Medications for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease in which the immune system mistakenly attacks the lining (synovium) of the joints, causing persistent inflammation, pain, and progressive joint damage. Unlike osteoarthritis, which results from wear and tear, RA is an immune-driven condition that typically affects multiple joints simultaneously — most often the hands, wrists, knees, and feet — and usually involves both sides of the body symmetrically. RA affects approximately 1.3 million adults in the United States and is two to three times more common in women than men; it most often begins between ages 30 and 60. Symptoms include joint pain, stiffness (especially in the morning lasting more than 30 minutes), swelling, warmth, and reduced range of motion, along with systemic effects such as fatigue, low-grade fever, and loss of appetite. Over time, untreated RA can permanently deform and destroy joints.

If left uncontrolled, RA can cause progressive joint destruction, deformity, and disability, and raises the risk of heart disease, osteoporosis, lung complications, and eye problems. Early, aggressive treatment is now the standard of care because it slows joint damage and improves long-term outcomes significantly. The cornerstone of RA treatment is disease-modifying antirheumatic drugs (DMARDs): conventional DMARDs like methotrexate reduce inflammation and slow disease progression; biologic DMARDs (TNF inhibitors, IL-6 inhibitors, and B-cell depleting agents) target specific immune pathways; and JAK inhibitors are a newer class of targeted oral medications. NSAIDs and corticosteroids help manage pain and inflammation while longer-term medications take effect. The medications listed below are among the most commonly prescribed for treating rheumatoid arthritis.