… and why “feeling better” isn’t a good reason to skip your meds.
Rheumatoid arthritis, or RA, can’t be cured, but it can be managed through medication and lifestyle changes. Since symptom improvement may be gradual or ebb and flow, it might be hard to gauge whether you’re on the right regimen.
“The goal with rheumatoid arthritis therapy is to induce a complete remission,” says Ashira Blazer, MD, a rheumatologist at NYU Langone Medical Center. “That means normalizing the inflammatory markers [and] reduce the number of tender and swollen joints.”
Patients may benefit from one of several types of prescription medications for RA. “Any given drug is likely to give about 30 to 40 percent of patients complete remission,” says Dr. Blazer. With all the different options, most patients are able to achieve remission with at least one type of drug.
If your medication is working, you and your doctor should notice some improvements, such as:
Less pain or disability during everyday activities
A reduction in RA symptoms
Less swollen joints
A decrease in inflammatory markers in the blood
The Importance of RA Treatment Adherence
“Compliance is a huge problem in all autoimmune diseases, especially rheumatoid arthritis,” says Dr. Blazer. “That’s because the disease naturally ebbs and flows.” Here are habits that can make RA flares worse.
It’s tempting to become less dedicated to your treatment regimen when things are going well—when there’s no pain motivating you to take your medicine and get a good walk in. “Many feel that they may be cured [and] they stop taking their medications,” says Dr. Blazer. “This is a really big mistake.”
A 2015 study in the Journal of Rheumatology found that as many as 40 percent of patients did not adhere to taking their medication as prescribed. Although reasons for skipping treatment varied by person, some common responses were perceived side effects and doubting the necessity of the medication.
Treating RA requires consistency. Not only can lapsing on your treatment regimen cause RA flares, but there can also be increased inflammation in your body (even if you don’t feel it).
If you’re thinking extra inflammation just means more pain later on, think again: Inflammation in the body can increase your risk of other diseases. In fact, having RA doubles the risk of many heart issues—including heart attack and stroke—according to the Arthritis Foundation. That’s partly because inflammation damages the lining of the blood vessels, which causes plaque to build up.
“It’s much easier to control a disease than it is to have a flare and bring it back,” says Dr. Blazer. “It’s very important to continue on the medications even if you feel well.”
Those who adhere to RA treatment are less likely to experience more serious complications, disabilities, and illnesses in the future. By maintaining your treatment regimen now, you can enjoy a more comfortable and independent life for years to come.
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The goal with rheumatoid arthritis therapy
is to induce a complete remission.
00:00:07,107 --> 00:00:11,027
So that means normalize
the inflammatory markers and
00:00:11,027 --> 00:00:15,130
also reduce the number of tender,
and swollen joints.
00:00:15,130 --> 00:00:19,007
00:00:19,007 --> 00:00:24,922
Any given drug is likely to give about 30
to 40% of patients a complete remission.
00:00:24,922 --> 00:00:27,747
That said, because we have so
many drug options.
00:00:27,747 --> 00:00:32,547
We tend to be able to induce remission
in the majority of patients.
00:00:32,547 --> 00:00:36,917
Patients who are taking medications
tend to feel much better.
00:00:36,917 --> 00:00:40,798
They tend to be able to perform
their activities of daily living and
00:00:40,798 --> 00:00:42,752
that's what we really look for.
00:00:42,752 --> 00:00:47,160
When they come in to see us, usually
once every three months, we look for
00:00:47,160 --> 00:00:49,330
swollen joints, tender joints and
00:00:49,330 --> 00:00:54,200
the number of joints that are in fault and
then we look for blood tests.
00:00:54,200 --> 00:00:57,082
The inflammatory markers
in the blood can come and
00:00:57,082 --> 00:01:01,618
go with rheumatoid arthritis treatment,
and we try to follow that over time.
00:01:01,618 --> 00:01:05,791
Compliance is a huge problem in all
autoimmune diseases, especially rheumatoid
00:01:05,791 --> 00:01:09,364
arthritis and that's because
the disease naturally ebbs and flows.
00:01:09,364 --> 00:01:13,934
You naturally have some flares and
periods of decreased activity, and
00:01:13,934 --> 00:01:16,303
no one wants to feel like their sick.
00:01:16,303 --> 00:01:20,787
So many people feel that they may be cured
or maybe it will never come back and
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they stop taking their medications.
00:01:23,073 --> 00:01:25,078
This is actually a really big mistake.
00:01:25,078 --> 00:01:28,372
First, because sometimes there's
inflammation that's on going that you
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don't know about.
00:01:29,254 --> 00:01:31,107
But it's damaging your joints or
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it's making you more likely to
develop cardiovascular disease.
00:01:34,823 --> 00:01:40,678
Also, it's much easier to control
disease than it is to have a flare and
00:01:40,678 --> 00:01:42,348
then bring it back.
00:01:42,348 --> 00:01:47,579
So it's very important to continue on
the medications even if you feel well.
00:01:47,579 --> 00:01:50,585
I had a patient whose grandmother and
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she looked to taking her
grandson to the water park.
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And because her rheumatoid
arthritis was so bad,
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she wasn't able to play with him and
do the things with him she wanted to do.
00:02:00,487 --> 00:02:05,080
And because we're able to treat her,
she came in with stories of taking him to
00:02:05,080 --> 00:02:09,194
water park and pictures and
that really brought joy back to her life.
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Many of the women with rheumatoid
arthritis are older and not having
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the ability to use their joints means
that they might lose their independence.
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So being able to treat them appropriately
means that they have normal,
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00:02:23,794 --> 00:02:27,434
How RA inflammation affects your heart. Arthritis Foundation. (Accessed on June 26, 2018 at https://www.arthritis.org/living-with-arthritis/comorbidities/heart-disease/ra-and-your-heart.php.)
Rheumatoid arthritis treatment. Arthritis Foundation. (Accessed on June 26, 2018 at https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/treatment.php.)
Salt E, Frazier SK. Adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a narrative review of the literature.
Van den Bemt BJ, van den Hoogen FH, Benraad B, Hekster YA, van Riel PL, van Lankveld W. Adherence rates and associations with nonadherence in patients with rheumatoid arthritis using disease modifying antirheumatic drugs. J Rheumatol. 2009 Oct;36(10):2164-70.