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Restarting Treatment for Rheumatoid Arthritis

Restarting Treatment for Rheumatoid Arthritis

If you’ve paused RA medication during the pandemic, here’s what your healthcare provider needs to know.

Rheumatoid arthritis is an autoimmune and inflammatory disease that causes painful inflammation in the joints. While there is no cure for RA, there are numerous treatments that can help control the disease and prevent complications. These include medications such as corticosteroids and DMARDs (disease-modifying antirheumatic drugs).

Like all medications, corticosteroids and DMARDs come with a risk of side effects. One of those side effects is an increased risk of infections. During the coronavirus pandemic, this particular potential side effect has been a concern among people taking these types of medications.

As a result of this concern, many people have stopped taking RA medications, either under the guidance of a healthcare provider or on their own. Other people may have been forced to discontinue a medication due to loss of income or loss of health insurance.

If you are living with RA and have stopped taking a medication during the pandemic, the following information may be helpful in getting back to treatment and getting RA under control.

If you stopped an RA medication on your own
Ideally, any changes to a medication or medication dosage will be made under the guidance and supervision of a healthcare provider. As we all know, circumstances are not always ideal.

If you’ve stopped taking a medication on your own, it is very important to see your healthcare provider as soon as possible and discuss RA and what you need to be doing to keep RA controlled. RA comes with a risk of permanent joint damage and deformity, and it can lead to disability.

Some important topics to discuss:

  • The reason or reasons you stopped medication. Was it concerns over infection? Loss of income or insurance?
  • When you stopped. If you don’t know the exact date, give your best approximation.
  • Any changes in symptoms you’ve noticed since stopping the medication.
  • Options for resuming treatment. Your provider may recommend going back to the medication you were taking or switching to a different medication. Discuss the potential side effects of the new treatment.
  • Your risk of COVID-19 infection, getting a COVID-19 vaccine, and any other concerns about your health and wellness (including stress, anxiety, and mental health).
  • If you have had a COVID-19 infection.
  • Your experience during the pandemic, including any changes to eating habits, exercise, or lifestyle.

If you stopped under the guidance of your HCP
The best-case scenario for discontinuing or changing a medication is doing so under the guidance of your healthcare provider. If this is the case, you should be continuing with your current treatment plan and keeping appointments with your provider to monitor your symptoms and how treatment is going. You should also be discussing:

  • Your current treatment and other treatment options.
  • What to do if you experience a flare of RA symptoms.
  • Any recent changes to your lifestyle, such as exercise, eating, or unhealthy habits.
  • Your risk of COVID-19 infection, getting a COVID-19 vaccine, and any other concerns about your health and wellness (including stress, anxiety, and mental health).
  • If you have had a COVID-19 infection.
  • Precautions to keep yourself safe during the pandemic.
  • Any concerns you have about treatment.
  • Other steps you can take to manage RA.

Remember, both RA and the pandemic are a different experience for everyone. Your healthcare provider is your best source of information.

Medically reviewed in February 2021.

Sources:
American Academy of Family Physicians. "Patient Education: Rheumatoid Arthritis."
Medical News Today. "How does RA affect different parts of the body?"
UpToDate. "Patient education: Rheumatoid arthritis treatment (Beyond the Basics)."
J. Youssef, S.A. Novosad, and K.L. Winthrop. "Infection Risk and Safety of Corticosteroid Use." Rheumatic Diseases Clinics of North America, 2016. Vol. 42, No. 1.
Arthritis Foundation. "Arthritis and Infection Risk."
Kevin Kunzmann. "COVID-19 Drove Significant Changes in Rheumatoid Arthritis Patient Treatment Regimens." HCPLive. November 3, 2020.
Healio Rheumatology. "US patients with RA substantially changed medication in response to COVID-19." November 13, 2020.
Centers for Disease Control and Prevention. "Rheumatoid Arthritis (RA)."
American College of Rheumatology. "COVID-19 Frequently Asked Questions."
Kelsey Kloss. "How the COVID-19 Pandemic Is Increasing Anxiety in Rheumatoid Arthritis Patients." CreakyJoints.org. February 10, 2021.
Lauren Gelman. "Getting a COVID-19 Vaccine with Autoimmune or Inflammatory Rheumatic Disease: New Guidance from the American College of Rheumatology." CreakyJoints.org. February 11, 2021.

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