Arthritis is not a single condition; it represents a group of more than 100 different but related diseases. Rheumatoid arthritis (RA)--an auto-immune disease characterized by chronic inflammation of the lining of the joints--affects more than 1 million Americans as reported by the Centers for Disease Control and Prevention. Although there is no cure for RA, several different types of medications are utilized to treat the symptoms of the disease.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs, called NSAIDs, are medications used to reduce inflammation caused by rheumatoid arthritis. These, in turn, decrease pain and improve joint function. NSAIDs work by blocking the enzymes known as COX1 and COX2, which are necessary for producing prostaglandins, prostacyclins and thromboxanes--all of which are involved in inflammation. These enzymes are also important for other bodily functions, including those in the digestive tract, kidneys and heart. This is why taking NSAIDs can also result in unwanted side effects.
Several commonly used over-the-counter medications belong to the group of NSAIDs, including ibuprofen, naproxen sodium and aspirin. The prescription medication celecoxib, a Cox-2 inhibitor, is often prescribed to treat RA; however, side effects may be serious.
Inhibiting the COX enzymes affects other parts of the body, producing side effects such as upset stomach, ulcers, heartburn and skin rash. Less common side effects include swelling of the face, feet or legs, confusion and a decrease in urine production. NSAIDs can increase blood pressure by impairing kidney function. This results in an imbalance of salts and fluids and by reducing the ability of blood vessels to relax, according to the Harvard Medical School. As a result, NSAIDs can contribute to serious heart complications.
Disease-Modifying Antirheumatic Drugs (DMARDs)
Although NSAIDs are effective at treating the inflammation caused by RA, they don't alter the course of the disease or prevent damage to the joints and bones. Disease-modifying antirheumatic drugs (DMARDs), on the other hand, can help prevent damage and improve joint function. DMARDs include a variety of medications, some of which are prescribed for other conditions. These include methotrexate, sulfasalazine, hydroxychloroquine, leflunomide and cyclosporine.
DMARD medications usually take longer to have an effect on RA, according to the Johns Hopkins Arthritis Center, but positive effect on joint function and low toxicity of most of the medications make it a first choice for many doctors.
Corticosteroids
Corticosteroids such as prednisone are commonly used to treat inflammation and are therefore useful for treating RA. Corticosteroids can be taken orally or injected into the muscle, bloodstream or even directly to the joint. Steroids can cause many unwanted side effects--including weight gain, increased blood pressure and increased blood sugar. Long-term use has been associated with osteoporosis and toxicity. For these reasons, steroids are often prescribed along with DMARDs to treat the inflammation in the short term. This provides time for the DMARDs to take effect.
