What Does My Rheumatoid Factor at Diagnosis Mean?

"I was just diagnosed with a rheumatoid factor of 150. What does this mean? What are the best medicines that have the least side effects?"

What is rheumatoid factor (RF)?

I'm sorry for your recent diagnosis. The rheumatoid factor (RF) is one blood test for a protein that is oftentimes present in people with RA. But there is no one perfect blood test for RA and diagnosis is primarily based on clinical symptoms...how many joints affected, inflammatory blood markers like C-reactive protein and sedimentation rate (ESR), images of joint damage, etc.

Rheumatoid factor doesn't tell the whole story

There is some research that shows that people with higher RF blood test results tend to have more severe symptoms but that is not always the case as many people don't have positive RF or inflammatory markers - called "seronegative" - and yet have severe symptoms. Here is a link that shows the official diagnostic criteria: http://rheumatoid arthritis.net/diagnosis/. The criteria were last revised in 2010.

Rheumatoid factor and RA treatment guidelines

The importance of RA treatment

I'm assuming that you are seeing a rheumatologist. If not, then you should connect with a good one as soon as possible. The prevailing guidelines are to begin to treat RA aggressively as soon as possible in order to avoid joint and tissue damage. Earlier treatment also means a better chance of achieving remission.

What RA treatment may look like

In terms of medicines, it is important that you work closely with your rheumatologist on a treatment plan. Most will begin with a corticosteroid like prednisone in order to knock down inflammation which will reduce pain and swelling. But you shouldn't stay on high doses of steroids for long as there are side effects.

You will likely be put on a disease modifying drug (DMARD) like methotrexate. These types of medicines impact your overactive immune system. The next line of medications include the so-called biologic because they are protein antibodies which must be injected or infused. Many RA patients end up on a combination of DMARDs and a biologic.

That's a lot of information and I'm sure your head is spinning with your recent diagnosis. I encourage you to read all you can, ask lots of questions, find a good doctor, and hang in there as many RA patients do well with treatment.

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