Donna Schwartz, a 62-year-old retiree, has the dream snowbird life. She produces and directs comedies at a local theater in Delray Beach, Fla., plays tennis, goes for long leisurely walks almost daily, and drives up to Long Island, N.Y., around the holidays to spend time with her grandchildren.
But Schwartz’s life wasn’t so fulfilling several years back. Diagnosed with rheumatoid arthritis (RA) in 1985, the New York native was forced to sell her packaging company and had resigned herself to spending...
Reduce joint inflammation. Signs of joint
inflammation include swelling, tenderness, and limited range of
Prevent or delay significant
joint damage and deformity.
Improve quality of life.
Medicines called disease-modifying antirheumatic drugs
(DMARDs) can slow or sometimes prevent joint destruction. Starting treatment early with DMARDs can reduce the severity of the disease.3 DMARDs are also called immunosuppressive drugs or
slow-acting antirheumatic drugs (SAARDs). These medicines work best when taken over a long period to help control the disease.8
DMARDS can be divided
into two general categories based on how they work: oral DMARDs and biologic
DMARDs. Oral DMARDS are taken by mouth. They interfere with the making or
working of immune cells that cause joint inflammation. Biologic DMARDS are
given by injection (infusion). They act in several different ways to affect how
immune cells work. DMARDs decrease joint
inflammation and damage.
Medicines may be
given together. This is called combination therapy. Oral medicines are combined
with each other or with biologic DMARDs. But biologic DMARDs are not used
with each other because of a higher risk of infection. By combining medicines, you may be able to take lower doses of individual medicines. This may reduce your risk of side effects.
Disease-modifying antirheumatic drugs
(DMARDs) are usually started within 3 months of your diagnosis. They are used to
control the progression of RA and to try to prevent joint
damage and disability. DMARDs are often given in combination with other
such as prednisone or Medrol. These medicines are used to reduce disease
activity and joint inflammation. But using only corticosteroids for an extended time is not considered the best treatment. Corticosteroids are
often used to control symptoms and flares of joint inflammation until DMARDs
reach their full effectiveness.
Analgesics (pain relievers). These don't reduce
inflammation but may help with pain control. They include:
In some people, a certain DMARD may not work at all. So a
different DMARD will be used.
If you're taking DMARDs, it's a good idea to have a rheumatologist manage your care.
Many DMARDs have serious side effects. You will need regular blood and urine tests to check the drug's effects on
blood-producing cells (bone marrow), the kidneys, and the liver.
Other medicines are being studied. One example is tacrolimus (Prograf), an inhibitor of a
protein called calcineurin. In one 6-month trial, people who had rheumatoid arthritis that had not responded to DMARDs had fewer symptoms.9