Reducing the inflammation and painful, swollen, tender joints in rheumatoid arthritis not only gives much greater comfort but also reduces progression of the disease. On the other hand, patients need to be fairly certain that they do have active rheumatoid arthritis and not some other condition that resembles it including lupus, fibromyalgia and others. Many of the treatments for rheumatoid arthritis are also helpful for psoriatic arthritis ankylosing spondylitis and certain other types of arthritis, but not for osteoarthritis—the arthritis that everyone gets to some extent with aging or joint injury.
Dr. Robert S. Katz, professor of medicine at Rush University Medical Center and the Feinberg School of Medicine at Northwestern University, recommends that patients with rheumatoid arthritis ask their doctor some of the following questions:
• Are you certain that I have rheumatoid arthritis and not osteoarthritis or fibromyalgia (chronic widespread pain)?
• Do you feel that I am a good candidate for a disease-modifying medication such as methotrexate or a biologic medication? Newer biologic medications include Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan and Simponi.
• If I choose a more complicated option, such as a biological drug given by self-injection or intravenously, will you help me with the approval process and any programs I am eligible for to reduce the cost of the medication for me?
• How do you plan to follow my progress? Is it through a physical exam and laboratory tests? Which laboratory tests will you be following in my case?
• Can you give me written material on some of these medications or direct me where to look online so I can read about the medicines independently? How will you decide which of these medications I should consider taking?