AllRefer Health - Caring for your Well Being

Home | About | FAQs | Contact Us

AllRefer Channels :: Yellow Pages | Reference | Health  

Diseases & Conditions
Select & Go
 Diet & Nutrition
 Diseases & Conditions 
 Injuries & Wounds
 Poisons & Overdoses
 Surgery & Procedures 
 Symptoms Guide
 Special Topics
 Tests & Exams
 Pictures & Images
 Medical Encyclopedia

You are here : AllRefer.com > Health > Diseases & Conditions > Rheumatoid arthritis : Treatment & Expectations

Rheumatoid arthritis

Alternate Names : RA, Arthritis - rheumatoid

Treatment

RA usually requires lifelong treatment, including medications, physical therapy, exercise, education, and possibly surgery. Early, aggressive treatment for RA can delay joint destruction.

MEDICATIONS

Disease modifying antirheumatic drugs (DMARDs): These drugs are the current standard of care for RA, in addition to rest, strengthening exercises, and anti-inflammatory drugs.

  • Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis. Leflunomide (Arava) may be substituted for methotrexate.
  • These drugs may have serious side effects, so you will need frequent blood tests when taking them.

Anti-inflammatory medications: These include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

  • Although NSAIDs work well, long-term use can cause stomach problems, such as ulcers and bleeding, and possible heart problems.
  • Celecoxib (Celebrex) is another anti-inflammatory drug, but it is labeled with strong warnings about heart disease and stroke. Talk to your doctor about whether COX-2 inhibitors are right for you.

Antimalarial medications: This group of medicines includes hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine), and is usually used along with methotrexate. It may be weeks or months before you see any benefit from these medications.

Corticosteroids: These medications work very well to reduce joint swelling and inflammation. Because of long-term side effects, corticosteroids should be taken only for a short time and in low doses when possible.

BIOLOGIC AGENTS:

Biologic drugs are designed to affect parts of the immune system that play a role in the disease process of rheumatoid arthritis.

They may be given when other medicines for rheumatoid arthritis have not worked. At times, your doctor will start biologic drugs sooner, along with other rheumatoid arthritis drugs.

Most of them are given either under the skin (subcutaneously) or into a vein (intravenously). There are different types of biologic agents:

  • White blood cell modulators include: abatacept (Orencia) and rituximab (Rituxan)
  • Tumor necrosis factor (TNF) inhibitors include: adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade), golimumab (Simponi), and certolizumab (Cimzia)
  • Interleukin-6 (IL-6) inhibitors: tocilizumab (Actemra)

Biologic agents can be very helpful in treating rheumatoid arthritis. However, people taking these drugs must be watched very closely because of serious risk factors:

SURGERY

Occasionally, surgery is needed to correct severely affected joints. Surgeries can relieve joint pain and deformities.

The first surgical treatment may be a synovectomy, which is the removal of the joint lining (synovium).

At some point, total joint replacement is needed. In extreme cases, total knee, hip replacement, ankle replacement, shoulder replacement, and others may be done. These surgeries can mean the difference between being totally dependent on others and having an independent life at home.

PHYSICAL THERAPY

Range-of-motion exercises and exercise programs prescribed by a physical therapist can delay the loss of joint function.

Joint protection techniques, heat and cold treatments, and splints or orthotic devices to support and align joints may be very helpful.

Sometimes therapists will use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint mobility.

Occupational therapists can create splints for the hand and wrist, and teach how to best protect and use joints when they are affected by arthritis. They also show people how to better cope with day-to-day tasks at work and at home, despite limitations caused by RA.

Frequent rest periods between activities, as well as 8 to 10 hours of sleep per night, are recommended.

Support Groups

For additional information and resources, see arthritis support group.

Prognosis (Expectations)

The course of rheumatoid arthritis differs from person to person. For some patients, the disease becomes less aggressive over time and symptoms may improve.

Other people develop a more severe form of the disease.

People with rheumatoid factor, the anti-CCP antibody, or subcutaneous nodules seem to have a more severe form of the disease. People who develop RA at younger ages also seem to get worse more quickly.

Treatment for rheumatoid arthritis has improved. Many people with RA work full-time. However, after many years, about 10% of those with RA are severely disabled, and unable to do simple daily living tasks such as washing, dressing, and eating.

Complications

Rheumatoid arthritis is not only a disease of joint destruction. It can involve almost all organs.

Problems that may occur include:

  • Anemia due to failure of the bone marrow to produce enough new red blood cells
  • Damage to the lung tissue (rheumatoid lung)
  • Injury to the spinal cord when the cervical spine (neck bones) becomes unstable as a result of RA
  • Rheumatoid vasculitis (inflammation of the blood vessels), which can lead to skin ulcers and infections, bleeding stomach ulcers, and nerve problems that cause pain, numbness, or tingling. Vasculitis may also affect the brain, nerves, and heart, which can cause stroke, heart attack, or heart failure.
  • Swelling and inflammation of the outer lining of the heart (pericarditis) and of the heart muscle (myocarditis). Both of these conditions can lead to congestive heart failure.
  • Sjogren syndrome

The treatments for RA can also cause serious side effects. If you experience any side effects, immediately tell your health care provider.

Calling Your Health Care Provider

Call your health care provider if you think you have symptoms of rheumatoid arthritis.




Previous
Symptoms, Diagnosis & Tests

Quick Jump
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11

Next
Prevention

Jump To Another Page

Review Date : 2/7/2010
Reviewed By : Mark James Borigini, Associate Clinical Professor of Medicine, University of California, Irvine, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Main Page of Rheumatoid arthritis



    Featured Topics    

Allergies

Breast Cancer

Depression

Diabetes

High Blood Pressure

Weight Management

ADAM

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

This website is certified by Health On the Net Foundation. Click to verify.
This site complies to the HONcode standard for trustworthy health information: verify here.
Copyright © 2011 AllRefer.com All Rights reserved.
Health Topics: 0-9 A-AID Air-Aor Aor-Azo B-Blo Blo-Bys C-Cha Cha-Col Col-CSF CSF-Cyt D-Dis Dis-Dys E-Ess Est-Eye F-FSP FTA-Fus G H-Her Her-Hys I-Iod Ion-Ivy J K L-Luc Lud-Lym M-Min Min-Myx N O P-Pes Pes-Pre Pre-Pyr Q R-Rig Rig-RVA s-SID SID-Spu Spu-Sys T-Too Too-Typ U V W X Y Z
About Us | Help | Privacy Policy | Editorial Policy | Advertising Policy | Accessibility | Terms of Use
Contact Us | Link to Us | User Satisfaction Survey | Healthopedia.com
Page Last Updated: 26 May, 2012