Management of Rheumatoid Arthritis

Featuring Dr. Kam Shojania, MD, FRCPC

Duration: 2 minutes, 24 seconds

When someone is diagnosed with rheumatoid arthritis, this is an urgent situation.

The disease needs to be treated. There are lifestyle measures that are important. Smoking increases the onset of rheumatoid arthritis and makes it more difficult to treat. So quitting smoking is essential in managing rheumatoid arthritis.

The most important thing, however, is getting on medications that will slow or stop the disease. In the past, we were more hesitant on using these medications. Now we realize if we use them aggressively at the beginning in stopping the disease, we can often withdraw them or reduce the dose and people can do very well.

So these medications are called disease-modifying anti rheumatic drugs. For short we call them “DMARDs” - D-M-A-R-D, small S. These DMARDs slow the progression of rheumatoid arthritis and in many cases improve life expectancy and function. The most common DMARD we use is methotrexate.

There are other DMARDs that are also used in rheumatoid arthritis, and in the past ten years it's been very exciting that we have options of medications we call biologics. These are relatively expensive, but they work very well in halting the disease progression and making people feel a lot better.

So there has a revolution in the way we manage rheumatoid arthritis. Fifteen, twenty years ago we helped people live with rheumatoid arthritis. Now we try to stop the disease.

Key points about rheumatoid arthritis are that it is a systemic disease that requires urgent treatment. Now going back if you want to prevent it or not get rheumatoid arthritis in the future, the most important thing we know right now is quitting smoking. Smoking increases rheumatoid arthritis by about seven times, and if you smoke, it's harder to treat.

So quitting smoking is really important. Otherwise, getting the disease under control with medications is extremely important, and once the disease is under control we use physiotherapy, lifestyle measures to improve function back to where it should be.

Presenter: Dr. Kam Shojania, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist