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Rheumatoid Arthritis: Finding the Right Medication for You

New drugs offer more options to short-circuit rheumatoid arthritis.
By
WebMD Feature

For people with rheumatoid arthritis, medications are a fact of life -- helping control pain and swelling, and preventing damage to joints. The newest drugs can even stop the disease in its tracks.

That's the good news -- the drugs keep improving, bringing real hope for the millions with this disease. They are more sophisticated than ever before. And there are more of them, each working in a slightly different way. So if one drug doesn't help a patient, there are options, says Arthur Kavanaugh, MD, a rheumatologist and professor of medicine at the University of California at San Diego.

Joint-Friendly Fitness Routines

Regular exercise boosts fitness and helps reverse joint stiffness for people with rheumatoid arthritis (RA). This slideshow demonstrates helpful exercises to get you started.

"The more options, the better, because we want to treat people more aggressively and get the disease under control as quickly as possible," Kavanaugh says.

Medication Options for Rheumatoid Arthritis

The tried-and-true anti-inflammatory medications can relieve pain, improve daily function, reduce joint swelling and tenderness, and improve range of motion -- and that's all good. "All my patients take these drugs," Kavanaugh says.

But there's so much more. In the past two decades, drugs that target the immune system have become a backbone of treatment. A class of drugs called disease-modifying antirheumatic drugs (DMARDs) is able to alter the course of rheumatoid arthritis by suppressing or interfering with the immune activity that attacks joints.

Some of these medications are traditionally used in treating other diseases -- like cancer or inflammatory bowel disease, or to prevent rejection of a transplanted organ - and have been found to also help with rheumatoid arthritis treatment. However, when a chemotherapy medication like methotrexate (Rheumatrex) is used, the dosage is much lower -- with considerably less risk of side effects -- than when used in cancer treatment.

"We use [DMARDs] aggressively from the start," says Kavanaugh. ""We use them early on, push harder on the doses, to get things turned around more quickly." However, DMARDs don't work for all patients, he notes. In those cases, the new biologic agents have offered new treatment options.

Biologic Drugs: The New Frontier in Treating Rheumatoid Arthritis

Indeed, the newer class of drugs - the biologic agents - shows even greater promise for more patients, Kavanaugh says. These drugs can prevent or delay damage to joints, even halt the disease, because they target the malfunctioning immune system -- a big factor in rheumatoid arthritis, he explains.

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