• Many rheumatoid arthritis (RA) therapies help manage symptoms and joint damage in RA.¹
• Starting effective RA treatment early can slow disease progression and prevent irreversible joint damage.¹
• People who take their RA treatment as directed may have improved symptoms.¹

RA is a chronic disease that currently has no cure.² For the best outcome, it is important to take charge of your treatment plan and give your input regarding how you want to manage your RA. There are several treatments for RA, and doctors recommend¹ most people begin therapy with disease-modifying antirheumatic drugs (DMARDs) as early as possible after an RA diagnosis.³

What Are Disease-Modifying Antirheumatic Drugs?

DMARDs are medications used to treat RA.³ DMARDs target inflammation at its source, which can reduce RA symptoms and slow disease progression, helping to prevent irreversible joint damage.

The U.S. Food and Drug Administration (FDA) has approved several types of DMARDs to treat RA. These fall into three groups: conventional DMARDs, biologic DMARDs, and the newer targeted DMARDs. Conventional DMARDs dampen the immune system as a whole, while targeted and biologic DMARDs take aim at specific parts of the immune system associated with the inflammation process.

Biologic DMARDs — also known as biologics or biologic therapies — can be divided into groups based on the part of the immune system they target and how they work. They may block the inflammatory action of certain immune cells or interfere with inflammatory proteins known as cytokines. Biologic DMARDs include tumor necrosis factor-alpha (TNF-alpha) inhibitors.

Targeted DMARDs are treatments synthesized through chemical reactions that also work by targeting specific parts of the immune system. These include Janus kinase (JAK) inhibitors.

With many treatment options available, it can be difficult to know which will work best for you. Share your treatment goals with your doctor and ask questions. They can help you better understand the benefits and risks of each treatment.

Read more about shared decision-making and RA.

Medication for Symptom Management

Other types of drugs may be purchased over the counter or prescribed by health care providers to manage symptoms of RA. These drugs may help improve symptoms or quality of life, but they do not slow disease progression or prevent joint damage.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are common pain relievers often available over the counter.⁴

Corticosteroids are used to control pain and inflammation in RA as well.⁵ Corticosteroids work quickly to reduce inflammation, and they are often used during RA flares. However, their adverse effects can make them unsafe to use long term.⁵ Examples of corticosteroids include prednisone, prednisolone, and dexamethasone.

While these medications can be useful for managing some RA symptoms, they do not slow disease progression or prevent joint damage.

Benefits of Starting Effective RA Treatment Early

Starting effective RA treatment early, soon after RA is diagnosed, may mean you are more likely to have an improvement in disease activity and your RA symptoms, leading to remission.⁶ For example, several studies have found that achieving remission, little to no symptoms, is correlated with improvement in symptoms including morning stiffness,⁷ pain, fatigue, and physical function.⁸

The definition of early RA accepted by most researchers is receiving a diagnosis within six months of first noticing the symptoms — such as painful, swollen, and tender joints.⁹ Rheumatologists look for RA using X-rays to see damage in the joints, along with blood tests for certain disease markers.

After the diagnosis is confirmed, a conventional DMARD — like methotrexate — is commonly prescribed to treat early RA.⁹ Your rheumatologist may prescribe a combination of medications to help improve effectiveness and to manage your condition.

When you begin treatment for RA, it is important to work with your rheumatologist to set goals to help you manage your RA. Attend your follow-up appointments and be sure to let them know how you are feeling about treatment and how your RA is impacting your daily life. It is important to voice any concerns you may have and highlight the progress you are making in achieving your goals of therapy.

Making the Most of Your RA Treatment Plan

Once you and your rheumatologist have decided on a treatment plan, there are steps you can take to help make sure it is as effective as possible. Continue discussing your treatment goals with your rheumatologist. They can help you evaluate progress and overcome any challenges you may experience in sticking with treatment.

Getting the Support You Need

RA is known to have a psychological impact as well.¹⁰ Depression and anxiety are common in people with rheumatic diseases, between two and 10 times more likely compared to the general public, and they can negatively affect your health.¹¹ According to the Arthritis Foundation, mental health problems can even make your arthritis symptoms worse. Treating both your RA and any mental health conditions you may have can help you better manage your disease.

Support from family, friends, spiritual communities, and in-person or online support groups can help you feel less alone as you cope with RA. If depression or anxiety are interfering with your daily activities, talk to your doctor about treatment, which may include medication or psychotherapy.

Monitoring RA While Using DMARDs

Monitoring your symptoms and overall disease activity while taking DMARDs can give your rheumatologist important information on how well the treatment is working. They will watch for flares and any side effects you may experience from the medication. Regular X-ray images may also be taken to assess treatment effectiveness.¹²

Your doctor may also order routine blood tests.¹³ These tests can include white blood cell counts and assessments of kidney function, liver function, and lipids (blood fats) such as cholesterol.

Sticking With RA Treatments

Sticking with your RA treatment can be difficult at times, especially if costs become problematic or if you experience side effects. Collaborate with your health care provider to choose the best treatment plan for you, and be sure to report any side effects or other concerns to your doctor.

If you have trouble following your RA treatment plan, there are ways to overcome these challenges.

Read about four smart ways to stick to your RA treatment plan.

Talk With Others Who Understand

On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 170,000 members come together to ask questions, give advice, and share their stories with others who understand life with RA.

Are you struggling to stick to your RA treatment? Share your thoughts and experience in the comments below, or start a conversation by posting on myRAteam.