Even though there is no actual treatment for rheumatoid arthritis (RA) to this day, there are a number of available medications in pharmacies that are designed to manage its symptoms and eventually improve the patient's condition.
In general, rheumatoid arthritis medications can be grouped into different classes, as discussed in the following paragraphs. Physicians will probably recommend an appropriate plan for treatment to reduce inflammation and pain of the joints, and avert damage to the joints. Depending on each case, the most effective treatment can be accomplished by combining these options:
Nonsteroidal Anti-inflammatory Drugs or NSAIDs
Nonsteroidal Anti-inflammatory Drugs, otherwise known as NSAIDs, work as an anti-inflammatory and in pain relief, but don't function to protect the joints from further damage. These drugs block the body from producing a substance called prostaglandins, which which sets off inflammation & pain.
Some examples of NSAIDs are naproxen (Aleve and Naprosyn) and ibuprofen (Advil and Motrin). Some more NSAIDs include etodolac (Lodine), meloxicam (Mobic), ketoprofen (Orudis), oxaprozin (Daypro), indomethacin, Celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), piroxicam (Feldene), and nabumetone (Relafen).
These drugs are commonly advised as soon as a positive RA diagnosis is made. But remember that when consumed in extreme dosages for extended periods, these medications can cause severe side effects, including gastric ulcers, stomach bleeding, plus liver and kidney damage.
Corticosteroids
Another type of RA medication is corticosteroids. Such medications restrain the immune system, thus managing inflammation.
Cortisone (Cortone), betamethasone (Celestone Soluspan), methylprednisolone (SoluMedrol, DepoMedrol), prednisolone (Delta-Cortef), dexamethasone (Decadron), triamcinolone (Aristocort), and prednisone (Deltasone, Orasone), are some corticosteroids.
Although corticosteroids may be successful in treating RA, they have been reported to cause negative side effects if taken in prolonged periods. Examples of such side effects include cataracts, easy bruising, glaucoma, thinning bones, diabetes, and excessive weight gain.
On account of their potential to develop severe side effects, such medications are often only used as a temporary solution to treat sudden outbreaks of RA. On the plus side, a single corticosteroid injection can inhabit inflammation of the joint for prolonged periods.
Disease Modifying Anti-Rheumatic Drugs (DMARDs)
DMARDs (Disease Modifying Anti-Rheumatic Drugs) pertain to a class of medications that work to inhibit the immune system from assaulting the joints, ultimately obstructing further joint damage. In treating RA, such medications are often taken alongside other medications for greater efficiency.
Rheumatoid arthritis causes permanent damage to the joints, which appears in the early stages. Accordingly, most doctors would advise DMARD therapy soon after making a diagnosis. Patients are most responsive to DMARD treatment in the early stages of RA. The earlier DMARDs are taken, the more advantageous it is for the person.
DMARD examples include hydroxychloroquine (Plaquenil), methotrexate (Rheumatrex), cyclosporine (Sandimmune, Neoral), gold salts (Ridaura, Solganal, Myochrysine, Ridaura), azathioprine (Imuran), cyclophosphamide, penicillamine (Cuprimine), sulfasalazine (Azulfidine), minocycline, and leflunomide (Arava).
While some DMARD products have produced positive results in treating rheumatoid arthritis, the potential for negative side effects is large. Taking DMARDs for a long time can set off toxicity of the liver and bone marrow, infections, allergic reactions, and autoimmunity.
Of the DMARDs previously listed, hydroxychloroquine has the lowest risk of causing liver and bone marrow toxicity, and is hence deemed to be one of the safest DMARD types. Unfortunately, hydroxychloroquine is by no means an especially powerful medication and is not effective enough on its own to alleviate rheumatoid arthritis symptoms.
In contrast, methotrexate is deemed to be one of the most powerful DMARDs in treating RA because of a number of factors. It has been known to treat RA without affecting the toxicity of the bone marrow and liver like most other DMARDs. Further, methotrexate has been proven effective and safe when used together with biological agents, another classification of RA drugs to be discussed later. It is for this reason that these drugs are often prescribed in combination with some biological agents in cases where methotrexate does not control RA on its own. Then again, it should be noted that while methotrexate is not as potentially unsafe as other DMARDs, it still has the ability toobstruct the bone marrow or set off hepatitis. In such cases, regular blood tests are recommended to guide the individual's condition, as well as to cease treatment at the first indication of trouble.
