Is My RA Medication Working?

My pathway to a rheumatoid arthritis diagnosis was lengthy. But, I felt so grateful to have reached a definitive answer - it meant that my doctor and I could begin to format an accurate treatment plan.

While there is no cure for RA, I was optimistic that the right medication(s) at the right dosing and frequency could allow me to manage my symptoms and even prevent additional degeneration due to disease over time.

Initial medication assessment

Because I was already living with Crohn’s disease (an autoimmune disease of the gastrointestinal tract), my doctor started off by saying we’d need a biologic medication that could systematically work to manage both conditions.

This meant I had a few options - some being administered via IV infusion and others by intramuscular injection. We reviewed the pros and cons of each medication option before choosing the first one I’d try.

What will my medication assessment look like?

This conversation will vary based on your specific body, RA disease activity, medical history, and any co-morbid conditions that you are also managing.

Other things to consider with initial medication assessments include how the treatment is administered, how often, what the potential side effects are, what insurance may cover, other medications you’re taking, your lifestyle, and your specific areas of focus for treatment.

Unfortunately for me, I had a reaction to the first medication I tried, preventing us from ascertaining whether it would be effective for managing my RA symptoms.

This led my doctor and me back to the drawing board. This time, we chose a different medication. A medication that I’ve now been on for almost 5 years.

What to look for after starting a new medication

Obviously, starting a new medication for RA opens a lot of questions - Will you respond favorably to the medication? Will it cause side effects? How long will it work for?

Initially, new medications may take anywhere from a few hours to a few weeks to offer symptom relief. Talk to your doctor about whatever is prescribed, and the dose and frequency in which that prescription is being taken, and ask about the expectation of symptom reduction.

How do I manage side effects?

While waiting and watching for relief from your RA symptoms, you’ll also be looking to notice whether you have any side effects or reactions from the new medication.

There are some side effects that are manageable, some that your doctor may need to prescribe pre-meds or another medication to help with, and some that might indicate this isn’t the correct treatment option for you.

This is where being vigilant and observant about your health and communicating with your care team is critical.

What to watch for going forward

Once you determine a new medication is in fact helping and is otherwise manageable, something to assess is how much medication you're receiving and how often you're receiving it.

Notice symptoms in between doses

Many RA medications have specific dosing schedules, and it's important to notice if your symptoms are returning between doses.

This feedback will help your care team to specialize your treatment so that it optimizes your health and decreases your bad days and chances of additional flare-ups.

In the event that you experience breakthrough symptoms or flare-ups, connecting with your doctor is extremely important.

While there may be situations in which symptoms increase for a short amount of time and need breakthrough or pro re nata (PRN) medication for support, there are other times in which we need combination therapy (ie: taking 2 types of medication at one time to manage RA) or to examine other medication options that might provide us more, long-lasting relief.

Overall, I've learned stress how important it is as an RA patient to both remain vigilant about my symptoms and to stay in regular communication with my rheumatologist.