Many patients ask: After a period of rheumatoid arthritis treatment, the joints don’t hurt anymore, so is it possible to stop taking medication? Other patients wonder: rheumatoid arthritis often cannot be cured, so what is the purpose of treatment? In general, the main symptom of rheumatoid arthritis is joint pain. Patients often also have swollen joints due to the pathological synovitis changes characteristic of rheumatoid arthritis. For joint swelling and pain, currently available medications such as oral NSAIDs (e.g., diclofenac, ibuprofen, meloxicam, celecoxib, etc.) and glucocorticoids (e.g., prednisone) are effective drugs. However, the process of internal joint lesions (e.g. synovial inflammation, synovial hyperplasia, subchondral destruction and bone erosion) does not really stop, and only a longer application of disease-modifying drugs (referred to as DMARDs, commonly used are methotrexate, leflunomide, hydroxychloroquine, and salazosulfapyridine) can stop the progression of the disease. In particular, some patients believe in the exaggerated efficacy of advertising, through the mail or in Southeast Asia, Hong Kong and Macao to buy rheumatoid “special drugs”, often containing the above-mentioned non-steroidal anti-inflammatory drugs and and glucocorticoids. For example, unscrupulous manufacturers have added prednisone or dexamethasone (another medium to long-acting glucocorticoid) and indomethacin (i.e., anti-inflammatory pain) to some Chinese medicine powders. After taking these drugs, the disease seems to be controlled in a short period of time, and the patient stops seeking further medical attention and does not seek specialist care. After taking the drugs for a period of time, the amount of “special drugs” needed to take more and more can not control the symptoms, until the body becomes fat, and even compression fractures, gastrointestinal bleeding and other side effects know that they have been fooled, but has missed a good opportunity for early diagnosis and treatment. Joint protection is the goal In reality, patients are more concerned about joint pain or not, swelling or not. Rheumatologists are not only concerned about the patient’s swelling and pain, but also about whether the drugs can stop the destruction of the bones and joints. Therefore, the principle of treating rheumatoid arthritis is to give NSAIDs and, if necessary, glucocorticoids to relieve pain and swelling as soon as possible. DMARDs will also be used early to reduce or delay bone destruction. Current research has found that joint swelling and pain and joint destruction are controlled by different signaling pathways, and sometimes the patient’s joints are not swollen and painful, but joint destruction continues silently. Therefore, in today’s situation where rheumatoid arthritis cannot be cured, it is our highest goal to prevent joint destruction, protect joint function, and maximize the patient’s quality of life. To achieve this goal, on the one hand, it is important to grasp the timing of treatment, early active and rational use of disease-modifying anti-rheumatic drugs (DMARDs); on the other hand, it is also important to adhere to long-term drug therapy, the chemically synthesized drugs in such drugs often take 4-8 weeks to take effect, so you must be patient. It is important to follow up and adjust the medication in a timely manner. It is clear that the relief of rheumatoid arthritis symptoms after treatment is not the same as the cure of the disease; the recent effect is not the same as the long term effect; DMARDs can delay the progression of the disease but cannot cure rheumatoid arthritis. Of course, as most of the currently used anti-rheumatic drugs have bone marrow suppression, liver function damage and increase the possibility of infection. Therefore, in order to avoid adverse drug reactions, blood and urine routine, liver and kidney function should be closely observed during the medication and the dosage should be adjusted at any time. How should the patient cooperate? Patients in early stage, acute stage or with persistent active disease should be followed up once a month until the disease is controlled. Patients in remission can be followed up every three months to six months, and the doctor will adjust the medication according to the patient’s disease activity in time to achieve remission or low disease activity. When the patient’s joint swelling and pain are reduced, try to reduce the dosage of NSAIDs and glucocorticoids or even stop using them, especially in patients who are older, have coronary heart disease, hypertension combined with aspirin use, and have a history of gastroduodenal ulcers. DMARDs should be used for a longer period of time under the guidance of a specialist, unless special circumstances such as infection, hepatic impairment, bone marrow suppression and planned pregnancy occur.