Rheumatoid arthritis: what to do when the patient doesn't respond to therapy?

Difficult to answer: Depends: more/different medicine, cortisone injections, more/different exercise, consider surgical intervention.

Many options : There are dozens of medications for rheumatoid arthritis. Rheumatologists usually start with a milder, less toxic medication like Methotrexate and add additional therapies as needed. Sometimes it takes trying 6 or more drugs until an effective regimen is found.