Non-biologic Drugs Tied to Tuberculosis Risk is higher with immunosuppressive medication. 03/20/09

Conditions > Rheumatoid Arthritis > Rheumatoid Arthritis Treatment > Arthritis Treatment: Early is Best

Arthritis Treatment: Early is Best

Receiving rheumatoid arthritis treatment sooner rather than later may be your key to remission

A hot topic among rheumatologists lately is whether when you treat rheumatoid arthritis (RA) matters as much as how you treat it. Some believe strongly in early arthritis treatment, prescribing an aggressive regimen of RA drugs during what is called....

Debbie

24 Mar 2012, 15:12

2 years ago I had a virus, followed by a 3 month bout with hives. I've read other comments by people that their RA symptoms followed a similar event. I recently had synovial fluid buildup removed from the tendons in my hand and the Orthopedist said I should see a Rheumatologist. At 56 years old, I expected to have stiffness from Osteoarthritis and have taken NSAIDS for years. I'm still waiting to see a Rheumatologist, minimum 4 month wait. I have clicking sounds in all joints except my hips. Lots of fatigue. I will see my PCP next week while waiting for the RA Dr appt.

sana cassim

24 Jan 2012, 14:10

hi, i am an indian. moved to new york this january. in sep last month i was diagnoised with ra. doctor said i had v. minute ra. i am on hcqs an sulphasanazite. i do not experience pain now. but i read ra can be remissioned by early aggressive treatment . can anybody help. i think i am not taking agressive treatment. help , show me doctor can anybody to save my life from yhis disease

Scared in SC

11 Jul 2011, 12:28

Although in retrospect, I had intermittent symptons for the past year, I was recently diagnosed with RA and have just started a treatment plan by my Rhuemotologist which includes Methrotrexate, Prednisone, Folic Acid. My first Metrhotrexate (6/2.5mg)treatment was just completed a few days ago. I have read a lot about this drug and have my concerns but am trusting my Dr at this point. While I am concerned about the long term side effects, I am equally concerned about the short term side effects such as nausea, fatique, hair loss potential weight gain, infection, etc. My unanswered question is: Are these gradual over time or immediate? For example, if I don't have nausea with the first treatment does this mean I won't or does the nausea come at some point after multiple treatments? Like most of us, I have a job, family and other responsibilites that I have to juggle and continue to balance with the treatment plan and any information will be appreciated.

Marie

14 Jun 2011, 13:23

I am a 47 yr old female. My mother and her mother have RA. I became severely ill 3 years ago. I began having symmetrical joint pain, severe fatigue, low grade fevers, seizure activity and morning stiffness. Also, I have a positive ANA (1:160). The symptoms waxed and waned but never went away until I was prescribed short runs of prednisone by my PCP. My Rheumatologist diagnosed me with fibromyagia. Now I have deformities in my fingers. I am not alone in this experience with doctors. I fought with my doctors for the last 3 years to get treatment that would improve my dwindling quality of life. I have found a Rheumatologist 50 miles away that has confirmed that I do not have fibromyalgia and that I do have RA.

Early treatment is important, but why do so many patients have to wait until they have damage before they are given treatment. This is not the patient's fault. What can be done to prevent this tragic scenario?

Iris

27 Apr 2011, 23:06

A few months ago I was diagnosed with RA. I thought it was the end of the world. The pain in my hands and shoulders are unbearable. I believe that being diagnosed with RA at 37 is horrible. I am very worried about taking methotrexate because my DR. says that this med was used for patients with cancer. I've been reading a lot and it seems that RA can just be the beginning of a lot of other conditions that are just waiting to attack. Very depressed and I need help!

