Are my rheumatoid arthritis meds safe for the long term?

Question

Hello doctor,

I am 38 years old and was recently diagnosed with rheumatoid arthritis after having joint pain and morning stiffness for many months.

My fingers and wrists feel stiff, especially in the morning, and sometimes I feel very tired also. The doctor started medicines, but I am worried about long-term joint damage.

Can rheumatoid arthritis cause permanent joint deformity if not controlled properly?
Also, are these medicines safe for long-term use, or do they have serious side effects?
And does diet or exercise help in controlling rheumatoid arthritis symptoms?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I understand your concern regarding the disease, but rest assured, while rheumatoid arthritis can look fearsome from the picture of deformities you might have imagined, we don't tend to see these deformities as common as before, and the trick here is that most cases are now diagnosed and managed early.

Early diagnosis and immediate initiation of proper immunosuppressive treatment help a lot in reaching early remission of the disease and thus hinder its clinical and radiographic progress. The key is to keep following up regularly with your doctors even if you are controlled under medication so that any early signs of disease activity can be controlled earlier and, at the same time, to regularly check for adverse events of the drugs.

These drugs do have some side effects regarding hepatotoxicity, bone marrow suppression, infection risk, and teratogenicity for some of them during pregnancy. Rest assured, as long as you're following up regularly with new investigations, including CBC (complete blood count), liver and renal functions, we can detect any early adverse events and properly manage them.

The recommended treatment includes Methotrexate 25 mg once weekly along with Folic acid 5 mg once weekly. A brief period of steroids taken at a dose of 10 mg per day is recommended for a two-week period only. Calcium and Vitamin D supplementation should also be continued as part of the treatment plan. A follow-up visit is recommended three months after starting therapy to assess the response to treatment and determine the next steps in management.

Finally, obesity tends to increase inflammation, so weight reduction and diet management do help in controlling disease activity in addition to our medications.

I hope I have answered your question.

Let me know if I can assist you further.

Regards