Rheumatoid Arthritis - Treatments

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What is the treatment for rheumatoid arthritis?

There is no known cure for rheumatoid arthritis. To date, the goal of treatment in rheumatoid arthritis is to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity. Early medical intervention has been shown to be important in improving outcomes. Aggressive management can improve function, stop damage to joints as monitored on X-rays, and prevent work disability. Optimal treatment for the disease involves a combination of medications, rest, joint-strengthening exercises, joint protection, and patient (and family) education. Treatment is customized according to many factors such as disease activity, types of joints involved, general health, age, and patient occupation. Treatment is most successful when there is close cooperation between the doctor, patient, and family members.

Two classes of medications are used in treating rheumatoid arthritis: fast-acting "first-line drugs" and slow-acting "second-line drugs" (also referred to as disease-modifying antirheumatic drugs or DMARDs). The first-line drugs, such as aspirin and cortisone (corticosteroids), are used to reduce pain and inflammation. The slow-acting second-line drugs, such as methotrexate (Rheumatrex, Trexall, Otrexup), and hydroxychloroquine (Plaquenil), promote disease remission and prevent progressive joint destruction.

The degree of destructiveness of rheumatoid arthritis varies among affected individuals. Those with uncommon, less destructive forms of the disease or disease that has quieted after years of activity ("burned out" rheumatoid arthritis) can be managed with rest plus pain control and anti-inflammatory medications alone. In general, however, function is improved and disability and joint destruction are minimized when the condition is treated earlier with second-line drugs (disease-modifying antirheumatic drugs), even within months of the diagnosis. Most people require more aggressive second-line drugs, such as methotrexate, in addition to anti-inflammatory agents. Sometimes these second-line drugs are used in combination. In some cases with severe joint deformity, surgery may be necessary.

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See what others are saying

Comment from: Shalu, 25-34 Female (Caregiver) Published: March 13

My wife is suffering from rheumatoid arthritis (RA) since 6 years ago. The doctor gave her Nucoxia 90mg, SAAZ-DS 1000mg, Dexorange and methotrexate 7.5mg. After using these medicine she was quite well till now but since 10 days she started having pain and swelling in both her legs and shoulder. She has stopped all the medicines except Nucoxia since two years.

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Comment from: theresa, 45-54 Female (Patient) Published: March 06

I was diagnosed about 10 years ago with rheumatoid arthritis. I was having almost daily episodes of paralyzing pain in my shoulders, wrists and knees. My ANA's were over 2700 and it was crippling. The Plaquenil and naproxen I was prescribed did nothing to either alleviate the pain or lessen the episodes. I was looking at disability. I attended a lecture on acupuncture and thought I'd give it a try. Within a year, my ANA's were down to 400s and the episodes were few and far between and less in severity. I also keep myself to a strict schedule. Now, I only have an episode if I get sick or run down. I take NO medication other than an occasional ibuprofen. I have an active full time job and good quality of life. It saved my life.

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