Patricia Whitten

11 Apr 2011, 14:29

I was diagnosed with RA and possibly lupus at a(clinic for low income,) 1 year ago next month. I was treated for the inflamation for 1 week, and then a few months later I had to go to the hospital ER, after a cat scan, was treated for the pain and referred to an Rheumatologist. Trying to get an appointment was four months out and then when they find out you don't have money or any insurancs and on a fixed income(SS is 723. mo.)they say that you need a down payment of min. of $337. just to come in for initial visit, never mind that you have to barely exist on your SS. I have high cholestreal, high CPR,high trigliserides,thyroid problem,high blood pressure,non-alcholic fatty liver, and to boot, fibromalisia, and two different kinds of arthirtis and GOD only knows if there is something else. I have no idea what to do, I'm in so much pain most all the time. Everything I know about the Ra and everything else I have researched through google, medical research universities and any place esle I find or stumble upon. If you aren't treated for the disease in the first year or 2, chances are it won't go into remission, plus stress causes flare-ups too, and you can get fluid around the heart sac(periacarditis) and it can and will affect your other organs, it can take your sight, cause multi-organ failure, it robs you of your independance to take care of yourself. Like trying to dress and feed yourself, can't cut up even an egg let alone a steak, can't put on your socks or shoes, can't hardly go to the bathroom without screaming from pain just to undo you clothes, and other personals, and if you wear dentures the way I do, can't hardly do that either. I'm losing my strength, and my independence and my will to care much anymore. I have kids that live nearby and not one of them ever call or come around for fear they will have to help me or feel guilty that they don't help. I lost my mom and my all 3 of my sisters to other health problems, so there is no one left to help. I can't lose my independence and my ability to drive. I self medicate because it is just as safe if not more than the RA Drugs with all of the side affects they cause, especially with the liver. However, there was an article on TV last week about something that is all natural ingredients called arthir-D, I have the phone number and I am going to check this out . I wish you all good health and happiness. I will let you know how or if it works out.

Ranajit Das

31 Mar 2011, 07:32

I am 32 years old man suffering from chronic rheumatoid Arthritis. It was year 1992, my small joints are affected like finger etc…
I am using several drugs like sulphasalazine , Methotrexate, HCQS, Folic acid, calcium tablets, etc but unable to cure … so that I was decided to change the allopathic treatment & shifted to homeopathic treatment in November 2009... but problem still remains…

Now my big joints are affected like solder joints, Hip joints, back spinal cord. Please suggest me what should I do? should it continue with homeopathic medicine ?
Regards,
Ranajit

april mullen

30 Mar 2011, 17:40

Iam 42 year old female.I was diagnoised with RA through blood work,i have the rh factor.I was seen by a rheumatologist and semmed to think treatment could wait,he also diagnoised with fibromyalgia.He agreed with my primary that they would treat me until i needed to see rheumatology,to be determined by primary.During a major flare up i seen my exercise and strech daliy.I need advice in how to communicate with a doctor.

Shelia Osborne

07 Mar 2011, 21:05

I was diagnosed in 2002 with RA thru extensive blood work to prove. I take Methotrexate, Prednisone, Pain Med, 1mg Folic Acid,(help me keep my hair) I was told the reason I still hurt is because 25% of all women with RA have Fibromyalgia. So I also when flare ups occur take Lyrica with Pain as well as my other meds. Sometimes the pain is so bad I will use 1/2 of a soma with the Lyrica and muscles will relax better for me.PCP cannot treat RA properly I was told. So my RA (Vanderbilt graduate) takes good care of me and monitors my pain. Pain and RA go hand and hand with me. I quit taking Plaqanil because it affected my eye sight and I now have implants, this was after a few years on this med. Reading all the comments I have really had eye openers. I cannot take things like enbrel, I have no spleen due to not having red cells, platelets at age 15 back in the 60's. Also when young had Hepatitis B due to some unclean water at horse barn. I was treated for Lupus and Lukemia when they took my spleen out. I got better and now I am 61 and RA (cousin to these diseases) is with me forever. It takes a good RA DR with a good relationship with patient. I found this out the hard way.

annie hart

01 Mar 2011, 01:12

can you die from a RA flare up or from the secondary complications or meds?

Sarah

09 Dec 2010, 23:41

I was diognosed w/ RA a year ago. The drugs scare me & have not taken them. I see a naturalpath and she helps. I found wheat & legumes cause me to hurt so I am gluten & bean free, lost 19 pounds from the diet change & alergy elimination diet. I also take W-Zyme 10 in AM & PM, no food an hour before & 2 hours after, sounds like a lot but it reduces the pain & there are NO side effects

Grace in New York

28 Aug 2010, 01:51

I've been diagnosed with RA SLE MS for many years and have been fortunate til recently
having to decide what medicine to go with.
To treat the RA or the MS? They're all
devistating to deal with. I'm taking
Celebrex, Plaquenil, Imuran, and prednisone
during a flare. I was taking Remicade with
the Methotrexate, it didn't work for me.
Don't give up hope, I still work full time as a Nurse, and it's hard for me many nights.
Keep moving. Don't let your joints get rusty.
Let people around you know how you feel, and
don't try to do everything at once. It doesn't work. I try to keep positive, but
where I work, many understand and are very supportive. I have a wonderful husband, and family, friends. Treat yourself with kindness.. put yourself first...
Best of Luck and Health...
Gracie

edie elliott

27 Aug 2010, 20:24

FOR ALL OF YOU PTS THAT ARE ON ENBREL,HUMIRA OR REMICADE, CALL THE DRUG COMPANY--- THEY HAVE PLANS FOR PTS THAT DO NOT HAVE INSURANCE OR NOT VERY GOOD COVERAGE-- THEY WILL HELP PAY FOR YOUR MEDICATIONS/

