How is Rheumatoid Arthritis Treated? •There is still no cure for Rheumatoid Arthritis. However, treatment has advanced significantly, with many options available that can be tailored to your specific needs. It is possible that the only reason you know you have rheumatoid arthritis is because you are on treatment. •Below is a general outline of treatment. Your rheumatogist may have you on treatment from more than one group. For information on a specific medication, please go to the specific medication page.
Non-steroidal Anti-Inflammatory Drugs (NSAIDs) •Examples: ibuprofen (Motrin or Advil) and naprosyn (Aleve). •NSAIDs are quick acting medications that reduce joint pain and swelling and thereby can make you feel better. •However, NSAIDs do not affect the underlying reason for rheumatoid arthritis, so even if you are feeling better with an NSAID, your disease can progress and you may develop irreversible bone damage. •NSAIDs must be used carefully for patients with high blood pressure, kidney or liver problems, and heart conditions.
Disease Modifying Anti-Rheumatic Drugs (DMARDs) •Examples: methotrexate, hydroxychloroquine, sulfasalazine, leflunamide •DMARDs are slow acting medications which reduce joint pain and swelling, and improve day to day function. They are also important as they slow or stop irreversible bone damage, making them the cornerstone treatment for rheumatic arthritis. •DMARDs are often used in combination to enhance their benefit. •Each DMARD does have the potential for side effects (see the medications page for specific details), BUT they are the most effective and safest option available for treatment.
Biologic DMARDS •Examples: Infliximab (Remicade), Etanercept (Enbrel), Adalumimab (Humira) •Biologics are the newest class of DMARDs •When used in combination with an older DMARD, usually methotrexate, they can be very effective in reducing pain and swelling and preventing bone damage •They are the most expensive class of DMARDs, ~$20,000/year •Side effects may include injection/infusion reactions, an increased risk of developing infections, re-activation of tuberculosis, neurological effects, and exacerbation of heart disease
Rheumatoid Arthritis vs Osteoarthritis
Glucocorticoids ("Steroids") •Examples: Prednisone •Steroids are a fast acting medication which can completely resolve joint swelling and pain. •Steroids are known for their numerous side effects, including but not limited to weight gain, poor sleep, glaucoma, cataracts, diabetes, osteoporosis and bone fractures. These side effects outweigh any benefit to use oral steroids long term. •In some situations, there is a role for steroids to bridge the gap until DMARDs start to take effect •Steroids can be an effective and safe choice when injected directly into a joint.
Exercise & Diet •Exercise and diet both can be important components in the treatment of RA and for general health •It is important to maintain as much range of motion around your joints as well as to keep the muscles around joints strong. Strong muscles help protect the joints. •Appropriate body weight can lessen joint stress, particularly in the lower extremities. •Omega - 3, found in supplements or fish, has demonstrated some benefit in RA. •STOP smoking! Smoking is a risk factor for the development of RA, but those who smoke also do not respond as well to treatment. •Speak to your physical therapist or dietitian about other strategies which may work best for you •For more dietary information, this article is from the Spring 2010 edition of Canadian Health magazine, quoting local Edmonton rheumatologist Dr. Joanne Homik.
Education •Learning more about RA, how it affects you, how to cope with it and how to treat it, is important. Please explore this site and visit some of our trusted links. Speak to your rheumatologist about other resources that may be available to you, including the Rheumatoid Arthritis Education program in Edmonton. •You can also help teach and train future doctors! Click here to find out more about the Patient Partners in Arthritis Program.