5 Signs It’s Time to Change Your Rheumatoid Arthritis Treatment

Treatment for rheumatoid arthritis (RA) can be tricky — what’s worked for you in the past may not always keep your RA under control.

In fact, it’s fairly common to need an occasional change in your treatment plan, whether it’s a switch within a drug class or a step up from non-steroidal anti-inflammatory drugs (NSAIDs) to disease-modifying anti-rheumatic drugs (DMARDs), biologics, or janus kinase (JAK) inhibitors.

Here are five signs that it may be time to talk to your doctor about making a change in your RA treatment:

1. You’re having a flare. Some people with RA experience periods in which their symptoms — such as stiff, swollen joints and fatigue — temporarily worsen. This can be due to stress, another illness, or sometimes no reason at all, according to the Arthritis Foundation. When this happens, your doctor may add corticosteroids — drugs that decrease inflammation — to your treatment plan, or increase the dosage of your current medication.

2. Your medication stops working. If your RA symptoms start creeping back after a period of being successfully controlled, it could be a sign that your medication isn’t working as well as it once did. Some people simply plateau on a medication after a certain amount of time, while others build up antibodies in their bloodstream that undo the effects of the medication. Be aware that this change can be subtle — symptoms typically don’t return with the same intensity as before you started treatment.

“Most people don’t go back to feeling acute pain,” says Elyse Rubenstein, MD, a rheumatologist with Providence St. John’s Health Center in Santa Monica, California. “There’s usually just a slight increase in symptoms.”

When medications become less effective, a switch is usually necessary. If you take a DMARD, your doctor may recommend adding a biologic drug — an RA medication that works by interrupting processes in the body that cause inflammation. If you’re already taking a biologic, switching to another type of biologic might be an option. If biologics aren’t helping, your doctor may have you try a newer class of drugs called JAK inhibitors. It’s important to work closely with your doctor to settle on the treatment switch that makes the most sense for you.

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