Question

I'm a 38-year-old woman, and I've recently been told I've got rheumatoid arthritis.

I take a lot of pain killers, but now the doctor wants me to take something that will alter my immune system. What does this mean? Is it dangerous?
 

Answer

Because you have recently been diagnosed with rheumatoid arthritis it is only natural to be wary of new treatments. We hope our explanations will help you learn more about your condition and ease your anxiety. You will also be better equipped to discuss your condition with your doctor.
 

Rheumatoid arthritis or RA is the most common type of arthritis which is triggered by the immune system. Rheumatoid arthritis is a chronic (long-term) disease that causes inflammation of the joints and surrounding tissues. It can also affect other organs. The cause of rheumatoid arthritis (RA) is unknown. It is considered an autoimmune disease. The body's immune system normally fights off foreign substances, like viruses. But in an autoimmune disease, the immune system confuses healthy tissue for foreign substances. As a result, the body attacks itself.
 

A new class of medications, BRMs (biologic response modifiers), such as TNF blockers and other biologic DMARDs (disease-modifying anti-rheumatic drugs), are medications that stimulate or restore the ability of the immune system to fight arthritis and rheumatic disease. They can specifically target parts of the immune system that lead to inflammation as well as joint and tissue damage in RA. These medications are also DMARDs, because they slow the progression of the disease. FDA-approved treatments include adalimumab (Humira), anakinra (Kineret), etanercept (Enbrel), infliximab (Remicade), abatacept (Orencia), and rituximab (Rituxan). In some cases these medications are used alone; in many cases, they are combined with methotrexate for added efficacy.
 

The optimal treatment of RA often requires more than medication alone. Proper treatment requires comprehensive, coordinated care, patient education and a number of providers, including rheumatologists, primary care physicians, and physical and occupational therapists.
 

Suitable exercises are important and strangely enough, they free up stiff joints and prevent more stiffness. A physiotherapist may be helpful guiding one in the correct exercises for the specific problem. Weight control is also important, as extra weight places an added load on painful joints. If you make sure that you have adequate pain relief, the stiffness can resolve a little by doing the exercise regularly. Walking of course is not always the answer, but swimming is an excellent exercise for arthritis as the water supports the joints and limbs whilst you move. Also gentle exercises in a warm pool or bath are beneficial at freeing up the joints.
 

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