1. Oh, Those Aching Joints
Rheumatoid arthritis (RA) is a chronic inflammation of the joints. It affects most joints of the body: shoulders, knees, wrists, elbows, fingers and feet. The joint typically swells and is painful. RA is symmetrical, meaning it attacks the same joint on both sides of the body. RA is an autoimmune disease, in which the body's immune system attacks the tissues of the joints. There is no cure for RA and the only available treatment is with medications, which can do something as simple as alleviate pain or go up to targeting the body's immune system.
2. Relieve, Reduce and Improve
The goal of rheumatoid arthritis medications is to relieve and reduce symptoms and improve the function of the affected joints as well as the quality of life for RA sufferers. Medications are designed to relieve pain and reduce inflammation. They can also prevent possible damage to and deformity of the joint by achieving and maintaining remission of the disease. The type of medication you are given depends on the progress of the disease and the severity of the symptoms.
3. The First Line of Defense
The most common drug treatment for those with RA usually involves nonsteroidal anti-inflammatories (NSAIDs). These would include Advil or Motrin (ibuprofen), Aleve (naproxen) and Relafen (nabumetone). In the mid-1990s, a subset of NSAIDs called COX-2 inhibitors were developed, which impede the enzyme responsible for the swelling and pain associated with RA. These include Celebrex, Vioxx and Bextra. Disease-modifying antirheumatic drugs (DMARDs), which act on the body's immune system, are becoming more popular to treat early-stage RA. These include cyclosporine, gold, methotrexate and sulfasalazine.
4. Calling Out the Heavy Hitters
In some cases, RA does not respond to any standard treatments. Other forms of medications beyond NSAIDs and DMARDs must be called upon. These are called biologic response modifiers and were introduced in the United States in the late 1990s. These, too, stimulate the immune system to fight joint inflammation by targeting tumor necrosis factor-alpha (TNF-alpha), a protein found in high levels in the presence of certain inflammations. These intravenous drugs have had success in alleviating symptoms of RA.
5. Giving RA the Old One-two Combination
An effective and less risky form of treatment to fight RA is to use a combination of a biologic response modifier together with a standard NSAID or DMARD. Since some rheumatoid arthritis medications can have serious side effects such as liver disease or birth defects, using combination therapy allows for a lower dose of each drug to be used and thus reducing any potential side effects. Combination therapy has shown to be effective in treating symptoms and inducing remission of RA.