Biological Agents
Biological agents or biological drugs function to treat inflammation via a range of methods.
One example of how biological drugs work is by inhibiting tumor necrosis factors (TNFs). Infliximab (Remicade), adalimumab (Humira), and etanercept (Enbrel) are some TNF blockers.
Another method of how biological agents curtail inflammation is through killing B cells. Rituximab (Rituxan), for example, merges itself to B cells, ultimately destroying them.
Other drugs that reduce inflammation through their own way are:
- tocilizumab (Actemra and RoActemra), functions by blocking interleukin 6 or IL-6 - anakinra (Kineret), blocks IL-1 (interleukin 1) - abatacept (Orencia), which serves to block T-cells
One thing to consider is that each of these biological drugs has its own potential for negative side effects. A drug's side effects must be considered when recommending it to an individual.
Salicylates
Salicylates reduce the body's production of prostaglandins. Prostaglandins are the cause of the inflammatory and painful symptoms of arthritis. Of late, the use of salicylates have been generally replaced with NSAID, mainly due to the fact that salicylates can cause negative side effects, such as causing potential kidney damage.
Pain Relief Medications
Lastly, various pain relief drugs can likewise be taken in rheumatoid arthritis treatment. Examples of pain relief medications are acetaminophen (Tylenol) and tramadol (Ultram).
Though anti-pain drugs neither alleviate inflammation nor delay the progression of joint damage, such drugs allow the patient to feel more comfortable and eventually function better in his/her daily life. For this reason alone, anti-pain medications are certainly worth trying.
Surgery as a Last Resort
If all the medications discussed previously fail to produce results, a physician may probably recommend surgical treatment. Some surgical procedures used in RA treatment are tendon repair, joint lining removal (i.e. synovectomy), as well as arthroplasty (joint replacement surgery), wherein the damaged parts of the joint are replaced with prosthetics.
In general, rheumatoid arthritis medications can be grouped into different classes, as discussed in the following paragraphs. Physicians will probably recommend an appropriate plan for treatment to reduce inflammation and pain of the joints, and avert damage to the joints. Depending on each case, the most effective treatment can be accomplished by combining these options:
Nonsteroidal Anti-inflammatory Drugs or NSAIDs
Nonsteroidal Anti-inflammatory Drugs, otherwise known as NSAIDs, work as an anti-inflammatory and in pain relief, but don't function to protect the joints from further damage. These drugs block the body from producing a substance called prostaglandins, which which sets off inflammation & pain.
Some examples of NSAIDs are naproxen (Aleve and Naprosyn) and ibuprofen (Advil and Motrin). Some more NSAIDs include etodolac (Lodine), meloxicam (Mobic), ketoprofen (Orudis), oxaprozin (Daypro), indomethacin, Celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), piroxicam (Feldene), and nabumetone (Relafen).
These drugs are commonly advised as soon as a positive RA diagnosis is made. But remember that when consumed in extreme dosages for extended periods, these medications can cause severe side effects, including gastric ulcers, stomach bleeding, plus liver and kidney damage.
Corticosteroids
Another type of RA medication is corticosteroids. Such medications restrain the immune system, thus managing inflammation.
Cortisone (Cortone), betamethasone (Celestone Soluspan), methylprednisolone (SoluMedrol, DepoMedrol), prednisolone (Delta-Cortef), dexamethasone (Decadron), triamcinolone (Aristocort), and prednisone (Deltasone, Orasone), are some corticosteroids.
Although corticosteroids may be successful in treating RA, they have been reported to cause negative side effects if taken in prolonged periods. Examples of such side effects include cataracts, easy bruising, glaucoma, thinning bones, diabetes, and excessive weight gain.
On account of their potential to develop severe side effects, such medications are often only used as a temporary solution to treat sudden outbreaks of RA. On the plus side, a single corticosteroid injection can inhabit inflammation of the joint for prolonged periods.
