Methotrexate is a very commonly prescribed RA medication and is the most popular of the disease-modifying antirheumatic drugs (DMARDs). It is also known by its brand name, Rheumatrex (Stada Pharmaceuticals). Methotrexate is classified as an antimetabolite drug, which means it is capable of blocking the metabolism of cells. It is particularly effective in suppressing rapidly [...]

Corticosteroids (or, as they are more commonly known, “steroids”) are a class of medications that are often given to people with inflammatory diseases. These medications are similar to natural hormone substances that are produced by the body. Steroids help to reduce inflammation and have been used for more than 50 years to treat RA. They [...]

Signs of RA have been found in the skeletal remains of Stone Age humans, and descriptions of RA have been found in the writings of doctors and healers for thousands of years. The ancient physicians understood that the disease began with pain and stiffness and progressed to increasing joint swelling, joint deformity, limitation of motion, [...]

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that reduce fever, pain, and inflammation. They include a large group of anti-inflammatory agents that work by inhibiting the production of prostaglandins (chemicals in the body that cause inflammation). As their name indicates, these drugs do not contain steroids such as prednisone, nor do they contain narcotics. NSAIDs are [...]

Remission in a person with RA can be defined as the absence of disease activity, such as swollen joints, pain, and stiffness. In the 1980s, when the authors of this book began practicing medicine, physicians approached RA differently than they do today. Back then, physicians were mostly concerned with controlling patients’ symptoms. Patients were treated [...]

Even people with advanced RA can benefit from medical treatment. The treatment benefits can include the following: Reduced joint pain Reduced involvement of other joints Increased mobility Reduced risk for cancer, heart disease, and stroke Joint Pain Even if a joint has undergone considerable erosion and lost some mobility, inflammation can still result in continued [...]

For people with RA, “watchful waiting” is not an appropriate treatment strategy. Medical studies reveal some important facts that demonstrate why early treatment of RA is necessary: The majority of joint destruction occurs in the first two years after disease onset. Significant joint destruction can occur even when the joint is not painful. Joint damage [...]

The goals of RA treatment have evolved in the last decade. In the past, the best that a patient could hope for was decreased pain and stiffness. Today, thanks to more effective drugs and earlier, more aggressive treatment of RA, expectations are much higher. Your doctor’s goals for treatment are multifold: Alleviating joint-related symptoms (such [...]

Rheumatoid arthritis does not appear to have any adverse effects on pregnancy outcome. Some medications used to treat RA have not been thoroughly studied in pregnant women, however, and should be used with caution in this population. How a woman with RA is treated during her pregnancy is a complicated decision that should be made [...]

Patients with RA appear to have a higher risk of developing cancers of the lymph nodes, known as lymphomas. In the past, studies have shown that the risk of developing lymphoma appears to be greater in patients who have more severe inflammation and in those with a longer duration of RA. The reasons for this [...]

Surveys of large groups of people show that individuals with RA have twice the rate of periodontal disease as people of the same age, sex, and socioeconomic status who do not have RA. Periodontal disease affects the tissues that surround and support the teeth. These tissues include the gums (gingiva), the bones that form the [...]

Although they are rare, joint infections do occur sometimes. It is important to know about this potential complication for two reasons. First, among all of the many types of arthritis, arthritis caused by infections results in the most rapid destruction of joints. In some cases, a joint can be totally destroyed after only a few [...]

Infections are a frequent complication in people with RA. Their risk for developing lung infections or pneumonia is also increased, which constitutes a serious problem. In medical studies, investigators have found that people with RA were nearly twice as likely as people without RA to develop infections, even after adjusting the rates for age, gender, [...]

I’ve heard that people with rheumatoid arthritis are prone to heart disease. Is that true? Yes, patients with RA have an increased risk of developing atherosclerosis and cardiovascular disease. In particular, RA is associated with a 40% increased risk for myocardial infarction (heart attack) and a 60% increased risk for congestive heart failure (CHF). The [...]

Anemia—an abnormally low number of red blood cells in your bloodstream—is a common complication of RA. Indeed, of all the problems associated with RA that are not related to joints, anemia is the most common. It is estimated to occur in 30% to 60% of all people with RA. Anemia tends to occur more frequently [...]

Yes, RA can increase your risk of developing osteoporosis and bone fractures. Osteoporosis is a disease of the bones that results in “thinner,” weaker bones that are more prone to fractures. It is a silent disease, however: A person can’t feel that his or her bones are getting less dense. Osteoporosis becomes obvious only when [...]

Most people with RA do not develop eye problems because of their RA, although approximately 25% of patients with RA will complain of some eye symptoms. The majority of these eye complaints is mild and requires only symptomatic treatment. A very small number of patients develop severe eye inflammation that can affect their vision. These [...]

I have a bump on my elbow that my doctor says is a rheumatoid nodule. What is a rheumatoid nodule? A rheumatoid nodule is a bump in the skin that is found in approximately 25% of people with RA. In fact, identifying a rheumatoid nodule in a person who has recently developed arthritis can help [...]

Depression occurs frequently in the general population and even more frequently in individuals with chronic diseases such as RA. The pain and disability associated with RA has a detrimental effect on the person’s lifestyle and ability to cope with daily life. RA is frequently associated with depression or anxiety; in fact, depression occurs in 20% [...]

Some patients with RA may develop dry eyes and a dry mouth, but these are not unusual symptoms linked only with this disease. Indeed, nearly one third of all elderly people—with or without RA—will report dry eyes and dry mouth to their physician. Symptoms of dryness can result from the aging process or from taking [...]