and joint damage by blocking an inflammatory protein called tumor necrosis factor (TNF). For some patients, TNF blockers stop the progression of rheumatoid arthritis. Studies show benefits when TNF blockers are combined with methotrexate. TNF blockers include Enbrel, Humira, Remicade, Cimzia, and Simponi.

Other biologics suppress different areas of the immune system and include Actemra, Kineret, Orencia, and Rituxan.

Since biologics suppress the immune system, they also increase the risk of infection. Severe infections have been reported with biologics.

Steroids

For severe RA or when RA symptoms flare, your doctor may recommend steroids to ease the pain and stiffness of affected joints. In most cases, they can be used temporarily to calm a symptom flare. However, in certain people, steroids are needed long term to control pain and inflammation.

Steroids can be given as injections directly into an inflamed joint or can be taken as a pill. Potential side effects of long-term steroid use include high blood pressure, osteoporosis, and diabetes. But when used appropriately, steroids are often effective and quickly improve pain and inflammation.

WebMD Medical Reference

Next Article:

Today on WebMD

fish oil capsule
Article
senior woman holding green apple
Article
 
young women in yoga class
Video
Man with knee brace
Article
 
Lucille Ball
Slideshow
Hand bones X-ray
Article
 
prescription pills
Article
Woman massaging her neck
Quiz
 
woman roasting vegetables in oven
Slideshow
Woman rubbing shoulder
Slideshow
 
Working out with light weights
Video
arthritis
Article