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Joints, Muscles and Bones Rheumatoid Arthritis Treatment
Treatment
Treating RA

Treatment

There are multiple approaches to treating RA, and not everyone has the same response to the same treatment.1 Early initiation of treatment can reduce the risk of joint damage and help improve outcomes for the individual with RA.1,2

Disease modifying anti-rheumatic drugs are a group of medicines used to treat RA. There are three main types of DMARDs – conventional DMARDs, biological DMARDs and targeted synthetic DMARDs which are described below. Surgery and other treatment options may also be recommended.1

Disease-modifying anti-rheumatic drugs (DMARDs)

DMARDs are medicines that help slow down RA and protect your joints from damage. While painkillers and anti-inflammatories help you feel better short term, DMARDs treat the underlying cause of RA — your immune system attacking your joints.

Conventional DMARDs

Conventional DMARDs, which are usually taken as tablets,, aim to slow RA progression and ease symptoms.1 Conventional DMARDs work by broadly blocking the effects of chemicals released when your immune system is attacking the joints.1 There are many different types of conventional DMARDs, you may have to try different types to find the one that works best for you.1

Keep taking the DMARD recommended by your doctor even if the effects are not immediately noticeable. It may take a few months to notice the impact of a DMARD.

Biologics and biosimilar DMARDs

Biologic medicines refer to medicines made from a biological source, such as living cells and organisms. “Biosimilars” is another term that may be used when talking about biologics. Biosimilars are biological medicines which are highly similar to the original biologic reference medicine in terms of quality, safety and efficacy. This means there is no clinically meaningful difference to the original biologic medicine. 

Biologic DMARD treatments, given by injection, are usually used in combination with conventional DMARDs and usually after conventional DMARD treatment has not been effective.1 They target specific parts of the immune system to reduce inflammation more precisely.

Targeted synthetic DMARDs 

Targeted synthetic DMARDs are DMARDs that work to block signals transmitted in the body from the immune system. Like biologics, targeted synthetic DMARDs target molecules related to inflammation, but these medications are synthetic rather than biological in origin.3 

Targeted synthetic DMARDs are tablets which are taken orally and, like biologics, are usually used in combination with conventional DMARDs and usually after conventional DMARD treatment has not been effective.1

Surgery

Medicines cannot always prevent your joints from becoming damaged. Surgery may be required to restore joint function, reduce pain, or fix deformities.1

Types of surgery that may be recommended for individuals with RA are summarised below:1

“Finger hand and wrist surgery (icon of a hand and a scalpel): examples include carpal tunnel release, release of tendons in the fingers, and removal of inflamed tissue lining finger joints. Arthroscopy (icon of a joint being operated on): removing inflamed joint tissue by inserting a thin tube with a light and camera (arthroscope) and removing damaged tissue via other small cuts and instruments. Joint replacement of ‘arthroplasty’: replacing part or all of a joint (e.g. hip, knee, or shoulder.”

Other treatments for RA

Several other treatments and approaches may be recommended, usually in combination with the other main options such as DMARDs and biologic treatments.1

These include:

Make sure to follow your doctor’s advice. For example, if you’re prescribed NSAID tablets, you may also be given another medicine called a proton pump inhibitor (PPI) to reduce the risk of damage to the stomach lining.

References

  1. NHS England. Rheumatoid Arthritis – Treatment. Available at: https://www.nhs.uk/conditions/rheumatoid-arthritis/treatment/. Last accessed April 2025.
  2. Smolen JS, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4, 18001.
  3. Biologics vs. JAK inhibitors for psoriatic arthritis – Medical News Today. Available at: https://www.medicalnewstoday.com/articles/biologics-vs-jak-inhibitors-for-psoriatic-arthriti. Last accessed April 2025.