Treatment for rheumatoid arthritis begins with and is usually dependent on medicine. Many of these medicines can sometimes cause serious side effects. When thinking about side effects of treatment, there are four important things to remember:

1. If untreated, rheumatoid arthritis leads to pain, dysfunction, and disability. If properly treated, the disease can be controlled, and functional status can be prolonged and often maintained.
2. The risk of side effects from treatment is many times less than the risk of deformity and disability if the disease is not treated.
3. Almost all side effects can be detected early and disappear when treatment is stopped.
4. The chances of serious side effects are low, and permanent damage from treatment is rare.

All of the medicines used to treat rheumatoid arthritis have some side effects, and some of the medicines have potentially severe side effects. These range from nausea and a mildly increased risk of infection to anemia and liver damage.

It would be best if doctors knew which people are most likely to develop severe joint destruction and deformity from their rheumatoid arthritis and could recommend the most aggressive treatment only for these people. But no such accurate projections of the course of the disease exist. At the same time, many of the current medicines, when used early in the course of the disease, can significantly decrease the total damage done to the joints. Since rheumatoid arthritis is a progressive disease with joint deformities that cannot be reversed after they occur, most doctors have come to the conclusion that it is best to recommend early, aggressive treatment with careful follow-up to catch any treatment-related toxicity immediately rather than waiting for permanent damage to happen.

Lack of durability of rheumatoid arthritis treatments

For reasons that are not totally understood, many treatments for rheumatoid arthritis lose their effectiveness over time. Why this loss of effectiveness occurs is unclear. But it may be related to the immune system becoming desensitized by a given course of treatment. Fortunately, the development of additional medicines that can fight rheumatoid arthritis provides further options for treating the disease if initial drugs lose their effectiveness.

The risk of not taking medical therapy

There are risks associated with medical therapy for rheumatoid arthritis. But it is worth remembering the risk of not taking the medicine. Rheumatoid arthritis is a progressive disease that causes destruction and deformity of the joints. After this damage occurs, it cannot be reversed. Medicine must be taken early in the course of the disease, before a lot of damage has occurred, to prevent progression of the illness.

Making the decision to take the risk of side effects can be difficult. To minimize risks to yourself, make sure that you are in close contact with your doctor while starting medicine so you can deal with and treat any potential toxicities of the medicine early and can adapt your therapy to medicines that you can tolerate and will take.