Rheumatoid Arthritis Drugs
For the past 10 years, studies have shown that early, aggressive treatment for RA can delay the onset of joint destruction. In addition to rest, strengthening exercises, and anti-inflammatory agents, the current standard of care is to initiate aggressive therapy with disease-modifying anti-rheumatic drugs (DMARDs) once the diagnosis is confirmed.
Anti-inflammatories use as Rheumatoid Arthritis Drugs
Anti-inflammatory agents used to treat RA traditionally included aspirin and non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin, Advil), fenoprofen, indomethacin, naproxen (Naprosyn), and others.
These are widely used Drugs that are effective in relieving pain and inflammation associated with RA. However, side effects associated with frequent use of many of these Drugs include life-threatening gastrointestinal bleeding.
Similar drugs, called Cox-2 inhibitors, are now a mainstay of anti-inflammatory therapy because the risk of gastrointestinal bleeding is significantly reduced with these drugs. Currently, there are two available -- rofecoxib (Vioxx) and celecoxib (Celebrex).
As mentioned, DMARDs alter the course of the disease. Included in this group are gold
compounds, which can be injectible (Myochrysine and Solganal) or oral (auranofin/Ridaura).
Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis with
good proven effectiveness.
Antimalarials drugs used as Rheumatoid Arthritis Drugs
Antimalarial Drugs, such as Hydroxychloroquine (Plaquenil), as well as Sulfasalazine (Azulfidine), are also beneficial, usually in conjunction with Methotrexate.
The benefits from these Drugs may take weeks or months to be apparent. Because they are associated with toxic side effects, frequent monitoring of blood tests while on these Drugs is imperative.
New drugs used as Rheumatoid Arthritis Drugs
In the last few years, new and exciting Drugs have been introduced. A promising medication that is fast becoming a first-line agent for the aggressive treatment of RA is called etanercept (Enbrel). Enbrel acts by inhibiting an inflammatory protein, called tumor necrosis factor (TNF).
Other new Drugs include infliximab (Remicade) that also blocks TNF and leflunomide (Arava), which blocks the growth of new cells. Anakinra is an even newer therapy that blocks the action of another inflammatory protein, interleukin-1. Anakinra and Etanercept are injectable Drugs, whereas Infliximab is given intravenously every 2 months.
Drugs that suppress the immune system, like azathioprine (Imuran) and cyclophosphamide (Cytoxan), may be used in people who have failed other therapies. These Drugs, which are associated with toxic side effects, are reserved for severe cases of RA.
Steroids used as Rheumatoid Arthritis Drugs
Corticosteroids have been used to reduce inflammation in RA for greater than 40 years. However, because of potential long-term side effects, corticosteroid use is limited to short courses and low doses where possible.
Side effects may include bruising, psychosis, thinning of the bones (osteoporosis), cataracts, weight gain, susceptibility to infections, diabetes, and high blood pressure. A number of Drugs can be administered in conjunction with steroids to minimize resultant osteoporosis.
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