How To Treat Rheumatoid Arthritis, New and Old Options
For more than 1.3 million Americans and millions more around the world, how to treat rheumatoid arthritis (RA) most effectively is an important question. The European League Against Rheumatism (EULAR) has issued new recommendations for managing rheumatoid arthritis, and here are some other older, natural options as well.
How do you treat rheumatoid arthritis?
Rheumatoid arthritis is one form of arthritis and also an autoimmune disease, which means the body’s immune system, for reasons unknown, attacks itself and destroys muscles, bones, joints, and cartilage involved with movement. This disease affects about three times more women than men and typically first appears between the ages of 30 and 60.
Finding effective ways to treat and manage this disease is important, and thus EULAR has just released its recommendations in this regard. Individuals with rheumatoid arthritis should be aware of these recommendations and other options, which are based on three literature reviews, when talking to their doctor about treating the disease.
For example, EULAR recommends that:
- People with RA should begin treatment with disease-modifying anti-rheumatic drugs (DMARDs) immediately after receiving a diagnosis of RA
- Patients should seek assistance from rheumatologists to administer the suggested drugs, which include methotrexate or combination therapy that includes other DMARDs
- Patients should take low-dose glucocorticoids in combination with DMARDs for up to six months
- If individuals do not respond to treatment within 6 months, biological DMARDs (e.g., abatacept, tocilizumab, or rituximab) should be given along with methotrexate
- The primary healthcare provider for people with RA should be a rheumatologist
- Patients should be monitored every two to three months, with modifications made to treatment if there is no improvement after three months or if the goal of treatment has not been reached after six months
Other treatment suggestions
Beyond the new EULAR recommendations, other studies have reported on natural approaches, as alternatives to or as complementary options with pharmaceuticals. Given the serious side effects associated with RA drugs, such alternatives are welcomed by many people with rheumatoid arthritis.
For example, research indicates that use of curcumin, a bioactive ingredient found in the spice turmeric, can be equally or more effective than the drug diclofenac in relieving RA symptoms. Other treatment alternatives include:
- Acupuncture: A review of 31 controlled trials of acupuncture for treatment of chronic pain, including rheumatoid arthritis, found that patients who received acupuncture overall had less pain than individuals who had no or sham acupuncture treatment. A subtype known as electro-acupuncture also has been found to be somewhat effective in relieving pain.
- Omega-3 fatty acids: These essential nutrients help reduce inflammation and improve function in rheumatoid patients. A typical dose is 1,000 to 2,000 mg daily.
- Diet: Studies show that eating foods that maintain the integrity of the intestinal tract and prevent leaky gut—when molecules from the intestines infiltrate the bloodstream, which can result in inflammation—can be helpful. Meats and dairy products are the biggest culprits, while whole grains, fruits, and vegetables are recommended.
- Grape seed extract: Among several studies of grape seed extract and inflammation, a 2012 study found that the natural supplements relieved symptoms associated with bone and cartilage damage, provided antioxidant benefits for patients with rheumatoid arthritis, and also inhibited osteoclastogenesis, a process by which bone cells destroy bone.
- Tai chi: Exercise is an important part of therapy for RA patients, and tai chi is a gentle yet effective way to stay in motion. Studies indicate that rheumatoid arthritis patients who practice tai chi enjoy better balance, grip, and coordination and less pain and inflammation.
Patients who have rheumatoid arthritis have many treatment options, ranging from drug therapies as noted in the new recommendations from EULAR, to alternative and complementary methods. Individuals with rheumatoid arthritis should investigate the new and old treatments for the disease and find options that work best for them.
European League Against Rheumatism