Drug Treatment Overview
Drug treatments for rheumatoid arthritis (RA) can be divided into two categories: drugs that treat the symptoms, and drugs that slow the progression of the disease. Your treatment plan may start with one or the other, or a combination of both, depending on how severe your condition is.
Medications that treat the symptoms of RA include acetaminophen (Tylenol); nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen; and corticosteroids (also known as steroids). These drugs provide rapid pain relief and temporarily reduce inflammation but do not affect disease progression and are generally not used for long-term care.
Medications that slow or stop the disease are called disease-modifying antirheumatic drugs (DMARDs). Intensive treatment with DMARDs can prevent joint damage and send RA into remission, but these are powerful drugs that also weaken the body's immune system and may cause serious side effects. Nevertheless, DMARDs are considered the gold standard in treating rheumatoid arthritis.
DMARDs also provide symptom relief, but unlike NSAIDs and steroids, which offer quick relief from pain and inflammation, DMARDs act more slowly and may take up to 6 months before the benefits can be felt. Intensive DMARD treatment may be combined with pain relievers or steroids for the first few months and should be monitored regularly.
A Brief History of RA Treatment
Rheumatoid arthritis used to be treated primarily with NSAIDs, sometimes together with corticosteroids. Mild DMARDs were used sparingly -- only after joints became deformed -- and the use of stronger DMARDs was considered only after several years of treatment, by which time disabling damage was often well under way.That all changed in the 1990s, when studies using x-ray images showed that joint damage often begins in the first few months of rheumatoid arthritis. Treatment guidelines were updated, and rheumatologists started using powerful DMARDs early on in the disease to slow or stop its progression before damage occurred.
Some doctors, however, remain cautious about using such potent drugs and may be reluctant to include them in a treatment plan. If you're not sure about the treatment your doctor suggests, get a second opinion.
