Finding the Right Treatment for RA


Paige Greenfield


Combination Therapy for RA

Treating RA early and aggressively could mean taking more than one RA drug at the same time, a process known as combination therapy.
pills and needles

Although there is no cure for rheumatoid arthritis (RA), there are many effective treatments available today. While some help soothe symptoms such as pain and inflammation, others target the disease more directly. Which treatments your doctor prescribes will depend on your RA—your particular experience. That's why it's important to always keep your doctor updated on how you're feeling. For instance, if pain is hindering everyday tasks, such as working or cooking, be sure to let your doctor know so he or she can reevaluate your treatment.

As difficult as it may be, remember to be patient. It can take some time before finding the best treatment for you. In fact, about 65 percent of people with RA need to change their medication at some point.

With every treatment, the goals stay the same:

  • Relieve pain

  • Reduce inflammation

  • Slow or stop joint damage

  • Help you feel better and improve your ability to participate in everyday activities

Is it time to try a new treatment?

Here's a look at some different options you and your doctor might try.

Disease-modifying antirheumatic drugs (DMARDs). These drugs work to slow the progression of the disease. They are one of the first lines of defense against RA. Doctors used to start with aspirin or other pain relievers, but studies have found that taking a more aggressive approach early on can help prevent joint damage down the road.

Some DMARDs can take weeks or months before you feel the effects, so you may need to take a nonsteroidal anti-inflammatory drug, such as ibuprofen or naproxen, for pain until they kick in. If the DMARD you're on doesn't achieve the goals above, your doctor might:

  • Switch you to another DMARD.

  • Add a second kind of DMARD. For instance, if you're taking a DMARD in pill form, you might try a DMARD that comes in a shot or IV.

  • Add a steroid to help with joint pain and swelling.

Chronic use of DMARDs can lead to side effects. They can range from minor conditions such as nausea and skin rash to more serious issues such as low white blood cell count, bone marrow suppression, and renal impairment. That's why it's essential to work closely with your physician when taking these medications.

Biologic agents. These medications work by blocking different steps in the inflammation process. RA occurs when the immune system attacks the membranes lining your joints, causing inflammation that results in pain and swelling. Stopping the inflammation process can bring you relief and also reduce joint damage. Biologic agents are often most effective when used in addition to a DMARD. But both types of medications suppress the immune system, which can increase your risk for infections and other health problems. Not every RA patient is a good candidate for biologics.

No matter what your treatment plan, be sure to visit your doctor regularly. He or she will perform urine, blood, or other laboratory tests to monitor your condition and determine whether your treatment is working or if adjustments need to be made.

What you can do to help

In addition to medications, doctors also recommend making lifestyle changes when you have RA. For instance, striking an ideal balance between rest and exercise can help. This often means getting more rest when symptoms flare up and fitting in exercise when you're feeling up to it. In addition, stress-reducing techniques such as visualization can make you feel better emotionally and help control pain.

Key Takeaways

  • Have patience finding the treatment that gives you relief.
  • Switching medications or trying different combination therapies may be necessary.
  • Talk to your doctor to find the option that best controls your symptoms.
Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 16, 2015

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