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How to treat rheumatoid arthritis?

Dr Anand Malaviya
Head of the Department of Medicine and Chief of Clinical Immunology and Rheumatology Services,
All-India Institute of Medical Sciences, New Delhi Consultant Rheumatologist, 'A&R Clinic'
Visiting Sr. Consultant, Rheumatologist, ISIC Superspeciality Hospital, New Delhi.

Q: I am suffering from Rheumatoid Arthritis for the last two years. Some doctor diagnosed me earlier saying that I had high uric acid, then subsequently another doctor diagnosed it as actually RA-II. Since then I am taking the following medicines.1. SAZO - EN - 4 tab daily; 2. Xenobid - 275 2 tab daily; 3. HCQS - 200 - 1 tab daily; 4. Topcid - 40 1 tab daily. My ESR - at the moment is 35 and RA is positive. Kindly advise whether I am taking the right medicines or I need some thing else. Kindly also advise whether this is curable or not and where can I find the best available advice.

A:Treatment of rheumatoid arthritis needs a thorough clinical assessment of the patient to decide on the following points: 1. Is it mild, moderate or severe?; 2. Is it early, established or late; 3. Is it erosive or nonerosive?; 4. Is the patient seropositive? Once these parametres are assessed, then the disease activity score and ACR-core set is defined by the formulas that are available with the rheumatologists. Once these parametres become available, then mild, moderately aggressive, aggressive, aggressive-with combination DMARDS, or the most aggressive with debulking combined with combination DMARDs, is decided upon. As you can see, treating rheumatoid arthritis is as elaborate as treating any other chronic serious disease including diabetes, hypertension, asthma, epilepsy and cancer. This is why it is best to consult a trained RHEUMATOLOGIST who would preform the above assessments and decide upon the best and the most appropriate form of management that you require.