Last updated: Dec 13, 2010
"I can deal with bouts of pain, but the fact that it's chronic and never going away, that's the hardest thing to deal with," says Angela Lundberg, 32, who was diagnosed at 18.
How treatment helps
Even though there are many different kinds of RA medication, the mainstay of treatment is the disease-modifying antirheumatic drug, or DMARD. (Other important classes of drugs for RA are inflammation-fighting corticosteroids, like prednisone, and nonsteroidal anti-inflammatory meds, or NSAIDs.)
"Each one of the drugs used to treat rheumatoid arthritis has its own unique set of side effects, some of them mild. But most of the drugs that are the most effective have potentially serious side effects," says Bruce Baethge, MD, a professor of internal medicine at Texas A&M Health Science Center College of Medicine in College Station and a rheumatologist with Scott & White in Temple. "Fortunately, they only occur in a small percentage of people, but that doesn't mean it can't happen."
More about rheumatoid arthritis
Dr. Ritchlin tells the story of one patient who had severe psoriatic arthritis, a cousin of rheumatoid arthritis. "His arthritis was flaring like crazy. He could barely walk," he recalls. But when asked how often he was taking Enbrel, the man told Dr. Ritchlin that it was only once every four months, rather than twice a week as recommended, because he was afraid of getting lymphoma.
Cost and other issues
DMARDs and other RA medications aren't necessarily easy to take, cheap, or fast acting. Some have to be taken two or three times a day (Plaquenil is one example); others are taken once a day; and some other drugs, like Enbrel, require a self-injection once a week.