Medications For Rheumatoid Arthritis
Although there is no actual cure for rheumatoid arthritis or RA to this day, there are a number of available drugs in pharmacies that are designed to alleviate its symptoms and eventually improve the patient’s health.
In general, RA medications can be classified into different classes, as enumerated in the succeeding paragraphs. Doctors can make proper plan for treatment to reduce joint inflammation and pain, and stop further damage to the joints. Depending on each case, successful treatment can be attained through a combination of the following 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 do not function to prevent further damage to the joints. These drugs impede the human body from manufacturing a substance called prostaglandins, which primarily triggers pain and inflammation.
Some examples of NSAIDs are naproxen (Aleve and Naprosyn) and ibuprofen (Advil and Motrin). Other NSAID examples include etodolac (Lodine), meloxicam (Mobic), ketoprofen (Orudis), Celecoxib (Celebrex), indomethacin, oxaprozin (Daypro), diclofenac (Voltaren, Cataflam), piroxicam (Feldene), and nabumetone (Relafen).
These drugs are often recommended when a final diagnosis of rheumatoid arthritis is made. However, But when consumed in excess dosages for extended periods, these medications can cause negative side effects, such as stomach ulcers, stomach bleeding, as well as potential damage to the kidney and liver.
Corticosteroids
Another classification of medication used for rheumatoid arthritis treatment is corticosteroids. These drugs restrain the immune system, thus lessening inflammation.
Betamethasone (Celestone Soluspan), methylprednisolone (SoluMedrol, DepoMedrol), Cortisone (Cortone), triamcinolone (Aristocort), prednisolone (Delta-Cortef), dexamethasone (Decadron), and prednisone (Deltasone & Orasone), are 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, these medications are usually only used as a temporary solution to manage sudden rheumatoid arthritis outbreaks. The good news is that just one corticosteroid injection is able to block joint inflammation for a long time.
Disease Modifying Anti-Rheumatic Drugs or DMARDs
Disease Modifying Anti-Rheumatic Drugs or DMARDs pertain to a classification of drugs that serve to inhibit your immune system from assaulting the joints, gradually obstructing further progression of joint damage. In rheumatoid arthritis treatment, these drugs are commonly consumed in combination with other drugs for more successful results.
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.
Some DMARD examples are methotrexate (Rheumatrex), hydroxychloroquine (Plaquenil), cyclosporine (Sandimmune, Neoral), gold salts (Solganal, Aurolate, Myochrysine, Ridaura), cyclophosphamide, penicillamine (Cuprimine), azathioprine (Imuran), minocycline, leflunomide (Arava), and sulfasalazine (Azulfidine).
Although various DMARD products have been successful in treating rheumatoid arthritis, the potential for negative side effects is high. Long-term DMARD consumption may lead to toxicity of the bone marrow and liver, infections, allergies (particularly of the skin), and autoimmunity.
Of the DMARD examples mentioned above, hydroxychloroquine has the lowest risk of producing liver & bone marrow toxicity, and is consequently considered as 1 of the safest DMARDs. The bad news is that hydroxychloroquine isn’t a particularly powerful drug and is not strong enough on its own to curtail RA symptoms.
In contrast, methotrexate is believed to be 1 of the most powerful DMARD types in treating RA because of a number of reasons. It has been known to treat RA without affecting the toxicity of the liver and bone marrow as in other DMARDs. In addition, methotrexate has been proven safe and effective when used alongside biological agents, which are another classification of RA drugs to be discussed later. Consequently, methotrexate is often recommended in combination with some biological agents if the drug does not cure the disease on its own. On the other hand, do note while methotrexate is not as risky as others, it still canblock the bone marrow or trigger hepatitis. In such cases, getting regular blood tests are recommended to guide the individual’s condition, as well as to stop treatment at the first hint of problems.
Biological Agents
Biological agents or biological drugs function to treat inflammation via a range of methods.
An example of how biological drugs work is by inhibiting tumor necrosis factors (TNFs). Adalimumab (Humira), infliximab (Remicade), and etanercept (Enbrel) are some TNF blockers.
Another way with which biological agents treat inflammation is through killing B cells. Rituxan (Rituximab), for example, unites with B cells, hence killing them.
Further medications that lessen inflammation through their own distinctive ways 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 prostaglandins production. Prostaglandins generate the pain and inflammation of arthritis. In recent years, the use of salicylates have been generally replaced with nonsteroidal anti-inflammatory drugs (NSAIDs), mainly since salicylates can cause negative side effects, such as damaging the kidney.
Pain Relief Medications
Last but not least, a range of pain relief medications can likewise be used to treat RA. Examples of pain relief medications include acetaminophen (Tylenol) and tramadol (Ultram).
Even though pain relief medications neither reduce inflammation nor suppress further joint damage, such drugs allow the individual become more comfortable and ultimately improve his/her overall condition. Hence, pain relief drugs are certainly worth considering.
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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