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How to Choose the Best Course of Treatment to Manage Rheumatoid Arthritis

  |  Issue: January 2016  |  

In addition, including lots of calcium-rich foods, such as low-fat dairy, green leafy vegetables, fatty fish, almonds, white beans and homemade broths, can offset bone loss associated with chronic steroid use, Ms. Pitman continues. A calcium supplement with vitamin D may also help.

Disease-modifying anti-rheumatic drugs (DMARDs) can result in gastrointestinal-related side effects, such as nausea and vomiting, as well as folate deficiency. In such instances, try small, nutrient-dense meals or snacks every two to three hours, opting for cold or room temperature foods. Consider smoothies or blended drinks for mouth sores or a sore tongue. A supplement may be necessary to increase the amount of folate in the diet. Eating whole grains, dark leafy greens, citrus fruits and orange-colored vegetables and fruits can help.

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Ultimately, a Mediterranean diet consisting of high amounts of minimally processed foods, fruits, non-starchy vegetables, low-fat dairy and fatty fish is ideal.

References

  1. Singh JA, Furst DE, Bharat A, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012 May;64(5):625–639. doi:10.1002/acr.21641.
  2. Smolen JS, Breedveld FC, Burmester GR, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2015 May 12. pii: annrheumdis-2015-207524. doi: 10.1136/annrheumdis-2015-207524. [Epub ahead of print]
  3. Barnabe C, Sun Y, Boire G, et al. Heterogeneous disease trajectories explain variable radiographic, function and quality of life outcomes in the Canadian early arthritis cohort (CATCH). PLoS One. 2015 Aug 24;10(8):e0135327. doi:10.1371/journal.pone.0135327.
  4. Schiff MH, Jaffe JS, Freundlich B. Head-to-head, randomised, crossover study of oral versus subcutaneous methotrexate in patients with rheumatoid arthritis: Drug-exposure limitations of oral methotrexate at doses ≥15 mg may be overcome with subcutaneous administration. Ann Rheum Dis. 2014 Aug;73(8):1549–1551.
  5. Pichlmeier U, Heuer KU. Subcutaneous administration of methotrexate with a prefilled autoinjector pen results in a higher relative bioavailability compared with oral administration of methotrexate. Clin Exp Rheumatol. 2014 Jul–Aug;32(4):563–571.
  6. Choe JY, Prodanovic N, Niebrzydowski J, et al. A randomised, double-blind, phase III study comparing SB2, an infliximab biosimilar, to the infliximab reference product Remicade in patients with moderate to severe rheumatoid arthritis despite methotrexate therapy. Ann Rheum Dis. 2015 Aug 28. pii: annrheumdis-2015-207764. [Epub ahead of print].
  7. Emery P, Vencovský J, Sylwestrzak A, et al. A phase III randomised, double-blind, parallel-group study comparing SB4 with etanercept reference product in patients with active rheumatoid arthritis despite methotrexate therapy. Ann Rheum Dis. 2015 Jul 6. pii: annrheumdis-2015-207588. [Epub ahead of print].
  8. U.S. Food and Drug Administration. FDA Drug Safety Communication: FDA strengthens warning that non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. 2015 July 9 (updated July 17, 2015).

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