Rheumatoid Arthritis Treatment
What kind of treatment options are there for sufferers of rheumatoid arthritis?
Is there one "right" treatment or many possible treatments? Is one drug sufficient
or is a combination of drugs a better option? Treatment options for Rheumatoid Arthritis
abound from drug therapy to supplements. Rheumatoid Arthritis is an immune system
disease so treatments of other immune system conditions such as allergies may also
Different types of drugs are used in the treatment of RA. These types include nonsteroidal
anti-inflammatory drugs (NSAIDs) such as ibuprofen, disease-modifiying antirheumatoid
drugs (DMARDs) such as methotrexate or antimalarials, corticosteroids such as prednisone,
and the newest treatments-biologic response modifiers (biologics) such as Enbrel
Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and relieve pain.
Ibuprofen, aspirin, naproxen sodium, and ketoprofen are examples of NSAIDs. A new
form of NSAIDs available in recent years is the COX-2 inhibitors. These also relieve
pain and reduce inflammation but without some of the side effects of other NSAIDs.
COX-2 inhibitors are less likely to cause stomach bleeding and kidney problems.
Celebrex and Bextra are two COX-2 inhibitors approved in the US.
Disease-modifying antirheumatoid drugs (DMARDs) are a second type of drugs used
in the treatment of Rheumatoid arthritis. These disease-modifying drugs work by
altering the immune system response and so reduce or prevent the inflammation. By
reducing the inflammation these drugs also help prevent damage to the joints. Methotrexate
is the most commonly prescribed of these drugs. Others in this category include
Plaquenil, Cytoxan, and gold. Arava is a new drug in this category and it works
by inhibiting production of inflammatory cells.
Biologic response modifiers (biologics) are the newest treatment on the market for
Rheumatoid arthritis. Remicade, Enbrel, Humira, and Kineret are currently approved
for the treatment of Rheumatoid arthritis in the US. Cytokines play an important
role in the body regulating inflammation. Biologics affect the cytokines in a way
to reduce inflammation. Remicade, Enbrel, and Himira work by inhibiting a cytokine
called tumor necrosis factor (TNF). Kineret works differently by inhibiting the
cytokine interleukin-1 (or IL-1). The difference between these biologic drugs and
other treatments for RA is that these affect specific areas of the immune system
rather than affecting the immune system as a whole.
Recent studies show that the best results for sufferers of Rheumatoid arthritis
come from combinations of these types of drugs for treatment. Studies of people
treated only with methotrexate or only with a COX-2 inhibitor showed less improvement
in their condition than people treated simultaneously with both methotrexate and
a COX-2 inhibitor. Talk to your physician about the different combinations that
are available to you. Small dosages of several drugs may be a better alternative
than large doses of just one type.