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I've just been diagnosed with rheumatoid arthritis. My physician wants me to start taking medications right away. I would rather wait as long as possible. She is advising against that strategy saying early treatment is best. What do you think?
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Treatment for RA has changed quite a bit in the past 10 to 15 years. Studies show that patients get better results if their disease is treated early and aggressively. Early is easy to understand. What does 'aggressively' mean?
Aggressive treatment starts with the use of medications called disease modifying anti-rheumatic drugs or DMARDs. Many patients are familiar with the most commonly prescribed DMARD: methotrexate or MTX. MTX has been around since the mid-1980s. But it wasn't always recommended right away because of concerns about toxicity. Only those patients with severe, advanced disease were given this drug.
Now we know that adverse responses to methotrexate (MTX) are much less than feared and the drug offers enough benefit to make it worth taking. Improved symptoms means better quality-of-life all the way around. And even better than that, disease modifying anti-rheumatic drugs (DMARDs) have been shown to slow and even stop joint destruction.
Today's best care starts patients on methotrexate (MTX) right away. Aggressive treatment requires taking methotrexate (MTX) at increasing dosages over a period of three to six months until you have gotten the best (maximum) response. Response is monitored closely.
Anyone who is not getting the desired or expected results by the end of six months' time will be given another DMARD or possibly one of the newer biologic agents. Biologic agents include etanercept, infliximab, adalimumab, and abatacept. These drugs fall into a category called tumor necrosis factor-alpha inhibitors or TNF-alpha inhibitors.
Many studies have shown that combining methotrexate (MTX), plus one other DMARD along with one of these biologic agents gives much better results than monotherapy with just one or the other. Taking all three types of medications is referred to as triple therapy.
With the new disease modifying anti-rheumatic drugs and biologic agents on the market, rheumatologists and primary care physicians have new and improved tools to help treat patients with rheumatoid arthritis.
Your physician is offering you what we call "best care" for your rheumatoid arthritis. Today's motto is: "care you would give your mother". It's possible now for you, "Mom", and everyone else with this disease to remain pain-free, active, and even disease-free for much longer than ever before. Early intervention is the new "gold standard" of care! It sounds like you are in good hands.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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