Rheumatoid arthritis is a chronic inflammatory disease that affects the joints in the body, particularly the hands, wrists and feet. The symptoms include joint pain, joint swelling and tenderness, red hands, nodules on the arms and morning stiffness. Medical treatment is aimed at reducing inflammation and slowing down joint damage.
Goals of Treatment
Goals of treatment include controlling disease activity, maintaining the ability to function in daily activities and improving the quality of life. The ultimate goal is to achieve complete disease remission.
Treatment
The first-line treatment for rheumatoid arthritis is a disease-modifying anti-rheumatic drug, or DMARD. Commonly used DMARDs include methotrexate, leflunomide, hydroxychloroquine, sulfasalazine and minocycline; the DMARD of choice is methotrexate. NSAIDs, such as naprosyn, diclofenac and indomethacin, are used to relieve symptoms until the benefit of DMARDs is seen, but they provide no impact on disease progression, according to "Pharmacotherapy: A Pathophysiologic Approach."
Side Effects
The "Drug Information Handbook" reports that the common side effects of methotrexate are inflammation of the mucous lining of the mouth, nausea, vomiting, diarrhea and increased liver enzymes. NSAIDs may cause stomach ulcers, heart problems, and liver and kidney damage.
References
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro et al; 2008
- "Drug Information Handbook"; Charles Lacy, Lora L. Armstrong, et al; 2009
