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Rheumatoid Arthritis Medication: The Right Care

Don't let RA slow you down. Get the facts about rheumatoid arthritis medications that'll keep you moving.

Rheumatoid Arthritis Medication: Live Longer, Live Better continued...

So how early should you begin treatment with rheumatoid arthritis medication? As soon as a diagnosis of rheumatoid arthritis is made, Matteson says. And that can usually be done with confidence as little as six weeks after the first onset of symptoms.

"It's never too early, and never too late -- there's plenty of data that even treating late does help, so don't despair if you didn't receive early treatment," says Theodore R. Fields, MD, FACP, clinical director of the Gosden-Robinson Early Arthritis Center at New York's Hospital for Special Surgery. "But, clearly there's a dramatic benefit of getting in there early to get the disease controlled."

Rheumatoid Arthritis Medication: A Range of Options

People with rheumatoid arthritis have a broad range of options for treatment, and doctors may try several rheumatoid arthritis drug combinations before they find the one that works best for you. Rheumatoid arthritis medications include:

  • DMARDs (disease-modifying antirheumatic drugs), can slow, and sometimes even prevent, joint damage, and destruction associated with rheumatoid arthritis. They include leflunomide (Arava), sulfasalazine (Azulfidine), hydroxychloroquine (Plaquenil), tofacitinib (Xeljanz), and methotrexate. Methotrexate is the most commonly prescribed first-line treatment for RA because it provides quick relief and has a relatively low rate of side effects.
  • Biologic DMARDs are a newer group of drugs derived from living organisms. These medications block various elements of the immune system that can fuel inflammation. They include Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, and Simponi.
  • Corticosteroids: They may reduce some joint damage by reducing inflammation, but their limited effectiveness and high rate of side effects do not make corticosteroids a good long-term treatment strategy.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): these drugs, such as ibuprofen and Motrin, relieve symptoms and mild inflammation but do not have any modifying effect on the disease itself.
  • Analgesics such as creams (capsaicin) or pain medication pills such as propoxyphene (Darvon) or Oxycodone.


Rheumatoid Arthritis Medication: Side Effects

Something to keep in mind: RA drugs, particularly the synthetic and biologic DMARDs, do not come without side effects.

Methotrexate, for example, can suppress your body's immune system -- it's used in larger doses in cancer chemotherapy. The biologic DMARDs can also weaken the immune system and have been linked to increased rates of infection and certain cancers.

"The overall benefit of the medications far outweighs the risks, but we treat individual patients, and we have to individualize the therapies as well," Matteson says. "We do it on the basis of how aggressive the disease is likely to be, as well as an assessment of other conditions in the patient's history that might affect their outcome, like tuberculosis or a history of bad infections."

What to Expect From Treatment With Rheumatoid Arthritis Medication

When treating patients, "our number one goal is remission," Fields says. "We can't always get there, but that's our goal, and in 23 years of practice, I've never seen more people coming back and saying 'I've forgotten I have arthritis' than I do today. That's still a minority, but most people come back and have some degree of improvement that often allows them to function socially, work, participate in sports, and have a pretty normal life even though they have some swelling and stiffness."

Patients need to be more educated than ever before when it comes to RA.

"You have to be involved. There's no room for the doctor to just say, 'You have rheumatoid arthritis, and I'm writing you a prescription for this,'" Fields says. "There are so many options and so many issues individual to the patient. Doctor-patient collaboration is essential."

Reviewed on January 05, 2010

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