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Treating Rheumatoid Arthritis: Questions to Ask Your Doctor

If you have rheumatoid arthritis, early and aggressive treatment can help you forestall joint damage and worsening pain. But all treatments have some side effects. To help you develop a good treatment plan for your RA, here are 10 questions to ask your doctor.

1. Is a DMARD appropriate for me?

Treatment for rheumatoid arthritis is complex -- as much art as science -- but certain drugs called DMARDs (disease-modifying anti-rheumatic drugs) have the ability to change the course of this disease in many people. Methotrexate is helpful for most people, but each person's treatment plan is unique. Make sure you feel comfortable with your treatment plan by asking questions.

2. Are the new "biologic" injectable medicines a good treatment option for me?

Biologic agents like Actemra, Enbrel, Humira, Orencia, Rituxan, Kineret, Remicade, Cimzia, and Simponi have become powerful tools in the treatment of rheumatoid arthritis. People with moderate to severe RA are frequently candidates for these therapies. These drugs are genetically engineered proteins that are derived from human genes. They inhibit the immune system, which plays a key role in inflammation in RA.

3. Can we ever consider stopping treatment or taking a drug holiday?

It's a bad idea to stop treatment for active rheumatoid arthritis. In special cases, if your disease is particularly mild or inactive, your doctor may consider pausing therapy and closely monitoring you.

4. What has been the rate of progression of my rheumatoid arthritis?

The course of rheumatoid arthritis is especially important but can be hard to predict. But looking at past progression can often help predict future progression.

5. What medication side effects have you noticed so far?

Your doctor might notice some side effects during an exam, like thinning of the skin from steroid use. Discovering others, like liver inflammation from methotrexate, requires lab testing.

6. Can you tell whether my joints have been damaged?

At each appointment, your doctor will examine your joints. You’ll also need regular tests like X-rays and labs. These are ways of checking how the disease has progressed and whether you need changes in your treatment.

7. What long-term plans should I be making for life with rheumatoid arthritis?

Sometimes medicines alone aren't enough. Occupational therapy, assistive devices, and re-tooling the home can all be important in the treatment of advanced rheumatoid arthritis.

8. Could surgery help me?

Surgery can help correct some of the effects of joint damage from rheumatoid arthritis. The advice of orthopedic surgeons, particularly hand specialists, can often be helpful.

9. Would referral to other specialists help me?

Most people with rheumatoid arthritis should see a rheumatologist regularly. Having a relationship with a physical therapist, occupational therapist, orthopedic surgeon, pain specialist, and/or psychiatrist can often help.

10. What more could I be doing to preserve my joint function?

If you have RA, there are lots of ways to take an active and important role in your treatment. Exercise and physical therapy can have a beneficial effect on your symptoms. Learning ways to cope and manage your pain can also make life with rheumatoid arthritis easier.

WebMD Medical Reference

Reviewed by David Zelman, MD on July 16, 2013
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