Unique Original Articles » Medications For Rheumatoid Arthritis

While there is no actual cure for rheumatoid arthritis (abbreviated as RA) to this day, there are a wide variety of available medications in the market that are designed to relieve its symptoms and in due course improve the patient’s health.

In general, rheumatoid arthritis drugs may be categorized into different categories, as described in the following paragraphs. Your physician will likely develop an appropriate plan for treatment to reduce joint inflammation and pain, plus avert cell damage in the joints. Depending on the specific case, successful treatment can be attained by combining any of the following:

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Nonsteroidal Anti-inflammatory Drugs, more commonly known as NSAIDs, work as an anti-inflammatory and in pain relief, but do not serve to prevent further joint. Nonsteroidal Anti-inflammatory Drugs hinder the body from the production of prostaglandins, which which sets off inflammation & pain.

Examples of these are naproxen (Aleve and Naprosyn) and ibuprofen (Advil and Motrin). Other examples include meloxicam (Mobic), ketoprofen (Orudis), etodolac (Lodine), indomethacin, Celecoxib (Celebrex), oxaprozin (Daypro) diclofenac (Voltaren & Cataflam), nabumetone (Relafen), and piroxicam (Feldene).

NSAID medications are frequently prescribed once a final diagnosis of RA is made. But keep in mind that when consumed in high dosages for a long time, NSAIDs may produce adverse side effects, like stomach ulcers, stomach bleeding, and even potential damage to the liver and kidney.

Corticosteroids

One more class of rheumatoid arthritis medication is corticosteroids. These medications block the immune system, thus managing inflammation.

Methylprednisolone (SoluMedrol, DepoMedrol), betamethasone (Celestone Soluspan), Cortisone (Cortone), dexamethasone (Decadron), prednisolone (Delta-Cortef), triamcinolone (Aristocort), plus prednisone (Deltasone & Orasone), are examples of corticosteroids.

Although corticosteroids can be successful in RA treatment, they are reported to cause severe side effects when taken in extended periods of time. Examples of such side effects include glaucoma, cataracts, easy bruising, thinning bones, diabetes, and excessive weight gain.

Because of the potential for adverse side effects, such drugs are often only used as a momentary solution to curtail sudden RA attacks. The good news is that one single injection of the drug will inhabit inflammation of the joint for a long period of time.

Disease Modifying Anti-Rheumatic Drugs, a.k.a. DMARDs

Disease Modifying Anti-Rheumatic Drugs (a.k.a. DMARDs) are a classification of drugs that act to block the immune system from assaulting the joints, eventually retarding the progression of further joint damage. When treating rheumatoid arthritis, such drugs are usually used on top of other meds for a more successful outcome.

Rheumatoid arthritis commonly causes permanent damage to the joints, which becomes apparent in the early stages of the disease. It is because of this that most physicians would recommend DMARD therapy soon after an RA diagnosis. You are most responsive to DMARD treatment during the early stages of RA. The earlier the drug is used, the more advantageous it is for the patient.

Common DMARD examples include cyclosporine (Sandimmune, Neoral), hydroxychloroquine (Plaquenil), methotrexate (Rheumatrex), gold salts (Solganal, Ridaura, Myochrysine, Aurolate), azathioprine (Imuran), penicillamine (Cuprimine), cyclophosphamide, sulfasalazine (Azulfidine), minocycline, and leflunomide (Arava).

While a number of DMARD products have been successful in treating rheumatoid arthritis, the risks for severe side effects is alarming. Long-term consumption of DMARDs can result in toxicity of the bone marrow and liver, susceptibility to infections, allergic reactions, as well as autoimmunity.

Of the DMARDs listed above, hydroxychloroquine has the least risk of producing liver and bone marrow toxicity, and is consequently believed to be 1 of the safest DMARDs to use. However, hydroxychloroquine isn’t a powerful drug by itself, and is not effective enough on its own to control RA symptoms.

Conversely, methotrexate is deemed to be one of the most powerful DMARDs to use in rheumatoid arthritis treatment due to several factors. It has been proven to treat RA without causing bone marrow and liver toxicity as in most other DMARDs. Further, it works safely and effectively when used together with biological agents, another group of RA drugs discussed below. Thus, methotrexate is often recommended for use with some biological agents in cases where the drug fails to control the condition on its own. However, keep in mind that while methotrexate is not as risky as others, it still can hinder the bone marrow or set off hepatitis. If this happens, regular blood tests are recommended to check the patient’s condition, as well as to cease treatment at the first hint of trouble.

Biological Agents

Biological agents or biological drugs function to treat inflammation through a range of methods.

One example of how biological agents work is by blocking tumor necrosis factors (TNFs). Adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade) are examples of TNF blockers.

Another way with which biological agents manage inflammation is through eradicating B cells. The Rituximab (Rituxan) drug, in particular, fuses itself to B cells, ultimately destroying them.

Further medications that alleviate inflammation in different ways are:

- tocilizumab (e.g. RoActemra and Actemra), which works by blocking interleukin (IL-6)
- anakinra (e.g. Kineret), which works by blocking IL-1 or interleukin 1
- abatacept (Orencia), which serves to block T-cells

Keep in mind that each biological drug has its own risks for severe side effects. The potential for side effects must be considered when giving it to a patient.

Salicylates

Salicylates serve to reduce the body’s production of prostaglandins. Prostaglandins produce the inflammation and pain of arthritis. In recent years, the use of salicylates have been widely replaced with nonsteroidal anti-inflammatory drugs, primarily due to the fact that the former cause serious side effects, e.g. potential damage to the kidney.

Pain Relief Medications

Lastly, several pain relief drugs can also be taken in rheumatoid arthritis treatment. Examples of medications which have the primary purpose of pain relief include tramadol (Ultram) and acetaminophen (Tylenol).

Even though anti-pain drugs neither cure inflammation nor delay the progression of further joint damage, these drugs allow the patient become more comfortable and eventually function better. For this reason, pain relief drugs are definitely worth considering.

Surgery as a Last Resort

If the drugs previously discussed prove ineffective, your doctor may recommend surgery. Examples of surgeries used in rheumatoid arthritis treatment are tendon repair, synovectomy (joint lining removal), as well as joint replacement surgery (arthroplasty), wherein the damaged areas of the joint are replaced with prosthetic ones.
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