Rheumatoid arthritis remains a crippling illness to treat, but new medications are making significant inroads into what used to be a crippling illness for almost everyone given his diagnosis. It has been 20 years since the advent of biologic drugs, starting with Enbrel and Remicaide. There are now more than 9 drugs which can help stop the disease and prevent further bone destruction. A new oral medication was released a few years ago, and rheumatologists are still sorting out the order of which medications work best for which aspect of rheumatoid arthritis, as well as psoriasis, psoriatic arthritis and ankylosing spondylitis. In addition, off label studies with these drugs show promise for other diseases such as sarcoid, reactive arthritis and polymyositis, among others. Drug side effects include infection and anyone who has seen TV drug commercials knows that although the list of side effects is long, infection is the greatest concern in 3-4% of patients. Nevertheless, there is not much more gratification than seeing a patient who previously could hardly move before starting these medications, regain their ability to work and enjoy life, again.