Treatments for Rheumatoid Arthritis: Medications

Treatments for rheumatoid arthritis are aimed to reduce pain and inflammation, maximize joint function, and prevent further joint destruction and deformity. Earlier treatments are as important as keeping the patients’ confidence and ability in dealing with their daily activities. Early treatments can minimize the risk of joint damage and pain. Since there is no cure for rheumatoid arthritis, proper treatments are essential to improve the patient’s quality of life. There are various treatments for this disease including: medication, occupational and physical therapy, weight management, and surgery.

rheumatoid_arthritis_s6_symptomsMedication could be the most effective way to reduce inflammation and relieve pain. It can also prevent or slow the joint damage. But it should be noted that many drugs for rheumatoid arthritis may cause serious side effects. Always discuss the benefits and risk of the medications with the doctor. Medications with the fewest side effects might be taken in early phase. As the disease progresses, a patient may need stronger drugs or combination of drugs. Medications can be classified into two classes: “first-line drugs” (fast-acting), such as aspirin and cortisone (corticosteroids), which are used to reduce pain and inflammation; and “second-line drugs” (slow-acting), such as methotrexate (Rheumatrex, Trexall), and hydroxychloroquine (Plaquenil), which promote disease remission and prevent progressive joint destruction. These “second-line drugs” are not anti-inflammatory agents.

Particular medications that commonly used in the rheumatoid arthritis treatments:

Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce inflammation, pain and swelling. NSAIDs include Acetylsalicylate (aspirin), naproxen (Naprosyn), ibuprofen (Advil, Medipren, Motrin), and etodolac (Lodine). Side effects may include ringing in your ears, stomach irritation, heart problems, liver and kidney damage. Additional medications are recommended to protect the stomach from the ulcer effects of NSAIDs.

Steroids. Doctors usually use corticosteroid medications, such as prednisone, to relieve acute symptoms, with the goal of gradually tapering off the medication. They are useful when the disease is not responding to NSAIDs, because they are more potent in reducing inflammation and in restoring joint mobility and function. They can be given orally or injected directly into tissues and joints. However, using corticosteroids in high doses for long periods of time can cause serious side effects, such as: thinning of bones, cataracts, weight gain, facial puffiness, and diabetes.

Disease-modifying antirheumatic drugs (DMARDs) can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. These are what we call as “second-line drugs”. Common DMARDs include methotrexate (Trexall), leflunomide (Arava), hydroxychloroquine (Plaquenil), sulfasalazine (Azulfidine) and minocycline (Dynacin, Minocin, others). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.

TNF-alpha inhibitors. Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), golimumab (Simponi) and certolizumab (Cimzia). Potential side effects include increased risk of serious infections, congestive heart failure and certain cancers.

Immunosuppressants. These medications act to tame your immune system, which is out of control in rheumatoid arthritis. Examples include azathioprine (Imuran, Azasan), cyclosporine (Neoral, Sandimmune, Gengraf) and cyclophosphamide (Cytoxan). These medications can increase susceptibility to infection.


Read also: Treatments for Rheumatoid Arthritis: Physical Therapy and Surgery

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