Rheumatoid arthritis (RA) is a serious condition. The body’s immune system attacks the lining of the joints, and potentially, blood vessels and other organs. This causes swelling, stiffness, and pain. RA cannot be cured, but it can be treated. Without treatment, RA can cause permanent damage to joints and internal organs, and disability.

The main drugs to treat RA are called DMARDS (disease-modifying anti-rheumatic drugs). These drugs help prevent damage to joints. They include both non-biologics and biologics. Non-biologic RA drugs have been used for a long time. And over time, they have demonstrated their safety and effectiveness. Side effects are well described, affect only a proportion of individuals, and can be managed with your rheumatologist. Biologics are a newer type of RA drug. However, in most cases, biologics should not be the first choice for treatment, according to the Canadian Rheumatology Association.

Non-biologic RA drugs are better studied than the biologics. There is excellent data that many people will respond to non-biologics. Non-biologics include: Methotrexate (Methoject and generic), Leflunomide (Arava and generic), Hydroxychloroquine (Plaquenil and generic), Sulfasalazine (Salazopyrin and generic).

The following side effects are rare, but they can be serious or life-threatening: Serious skin or lung infections, Skin cancers, Serious allergic reactions. Other side effects are less serious: Minor infections, headache, and reactions at the injection site. People usually don’t change treatments because of these side effects.

Most people should try at least one non-biologic RA drug for a period of at least three to four months before moving to a biologic. If there is no improvement, a rheumatologist may talk to you about trying biologics. If a non-biologic did not help you, there’s a good chance that a biologic will give relief. People react to drugs differently. If one biologic does not help, another may be successful. But two biologic drugs should never be taken at the same time.

Conditions: Rheumatoid arthritis

Treatments: DMARDS (disease-modifying anti-rheumatic drugs), biologics, non-biologics, Methotrexate (Methoject and generic), Leflunomide (Arava and generic), Hydroxychloroquine (Plaquenil and generic), Sulfasalazine (Salazopyrin and generic).