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What is the systematic treatment of rheumatoid arthritis?

Q: My mother has been suffering from rheumatoid arthritis for the past 15 years. We took her to many doctors and kept changing physicians. Currently she is on Salazopyrin and Indocap. Now onwards at least I want her to go through a systematic treatment procedure. Please guide us.

A:Rheumatoid arthritis treatment has undergone a sea-change in the recent past. Unlike in the past, now the disease can be almost completely controlled (long remissions) if proper treatment (under care of trained qualified rheumatologists) is initiated in the first 3 months from the onset of symptoms. Even up to 2 years from the onset, there is still some chance that the disease shall be controlled and further damage would be checked. Unfortunately, beyond 2 years the structural damage in the joints is not well controlled and patients keep on getting increasing deformities and disabilities, many of them ultimately require surgery. Yet, the basic underlying disease process (namely - self killing by the body's immune system - the phenomenon of auto immunity, which is the cause of rheumatoid arthritis) can be controlled at any stage of the disease. In a late case like your mothers, a team consisting of rheumatologists who would stage the disease and decide on the best combination of latest drug therapy + occupational therapists and physiotherapists + surgeons expert in assessing the structural damage in the joints; is the only way to manage such patients. Such a 'team approach' is available in some of the centres in the country.

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