Rheumatoid Arthritis Treatment and Research

by National Institute on Aging

(Page 6 of 7)

Treatments for rheumatoid arthritis can help relieve your pain, reduce swelling, slow down or help prevent joint damage, increase your ability to function, and improve your sense of well-being.

Exercise, medication, and, in some cases, surgery are common treatments for rheumatoid arthritis.

People with rheumatoid arthritis need a good balance between rest and exercise; they should rest more when the disease is active and exercise more when it is not.

Reducing stress also is important. Doing relaxation exercises and taking part in support groups are two ways to help reduce stress. For more information on exercise classes, you may want to contact the Arthritis Foundation at 1-800-283-7800.

Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease.

DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids.

New types of drugs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra.

Early treatment with powerful drugs and drug combinations - including biological response modifiers and DMARDs - instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage.

In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Surgery may also improve a person's ability to perform daily activities. Joint replacement and tendon reconstruction are two types of surgery available to patients with severe joint damage.

Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits.

An overall nutritious diet with the right amount of calories, protein, and calcium is important. Some people need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis.

Scientists are making rapid progress in understanding the complexities of rheumatoid arthritis. They are learning more about how and why it develops and why some people have more severe symptoms than others.

New drugs called biologic response modifiers and combinations of drugs are under study. Research efforts are focused on developing drugs that can reduce inflammation and slow or stop the disease with few side effects.

Some evidence shows that infectious agents, such as viruses and bacteria, may trigger rheumatoid arthritis in people with an inherited tendency to develop the disease. Investigators are trying to identify the infectious agents and understand how they work. This knowledge could lead to new therapies.

Researchers are also exploring why so many more women than men develop rheumatoid arthritis. In the hope of finding clues, they are studying complex relationships between the hormonal, nervous, and immune systems in rheumatoid arthritis.

For example, they are exploring whether and how the normal changes in the levels of steroid hormones such as estrogen and testosterone during a person's lifetime may be related to the development, improvement, or flares of the disease. Scientists are also examining why rheumatoid arthritis often improves during pregnancy.

The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov.

Quiz

1. To manage the symptoms of rheumatoid arthritis, patients usually

A. eat special foods.
B. take medications.
C. exercise daily, regardless of symptoms.

B is the correct answer. Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain. Others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. Early treatment with DMARDs and drug combinations instead of single drugs may help stop the disease from progressing and reduce or prevent joint damage.

2. People who have rheumatoid arthritis should

A. strike a good balance between rest and exercise.
B. never exercise.
C. exercise three to four times per day at a minimum.

A is the correct answer. People with rheumatoid arthritis can benefit from exercise, but they need to maintain a good balance between rest and exercise. They should get rest when the disease is active and get more exercise when it is not.

3. For some people with rheumatoid arthritis, surgery

A. is never recommended.
B. may improve joint function and reduce pain.
C. is the most common treatment.

B is the correct answer. In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Surgery may also improve a person's ability to perform daily activities. Joint replacement and tendon reconstruction are two types of surgery available to patients with severe joint damage.

4. One approach to treatment that may reduce or help prevent the progression of rheumatoid arthritis is

A. applying heat to various areas of the body.
B. doing relaxation exercises.
C. taking disease-modifying anti-rheumatic drugs or DMARDs, and combinations of drugs.

C is the correct answer. Early treatment with disease-modifying anti-rheumatic drugs or DMARDs, and drug combinations instead of single drugs may help stop the disease from progressing and reduce or prevent joint damage. For example, combinations of DMARDs such as methotrexate, sulfasalazine, leflumonide, and cyclosporine are one common approach to accomplishing these goals. However, it is important to remember that the treatment approach varies for each individual patient and depends upon the severity of the disease.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.