Rheumatoid Arthritis Treatment

When treating Rheumatoid Arthritis (RA) it varies from person to person.  Some people don’t have very aggressive RA and they are able to just take anti-inflammatory and pain medication such as ibuprofen or aspirin.  Others need “second line drugs” as well as the anti-inflammatory medications, possibly even a couple second line drugs along with anti-inflammatory drugs.  The second line drugs suppress the immune system since that is what causes RA.  Your immune system is attacking your own body tissue especially in joints causing the inflammation and pain.  When these two types of drugs aren’t effective for some people, doctors then will use biologic medications, which are a new class of drug.

Biologic medications, such as Etanercept, infliximab, and adalimumab, intercept a protein in the joints that causes inflammation before it can act on its natural receptor and cause inflammation.  Symptoms can be significantly and quickly improved while using these drugs.  Etanercept is injected once or twice a week, infliximab is given intravenously, and adalimumab is injected every other week or weekly.  Research has shown biologic medications to also prevent the progressive joint destruction from rheumatoid arthritis.  They are often used when second line medications aren’t effective, but are often used in combination with methotrexate which is a second line drug.  These biologic medications are rather expensive.

Aside from biologic medications, there is also the Prosorba column therapy, which is not commonly used.  The Prosorba column therapy involves pumping blood from a vein in the arm into a cell separator (apheresis machine).  The liquid part of the blood (plasma) is then separated from the blood cells.  The Prosorba column is a plastic cylinder that contains a sand-like substance coated with Protein A.  Protein A binds unwanted antibodies from the blood that promotes the arthritis.  Prosorba column counters the effects of these harmful antibodies and reduces the symptoms of moderate to severe RA in adult patients who found other medications to be ineffective.

Exercise is a great way to improve joint mobility and strengthen the muscles around the joint.  Swimming is very helpful because there isn’t a lot of stress on the joints while you are exercising.  Physical therapists are trained to provide proper exercise instructions and offer splinting supports.  Wrist and finger splints can be helpful in reducing inflammation and maintaining joint alignment. Canes, jar grippers, and toilet seat raisers can make daily life easier.  Physical therapists would also teach you to use hot or cold applications to assist with exercise. 

Surgery can restore joint mobility or repair joint damage.  Arthroscopy is a procedure where a surgeon uses a tube-like instrument to see and repair joint tissues.  Partial or complete joint replacement is another option.  Total joint replacements replace a destroyed joint with artificial materials.  Small joints are usually replaced with plastic material and larger joints like hip and knees are replaced with metal.  All of these treatments depends on the severity of the disease for each person and is up to a doctor to recommend which one is best for you.