Rheumatoid arthritis (RA) is an autoimmune disease. In it, your own immune system attacks the cells lining your joints. Symptoms include pain and swelling of the joints, especially in your hands and feet. As the disease progresses, it may cause deformities in these small bones and joints. It may even cause problems with major organs.
There’s currently no cure for RA. However, there are a number of treatment options that can effectively treat both short- and long-term symptoms of the condition. They can also prevent more damage to the joints.
There are three types of treatments commonly used for RA.
Disease modifying antirheumatic drugs (DMARDs)
These drugs have become the treatment of choice for RA. This is because they are very effective. These drugs can slow down the progression of RA. This helps prevent permanent joint damage and other long-term problems. However, DMARDs can take months to work fully.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Over-the-counter NSAIDs include drugs like ibuprofen (Advil) and naproxen (Aleve). For RA, they are often used with prescription medications. NSAIDs can control pain and inflammation to help you feel better. However, they don’t prevent joint damage or offer any long-term benefit.
Biologic drugs are the newest treatment option. They are a specialized type of DMARD. They target specific parts of the immune response. Biologics generally work within a few weeks, which is sooner than standard DMARDs take effect.
Reasons to change treatments
There are many different ways to treat moderate to severe RA. What works for one person may not work for you. On top of this, what works for you today may not work so well in the future.
Here are five things that might suggest it’s time to talk to your doctor about changing your treatment plan.
1. Your medication no longer seems to be working
This is a common problem that happens with many types of medications. The treatment that once controlled your symptoms can become less effective or even stop working altogether. This is known as “tolerance.” It happens when your body gets used to the drug and you no longer respond as well to the medication as you once did.
2. Your symptoms flare up
When your symptoms get worse for a short time, or flare up, your doctor may suggest increasing the dosage of your drugs. This can help ease your pain and stiffness. Or your doctor may recommend taking another drug for a time to help your symptoms. They may tell you to take NSAIDs or corticosteroids, for instance.
3. You have new symptoms
If you’re noticing new symptoms, like pain and swelling in a different part of your body, it could mean that your RA is becoming more severe. It might be time to move from DMARDs to biologics. Or your doctor may suggest combining two or more drugs. This treatment may work better to slow down the effects of RA.
4. Your side effects are unmanageable
Different RA drugs cause different side effects. Some can be dangerous to your overall health, while others are just bothersome. Some of the side effects caused by typical RA drugs include:
- suppressed immune system
- infections like pneumonia
- liver and kidney problems
- bruising and bleeding
- abnormal lab test results
- heart attack
If you can’t tolerate your side effects, talk with your doctor. They may prescribe a different drug to you.
Also, talk to your doctor about any concerns you have about side effects. They will make sure that the benefits of the drug outweigh the potential side effects and complications.
5. Your symptoms have disappeared
If your symptoms have gone away for at least a few months, this could mean that your RA has gone into remission. Even though you’ve found relief, this does not mean that you’re cured.
If your doctor thinks that your RA has gone into remission, they may suggest reducing the dosages of your medications. Or they may have you step down from a biologic to a DMARD. This would also be the time to stop taking NSAIDs for a while. This is because NSAIDs only treat symptoms (which you don’t currently have) and can have side effects of their own.
There are many options available to treat RA symptoms. Tell your doctor exactly how you feel and what side effects you have. This can help your doctor find the best treatment for your condition.
Even if an RA treatment used to work for you, know that it’s normal for it not to work as well now. Many people need to change their RA treatment plan from time to time. If you think you may need to adjust your RA medication, talk to your doctor sooner rather than later. Finding the right drugs for your RA can make a real difference in your health and quality of life, both now and in the future.