Treatment of Rheumatoid Arthritis

Rheumatoid arthritis is a disease with unknown cause, at least until the time of this writing, hence there is no definitive, once and for all, treatment available today. This is an inflammatory disease with swollen, stiff, and painful joints as its main symptoms, which leads to impairment of movements and  deformities of the joints. This handicap will eventually affect the person both mentally and physically.

Educating the patient is the most important thing a doctor should do the first time a patient is diagnosed as having rheumatoid arthritis. Any patient should have a clear understanding of what is going on in her/his body, what would be expect to happen in the future, and what kind of change should she/he do now to anticipate it, this including kind of things that she/he might not be able to change. All this knowledge should be made available to the patient in such a way that it will give them a positive attitude toward their condition. Instead of feeling sad and worry about their future, the patient should be encouraged to do something about it and control it. Education should also include the types of proper  exercises, proper rest, and kind of diet that she/he would have to watch.

Treatment of rheumatoid arthritis is a race against time. It should be started as soon as the patient is diagnosed as having rheumatoid arthritis. The patient and the doctor should closely cooperate to have common terms and targets. More delay will eventually lead to more probability of joint damage. In other words, time is joint.

Non-steroidal anti-inflammatory drugs (NSAIDs) is a group of drugs which usually become the first drug that a doctor would prescribe to any patient with arthritic pain. These are the painkillers as we all know, but their main mode of action is as anti-inflammation. Aspirin is the most popular example, while coxibs is a group of more recently found NSAIDs. As painkiller, these drugs are of great help in acute conditions, but they do not have many impact on long time progress of the disease.

Glucocorticoids  are also used to reduce inflammation. These drugs is usually used as a single drug or  in combination with other group of drugs which called disease modifying anti-rheumatic drugs (DMARDs). This later group play an important role in modern treatment of rheumatoid arthritis.

The long known traditional DMARDs are hydroxychloroquin, methotrexate, sulfasalazin and the more recent leflunomide. Modern DMARDs are usually referred to as biological DMARDs which include drugs such as rituximab, adalimumab, etanercept, abatacept, and infliximab. These drugs help in reducing the long time impact of rheumatoid arthritis such as disability and joint damage, but due to their side effects they should be administered under close observation. The patient should be well informed concerning the expected result.