Rheumatoid arthritis - Medical treatment of RA

7 important questions on Rheumatoid arthritis - Medical treatment of RA

What are the goals of (medical) interventions in the early stages of RA?

  1. Slow down disease progression
  2. reduce pain
  3. eliminate unnecessary anxiety
    1. prevent maladaptive behaviour patterns

What drug treatment can be used in the early stage of RA?

  • Use of immunosuppressive medication, to prevent/slow down joint damage.
  • DMARDS = disease modifying anti-rheumatic drugs
  • After that the use of anti-TNF (specific element intervening on the inflammation process)

What drug treatment can be used to target pain and/or inflammation in RA?

  • Non-steroidal anti-inflammatory drugs (NSAIDS; ibuprofen), cortisone, steroids
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What are possible side-effects of DMARDS

  • Upset stomach (nausea, diarrhea)
  • fatigue
  • headache
  • liver damage
  • vulnerability to infection

What are possible side-effects of NSAIDS?

  • Gastro-intestinal problems (ulcers)
  • higher risk at CVD/stroke

What is the effect of medication side-effects on medication use?

Large non-adherence of medication intake (20-70%) or patiënts only taking medication when symptoms are present.

What are possible barriers for patients to adhere to physical activity recommendations?

  • Pain/disability/depression
  • failure to see benefits
  • maladaptive beliefs about exercise
  • environmental factors

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