Medication Is The Key to Achieving Remission

[Amy_Lee]

The most important factor in rheumatoid arthritis remission is early and aggressive treatment with medication that improves or alleviates symptoms and halts the progression of the disease, says Dr. Greer.

Although RA drugs do have side effects, the repercussions of the disease are generally much worse than the side effects associated with the medications, Greer says. “Not treating is not an option,” he states emphatically.

Why Does Relapse Occur?

The No. 1 reason people with RA relapse: They go off their medications. People start feeling good and stop their meds, but doing so does more harm than good.

everydayhealth.com/rheumato...

[AgedCrone]

Well said Amy.....discomfort/pain at the onset of R A is 99% inevitable.....& we do all have the choice whether to continue with the prescribed drugs...no matter how bad they make us feel...to decide if they really are the answer.

Not easy when you need to work & look after others....especially in UK where waiting times to get diagnosed & started on any treatment can take many months.

It does seem those who can get through those first bad times do progress to some sort of remission, or at least be able to deal with remaining symptoms better than those who decide not to stay with RA drugs.

[Amy_Lee in reply to AgedCrone]

Dear AgedCrone,

You are absolutely right. All of us need to go through the very painful early stage. If we can get treatment early, then our chance of going into remission will be very much higher.

I remember when I visited my rheumy the very first time, they only sent me to X-Ray and the blood test. Nothing else that they said or told me, no medication too though I was in great pain. I could not just accept that and demanded some painkiller at least while waiting for the next appointment in 2 weeks time.

I was told to go to the emergency department to get the painkiller as rheumatology department would not prescribe any medication without looking at the blood test results. I was so mad and angry then as I was in great pain and I had to walk to another department to queue up and wait again.

I am glad all over now for me, I am in remission and happy to be back to my normal life.

[charisma]

It’s a pity that some simply cannot persevere with a drug eg having a bad reaction to it; it stops being effective; it just never worked.

[Amy_Lee in reply to charisma]

Dear Charisma,

I am on mtx and leflunomide. They did give me a lot of side effect including my liver indicators went up more than 3 times higher the normal. That was the time when my rheumy started to reduce the dosage of mtx slowly.

My rheumy told me that mtx would bring me very much more benefits than the side effects, after I complaint to her, so she wanted me to continue to tolerate with them and carried on with mtx. I am glad most of the side effects went off after more than a year except the nausea and vomiting feeling of mtx.

When the dosage of mtx was reduced to 7.5 mg a week, the nausea and vomiting feeling were also gone now. I am so glad that I manage to come to this stage.

[charisma in reply to Amy_Lee]

Yes, it is very good to be at the place of drug induced remission without severe side effects. You are fortunate. May it continue for you, Amy-Lee.

I am still struggling to reach stability of low disease activity but it will be soon, when drug infusions finally do their job.

[Amy_Lee in reply to charisma]

You hope you will achieve it soon. I am still in minimum dosage of mtx and leflunomide. My rheumy did mention that she intended to slowly stop leflunomide. Yet to see, I am not very sure yet as she also warned of flare if I stop both DMARDs.

This is a very difficult decision where she thinks I am suitable for medicine free remission but the worry is always there hence I am still on DMARDs until now.

[notsochunky]

Thank you for the link Amy. Explains things in a very clear no nonsense way. How are you at the moment? Has your medication changed?

[Amy_Lee in reply to notsochunky]

Hi Notsochunky,

I do find the link is very informative hence I posted here to keep it for easy future reference. I am glad that it is useful to some of you too.

I have been in remission since Nov 2015 after a year and a half treatment. I am sero negative, that is one plus point for me to go into remission, I think. In addition, I was also treated very early, this is another plus point to me. My joints are not damaged so far.

What about you? Your condition is good?

[JFlay]

Hi Amy,

After 15 months or so I've managed to get to remission, I'm seropositive.

I still get some stiffness and fatigue but it's manageable. I'm now just on hydroxychloroquine, I hope Mr Trump doesn't steal it all ! 🙄

Wish you all the best.

[Amy_Lee in reply to JFlay]

Hi JFlay, great to know that you are in remission after just 15 months of treatment. Actually for my case I was no longer in pain after a year. However, my rheumy said that she preferred to wait for longer if my condition was the same, then she would declare my remission position.

One thing, I do not have stiffness and fatigue anymore. I just live a very normal life now though my joints are weaker. Not sure what is the standard of remission? May be you should let your rheumy know about the stiffness and fatigue to see if there is anything he or she can do to improve your situation.

[JFlay in reply to Amy_Lee]

Yes we discussed stiffness and fatigue recently. The standard for remission in the UK seems to be the DAS score (?).

Personally I feel that although I meet the score I still have some low activity, as a recent ultrasound of my feet showed some inflammation in my toe joints. Anyway, I feel much better than at the beginning 👍

[Amy_Lee in reply to JFlay]

I see. Over here, I do have some RA friends with some disease activities but they were told in remission too. I think my rheumy was a bit careful with my case. Now though she told me that she intended to slowly remove leflunomide for me but that was more than a year ago story. I think she is still worried and I am not going to push for it as I also worry that the problem may come back. I am happy with my condition right now.