ALSO,MY SON WAS DIAGNOSED AT 17YR OLD WITH ENTHISITIS, ON METHOTREXATE AND ENBREL-DOING BERY WELL. YOU NEED TO ASK QUESTIONS,YOU NEED TO BE YOUR OWN ADVOCATE!!!! READ,EMAIL AND ASK QEUSTIONS OF YOUR DRS SO YOU CAN MAKE EDUCATED DECISIONS FOR YOURSELF.

Dora

21 Aug 2010, 15:15

Last week I was diagnosed as having Psoriatic Arthritis. I went to the specialist after having a swolen finger for 5 months with swelling that refuses to go away. No pain. The doctor prescribed ibuprofen, but recommends that I'll take Methotrexate to prevent further deterioration. I'm reluctant to take Methotrexate because of its side effects. Did any of you who is taking Methotrexate experienced a full remission?
Thanks,
D

kerri routledge

10 Aug 2010, 16:25

i was told i have rheumatiod arthritis just a few months ago but dealing with the pain and flares for about a year now, i was started on 10mg of prednizone daily by my reg. dr ,then my rheumatoligist put me on 8/2.5mg of methotrexate(once a week) ,1mg of folic acid and 10 mg of prednizone daily. but still no relief. now he wants to(ADD ANOTHER MED) put me on enbrel weekly injections. as like everyone in the u.s. insurance is hard to afford. im on a very limited insurance it only allows max $250 for labs and meds, how can u get the treatments u need when u make to much for welfare but not enough for a good insurance(not to mention if i change insurance now its PRE ADSITING CONDITION)im 36 yr old single parent and if i dont work, we don't eat. but now i have this RA that is now in control of my body. im depressed all the time. in constant pain and cant afford the new meds the dr what to prescribe.much less the monthly labs and dr app that are paid out of pocket. whats sad is the side effects means less to me that not being able to provide for my son. i feel like im at a dead end road. there has to be something out there to help. being in pain all the time is very over whelming, i just wish this nightmare would end. the embarrassment of not being able to do the simple things. not being able to work longer than a 5 hour shift or suffer the consequences. to be told there is no cure that i will have this for the rest of my life is so depressing. how do u exercise if u cant even stand some days much less walk. please tell me there a light at the end of the tunnel. i keep hearing there are grants out there to help people with there treatments. any info will be greatly appreciated! and best wishes to all dealing with this.

Regina

22 Mar 2010, 19:11

I was diagnosed in October last year. The doc.said i had a very severe case of ra. After the month of methotrexate i was in pain, so he thought i had polymyositis. But he says its ra. Can anyone give some information on the difference between the two? ALL I know is that they have the same treatment. Im on methotrexate 6 pills and humeria.

warren ross

08 Feb 2010, 15:32

I NAVE PALINDEOMIC RHEUMATOID ARTHICTIS
AND WOULD LIKE MORE INFO.

THANKS YOU

gunnar

09 Jan 2010, 01:30

I have also had extreme fatigue that I have been fighting with.... and depression. Kind of feeling like I am worthless. The good thing is that I recognize this, however, I still feel this way.

Gunnar

09 Jan 2010, 01:25

I was recently diagnosed. I was in so much pain that I went to a walk in clinic. I am ultimately with an RA Dr. and he has me on steroids ( i think he said 10%). I feel great now, but have been on steriods for this before for a week, and know that when I come off the 30 day steroids, that it will be hell again.
My docter is older and I would like a younger Dr. in the Brookfield, WI area. I told him I quit smoking in July ( 6 mos. ago) and he can't relate to that. Never smoked etc. I am currently on nicotine gum.
I had a ton of stress in the last 6 months that may have lead up to this. Including quitting smoking. Any thoughts out there? The nicotine gum symtoms seem to be similar to the RA. What do you all know about this?

JOY

17 Nov 2009, 17:37

Several people have told me they had good results after treating RA symptoms with minocycline or other cycline drugs. Anyone have experience with either of these?

