Symptom Management vs. Disease-Modifying Therapies: How to Find the Right Autoimmune Treatment For You

If you have an autoimmune disease like millions of other Americans, you may be wondering about your treatment options. The medical community has learned a great deal about autoimmune diseases in recent years, which means treatments are advancing. There’s still no cure, but current therapies can reduce symptoms, prevent complications, and improve quality of life. Keep reading to learn more.

What are the treatment options for autoimmune disorders?

With more than 80 autoimmune diseases known, it would be difficult to list all available treatment options here. Furthermore, some autoimmune diseases are systemic, meaning they affect multiple organs and tissues in the body, whereas others are limited. Systemic autoimmune diseases (like rheumatoid arthritis) tend to cause widespread and debilitating symptoms as well as tissue and organ damage. As such, they require more aggressive treatment. On the other hand, limited (single-organ) autoimmune diseases (like Hashimoto’s thyroiditis) don’t cause widespread symptoms or organ damage, so treatment is a little more straightforward.

Of course, this is a simplified way of looking at autoimmune disease treatment. But, for the purposes of this article, we’ll be focusing on treatment options for systemic autoimmune disorders. 

What is the goal of autoimmune disorder treatment?

Autoimmune treatments are meant to:

• Decrease symptoms

• Prevent further disease progression and complications

• Improve quality of life and function

Medications can help people with autoimmune disease reach these goals. Sometimes, other treatments are needed, especially if the autoimmune disorder affects your mobility, ability to care for yourself day to day, and/or emotional health. So treatment can also include: 

• Physical therapy

• Occupational therapy

• Speech therapy

• Mental health support

What are the medication options for managing autoimmune symptoms?

When inflammation from autoimmune disorders causes pain or damage — such as with rheumatoid arthritis or inflammatory bowel disease — nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (“steroids”) are often prescribed. 

NSAIDs — such as naproxen, celecoxib, and diclofenac — can help with pain and also help lower inflammation. Steroids — such as prednisone and methylprednisolone — are strong anti-inflammatory medications that can also quickly reduce symptoms. They are commonly prescribed to treat flares or episodes of worsening symptoms.

However, NSAIDs and steroids are meant to be used for short periods of time because there is a greater risk of side effects with long-term use.

How do disease-modifying therapies work?

In autoimmune diseases, the immune system doesn’t function as it should. It tends to react abnormally and cause inflammation, which damages organs and tissues. Disease-modifying treatments work by targeting specific parts of the immune system. By doing so, they can slow progression of autoimmune damage and prevent complications. They often help relieve symptoms, too, so you don’t have to depend heavily on steroids.

Traditional or conventional disease-modifying medications have been around for decades and are usually available as tablets. Examples include:

• Methotrexate

• Hydroxychloroquine

• Leflunomide

• Sulfasalazine

Biologic medications target cells or signalers in the immune system very specifically. They are typically given by injection or infusion (through an IV), though there are a few exceptions. Examples include: 

• Adalimumab (Humira)

• Etanercept (Enbrel)

• Infliximab (Remicade)

• Ocrelizumab (Ocrevus)

• Rituximab (Rituxan) 

• Tocilizumab (Actemra)

• Tofacitinib (Xeljanz)

• Ustekinumab (Stelara)

It’s important to know that finding the right disease-modifying medication might take some trial and error. Treatment guidelines can help healthcare providers come up with a treatment plan, but it’s sometimes hard to predict how people will respond to these medications. What works for someone else with the same condition may not work for you. Keeping track of how you respond to a new medication or dose is helpful in understanding when you might need to switch treatments. 

What are the side effects of disease-modifying therapies?

Possible side effects vary by medication, but there are some common ones. These include:

• Infections, particularly of the gastrointestinal and respiratory tracts

• Nausea 

• Diarrhea 

• Headache 

• Skin rash

Some disease-modifying medications may cause liver or kidney damage, so it’s common to get frequent blood tests while taking these medications. Because these medications affect the function of the immune system, there is a higher risk of serious infections (those requiring hospitalization). 

Which autoimmune diseases can be treated with modifying therapies?

Disease-modifying treatments are available for several autoimmune diseases, such as:

• Crohn’s disease

• Multiple sclerosis

• Psoriasis 

• Rheumatoid arthritis

• Systemic lupus erythematosus

• Ulcerative colitis

Can disease modifying therapies cure autoimmune disorders?

Available medications do not cure autoimmune disorders, and they may be required for life. Typically, when these medications are stopped, autoimmunity progresses and inflammation returns. 

Are disease modifying therapies covered by insurance?

There’s some variability in how easily someone with an autoimmune disorder can get their medication covered by insurance. Of course, it depends on your exact plan, but sometimes people need to try older, more established medications before they can get treatment with a newer, more expensive biologic medication. 

It’s always best to check with your insurance plan to get the specifics. If cost is an issue for you, speak with your healthcare provider about treatment alternatives or ways to save. Many pharmaceutical companies offer savings programs, and GoodRx can help you find the best price for oral medications.