Sometimes people ask me whether taking treatment for RA matters. Over the last couple of years, I’ve answered dozens of emails with this question, posted on Facebook last week: “What are the consequences of not treating RA?”
Why patients wonder about not treating Rheumatoid Arthritis
Since I live with RA myself, I know the validity of this question; it should not be brushed off. Living with the trouble, expense, and side effects of treatments is a burden on people. Personally, I have reached the point a few times when I say, “I only want out. I can’t see another doctor or swallow another pill. Ever.” I’m tempted by the thought that I can just reject all labels and treatments and will myself well again. There are people selling books who promise it worked for them. Why not?
Because Rheumatoid Arthritis is not a phantom of our making; it is a real monster that is attacking our bodies. We can’t rescue ourselves any more than Leia could from the hands of Darth Vader. Okay men – compare it to a young Marine in enemy hands. Our battle is real. We need real weapons.
What’s the goal of treating Rheumatoid Arthritis?
Without treatment, we know what Rheumatoid Arthritis can do.
- Joint destruction: RA attacks bone, cartilage, and soft tissue causing joints to weaken and deform to varying degrees.
- Disability: joint destruction and systemic effects of RA lead to inability to perform tasks.
- Systemic inflammation: RA disease leads to earlier death, often because of its effect on the heart or other organs.
No one can assure you what will happen with RA since disease progression varies, possibly due to genetics. But the goal of treating RA is the same for everyone: to interfere with the disease process. Slow progression, delay disability, and extend life.
How much will treating my Rheumatoid Arthritis help?
It’s also true that we need better weapons. We must acknowledge that patients ask such questions because the weapons we have for Rheumatoid Arthritis treatment are not highly effective in a majority of patients. Success in a clinical trial is 20% improvement, and about 29% of patients reach only this level of improvement. Another one-third are “non-responders.” Only about 20% of people receive 70% improvement. And sooner or later, treatments lose effectiveness.
Remember Luke Skywalker took out the Death Star with one shot from his X-wing. Rheumatoid Arthritis treatments have the same goal: to use a molecule to take sharp aim at the offending immune signal. Today’s treatments work better in some patients than others, so of course the goal of research is to find treatments that work on all RA, stopping symptoms and disease progression.
Next time in part 2, I’ll respond to a similar frequently asked question: “What if the treatment is worse than the disease?”
- New Way to Report Response in RA Clinical Trials?
- Video: Rheumatoid Patient Foundation Gives RA Patients a Voice
- Tofacitinib / CP-690550 aka Tasocitinib Succeeds in Pfizer’s 2nd Phase 3 Trial