Tonya

15 Oct 2009, 21:46

I was diagnosed with Lupus 2.5 years ago. I was in and out of the ER monthly for the first year. To Brenda: I was covered in sores all over my hands and elbows at every joint. Some were even open. My symptoms have been controled since late last year. I take methotrexate once a week. Watch that you have blood tests monthly. I went from 8-6 a week when a small problem arose. It has not shown up again. I take placquinal twice a day, I am down to 3 prednisone a day. For the sores I was put on Nebumetone twice a day. So far they have not returned. You can get low iron levels so I take 1 folic acid a day. When you look at it all it sound like a lot of medicine but except for a small flare up after taking the flu shot I have been fine for most of this year. It just took a while to get used to remembering all of it. When I look at where I started and where I am now I can live with it.

joyce

28 Sep 2009, 21:38

My PCP thought I was a drug seeker when he first met me, because I complained of such bad pain, and aparently I didn't "look like" I was in pain. I wasn't having a flare but I was truly in pain. He decided he would prove there was nothing wrong with me by ordering blood tests, well he had egg all over his face! When he had me return to go over my results I was shocked because he actually told me he thought I was just looking for drugs! And quickly apologized, and told me I need to see a Rhum.

Noella Willier

24 Jun 2009, 01:27

I was diagnosed with R.A. in 2000 and kept it in remission with natural remedies for 5 yrs when I ran out of money and the R.A. went full blown I went on Metrotrexate in at end of 2006 and have been on Metrotrexate and celbrex combo and Metro and Naproxen which went well for about 6 months and now I am on Metro and predisone which has given me the best results as a combo. After reading side affects of people in their 60's, its risky business. I lost a bro of lupus and I am T.B. positive and my rheumatologist is pushing Enbrel on me and after reading the enbrel side affect experiences, it does not sound too promising, does anyone have any suggestions for me please. Noella

Lou

05 Jun 2009, 22:11

I was diagnosed with RA two months ago.
Started on Prednisone,Meloxicam and Mesothraxate 4 pills once a week.
After the forth week of Mesothraxate I developed a lung infection and my Rheumatologist took me off of it. Went to see him two weeks later after I was better and he decided to put me back on the Mesothraxate because he is not sure if the infection was caused by the medication.
Honestly I am afraid to take Mesothraxate again, but I am also afraid to start on biologics.
I am so confused when it comes to making the right decision on the course of treatment.
I think I just want to call and tell the Dr. that I don't want to try Mesothrexate again but feel that he is the doctor and that I should do what he says.
A confused patient.

Dawn Masterson

05 Jun 2009, 20:52

I thought I had a high resistance for pain. But nothing prepared me for RA. It started in my feet, then knees. My doctor ordered water pills to get rid of the swelling. This probably brought my RA out of hiding. Then all of a sudden I was an invalid. I called the doctor crying I was hyperventilating ready to call an ambulance. They finally gave me steroids. I have relief now for 2 days but oh my God I guess I have something very horrible.

Dawn Masterson

05 Jun 2009, 20:51

brenda

02 Jun 2009, 15:50

I have been recently Dx with RA. My Rheumatologist Rx Placquinil / and steroids. The steroids masked the side effects of the Placquinil x 2 weeks.When the steroids wore off I broke out in a rash all over my body with open sores,in my hair and in my mouth. I itched like crazy for 4 days, could not sleep and was sent to a Dermatologist he Rx steriods high dose x 2 days - I continued to break out and itch/ no sleep still, I was exhausted.He(dermatologist) Rx cyclosporin x 4 days.After 2 days I finally went to sleep. It has been 2 months since this happened I still have dry itchy skin and still have RA. Makes me wonder(what did this medicine do to my vital organs) I am apprehensive about going back to see my Rheumatologist.I know there are other medicines out there that are used.I ask myself (am I?) brave enough to jump in for another round of hell? It Will take some time for me to decide, I suppose I am doomed for RA.

