Don't let RA slow you down. Get the facts about rheumatoid arthritis medications that'll keep you moving.

When the burly, 45-year-old construction worker and heavy equipment operator first came to see rheumatologist Eric Matteson, MD, at the Mayo Clinic in the summer of 2006, he didn't look like the strong, vigorous man he'd once been. He had been suffering from rheumatoid arthritis for about three months. It had gotten so bad that he was no longer able to work, and he needed rheumatoid arthritis medication, badly.

Matteson noted the man's rheumatoid arthritis (RA) was particularly aggressive, with more than 20 joints involved. Matteson started the construction worker on several rheumatoid arthritis medications, including six weeks of steroid treatment followed by a combination of disease-modifying antirheumatic drugs (DMARDs).

Within three weeks, the 45-year-old was back at work. A few months later, the man stopped showing improvement and Matteson changed his rheumatoid arthritis medications to include a tumor necrosis factor (TNF) blocker -- a drug that helps prevent inflammation and preserve joint health. "Now, he has virtually no disease activity at all, he's working full time, and he's doing everything he needs to do," says Matteson.

As recently as 1990, a person diagnosed with rheumatoid arthritis may have been put on Motrin or a pain reliever and sent home. A common notion then was to wait until X-rays showed evidence of joint damage before starting aggressive treatment with rheumatoid arthritis medication. But over the past 15 years, experts have learned that early aggressive treatment is essential to help prevent long-term damage and disability from rheumatoid arthritis.

rheumatoid arthritis Medication: Live Longer, Live Better

Many people think of rheumatoid arthritis as a debilitating chronic disease, but not necessarily a deadly one. Yet people with RA have been found to have a life expectancy that's shorter than people without the disease. That's largely because they're at increased risk for other conditions, like heart disease, renal disease, infections, and respiratory problems.

rheumatoid arthritis medication can do more than just keep you from being disabled -- it may add years to your life.

"Disease-modifying treatment early on has led to a lessening of disability from rheumatoid arthritis, and even an improvement in patients' life expectancy," Matteson says. "When you begin these treatments early on, you are less likely to develop erosive disease in the joints, and less likely to develop other, related conditions such as lung disease, vasculitis, and pericarditis, all of which are major contributors to early mortality in people with rheumatoid arthritis."

Several major studies have documented the dramatic benefits of early treatment with rheumatoid arthritis medication. Research presented at the 2006 American College of Rheumatology Annual Scientific Meeting found that early, intensive treatment with a combination of rheumatoid arthritis medication offers a chance of remission.

And a study by Matteson and his colleagues, published in Arthritis Care and Research, found that patients who developed RA more recently, and are receiving more aggressive treatment, require as much as 35% fewer joint replacement surgeries than people diagnosed 20 years ago, Matteson tells WebMD.

So how early should you begin treatment with rheumatoid arthritis medication? As soon as a diagnosis of rheumatoid arthritis is made, says Matteson -- something that can usually be done with confidence as little as six weeks after the first onset of symptoms.

"It's never too early, and never too late -- there's plenty of data that even treating late does help, so don't despair if you didn't receive early treatment," says Theodore R. Fields, MD, FACP, clinical director of the Gosden-Robinson Early Arthritis Center at New York's Hospital for Special Surgery. "But clearly there's a dramatic benefit of getting in there early to get the disease controlled."

rheumatoid arthritis Medication: A Range of Options

People with rheumatoid arthritis have a broad range of options for treatment, and doctors may try several rheumatoid arthritis medication combinations before they find the one that works best for you. rheumatoid arthritis medications include:

• DMARDs (disease modifying antirheumatic drugs), can slow, and sometimes even prevent, joint damage and destruction associated with rheumatoid arthritis. They include leflunomide (Arava), sulfasalazine (Azulfidine), hydroxychloroquine (Plaquenil), and methotrexate. Methotrexate is the most commonly prescribed first-line treatment for RA because it provides quick relief and has a relatively low rate of side effects.
• Biologic DMARDs (such as TNF blockers) is a newer group of drugs derived from living organisms. These medications interfere with the activities of cytokines, an element of the immune system that can fuel or suppress inflammation. They include Enbrel, Humira, Kineret, Orencia, Remicade, and Rituxan.
• Corticosteroids: They may reduce some joint damage by reducing inflammation, but their limited effectiveness and high rate of side effects do not make corticosteroids a good long-term treatment strategy.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): these drugs, such as ibuprofen and Motrin, relieve symptoms and mild inflammation but do not have any modifying effect on the disease itself.

rheumatoid arthritis Medication: Side Effects

Something to keep in mind: RA drugs, particularly the synthetic and biologic DMARDs, do not come without side effects.

Methotrexate, for example, can suppress your body's immune system -- it's used in larger doses in cancer chemotherapy. The biologic DMARDs can also weaken the immune system and have been linked to increased rates of infection and certain cancers.

"The overall benefit of the medications far outweighs the risks, but we treat individual patients, and we have to individualize the therapies as well," says Matteson. "We do it on the basis of how aggressive the disease is likely to be, as well as an assessment of other conditions in the patient's history that might affect their outcome, like tuberculosis or a history of bad infections."

What to Expect From Treatment With rheumatoid arthritis Medication

When treating patients, "our number one goal is remission," says Fields. "We can't always get there, but that's our goal, and in 23 years of practice, I've never seen more people coming back and saying 'I've forgotten I have arthritis' than I do today. That's still a minority, but most people come back and have some degree of improvement that often allows them to function socially, work, participate in sports, and have a pretty normal life even though they have some swelling and stiffness."

Patients need to be more educated than ever before when it comes to RA.

"You have to be involved. There's no room for the doctor to just say, 'You have rheumatoid arthritis, and I'm writing you a prescription for this,'" says Fields. "There are so many options and so many issues individual to the patient. Doctor-patient collaboration is essential."