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Treatment for rheumatoid arthritis begins with and is usually
dependent on medicine. Many of these medicines can sometimes cause serious
side effects. When thinking about side effects of treatment, there are four
important things to remember:
All of the medicines used to treat rheumatoid arthritis have some
side effects, and some of the medicines have potentially severe side effects.
These range from nausea and a mildly increased risk of infection to
anemia and liver damage.
It would be best if doctors knew which people are most
likely to develop severe joint destruction and deformity from their rheumatoid
arthritis and could recommend the most aggressive treatment only for these
people. But no such accurate projections of the course of the disease
exist. At the same time, many of the current medicines, when used early in
the course of the disease, can significantly decrease the total damage done to
the joints. Since rheumatoid arthritis is a progressive disease with joint
deformities that cannot be reversed after they occur, most doctors have come to
the conclusion that it is best to recommend early, aggressive treatment with
careful follow-up to catch any treatment-related toxicity immediately rather
than waiting for permanent damage to happen.
For reasons that are not totally understood, many treatments for
rheumatoid arthritis lose their effectiveness over time. Why this loss of effectiveness
occurs is unclear. But it may be related to the immune system becoming
desensitized by a given course of treatment. Fortunately, the development of
additional medicines that can fight rheumatoid arthritis provides further
options for treating the disease if initial drugs lose their effectiveness.
There are risks associated with medical therapy for rheumatoid
arthritis. But it is worth remembering the risk of not taking the medicine.
Rheumatoid arthritis is a progressive disease that causes destruction and
deformity of the joints. After this damage occurs, it cannot be reversed.
Medicine must be taken early in the course of the disease, before a lot of
damage has occurred, to prevent progression of the illness.
Making the decision to take the risk of side effects can be
difficult. To minimize risks to yourself, make sure that you
are in close contact with your doctor while starting medicine so you can
deal with and treat any potential toxicities of the medicine early and can
adapt your therapy to medicines that you can tolerate and will take.
Current as of:
June 5, 2012
Anne C. Poinier, MD - Internal Medicine
& Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
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