Rheumatoid Arthritis: A Pharmacist’s Tips for your Treatment

Published: June 01, 2022
Barbara Young
By Barbara Young, PharmD

Rheumatoid arthritis (RA) is a type of arthritis that causes swelling, pain, and stiffness of the joints, usually the fingers and wrists. It is an autoimmune disease in which your body’s immune system attacks the healthy cells in your tissues and other parts of your body. Rheumatoid arthritis is a progressive disease, usually causing worsening symptoms over time. This may result in deformity of the joints and a loss of movement, reducing your ability to work and perform other activities. As the condition develops, it may affect other parts of the body, such as the heart, lungs, and eyes.

Who is most at risk of getting rheumatoid arthritis?

Several factors have been noted to affect the risk of having rheumatoid arthritis.

  • Age: Although RA is most often diagnosed between the ages of 30—50, the chance of having it increases with age.
  • Genetics: People with certain genes or inherited traits are more likely to be diagnosed with the condition.
  • Obesity: Studies have shown that the more overweight an individual is, the greater the risk.
  • Breastfeeding: Women who have breastfed their infants have a decreased risk of developing RA.

What are the symptoms of rheumatoid arthritis?

Symptoms associated with RA include:

  • Pain or aching in more than one joint
  • Stiffness in more than one joint, usually in the morning
  • Tenderness and swelling in more than one joint
  • Weight loss
  • Fever
  • Fatigue or tiredness
  • Weakness

The pain, stiffness, and swelling usually occur on both sides of the body, like in both hands and fingers. These symptoms may increase or decrease over time and with treatment. Your doctor will order laboratory blood tests to help diagnose if you have RA.

What medication treatments are used for rheumatoid arthritis?

Treatments are available to reduce the inflammatory processes that cause your RA symptoms. These drugs are called disease-modifying antirheumatic drugs or DMARDs. These medications are the mainstay of RA treatment and are categorized into two groups – nonbiologic and biologic.

The nonbiologic medications include such treatments as methotrexate (usually the first treatment used), leflunomide, and others.

If the nonbiologic medication or medications are not effective in controlling your symptoms, your doctor may prescribe a JAK inhibitor or biologic DMARD medications. These medications are usually more expensive and require careful monitoring of side effects. Biologic DMARD medications are usually given by injection, and the JAK inhibitors are taken by mouth.

Other medications that may be used to control the symptoms of pain and stiffness are over-the-counter pain relievers such as ibuprofen or naproxen. Corticosteroids are administered by a healthcare professional by injection into the joint. These medications are usually used on a short-term basis and generally do not affect the progression of the disease.

What else can I do to treat RA?

Aside from medication therapy, there are many other ways to improve your response to RA. An important part of your treatment is to exercise to improve your muscle strength with activities such as walking, swimming, or biking.

Other strategies to improve RA include losing weight (if you are above your target weight) and eating a healthy diet. Manage your alcohol intake, especially if it is a concern when taking certain medications. Another important strategy is to stop smoking and avoid cigarette smoke when possible. Also be sure to keep up to date with the vaccinations recommended by your doctor and pharmacist to reduce the risk of serious infection.

I’m having trouble getting and affording my medication – what can I do?

Many of the biologic medications used for the management of RA are very expensive. Your insurance company may require prior authorization from your doctor to cover payment for the drug. In addition, you may have significant co-pays that your insurance does not include. You or a caregiver can give injectable medications at home (instead of going to your doctor or a clinic), but that will require special training for you to give the medication.

Does this all sound complicated?  Ask your pharmacist! Pharmacists are the medication experts and can answer your questions.

You may benefit from using a specialty pharmacy. Specialty pharmacies can help you to navigate getting the drug, working with your insurance company, or getting financial assistance to get the maximum coverage for payment. They will also make sure you understand how to use or take the medication and the importance of taking or using it regularly. They also can work with your doctor to make sure you are getting lab tests to check your response to the drug or any other required monitoring.

Specialty pharmacists are also available to answer any questions about your medication or side effects. In many cases, specialty pharmacies can ship the medication right to your home or the setting where you will receive your treatment. This not only makes it easier and more affordable, but also gives you support to use your medications correctly.

Summary:

Medications and other treatments for managing RA are important for controlling your disease and maintaining your quality of life. Be sure to ask your pharmacist or specialty pharmacist for help to receive the maximum benefit from your medications.

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