Kay Teague

26 Apr 2009, 20:54

I have been diagnosed for the 2nd time with RA.
I was diagnosed with Fibromyalgia in August 2001 by a Rheumatologist. I followed her instructions, went to physical therapy, am being followed by a psychariatist, and told the medicine she prescribed. After about 2 years I started having bad joint pains.She said it was just the fibro and she started prescribed really strong narcotics. I have always had a slightly elevated Rheumatoid factor, but the other tests have been normal until about 3 years ago when my WBC, RBC, and platelets started being elevated. I wasn't able to get an appointment with my Rheumatologist when both of my knees almost doubled in size with increased pain, warmth, and redness. My primary care doctor stated I had rheumatoid arthritis-he was aware of the fibro history and joint pain history-he started me on low dose of Methotrexate and
Prednisone. I responded quickly and felt much better. At my next appointment with the Rheumatologist, she asked why I was taking methotrexate I told her my PCP put on it because of my knees. She was quite agitated and said "YOU ONLY HAVE FIBROMYALGIA, YOU DO NOT HAVE RHEUMATOID ARTHRITIS!!!" and told me to stop the prednisone and methotrexate.
My insurance changed and I wasn't able to she her any longer. My primary care doctor retired. My pain and fatigue became so bad I had to quit work. I waited almost 3 years to be declared " disabled" in December 2008. In Greenville County SC there are not many rheumatologists. Most of them want to review a patient's records before they accept them into their practice. The wait for a new patient appointment is about 4 months. Most of them will turn down a patient with fibromyalgia. Last fall, I started having problems with my feet and ankles, so I went to see my orthopaedic doctor that did surgery on my feet. He looked at me and said I think you have more going on with you that fibromyalgia and he ordered some lab. MY non cardiac CRP was elevated so he referred me to a new hospital based rheumatology group. I was seen as a new patient within 2 weeks. My new rheumatologist is wonderful. I have been seeing her since Dec 1, 2008. After knee xrays (never ordered before), several medication trails, wrist MRI, and follow up wrist x-ray to verify fluid accummulation, she has restarted me on methotrexate 2.5 mg take 4 one day a week and Folic acid 1gm daily. I can't say I'm feeling much better yet because I've just started these meds but I know that she is concerned about me. She admitted to me that I don't really look like I have RA unless you review all my symptoms,
elevated CRP, slightly elevated Rh factor, elevated WBC and platelets, positive MRI and x ray results, strong family history of RA on both sides of the family, osteopenia, DDD, entrapment syndromes-carpal and tarsal tunnel, it all adds up. I don't know what it takes to get a doctor to recognize other symptoms other than labs. But this new doctor was able to piece together several symptoms because she was willing to listen to her patient and doesn't depend on labwork results. Early detection of RA is critical to prevent joint destruction and early symptoms may be different. Unfortunately, I feel that my RA has not been caught early and I think it is likely I will need to move beyond methotrexate to the next line of RA drugs. To all doctors, RNs, PAs, ,and rheumatologists, please please please listen to your patients, listen to what they are saying, ask questions, don't rely only on the standard lab results. It is possible to have more than one medical problem. Just because I have fibromyalgia, it doesn't rule out any other diseases. In fact, I read a report that states patients with RA have an increased chance of also having fibromyalgia.

Angela

19 Apr 2009, 19:35

What I find seriously concerning is seeing so many people that experienced what I personally had to go through with general MDs.
Should the Professional RA community consider better education in early symptoms recognition for PCPs?
I went through 6 months of hell to get diagnosed and start treatment, and I'm severe category RA, age 32 at diagnosis. I also "finally found a doctor" to take me seriously, but by that time I could barely move so they didn't have much choice. I was so severe that I was hospitalized 1 day later after finding my new PCP.

Why do so many general MD's not even consider RA?

Chassity

08 Apr 2009, 13:41

Nevermind...:]

Chassity

08 Apr 2009, 13:39

Hello, and excuse me. But I have a question which I not seem to find on here for some reason I'm in mi health class right now, and unfortunatly. I cannot find this question.
" For arthritis pain. What are the cures, symptoms, injuries,and cares for such thing?
Thank you,
Chassity Schenally

Jim

06 Apr 2009, 21:03

I'd like to second Dr. Deb's notion regarding follow-up. It would serve the audience well if the comments left by the community were followed up by the author of the source article. As community, we can respond to each other...but I know I'd benefit from the expertise of the Arthritis Today panel. This really is a great source of information. Of course there is always room for improvement.

