Treatment of rheumatoid arthritis

  Rheumatoid arthritis is an autoimmune disease of unknown etiology, with a prevalence of about 0.32-0.36% in China. The main manifestation is symmetrical, chronic, progressive polyarthritis, resulting in destruction of joint cartilage, bone and joint capsule, eventually leading to joint deformity and loss of function.  Rheumatoid arthritis is treated with a variety of medications, commonly used drugs are divided into four categories, namely non-steroidal anti-inflammatory painkillers, anti-rheumatic drugs to improve the condition, glucocorticoids and botanicals. Although NSAIDs can reduce the symptoms of rheumatoid arthritis, they cannot change the course of the disease and prevent joint destruction, and must be used in combination with anti-rheumatic drugs to improve the disease; anti-rheumatic drugs to improve the disease work slowly, although it does not have immediate pain relief and anti-inflammatory effects, but has the effect of improving and delaying the progress of the disease.  Small doses of glucocorticosteroids (prednisone 10mg daily or equivalent other hormones) can relieve the symptoms of most patients, and act as a “bridge” before the effect of disease-modifying anti-rheumatic drugs, or as a short-term measure when the effect of non-steroidal anti-inflammatory analgesics is unsatisfactory, but the tendency to treat rheumatoid arthritis with hormones alone must be corrected. The tendency to treat rheumatoid arthritis with hormones alone must be corrected. It should be clear that the relief of symptoms after treatment is not the same as the cure of the disease, and the recent effectiveness is not the same as the long-term effectiveness.  Most patients with rheumatoid arthritis have a prolonged disease course, and the disability rate for the first 2-3 years of rheumatoid arthritis is high, and if not treated early and reasonably, joint destruction can reach 70% within 3 years, while active and correct treatment can lead to remission in more than 80% of rheumatoid arthritis patients, and only a few eventually become disabled. Therefore, early and aggressive treatment with anti-rheumatic drugs that improve the disease is the key to reducing disability.  In addition to rational drug therapy, patients should also be aware of the many lifestyle considerations for rheumatoid arthritis and the rehabilitation exercises for the affected joints.