Some people with rheumatoid arthritis (RA) are apprehensive about talking to their arthritis doctor about taking disease-modifying anti-rheumatics (DMARDs) or biologics to gain control over their symptoms. Although there are potential risks with any medication, the choice to avoid treatment can be costly.
RA Is A Debilitating Disease
Since many people erroneously liken RA to osteoarthritis (OA) they assume RA is merely some aches and pains. Much like OA, RA can destroy the joints it affects, leading to the need for joint replacements and causing significant disability. RA differs significantly from OA because of the underlying diseases process, which is mediated by the immune system. This means the damage is caused by over-activity of the immune system and it specifically targets the synovial membrane, leading to damage in the joints and surrounding soft tissues. Unlike OA, RA is widespread, meaning it typically affects most joints symmetrically. Although its effects on the small joints of the hands and feet are most notable, it also affects the large joints and can cause damage to the cervical spine. To a lesser degree, the organs may be affected, such as the heart and lungs.
RA Increases Your Risk Of Other Conditions
Systemic inflammation can cause damage to the vascular system, increasing the risk of early-onset heart disease. Another concern with uncontrolled RA is the potential for development of cancer, specifically those affecting the lymphatic system and blood cells. Ongoing inflammation also weakens the joints, which can lead to osteopenia or osteoporosis. Other conditions that may be indirectly related to RA include those that may be associated with its debilitating effects. It is often harder for people with chronic joint pain, swelling, and limitations to maintain their activity. This can lead to increased weight gain, further making activity more difficult. Excess weight and little physical activity is often correlated with higher rates of diabetes and hypertension, which can do damage on their own.
RA Can Become Harder To Control
Many rheumatologists advocate early, aggressive treatment to minimize the risks associated with RA. The longer inflammation remains out of control, the harder it is to find a medication that works. Additionally, sometimes patients or their doctors believe going into remission is a good reason to stop a current therapy. If you have found a medication that has been successful at reducing symptoms, stopping can be damaging. RA will eventually flare up again, because it is a chronic disease. In many cases, the previous successful treatment will no longer work because your immune system will have developed a tolerance to its effects, making it harder to find a different treatment when symptoms return.
Before you decline treatment for RA or agree to stop your current treatment after achieving remission, think seriously about the long-term ramifications. Achieving and staying in remission will give you the best possible chance of avoiding joint damage and maintaining your functionality.
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