RA occurs when the body’s immune system attacks the joints. This can lead to swelling of the synovial tissue that lines the joints, causing them to become increasingly painful, swollen, and stiff. Disease-modifying antirheumatic drugs (DMARDs) are most effective for treating RA. The drugs methotrexate, leflunomide, and sulfasalazine work equally well, while adalimumab, etanercept, and infliximab are also equal to each other in effectiveness. Combining a DMARD with a steroid such as prednisone has been shown to work more effectively than a DMARD alone. Possible side effects of RA drugs include weakening of the body’s defenses against serious infections, kidney and liver problems, and birth defects. The risks can be reduced by getting regular checkups and blood tests, avoiding people who are ill, keeping flu and pneumonia shots current, and keeping bones strong by getting enough calcium and vitamin D.

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