How do we Treat Rheumatoid Arthritis?
If you have been given the diagnosis of rheumatoid arthritis, do not panic! We have gained a huge understanding of this disease and developed very effective medications over the last decade.
The goal of treatment is to suppress the disease to prevent joint damage. It is extremely important that it is diagnosed early before the joints are damaged permanently. Clinical evidence suggests early aggressive treatment results in a higher chance of achieving remission. Your rheumatologist may use the term ‘window of opportunity’ which is usually defined as the first 6 months after the diagnosis.
There are two groups of medications commonly used to treat rheumatoid arthritis.
- Anti-inflammatory medication and corticosteroids are effective in controlling the symptoms but they do not prevent joint destruction. They work rapidly and most patients experience improvement within a few days. They are gradually tapered once the symptoms improve.
- Diseases modifying anti-rheumatic drugs (DMARD) are medications, which work on the deranged immune pathway. These medications include methotrexate, sulphasalazine, hydroxychloroquine, leflunomide, azathioprine and cyclosporin. They have different side effect profiles and all must be monitored very closely. Only 30-50% of patients have adequate disease control with one agent and the majority of patients require combination treatment, and some patients require a biological DMARD (bDMARD).
Biological DMARDs (Humira, Enbrel, Remicade, Simponi, Cimzia, Orencia, Actemra and Mabthera) are more powerful immunosuppressants and are given as either subcutaneous injections or regular infusions into the vein. These medications have revolutionised the treatment of rheumatoid arthritis over the last decade. Patients who previously had aggressive disease, who did not have adequate control even with triple or quadruple combination therapy can often achieve significant improvement with this family of medication. Medicare Australia subsidises treatment if your disease is not well controlled after six months’ of combination therapy.
Most patients with rheumatoid arthritis require long-term treatment and it is essential to have regular blood tests to monitor treatment response and treatment toxicity. Your rheumatologist will advise you the appropriate monitoring protocol.
Patients with rheumatoid arthritis have a higher risk of osteoporosis and cardiovascular disease. It is extremely important to address these issues at the same time. Your rheumatologist will work with your general practitioner to facilitate investigations including bone mineral density, blood tests for cholesterol, triglycerides and blood sugar. If you have hypertension and/or diabetes, it is crucial that these are optimally controlled.
Lastly, there is solid evidence that smoking increases the severity of rheumatoid arthritis, accelerates bone loss resulting in osteoporosis and exponentially increases the risk of heart attacks and strokes. Smoking cessation is as important as DMARDs and should be an integral part of rheumatoid arthritis treatment.
Get the help you deserve - talk to our friendly team today! 1300 252 698
Our Latest Articles
Like most rheumatologists, the doctors at BJC ....
Ketosis, bulletproof coffees, keto flu, fat ....
Now one thing I have found as an Exercise ....
-
What is chair yoga and is it for me?
By Rhianne Kerr on June 8, 2020
Now one thing I have found as an Exercise Physiologist and Yoga Teacher, is that a traditional yoga practice is not necessarily for everyone. It can ...
BJC Health and Fitness -
Struggling with fatigue?
By Sarah Comensoli on May 19, 2020
We've had a number of clients reach out to us in the last few weeks expressing that it's more difficult at the moment to get a good handle on their ...
BJC Health and Fitness -
Restricting medical care to traditional in-clinic consultation is so 20th century!
By Dr Irwin Lim on May 17, 2020
Like most rheumatologists, the doctors at BJC Health have fixed session times at various clinics where we consult. We typically start at 0800 and end ...
BJC Connected Care -
Feeling more aches and pains?
By Sarah Comensoli on May 10, 2020
We totally appreciate at the moment that some of our clients are experiencing more aches and pains than they’re usually accustomed to, and we get it. ...
BJC Health and Fitness -
How our Rheumatology service might look after 6 months of the Covid-19 pandemic
By Dr Irwin Lim on April 20, 2020
On the 5th March, our team of BJC Health leaders met in my living room to discuss our plans for the next 10 years. The planning phase had commenced 4 ...
BJC Connected Care -
Emergency Rheumatology Service for those who can't attend hospital clinics during COVID-19 pandemic
By Dr Irwin Lim on April 14, 2020
Thank you for the kind words and support you’ve provided BJC Health on social media. Our multidisciplinary team is working hard to engage and develop ...
BJC Connected Care -
How Covid-19 sped up Rheumatology Telehealth delivery
By Dr Irwin Lim on April 7, 2020
It’s been a really challenging time for us at BJC Health as I am sure it has been for all of you. If one good thing has come out of the COVID-19 ...
BJC Connected Care -
Asked to see a Physio for a Metrology Assessment? Here's what to expect.
By Dominic Fitzgerald on March 11, 2020
If you have recently been diagnosed with Ankylosing Spondylitis (AS) or a Spondyloarthropathy (SpA), some Rheumatologists might look to refer you to ...
BJC Health and Fitness -
Living with a chronic disease is like living in a cell
By Sarah Comensoli on March 1, 2020
Those words came directly from a client who has recently started working with our allied health team here at the clinic. No-one has ever explained ...
BJC Health and Fitness -
Chewing the fat. Is the keto diet the way to go?
By Stephanie Hage on January 27, 2020
Ketosis, bulletproof coffees, keto flu, fat bombs… all buzzwords that you might hear related to the ketogenic (keto) diet. But what exactly is the ...
BJC Diet and Nutrition -
Game changers: is a plant-based diet the key to good health?
By Stephanie Hage on December 19, 2019
Game Changers - it’s the documentary that everyone is talking about. It seems as though one day I woke up, opened my Instagram account and found ...
BJC Diet and Nutrition -
The Portfolio Diet...Does it help with inflammation?
By Stephanie Hage on October 23, 2019
As a dietitian, the word “diet” is probably my least favourite word. I appreciate that for many, this single word can bring up past memories of ...
BJC Diet and Nutrition -
Diet Mythbusters!
By Stephanie Hage on September 19, 2019
The internet can be both your best friend and worst enemy when it comes to finding information about food. If you have a rheumatic disease such as ...
BJC Diet and Nutrition -
Are you realllyy eating well?
By Stephanie Hage on August 23, 2019
What does eating well mean to you? It could be: Keeping your blood test results in check Eating adequate serves of food from each of the food groups ...
BJC Diet and Nutrition -
Introducing Rheumatology Republic - Join our community!
By Dr Irwin Lim on March 5, 2019
I’m sorry that I’ve been missing from this blog. I was galvanized to start blogging in late 2010 to try and rectify community attitudes to ...
BJC Connected Care
BJC Parramatta
Level 1, 17-21 Hunter Street,
Parramatta NSW 2150
Tel: +61 2 9890 7633
Fax: 02 98907655
BJC Chatswood
Ground floor, 7 Help Street,
Chatswood NSW 2067
Tel: +61 2 9413 2979
Fax: 02 9413 3316
BJC Bondi Junction
Suite 105, Level 1, 332-342 Oxford Street,
Bondi Junction NSW 2022
Tel: +61 2 9055 1790
Fax: 02 9169 3497