Disease Modifying Anti-Rheumatic Drugs (DMARDs)
DMARDs (Disease Modifying Anti-Rheumatic Drugs) pertain to a class of medications that work to inhibit the immune system from assaulting the joints, ultimately obstructing further joint damage. In treating RA, such medications are often taken alongside other medications for greater efficiency.
Rheumatoid arthritis causes permanent damage to the joints, which appears in the early stages. Accordingly, most doctors would advise DMARD therapy soon after making a diagnosis. Patients are most responsive to DMARD treatment in the early stages of RA. The earlier DMARDs are taken, the more advantageous it is for the person.
DMARD examples include hydroxychloroquine (Plaquenil), methotrexate (Rheumatrex), cyclosporine (Sandimmune, Neoral), gold salts (Ridaura, Solganal, Myochrysine, Ridaura), azathioprine (Imuran), cyclophosphamide, penicillamine (Cuprimine), sulfasalazine (Azulfidine), minocycline, and leflunomide (Arava).
While some DMARD products have produced positive results in treating rheumatoid arthritis, the potential for negative side effects is large. Taking DMARDs for a long time can set off toxicity of the liver and bone marrow, infections, allergic reactions, and autoimmunity.
Of the DMARDs previously listed, hydroxychloroquine has the lowest risk of causing liver and bone marrow toxicity, and is hence deemed to be one of the safest DMARD types. Unfortunately, hydroxychloroquine is by no means an especially powerful medication and is not effective enough on its own to alleviate rheumatoid arthritis symptoms.
In contrast, methotrexate is deemed to be one of the most powerful DMARDs in treating RA because of a number of factors. It has been known to treat RA without affecting the toxicity of the bone marrow and liver like most other DMARDs. Further, methotrexate has been proven effective and safe when used together with biological agents, another classification of RA drugs to be discussed later. It is for this reason that these drugs are often prescribed in combination with some biological agents in cases where methotrexate does not control RA on its own. Then again, it should be noted that while methotrexate is not as potentially unsafe as other DMARDs, it still has the ability toobstruct the bone marrow or set off hepatitis. In such cases, regular blood tests are recommended to guide the individual's condition, as well as to cease treatment at the first indication of trouble.
Biological Agents
Biological agents or biological drugs function to treat inflammation via a range of methods.
One example of how biological drugs work is by inhibiting tumor necrosis factors (TNFs). Infliximab (Remicade), adalimumab (Humira), and etanercept (Enbrel) are some TNF blockers.
Another method of how biological agents curtail inflammation is through killing B cells. Rituximab (Rituxan), for example, merges itself to B cells, ultimately destroying them.
Other drugs that reduce inflammation through their own way are:
- tocilizumab (Actemra and RoActemra), functions by blocking interleukin 6 or IL-6 - anakinra (Kineret), blocks IL-1 (interleukin 1) - abatacept (Orencia), which serves to block T-cells
One thing to consider is that each of these biological drugs has its own potential for negative side effects. A drug's side effects must be considered when recommending it to an individual.
Salicylates
Salicylates reduce the body's production of prostaglandins. Prostaglandins are the cause of the inflammatory and painful symptoms of arthritis. Of late, the use of salicylates have been generally replaced with NSAID, mainly due to the fact that salicylates can cause negative side effects, such as causing potential kidney damage.
Pain Relief Medications
Lastly, various pain relief drugs can likewise be taken in rheumatoid arthritis treatment. Examples of pain relief medications are acetaminophen (Tylenol) and tramadol (Ultram).
Though anti-pain drugs neither alleviate inflammation nor delay the progression of joint damage, such drugs allow the patient to feel more comfortable and eventually function better in his/her daily life. For this reason alone, anti-pain medications are certainly worth trying.
Surgery as a Last Resort
If all the medications discussed previously fail to produce results, a physician may probably recommend surgical treatment. Some surgical procedures used in RA treatment are tendon repair, joint lining removal (i.e. synovectomy), as well as arthroplasty (joint replacement surgery), wherein the damaged parts of the joint are replaced with prosthetics.
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