Even though there is no definite cure for rheumatoid arthritis (abbreviated as RA) thus far, there are a number of available medications being offered that are meant to manage its symptoms and in due course improve the condition.



In general, RA drugs may be classified into distinct classes, as enumerated in the succeeding paragraphs. Physicians will probably create proper treatment plan to reduce inflammation and pain of the joints, plus stop cell damage in the joints. Depending on each case, effective treatment can be attained through a combination of the following options:

NSAIDs or Nonsteroidal Anti-inflammatory Drugs

Nonsteroidal Anti-inflammatory Drugs, more commonly known as NSAIDs, are effective in pain relief and inflammation reduction, but don’t serve to protect the joints from further damage. These medications block the body from producing a substance called prostaglandins, which triggers inflammation & pain.

Common NSAID examples are naproxen (Naprosyn, Aleve) and ibuprofen (Motrin, Advil). Some more NSAIDs include etodolac (Lodine), meloxicam (Mobic), ketoprofen (Orudis), Celecoxib (Celebrex), indomethacin, oxaprozin (Daypro), diclofenac (Voltaren, Cataflam), piroxicam (Feldene), and nabumetone (Relafen).

These drugs are regularly prescribed as soon as a final rheumatoid arthritis diagnosis is made. However, But when consumed in excessive dosages for a long time, these drugs can cause severe side effects, such as stomach bleeding, gastric ulcers, and even kidney and liver damage.

Corticosteroids

A different type of medication used for rheumatoid arthritis treatment is corticosteroids. Such medications impact the immune system, thus alleviating inflammation.

Cortisone (Cortone), betamethasone (Celestone Soluspan), methylprednisolone (SoluMedrol, DepoMedrol), prednisolone (Delta-Cortef), triamcinolone (Aristocort), dexamethasone (Decadron), as well as prednisone (Orasone, Deltasone), are some of the most common corticosteroids.

While corticosteroids may be successful in treating rheumatoid arthritis, they have been reported to trigger negative side effects when used in prolonged periods. Some side effects include easy bruising, cataracts, glaucoma, excessive weight gain, diabetes, and thinning bones.

Given their potential to develop adverse side effects, such medications are generally only used as a temporary remedy to curtail sudden attacks of rheumatoid arthritis. On the positive side, just 1 corticosteroid injection can block inflammation of the joint lasting for a long period of time.

Disease Modifying Anti-Rheumatic Drugs or DMARDs

DMARDs (or Disease Modifying Anti-Rheumatic Drugs) pertain to a class of drugs that serve to block the immune system from assaulting the joints, eventually delaying the progression of further joint damage. In treating RA, disease modifying anti-rheumatic drugs are often consumed together with other meds for increased efficiency.

Rheumatoid arthritis commonly causes permanent joint damage, which starts to manifest at the onset. It is because of this that the majority of physicians would prescribe DMARDs soon after making a diagnosis. Individuals are most receptive to DMARDs during the early stages of RA. The sooner DMARDs are used, the more effective it is for the RA patient.

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

Although various DMARDs have been proven effective in treating RA, the potential for severe side effects is enormous. Long-term DMARD use can lead to toxicity of the bone marrow and liver, susceptibility to infections, allergies (particularly of the skin), and even autoimmunity.

Among the DMARDs listed above, hydroxychloroquine has the lowest potential for producing liver and bone marrow toxicity, and is thus considered as one of the safest DMARDs. The bad news is that hydroxychloroquine is not a powerful drug by itself, and is not effective enough on its own to treat rheumatoid arthritis symptoms.

Conversely, methotrexate is deemed as one of the most powerful DMARDs to use in treating RA because of a number of reasons. Methotrexate has been reported to work in RA treatment without affecting the toxicity of the liver and bone marrow as in the majority of DMARDs. In addition, it works safely and effectively when used together with biological agents, another type of RA drugs to be discussed later. Consequently, methotrexate drugs are frequently prescribed in combination with biological agents in cases where the drug does not control RA on its own. On the other hand, keep in mind that although methotrexate is not as potentially dangerous as others, it still may likely suppress the bone marrow or trigger hepatitis. If this happens, getting regular blood tests are always advised to check the patient’s condition, and to cease treatment at the first indication of problems.

Biological Agents

Biological drugs, also known as biological agents, function to lessen inflammation through various methods.

One example of how biological agents work is by inhibiting tumor necrosis factors (TNFs). Infliximab (Remicade), adalimumab (Humira), and etanercept (Enbrel) are some examples of TNF blockers.

One other method of how biological agents control inflammation is by eradicating B cells. The Rituxan (Rituximab) drug, for instance, fuses itself to B cells, thus killing them.

Other medications that reduce inflammation through their own way are:

- tocilizumab (RoActemra, Actemra), serves to inhibit IL-6 (interleukin)

- anakinra (Kineret), which serves to block IL-1 (interleukin 1)

- abatacept (Orencia), works by inhibiting T-cells

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

Salicylates

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

Pain Relief Medications

Finally, various pain relief medications may likewise be used to treat rheumatoid arthritis. Examples of pain relief medications include tramadol (Ultram) and acetaminophen (Tylenol).

While anti-pain drugs neither alleviate inflammation nor delay further joint damage, these medications allow the individual to feel more comfortable and in due course function better. For this reason, anti-pain drugs are absolutely worth considering.

Surgery as a Last Resort

If all these medications prove ineffective, a physician may possibly recommend surgical treatment. Some surgeries meant to treat rheumatoid arthritis are tendon repair, synovectomy (i.e. joint lining removal), as well as arthroplasty (i.e. joint replacement surgery), in which the damaged joint areas are replaced with prosthetics.