Rheumatoid arthritis is an inflammatory condition in the joints that is characterized by swelling, pain, and redness, especially around the joints. The presence of nodules is also a characteristic of rheumatoid arthritis.
Medications are the primary mode of treatment for rheumatoid arthritis. There are medications used for the management of symptoms, while there are other medications that work to lessen the structural effects of the condition on the joints and the bones. The types of medications used depend on how fast the condition is progressing and how it affects day-to-day activities.
Goal of treatment
The goal of treatment is to lessen the severity of the condition and to bring a possible remission. Immediate objectives in the use of most medications include:
- for relief of pain
- improvement of daily function
- reduction of joint inflammation and its symptoms, including joint swelling, pain, redness, and limited range of motion
- prevention of significant disability
- improvement of the quality of life
Medications
There are categories of drugs used in the treatment of rheumatoid arthritis. These include NSAIDs, analgesics or painkillers, corticosteroids, DMARDs or disease-modifying anti-rheumatic drugs, and the newer biologic drugs.
Painkillers
Although NSAIDs are classified under painkillers, there are other painkillers that are also useful for the reduction of RA symptoms. Paracetamol often helps in regulating the pain that comes with RA. Although it does not have an anti-inflammatory action, paracetamol is a good option in addition to or instead of anti-inflammatory drugs. Another painkiller that is typically given is codeine.
NSAIDS
This class of drugs has been used in the treatment of rheumatoid arthritis for more than 30 years. They come with anti-inflammatory, analgesic, and antipyretic properties. However, they come with several side effects as well, among them nausea, vomiting, ulcers, and bleeding in the stomach. They may also cause fluid retention and edema in users.
NSAIDs work by blocking the enzymes that promote the formation of prostaglandins, specific substances in the body that promote pain, inflammation, and fever. Blocking the enzyme prevents the prostaglandins from promoting inflammation and fever, thus, reducing pain and swelling.
Corticosteroids
These are medications with anti-inflammatory and immunoregulatory activity. Given orally, through IV, or direct injections, corticosteroids work by blocking the production of substances that trigger the production of allergic and inflammatory actions. They also prevent the function of white blood cells, which play a significant role in the immune system. This means that individuals who take corticosteroids may suffer from compromised immune systems and are therefore more susceptible to infections. Other side effects of corticosteroids include increase in weight, moon face, deposits of fat in the chest, upper back, behind the neck, and the stomach, water retention, delayed wound healing, easy bruising, muscle weakness, and stomach ulcers. Because of these side effects, corticosteroids are given at the lowest doses and are only given for a duration of several weeks for short-term therapy, before the intake of the medication is tapered on a two-week period. The drug is only given for long-term therapy in the most severe cases of inflammation.
Biologic drugs
Biologic drugs include abatacept, etanecerpt, and anakinra. These drugs work by inhibiting key factors responsible for the inflammatory response in the immune system. However, use of these drugs is contraindicated in persons who are allergic to the drugs or the components. There are also conditions for the use of these drugs. For one, they cannot be used simultaneously with other drugs like TNF antagonists. Side effects commonly associated with biologics include headaches, upper respiratory tract infections, sore throat, and nausea.
Disease-modifying anti-rheumatic drugs (DMARDS)
DMARDs are drugs that not only ease the symptoms of rheumatoid arthritis but also reduce the damaging effect of the condition on the joints. DMARDs work by preventing the formation of inflammation in the joint by blocking the substances involved in the inflammation process. The usual is a combination of at least two DMARDs after the RA has been diagnosed and most often the drug used is methotrexate plus another DMARD. Doctors stress that the effects are not seen right away but it is important to keep on taking the combination of DMARDs as prescribed. Side effects to DMARDs used include damage to the liver and other blood-producing cells.
Other drugs
There are newer drugs introduced for the treatment of rheumatoid arthritis. These include anti-TNF drugs. These drugs block the effect of alpha-TNF, a chemical that plays an important role in the development of inflammation in the body. The blockage of the effect of this chemical has been shown to cause a marked reduction in the damage to joints and a reduction of symptoms. These drugs need to be given by injection and they are very expensive.
Prevention of complications
Remember that medications are only a means to regulate the symptoms of this condition. To make sure that you have reduced chances of developing complications like cardiovascular disease, osteoporoses, and infections, a couple of preventive practices must be adopted. These include eating a healthy diet, losing weight if you are overweight, quitting smoking, as well as controlling blood pressure levels. Immunizations are also important in order to prevent infections.