When it comes to rheumatoid arthritis, it used to be widely believed to be an “incurable disease” and an “undead cancer”. Indeed, rheumatoid arthritis is an incurable rheumatic disease with complex causes and diverse manifestations, and medical science was once at its wits’ end. However, in the past decade or so, modern medicine has significantly improved the treatment effect of rheumatoid arthritis, and the goal of treatment is no longer limited to “stopping pain and controlling symptoms”, but rather “relieving the disease”, 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. The rheumatoid arthritis treatment myths Myth 1: Look at the ads and take the drugs. The actual fact is that you will find a lot of people who are not able to see the obvious results within a short period of time in the regular hospital, and many patients often look at the advertisements to buy drugs, or are entrusted with some so-called special drugs, native medicine treatment. The composition of these drugs is generally just dexamethasone (a long-acting hormone that should not be taken for a long time), anti-inflammatory pain and vitamins. And the drug sellers will say: “This product is composed entirely of herbal formulas and vitamins” and is a special medicine for rheumatic diseases. It is true that patients feel great pain relief in the early stage of taking the drugs, but these drugs cannot really relieve the disease, and long-term use of joints are still seriously deformed, and may bring gastrointestinal damage (even gastrointestinal bleeding, perforation), osteoporosis, infection, diabetes and other adverse reactions. Therefore, it is very easy to see advertisements to buy drugs or purchase their own native medicine is very dangerous, and will make the original simple condition become complicated. Misconception 2: Seeking medical help when you are sick. Patients with 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, “all drugs are toxic in three parts”. Both Western and Chinese medicines have certain toxic side effects. For example, Chinese medicine has ovarian toxicity, which is reversible in the early stages, but can inhibit reproductive function and early menopause if applied for a long time, and may also affect liver function and white blood cells. Do not pursue a one-sided treatment without side effects, because many “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. Rheumatoid drugs include those that control symptoms and those that relieve the disease, and those that relieve the disease work relatively slowly. Long-term treatment is required. The key to effectively stop joint destruction is “early” and “standardized treatment” 1, early treatment rheumatoid arthritis cartilage or bone destruction can occur within three months of the onset. 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 the symptoms appear, you should go to the rheumatology department of a regular hospital as soon as possible. 2, standardized treatment Currently, the treatment of rheumatoid arthritis drugs are divided into several categories. One is the drugs to control the symptoms, mainly including anti-inflammatory and pain-relieving drugs; the other is the drugs to relieve the disease, mainly including immunosuppressants 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 released the latest treatment recommendations for rheumatoid arthritis to the world in 2008. 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 biologics (mainly two kinds of tumor necrosis factor antagonists and CD20 monoclonal antibodies), which mainly target some patients with more severe arthritis and achieve outstanding efficacy, but may also have some adverse effects, mainly because of the high price, which limits the popularity. Specialists should use a combination of palliative antirheumatic drugs according to the severity of the disease. Methotrexate is the drug of choice and is the centerpiece of the combination therapy 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 they are being applied under the guidance of a specialist. In addition, other drugs used to treat rheumatoid arthritis include Leflunomide, hydroxychloroquine, salazosulfapyridine, azathioprine, and some plant-derived immunosuppressants such as Radix et Rhizoma and Paeoniflora totalis (Paflin). How to think about “hormones” When it comes to hormones, people can 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 on top of antirheumatic drugs (e.g., methotrexate) to relieve the disease; the other is that “small doses and short courses of treatment” should be used, for example, the daily dose of prednisone should not exceed 3 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 delay joint destruction and play a synergistic role with other antirheumatic drugs for disease relief. As a result, the position of hormones in the treatment of rheumatoid arthritis has changed. As one scholar described, “Abuse hormones, and they are the devil that helps the enemy; use them just right, and they are the angel.” In conclusion, as modern medicine has updated its understanding of rheumatoid arthritis and its therapeutic perspective, the efficacy of treatment has 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.