How Effective Is Your RA Treatment?
The goal of rheumatoid arthritis (RA) treatment is threefold. One, to control the symptoms of RA. Two, to prevent damage to joints and internal organs. Three, to enhance your quality of life and your ability to function. Treatment consists of a variety of medication, including DMARDs, Biologics, and NSAIDs. There are a number of ways to monitor how effective your treatment is.
Assessing the effectiveness of your treatment starts with the approach that is being used. You are more likely to make progress if the treat-to-target method of managing your RA is used. In this approach, your response to treatment is measured every three months, and if your RA is not controlled, the treatment is modified. This more aggressive way of treating RA has resulted in better outcomes.
Blood tests can be used to assess if your treatment is working. Anemia, a common symptom of RA, is indicated by a low hemoglobin test. As well, the inflammation markers CRP and ESR measure the levels of inflammation in your body. One drawback is that these tests measure general inflammation in your body. Their values increase with RA activity, but also when you have an infection.
There is a newer test that specifically tests the level of RA activity. The Vectra DA blood test measures 12 biomarkers that are associated with RA activity, collecting them into one score that reflects how well your treatment is working. It complements your rheumatologist’s assessment and physical exam. The Vectra test is only available in the US and is quite expensive.
Doctors frequently use imaging tests to check for damage in your joints or progression of damage, which can happen if your treatment is not working. X-rays are commonly used, but do have some limitations. Although they show damage that has happened in your bones, they do not indicate soft tissue inflammation or low levels of damage.
Both the CT scan and the MRI can offer a more detailed look at what’s going on inside your body, including your bones, soft tissue, and blood vessels. One drawback to the CT scan is that it can expose you to a quite high dose of radiation. An MRI can detect damage six months prior to an x-ray, but it is an expensive test.
Ultrasound is a fairly new addition to the imaging tests used to assess how well treatment is working in people with RA. It can be used to detect both erosion in the bone, as well as inflammation. It is also a fairly inexpensive test. Because its use in rheumatology is new, it is not yet widespread, as rheumatologists and technicians need training in order to use it effectively.
Often, one of the first signs that a medication is suppressing RA is an increase in energy. If you’re less tired and have less brain fog, it’s an excellent sign that you’re getting better. Conversely, if you’re consistently more tired without doing more than your normal tasks, it may be an indication to talk to your rheumatologist about whether your treatment needs adjusting.
The classic RA symptoms of swelling and pain in the joints, morning stiffness, and low-grade fevers can also indicate the effectiveness of your treatment. Maybe your morning stiffness doesn’t last quite as long, or is as intense as it used to be. Perhaps you have less flares, pain, and your joints aren’t squishy with swelling. These all point to the medication doing its job.
Ultimately, the effective treatment of your RA is designed to give you quality of life, both physically and emotionally. When your RA is controlled, you are able to participate in your life, your family, and your community. If you are satisfied with the quality of life which your health enables you to attain, the treatment is a success.