Rheumatoid Arthritis Treatment Options

Dr. John Wade, MD, FRCP(C), talks about the various treatment options for Rheumatoid Arthritis including revolutionary second line therapies.

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Dr. John Wade, MD, FRCP(C), talks about the various treatment options for Rheumatoid Arthritis including revolutionary second line therapies.
Video transcript

Featuring Dr. John Wade, MD, FRCP(C), Rheumatologist

Duration: 2 minutes, 47 seconds

Rheumatoid arthritis is a common type of arthritis. It’s seen in about one percent of the general population, more common in women than men – about three to one. And it often presents with pain, swelling and stiffness in the small joints, typically of the hands and feet, but it can go on and involve the larger joints, such as the ankles, the elbows, the wrists or the knees.

Typically, when we talk about treatment for rheumatoid arthritis, often patients have already tried some over-the-counter medications such as anti-inflammatories, things like ibuprofen or naproxen. These medications can be effective in controlling symptoms, they take away pain, but they’re not effective in reducing the long-term swelling or damage we see in rheumatoid disease.

After patients have often tried anti-inflammatories, then their physician or typically rheumatologist will recommend starting on disease-modifying agents – we call them DMARDs. There are four common types of DMARDs that we’ll use, and those include methotrexate, anti-malarials, sulphasalzine, and laflumonide.

These medications are usually taken by pill, typically on a daily basis or a weekly basis, and they’re given over a period of weeks to months. And often these medications, if used appropriately in the right situation, at the right dose, will be effective in controlling the symptoms of the inflammation of rheumatoid arthritis.

If your rheumatologist has tried you on first-line therapy for arthritis, so if they put you on medications at good doses for good lengths of time, either alone or in combination, and if you’ve failed after a number of months in responding to these first-line therapies, then your rheumatologist may be looking at offering you a second-line therapy.

Second-line therapies are a major advance to the treatment of rheumatoid arthritis. We now have therapies that are second in line that are both pills, typically given either once a day or twice a day, injections under the skin that may be given anywhere from once a week, to every two weeks, to every month, or there may be some therapies that are given by intravenous. And the intravenous therapies can be given anywhere from every four weeks, some every eight weeks, and there’s one that we give in infusions every six months.

If you have rheumatoid arthritis and you’ve failed first-line therapies, you need to go and talk to your rheumatologist about these newer therapies available to treat rheumatoid disease, whether it’s an oral therapy, or an injection, or an infusion, these new therapies have revolutionized the treatment of rheumatoid arthritis.

Presenter: Dr. John Wade, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist

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If you are dealing with Rheumatoid Arthritus do you really understand your options. Take the quiz and see how you stack up.

Questions True False  
1 Rheumatoid Arthritis effects more men than women.

2 Anti-inflammatories such as Ibuprofen or Naproxen only treat the symptoms of RA and do not prevent long term damage to joints.

3 First line therapies that your Rheumatologist may try an RA patient on are called Disease Modifying Agents (also known as DMARDS).

4 If first line therapies fail, second line therapies are available and inclue oral medication, subcutaneous injections or IV infused therapies.

5 If patients have failed to get control of their RA on first line therapies, it is likely they will also fail on second line therapy.

6 Second line therapies have revolutionized the treatment of Rheumatoid Arthritis.


This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.