Medicines are the main treatment for rheumatoid arthritis. The types of medicines used depend on the severity of your disease, how fast it is progressing, and how it affects your daily life.

It is common for people with rheumatoid arthritis to have periods when the disease eases and then times when it gets worse. A long-range treatment plan that takes into account your lifestyle, medical history, and treatment options should be developed, followed, and regularly reviewed by all those involved in your health care-most importantly, you.

If your symptoms ease and you are in remission, you and your doctor will decide whether you can take less medicine or stop taking medicine. If your symptoms get worse, you will have to start taking medicine again.

Medicines to treat rheumatoid arthritis are used to:

• Relieve or reduce pain.
• Improve daily function.
• Reduce joint inflammation. Signs of joint inflammation include swelling, tenderness, and limited range of motion.
• Prevent or delay significant joint damage and deformity.
• Prevent permanent disability.
• Improve quality of life.

Medicines called disease-modifying antirheumatic drugs (DMARDs) that can slow or sometimes prevent joint destruction are now recommended early in the course of the disease. All people with rheumatoid arthritis are considered candidates for DMARD treatment. DMARDs can help prevent the significant joint damage that may occur in the early stages of rheumatoid arthritis. DMARDs are also called immunosuppressive drugs or slow-acting antirheumatic drugs (SAARDs).

Early treatment with DMARDs may significantly reduce disease severity. Experts recommend that DMARD treatment be continued for a prolonged period of time to sustain the benefit of disease control.⁸

DMARDS can be divided into two general categories based on how they work: oral DMARDs and biological DMARDs. Oral DMARDS are taken by mouth. They interfere with the making or working of immune cells that cause joint inflammation. Biological DMARDS are given by injection (infusion). They act in several different ways to affect how immune cells work. DMARDs decrease joint inflammation and damage.

Medicines may be given together. This is called combination therapy. Oral medicines are combined with each other or with biological DMARDs. But biological DMARDs are not used with each other because of a higher risk of infection.

Combination therapy may allow for lower doses of an individual drug to be used, which may reduce the risk of side effects that can occur with higher doses. Combination therapy may be an effective way to reduce symptoms of rheumatoid arthritis, control the disease, and prevent it from getting worse. And you may need fewer treatment adjustments with combination therapy than with treatment using individual medicines.¹³

Some medicines for rheumatoid arthritis may cause birth defects. If you are pregnant or are trying to become pregnant, talk with your health professional about your medicines.

Medication Choices