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Rheumatoid Arthritis: Finding the Right Medication for You

New drugs offer more options to short-circuit rheumatoid arthritis.
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Biologic Drugs: The New Frontier in Treating Rheumatoid Arthritis continued...

Abatacept (Orencia), etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), and anakinra (Kineret) are FDA-approved biologic agents for treatment of rheumatoid arthritis. They interfere with immune system chemicals called cytokines -- all of which are involved in inflammation-related joint and tissue damage.

"With the advent of these [cytokine] blockers, we can target specific components of the immune system -- not the entire immune system," he explains. "Each of these works differently, and they are very good therapies."

In February 2006 the FDA approved Rituxan -- in combination with methotrexate -- for the treatment of RA. It's the first RA treatment that selectively targets immune cells known as CD20-positive B cells. B cells are believed to play a role in the inflammation associated with RA. Rituxan is intended for patients who have not improved with treatments called tumor necrosis factor (TNF) antagonists, such as Enbrel and Remicade.

"These newer treatments are able to work better, and work in a greater number of patients," Kavanaugh adds. "We're now able to improve signs and symptoms, make people more functional, keep quality of life up, and do a much better job of preventing damage. We really are seeing a big difference. Greater numbers of people are able to stay functional."

Pros and Cons of Medications Used to Treat Rheumatoid Arthritis

Here are brief descriptions of the various medications used to treat rheumatoid arthritis.

Anti-Inflammatory Painkillers

These drugs are used by nearly everyone with some form of arthritis. There are several options available over the counter and by prescription -- and all work to relieve joint swelling, stiffness, and pain. However, they do not stop the disease from getting worse.

Traditional nonsteroidal anti-inflammatory drugs (NSAIDs) like Motrin and Aleve can be hard on the stomach. Cox-2 inhibitors like celecoxib (Celebrex) are newer NSAIDs that are safer for the stomach, yet just as effective in relieving pain and inflammation.

All prescription NSAIDs, including Celebrex, carry an FDA warning about the risk of heart attacks, strokes, and potentially life-threatening stomach bleeding. But these drugs are a very effective treatment for rheumatoid arthritis. Patients and their doctors need to weigh the benefits of these drugs with the risks. Controlling risk factors such as cholesterol and blood pressure can help lower the heart and stroke risk.

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