“Treatment of RA is very individual,” says Eric M. Ruderman, MD, professor of medicine in the rheumatology division at Northwestern University’s Feinberg School of Medicine in Chicago. The best approach? Don’t get swayed by misinformation about this disease. Work closely with your doctor to get the facts and understand your own situation. Here’s the truth behind common misconceptions about RA treatment.
- Myth: You can’t effectively treat RA symptoms. “RA symptoms are completely treatable,” says Dr. Ruderman. Available treatments, such as disease-modifying anti-rheumatic drugs (DMARDs), biologics, and janus kinase (JAK) inhibitors for RA, have changed the treatment landscape. Whether over-the-counter or prescription, there’s usually a medication that can help reduce swelling and ease joint pain. It’s important to talk to your doctor about how you’re doing so you can discuss a treatment plan that addresses your individual symptoms.
- Myth: Treating RA is the same as treating other forms of arthritis. There are more than 100 types of arthritis and related conditions, according to the Arthritis Foundation. The most common types of arthritis are RA, osteoarthritis, psoriatic arthritis, and gout. Some treatments overlap and some are different — it all depends on the type of arthritis, says Ruderman. Treatments for inflammatory arthritis such as RA or psoriatic arthritis can be similar, he explains.
- Myth: It’s safe to take corticosteroids indefinitely for RA. When you take corticosteroids such as prednisone over long periods of time, you can develop serious side effects. A review of studies published in April 2019 in Rheumatology notes that risks include bone loss, infections, and high blood pressure. But in some people, the benefits of taking low-dose corticosteroids outweigh the risks, Ruderman says. Your doctor can help make this call, but be sure to always share information on how you feel when taking corticosteroids for extended periods of time.
- Myth: Biologic drugs and JAK inhibitors are only for people with severe RA. Typically, these medications are recommended when traditional DMARDs aren’t effective. “And this can occur in people who don’t have a severe form of RA,” says Dalit Ashany, MD, assistant professor of medicine at Weill Cornell Medical College and a rheumatologist at the Hospital for Special Surgery in New York City.
- Myth: RA medications start working right away. In truth, they usually don’t, Ruderman says. Timing depends in part on the type of medication you’re taking. For DMARDs, you might not know about effectiveness for several months or longer. With biologic medications, it typically takes four to six weeks to experience any benefits. JAK inhibitors tend to work more quickly — improvements can be seen in as little as a few days to two weeks, though it can take up to 12 weeks or even six months to achieve the full effects.
- Myth: Once you’re feeling better, you can stop treatment. When you get your RA under control, you may be tempted to stop taking your medication. But stopping treatment can have serious long-term consequences for your condition, says Sharon L. Kolasinski, MD, professor of clinical medicine and director of rheumatology at the Penn Musculoskeletal Center in Philadelphia. One risk is that the medications may not work as well when restarted. “Over time, you may be able to reduce your medications, but this should be done in a very gradual and stepwise manner, under the guidance of your doctor,” says Dr. Kolasinski.
- Myth: RA can be cured. “A cure implies that you treat it and it goes away,” Ruderman says. “We’re not there yet with RA.” Still, you can work with your doctor to develop a treatment plan that helps relieve your symptoms and slow the progression of the disease. It can take time to find the right combination of treatments, but you should be able to find an RA treatment plan that helps you achieve and maintain remission, he says. “Once joint damage occurs, disability becomes inevitable,” explains Ruderman. “Our job is to catch RA early and control the disease so permanent damage never sets in.”