Rheumatoid Arthritis treatment centers on a collection of medications whose action is to depress the immune system. The body’s immune system is complex and includes many proteins that influence the inflammation process.

• Each of the  RA biologic medications depress a specific protein directly. Presently the only way to determine if a targeted biologic affects a patient’s  problem protein is to try it. Those who have a successful match find the process well worth it. Those with no luck will hopefully get luck and reach success with a different biologic.

The chemically created RA drugs such as methotrexate affect the immune system in a more general way. Some of which are not really understood.

In 1760 Daniel Bernoulli, a mathematician working at the University of Basil in Switzerland, was the first to calculate risk/reward statistics regarding medical treatment. His subject was smallpox inoculations. The risk was the rare situation where the inoculation would cause a fatal case of smallpox. The reward of mass inoculation was that the individual lifespan would increase by 3 1/2 years. He mathematically determined the benefit of smallpox inoculations.

• So that is how it is done with medications today. Is the reward worth the risk for the given population? The rheumatoid arthritis biologic medications clearly demonstrate this practice. Patients do die as a result of the biologics. And their death is caused by a medication prescribed for a disease that isn’t usually fatal.

 However, patients determine the risk is worth having the relief from symptoms and relief from permanent disability. Sometimes their doctors do not explain the risks in a clear manner. They fear frightening the patient.  Also, the FDA has determined that this risk is worth it. That is why these drugs have been approved. More than one RA patient has said that they would eat poison if it would relieve their symptoms.  RA symptoms are that incapacitating.