Peggy

06 Apr 2009, 08:46

Diagnosed 6 weeks ago with RA; from what I read it is moderate to severe (I thought it was h...) and I see from comments I was very lucky to have an MD who didn't believe the negative lab work and sent me to a rheumatologist after my 2nd visit about roaming, crippling pain in multiple joints; he thought RA even though labs neg.; also very lucky to have a rheumatologist who chose to treat aggresively. No severe flares for 3 weeks, minor flares less frequent. I'm hoping for no flares soon.
I love this site, so full of good info, tips etc.. Thanks

deborah konietzko, md

24 Mar 2009, 00:06

I'd be interested to hear comments from the Rheumatologists quoted in the above article, after they've seen the comments.
The ones I've seen don't want to discuss current research, or (or "have time" to) have a real discussion about issues such as those many of the the people commenting above have raised.
I didn't have access to last year's European Rheumatology Conference concensus paper on RA, but have been told i should consider going to Europe because they are ahead of us in RA treatment! If i were well, had money and support people, that would be conceivable, but even then, it shouldn't be necessary!
US Rheumatologists: "we need help (here)!"
Please ask yourselves: "If it were my daughter, wife or mother, what would I recommend?"

Out of exasperation, I'm thinking of developing a pilot study; i am requesting input.

When doctors and nurses (3 out of the 5 of us commenting above) can't get good guidance from their colleagues, this indicates there are serious problems which need resolution.
Thanks.
Please forward this so we may be responded to.

sick n tired of being sick n tired

23 Mar 2009, 17:57

I was diagnosed with Psoriatic Arthritis/Rheumatoid Arthritis and probable spondylitis, 3 years ago. I am on my way to a pain management Dr at the suggestion on Rheumatologist. Humira worked good but exceeded my annual prescription benefits and got a serious infection on Remicade.

Currently I on Placquinil, NSAIDS no longer work, on my 6+ month of Orencia infusions, and on the maximum dosage of injectible methotrexate. What options are left for me?

I just turned 39 and take 14 meds a day (3 are vitamin/supplements-to ward off side effects the other 11 Rx)-which equats to 24 PILLS A DAY, on top of monthly B-12 shots, Orencia infusions and weekly methotrexate injections. Did I forget to mention, thyroid, kidney disease, hypertension, latent TB, fibromyalgia, chronic cough, IBS and osteopenia....

Leigh Ann

19 Mar 2009, 15:44

I recently have met w/rheumatologist who thinks I have RA and suggested methotrexate soon. I have a one year old and was planning on getting pregnant again at the time of this diagnosis. I'm unsure of where to plan my next pregnancy. I'm a 35 years old and do not want to wait too long to get pregnant again. Also, had flares last spring while pregnant, which they tell me is unusual.Also, do not want the disease to continue/start damage..Any suggestions?

amy

12 Mar 2009, 23:29

I was finally diagnosed last monday. Thanks to a doctor that actually listened to my concerns. I have been complaining of problems for years but to no avail. Looking back on my symptoms,I have probably had this at least 10 years but in a latent phase. General pain, easily dismissed skin pigmentation and OB complications that were written off as pregnancy induced hypertention (with acute renal failure of unknown origin). My doctor is suggesting celebrex only. I am not sure what to do even though I am an RN. I have exprience with RA but it is so different when you are the patient. I have been treating my symptoms with OTC's and massage for years but now my hips are involved. I am having difficulty walking even though i'm only 33. My doctor doesnt feel I need agressive treatment, mainly due to my age. Truthfully I am afraid of the drugs available. I had severe renal complications with both of my pregnancies. I don't want to end up on dialysis but at the same time, relief of the constant pain and fatigue would be nice.I am out of space!

mary alexander lpn

11 Mar 2009, 19:21

Ihavejust been diagnosed with RA but being an educated medical proffessional I have known for about two years I had the signs/symptoms of the disease.My Dr seems to think waiting on agressive treatment will be more benefical concerning my renal status.I am concerned with the benefits of early vs later treatment.I love my job as a Hospice nurse and do not want the disability to jeporadize that.Im only 46 and hope to continue working for several years.So which is more benefical with less side effects?

deborah konietzko, md

06 Mar 2009, 19:34

I find that, having RA myself, still "early" (one year out), the clinical skills of rheumatologists are very variable when signs are subtle. Some seem to think that if they can't see it from across the room, then you've got no problem... Maybe symptoms, but not worth treating...
There is still a great reticence to treat at the subtle early stage, even when there are blood markers (RF and anti-CCP) unless they include CRP. Also there is a lack of LISTENING to the patient.
And as for use of ultrasound or extremity MRI, these are barely utilized. Since it's hard to predict how much progression which patients will have, and since MRI findings (not plain films) can show occurrence of abnormalities within the first 6 months, it would seem eminently reasonable to get some kind of baseline to track those you are lucky enough to reach early on.
But there's no interest...
Is it all about the money?
sign me,
A frustrated doc

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Arthritis Treatment: Early is Best

Receiving rheumatoid arthritis treatment sooner rather than later may be your key to remission

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