Does Rheumatoid Arthritis (RA) Always Get Worse?

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  1. Progressive rheumatoid arthritis (RA). Progressive means the disease can worsen over time. It can be slowly progressive (typically months to years) or rapidly progressive (days to weeks), depending on how early it is diagnosed and treated. Also, it can be more active in some patients than others.
  2. Come-and-go (intermittent). As the name suggests, the symptoms come and go. You can have no symptoms or few problems for months between your flare-ups. This pattern affects about 15 percent of patients with RA.
  3. Long remissions. In these periods, you have no symptoms for many years or decades, but you still have the disease (you’re not cured). You may have a sudden onset of the disease (the disease starts suddenly), but then you have long remissions without actual cure.

Whatever the kind of pattern you have, your goal is to keep the disease off (remission) as long as possible since curative therapy is not available yet. More months /years of remission you have, the lower the risk of RA complications to occur and you can have an average expected lifespan like any others.

How can you tell which kind of pattern you have? Though the answer is not always easy, here are some general warning signs of progressive rheumatoid arthritis:

  1. The disease was diagnosed at a young age. This means there are more years for the disease to become more active in your body.
  2. You often have intense flares that last a long time.
  3. Rheumatoid nodules (typically found on the elbows) or other RA complications. The complications may signal that the disease has become advanced. Also, if you have a lot of damage in the affected joint when the disease was diagnosed.
  4. Higher levels of anti-CCPs or RA (rheumatoid factor) that show up in your blood tests.
  5. Or you have other indicators that signal more active inflammation – ask a doctor for more guidance!

Treatments and lifestyle measures can help prevent the disease from worsening, delaying its progression. If your RA is progressive, you usually require a long-term treatment plan to control the disease intensively.

Though there are only a small percentage of people with RA who can have a lasting disease remission, anyone can have a chance to expect a better prognosis of the disease. With prompt treatment, the disease is controllable – see also the prognosis (life expectancy) in this section!

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