Medicines are the main treatment for rheumatoid arthritis. The types of medicines used depend on how severe your disease is, how fast it is progressing, and how it affects your daily life.
If your symptoms ease, you and your doctor will decide if you can take less medicine or stop taking medicine. If your symptoms get worse, you will have to start taking medicine again.
Medicines 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) can slow or sometimes prevent joint destruction. Starting treatment early with DMARDs can reduce the severity of the disease. DMARDs are also called immunosuppressive drugs or slow-acting antirheumatic drugs (SAARDs). These medicines are usually taken over a long period to help control the disease.
DMARDs can be thought of as nonbiologic or biologic, depending on how they are made and how they act in the body. But they are all used to block harmful responses from the body's immune system. DMARDs are sometimes combined with one another or with other medicines. By combining medicines, you may be able to take lower doses of individual medicines. This may reduce your risk of side effects.
Medicines to slow the disease
Disease-modifying antirheumatic drugs (DMARDs) are usually started within 3 months of your diagnosis. They are used to control the progression of RA and to try to prevent joint damage and disability. DMARDs are often given in combination with other medicines.
Commonly used nonbiologic DMARDs
Less commonly used nonbiologic DMARDs
Biologic DMARDs (biologics)
There is a newer biologic drug called tofacitinib (Xeljanz) for adults who have moderate to severe rheumatoid arthritis. This medicine is for people who have not responded well to methotrexate or who cannot take it. Tofacitinib is taken by mouth. It reduces the symptoms of rheumatoid arthritis and allows people to be more active. But the long-term safety of this medicine is still being studied.2, 3
Medicines to relieve symptoms
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. NSAIDs are used to control pain and may help reduce inflammation. They don't control the disease or stop it from getting worse. NSAIDs may be combined with DMARDs.
- Corticosteroids such as prednisone. These medicines are used to reduce disease activity and joint inflammation. But using only corticosteroids for an extended time is not considered the best treatment. Corticosteroids are often used to control symptoms and flares of joint inflammation until DMARDs reach their full effectiveness.
- Analgesics (pain relievers). These don't reduce inflammation but may help with pain control. They include:
What to think about
- Some DMARDs can take up to 6 months to work.
- In some people, a certain DMARD may not work at all. So a different DMARD will be used.
- If you're taking DMARDs, it's a good idea to have a rheumatologist manage your care.
- Many DMARDs have serious side effects. You will need regular blood and urine tests to check the drug's effects on blood-producing cells (bone marrow), the kidneys, and the liver.
- If you have other conditions such as high blood pressure or high cholesterol, your doctor may recommend that you take medicine to control them.
Be safe with medicines. Read and follow all instructions on the label.