The effective treatment of rheumatoid arthritis includes medications that slow the progression of joint damage and deformity. These drugs are called disease-modifying anti-rheumatic drugs (DMARDs), and they are a vital part of an overall treatment plan.

Doctors prescribe DMARDs for people with inflammatory arthritis who are at risk of permanent joint damage. Each DMARD works in different ways to slow or stop the inflammatory process that can damage the joints and internal organs.

DMARDs can improve quality of life for most people. Some even achieve a remission while taking them. Most of the time, the disease activity continues, but at a slower pace. While taking one or more DMARDs, there may be longer symptom-free periods, or less painful flare-ups. Taking a DMARD regularly makes it less likely to have long-term damage to joints, too.

There can be side-effects. The Food and Drug Administration (FDA) has approved all DMARDs, and many people take them without ever having problems. But because they work throughout the body to fight rheumatoid arthritis, their powerful action typically does cause some side effects, such as:

• Stomach upset. Other medicines can help treat these symptoms, or they can improve as your body adjusts to the drug. If the symptoms are too uncomfortable, your rheumatologist will try a different medication.
• Liver problems. Less common than stomach upset, you may need blood tests on a regular basis to make sure your liver is not being harmed.
• Blood issues. DMARDs can affect the immune system and raise the risk of infection. Infection-fighting white blood cells may also be decreased. Low red blood cells (anemia) can make you tired more easily. An occasional blood test will make sure your blood counts are high enough.

Though DMARDs can have side-effects, there is a good reason to take them: They usually work. Even if you are in a remission, many rheumatologists believe you should continue taking a DMARD, just to keep your rheumatoid arthritis at bay.

DMARDs are often prescribed together or with a biologic. This is called combination therapy. Biologic drugs are the newest type of treatment for rheumatoid arthritis, but it’s important to understand the differences between treating rheumatoid arthritis with these newer medications compared to traditional DMARDs:

• Drug target. DMARDs target the entire immune system, while biologics work by targeting specific steps in the inflammatory process.
• Response time. It can take months before you’ll know whether a DMARD is working for you. With biologics, you’re likely to experience results within four to six weeks, after just a few treatments. In the meantime, your doctor may also prescribe a nonsteroidal anti-inflammatory drug or a steroid medication to help relieve pain and swelling.
•  Risks. Both DMARDs and biologics can increase your risk for infections, so tell your doctor if you experience a fever, chills, or cold symptoms. Serious infections, such as pneumonia, are the biggest risk of taking a biologic.
• Cost. Biologics are much more expensive than traditional DMARDs. If you need help paying for your rheumatoid arthritis treatment, you may be able to apply for assistance through your specific medication’s manufacturing company.

Both traditional DMARDs and newer biologics are changing the way doctors treat rheumatoid arthritis. Today, there are actually better treatment options for rheumatoid arthritis, and earlier treatment is best. That’s because once joint damage has occurred, it can’t be undone.

Source: Comfort Keepers, whose services include assisting seniors living independently at home. Comfort Keepers has a location in Federal Way.