When it comes to rheumatoid arthritis, it is widely believed to be an “incurable disease” or even an “undead cancer”. Indeed, rheumatoid arthritis is an incurable rheumatic disease, medical science was once helpless to do anything about it, and many patients in the past suffered from the pain of the disease for a long time, eventually leading to the end of joint deformation and disability. However, in the past decade or so, modern medicine has significantly improved the treatment of rheumatoid arthritis, and the goal of treatment is no longer limited to “symptom control”, but rather “remission”, stopping joint destruction and preventing disability. To achieve this goal, the key is “early standardized treatment”.
Unfortunately, there are still many “misconceptions” about the treatment of rheumatoid arthritis.
Rheumatoid arthritis treatment myths
Myth #1: Self-selected rheumatic drugs.
Because rheumatoid arthritis is a chronic disease, it cannot yet be completely eradicated. Many rheumatism patients have long been a doctor, often shopping for their own drugs, or friends and relatives from Hong Kong and Macao or abroad to buy some so-called special drugs treatment. The composition of these drugs is only dexamethasone (a long-acting hormone that should not be taken for a long time), anti-inflammatory pain and vitamins. The Chinese instructions, however, state that “this product is composed entirely of herbal formulas and vitamins” and that it is a special medicine for rheumatism. It is true that patients feel very relieved of pain in the early stage of taking the drugs, but these drugs cannot really relieve the disease, and the joints are seriously deformed as usual with long-term use, and they may bring adverse reactions such as gastrointestinal damage (even gastrointestinal bleeding and perforation), osteoporosis, infection and diabetes. Therefore, self-selected rheumatic drugs are very prone to danger, and will make the original simple condition becomes complicated.
Myth #2: Seeking medical help when you are sick.
Patients who have rheumatoid arthritis are often very anxious. On the one hand, because the pain and swelling of joints all over the body seriously affects work and life, on the other hand, is worried about joint deformation and disability, and looking around for a cure “famous doctors, secret recipes”. All the “famous doctors” have searched everywhere, the size of newspapers, television, advertising on the “rheumatic drugs” have tried. A few years down the road, not only to see a doctor to take medicine spent a lot of money, and more harm is to delay the timing of treatment, joint damage and deformation in the end.
Misconception 3: Western medicine has a lot of side effects, but Chinese medicine has no side effects.
In fact, “every medicine has three toxins”. Both Western and Chinese medicines have certain toxic side effects. For example, the Chinese medicine Leigongteng has greater ovarian toxicity than the western medicine, long-term application can inhibit reproductive function and early menopause, and may also affect liver function and white blood cells.
Do not pursue a one-sided treatment with no side effects, as many of the “silver bullet” type drugs do not work at all. Of course, experienced doctors will try to choose an individualized treatment plan with good therapeutic effects and no obvious adverse reactions according to the patient’s specific situation, and closely monitor the indicators of adverse reactions to improve the safety of drug use.
Myth 4: Stop taking the medication on your own when your joints don’t hurt anymore. After a period of treatment, some patients find that their symptoms have been reduced, so they stop taking the medication and stop treating themselves. In fact, the improvement of clinical symptoms and the complete remission of the disease is not the same, no pain may only be a superficial phenomenon, arbitrary discontinuation of drugs to relieve the disease, the lesion will continue to move forward. The drugs used to treat rheumatoid arthritis include those that control the symptoms and those that relieve the condition, with those that relieve the condition taking effect relatively slowly. Rheumatoid arthritis requires long-term treatment.
The key to effectively stop joint destruction is “early” and “standardized treatment”.
1.Early treatment
Rheumatoid arthritis cartilage or bone destruction can appear within 3 months of the onset of the disease. The internationally recognized treatment window (i.e., the best time for treatment) is within 3 months of disease onset. Numerous clinical cases confirm that most joint erosions in rheumatoid arthritis occur within the first 1-2 years of disease onset. At this point, if appropriate treatment is not given immediately, it can lead to joint deformity and impaired function, making the disease more difficult to treat and reducing the patient’s quality of life. Therefore, it is advocated that once symptoms appear, you should go to the rheumatology department of a regular hospital as soon as possible.
2, standardized treatment
At present, the treatment of rheumatoid arthritis drugs are divided into several categories. One is the drugs to control the symptoms, also known as the drugs to treat the symptoms, mainly including anti-inflammatory and pain-relieving drugs; the other is the drugs to relieve the disease, also known as the drugs to treat the root cause, mainly including immunosuppressive drugs and other slow-acting drugs (DMARDs). The standardized treatment of rheumatoid arthritis is the early use of these disease-relieving anti-rheumatic drugs. This is because only this class of drugs can control the disease and stop joint destruction and deformation. The American College of Rheumatology has released the latest treatment guidelines for rheumatoid arthritis to the world. The Chinese Society of Rheumatology in China has also developed relevant treatment guidelines that further emphasize the importance of early standardized treatment of rheumatoid arthritis. Another new class of drugs is the biological agents (tumor necrosis factor antagonists), which mainly target some patients with more active arthritis and achieve better efficacy.
Specialists should use a combination of palliative anti-rheumatic drugs according to the severity of the disease. Methotrexate is the drug of choice and is the centerpiece of the combination regimen. Although methotrexate is currently recognized as the most effective drug for the treatment of rheumatoid arthritis worldwide, it was approved by the U.S. FDA for the treatment of active rheumatoid arthritis as early as 1988. However, in China, it is still listed as an “anti-tumor drug” in the manual, which inevitably raises questions and concerns among patients. In fact, methotrexate is a classic immunosuppressant that plays both an immunosuppressive and anti-inflammatory role in the treatment of rheumatoid arthritis. Its application in rheumatoid arthritis is very different from oncology treatment and the dosage is smaller. Patients can rest assured that it is applied under the guidance of a specialist. In addition, other drugs used to treat rheumatoid arthritis include Leflunomide, hydroxychloroquine sulfate, salazosulfapyridine, azathioprine, and some plant-derived immunosuppressive drugs.
How to view “hormones”
When it comes to hormones, people love and hate them. Because of their rapid anti-inflammatory and pain-relieving effects, hormones (adrenocorticotropic hormones) have been widely used in the treatment of various kinds of arthritis in the past decades. At present, the irrational use of hormones is still quite common, and this has brought great harm. As a result, people are resistant to hormones and believe that they are addictive if they are used.
In fact, both “abusing” hormones and “blindly opposing” hormones are undesirable. First of all, hormones should not be abused and are not the first choice of treatment for rheumatoid arthritis. However, hormones can and should be used if there are severe joint symptoms, persistent active synovitis, or severe extra-articular manifestations, such as vasculitis or organ damage. However, there are two important principles in the application of hormones: one is that hormones must be added to antirheumatic drugs (e.g., methotrexate) used to relieve the disease; the other is that “small doses and short courses” should be used, for example, the daily dose of prednisone should not exceed 2 tablets and the course of treatment should be controlled within 3-6 months. The other is “small dose and short course”.
Recent studies have found that early and short-term application of hormones in small doses can perpetuate joint destruction and play a synergistic role with other antirheumatic drugs to relieve the disease. Thus the position of hormones in the treatment of rheumatoid arthritis has changed. As one scholar described, “Used properly, hormones are angels; abused, they become demons that aid the evil.”
In conclusion, as modern medicine has updated its understanding of rheumatoid arthritis and its therapeutic perspective, outcomes have gradually improved. Rheumatoid arthritis has changed from an “incurable disease” to a “treatable disease” in the past. However, the key to alleviating rheumatoid arthritis is early and standardized treatment.