Rheumatoid arthritis - Treatments

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Rheumatoid arthritis makes your joints swollen and painful. It often starts with the joints in your fingers feeling stiff. It is an unpredictable disease, and it's hard to say how it will affect you. For most people, the symptoms come and go. In others, they get slowly worse.

But there are treatments that can reduce the swelling, pain and joint damage caused by rheumatoid arthritis. These treatments can help you to keep doing the things you normally would.[1]

Key points about treating rheumatoid arthritis

  • Drugs can prevent your joints from wearing down and help to ease your pain and swelling. These are called disease-modifying anti-rheumatic drugs (or DMARDs for short).
  • If you start taking these drugs early on, they may slow your disease and stop your joints from wearing down. But you may need to take them for many years.
  • Many of these drugs have side effects that stop some people from taking them.
  • Low doses of steroid tablets can also help to reduce swelling and prevent your joints from wearing down.
  • Your doctor may give you other drugs called nonsteroidal anti-inflammatory drugs (NSAIDs for short). These drugs also help to control the pain and swelling of rheumatoid arthritis. To read more about them, see Nonsteroidal anti-inflammatory drugs.
  • Some people find that changing what they eat and exercising helps their arthritis. To learn more, see Diet and exercise in rheumatoid arthritis.

Treatments for rheumatoid arthritis

Which treatments work best? We've carefully weighed up the research and divided these treatments into the following categories. All of these drugs are used to help ease the pain and swelling of rheumatoid arthritis. Some can also help stop your joints from wearing down.

You can find out more about each treatment by clicking on the links below.

For help in deciding which treatment is best for you, see .

Treatments that work

  • Antimalarials: These drugs are usually used to treat malaria. But they can help for rheumatoid arthritis. Hydroxychloroquine (brand name Plaquenil) is a common antimalarial. More...
  • Steroid tablets: The most common steroid used in rheumatoid arthritis is prednisolone. More...
  • Methotrexate: The brand name for this drug is Maxtrex. More...
  • Minocycline: This is an antibiotic that is sometimes used to treat rheumatoid arthritis. A common brand name is Minocin. More...
  • Sulfasalazine: The brand names for this drug are Sulazine and Salazopyrin. More...

Treatments that are likely to work

  • Leflunomide: The brand name for this drug is Arava. More...
  • Oral gold (auranofin): This is a form of gold that you swallow as a tablet. The brand name is Ridaura. More...
  • Anti-TNF drugs: These drugs slow down the damage to your joints by affecting the way your immune system works. Drugs that do this are sometimes called biologic drugs. The most common ones are etanercept (brand name Enbrel) and infliximab (brand name Remicade). More...

Treatments that work, but whose harms may outweigh benefits

Other treatments

  • Rituximab: This drug is usually used to treat people with cancer. But it's also given to some people with rheumatoid arthritis who haven't been helped by other drugs. It slows down the damage to your joints by affecting the way your immune system works. Drugs that do this are sometimes called biologic drugs. More...
  • Abatacept: This drug can be used to treat people who haven't been helped by other treatments. Its brand name is Orencia. It slows the damage to your joints by affecting the way your immune system works. Drugs that do this are sometimes called biologic drugs. More...

Treatment decisions

There has also been lots of research on when you should start and stop taking these drugs and what combinations of drugs work best. We have divided the information about this into the following categories.

Treatments that work

  • Starting treatment early: People who start drug treatments early have less swollen and less painful joints than those who start treatment later on. More...

Treatments that are likely to work

  • Continuing treatment for a long time: People who are able to take drugs for a long time have less swollen and less painful joints than those people who take them for a short time. More...
  • Taking two or more drugs: Research shows that taking more than one drug for rheumatoid arthritis is sometimes better than using just one drug. But the side effects of drugs may stop you from taking certain combinations. More...

References

  1. Hamilton J, McInnes IB, Thomson EA, et al. Comparative study of intramuscular gold and methotrexate in a rheumatoid arthritis population from a socially deprived area. Annals of the Rheumatic Diseases. 2001; 60: 566-572.

Glossary

immune system
The immune system is made up of the parts of the body that fight infection. The body is constantly being threatened by infections from things like bacteria, viruses and parasites. The immune system fights these infections in different ways. At the microscopic level, the immune system uses antibodies and white blood cells, which travel in the blood and target infectious agents, such as bacteria. These microscopic parts of the immune system either kill the infectious agent directly, or take it to other parts of the body, like the spleen, where it can be dealt with. The lymph nodes are another important part of the immune system. Within them, white blood cells filter through the foreign material that has entered the blood, to see if there are any infections. When you have a swollen gland during a cold, this is actually a lymph node that is reacting to the infection. Unfortunately, it is possible for the immune system to become confused and to attack healthy parts of the body. Diseases that result from this type of situation are called autoimmune diseases.
antibiotics
These medicines are used to help the fight infection. There are a number of different types of antibiotics that work in different ways to get rid of bacteria, parasites and other infectious agents. Antibiotics do not work against viruses.

© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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