The Evolution of RA Treatments
Recently I realized that my story as a patient mirrors the evolution of rheumatoid arthritis treatments! As a small child I started with basic Tylenol and now I am taking the newer class of drugs called biologics.
The evolution of RA treatments
When I was diagnosed as a toddler the doctor had my mom squirt liquid Tylenol into my mouth so that I would swallow the medicine. However, soon I needed a higher dose in the form of a pill and my mother was trying to coax me into taking it every day. While I first enjoyed the novelty, she soon discovered that I hated the taste and would try to spit it up.
Conventional DMARDs and steroid
Things didn’t get much better with my medication habits as I grew and my RA continued to aggressively attack my body. I was taking Plaquinel and tolectin plus steroids. And while I was starting to learn the importance of taking these medications for my illness, I so despised the taste and the strictness of the regimen that I would hide the pills in my chair cushion. But my clever mother found me out, so my secret stash and my treachery were revealed!
After a while the doctor decided the medications were not working. The cutting-edge treatment at the time was gold shots. Literally, injections of gold in my behind. And boy did it hurt. It wasn’t even fast, but slow - over the course of a minute or longer because the gold solution was thick. We had to drive an hour to the doctor’s office for each shot and the frequency was high at first, tapering off in time.
Gold pills and NSAIDs
When a pill form became available, I soon was taking gold pills. Then a variety of NSAIDS. First there was oral Naprosyn, which to me tasted exactly like vomit. I could not believe these pharmacists could concoct a medication that resembled throw-up so perfectly! But now that I was a little older, I had to take the drug and be responsible for my treatment. As much as I wanted to hide or toss the disgusting medicine, it was an important part of my daily life.
When Naprosyn became available in a pill, I danced for joy. No more drinking vomit! But unfortunately, the drugs were not hugely effective and my disease progressed.
Methotrexate: another conventional DMARD
For some time in my early 20s, the RA became a little quieter and I got along with a daily NSAID. But when the disease came roaring back, it was time to try methotrexate. We had considered it in my teen years but worried about the serious risks and side effects. Instead, I had hip and knee joint replacements.
Taking it as an adult, although my disease had progressed, the methotrexate really curtailed the ongoing inflammation and brought a new level of stability to the RA. Unfortunately, I also experienced problems with becoming immunosuppressed (such as shingles and other illnesses). While the drug helped, it soon became apparent that I had a tolerance threshold for my liver and that another drug was needed to help.
Now I have been on a biologic for about three years and experienced some positive results with slowing my RA and decreasing my inflammation. It may be time to mix up my treatment again, but that is a story for another day.
The development of RA treatments options
What is powerful to me, about recounting this progression of treatments, is understanding how far we have come in developments and options. Sure, no treatment is perfect nor one size fits all. But we have a few tools to fight RA.
I look forward to watching the evolution of RA treatments continue as we further our understanding of the disease and related autoimmune conditions. Let the evolution continue!
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?