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Treatments for Rheumatoid Arthritis

Rheumatologist discusses treatment options with patient Although there is no cure for rheumatoid arthritis (RA), there are a variety of available drugs that mask the symptoms and slow the progression of the disease. Additionally, there are numerous physical and occupational therapies, home remedies, weight loss plans, relaxation techniques and medical surgeries to relieve joint pain. It is important to discuss with your rheumatologist any treatment methods you plan to employ.

(If you have been diagnosed with RA, you may qualify for our rheumatoid arthritis clinical trial in Birmingham, AL.)

The following is a list of treatments used to manage rheumatoid arthritis:

– Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce pain and inflammation. Mild forms of NSAIDs include ibuprofin (advil and motrin) and naproxen (aleve), and there are stronger forms available by prescription. NSAIDs do not preclude joint damage, nor do they inhibit or slow the worsening condition of RA. Treatment begins working a few days after it has begun. Side effects of NSAIDs include gastrointestinal irritation, ulcers, burning and bleeding; ringing in the ears; liver damage; kidney damage; edema; increased blood pressure and heightened risk of cardiovascular disease.

Corticosteroids reduce pain and inflammation and also slow the progression of joint damage. Corticosteroid drugs include prednisone, Medrol and methylprenisolone. These drugs are administered orally, or by needle into the joint, intramuscularly or intravenously. Corticosteroids have a short commencement of treatment. Side effects include weight gain, increased blood sugar, cataracts, increased blood pressure, diabetes, thinning of the bones, redness in the cheeks, widened neck and accelerated osteoporosis.

Immunosuppressants control the immune system by suppressing its self-inflicting harmful course of action. Immunosuppressants include cyclophosphamide (Cytoxan), azathioprine (Azasan and Imuran) and cyclosporine (Neoral, Gengraf and Sandimmune). The primary side effect of these drugs is susceptibility to infection. Other side effects include itching, harsh abdominal pain and flu-like symptoms such as headache, sore throat and runny nose.

Disease-modifying antirheumatic drugs (DMARDs) slow the progression of RA and limit the damage it inflicts upon the tissues and joints. DMARDs include hydroxychloroquine (Plaquenil), minocycline (Dynacin and Minocin), golimumab (Simponi), methotrexate (Trexall), tocilizumab (Actemra), etanercept (Enbrel), infliximab (Remicade), certolizumab pegol (Cimzia), abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), rituximab (Rituxan) and sulfasalazine (Azulfidine). DMARDs may take a few weeks for the treatment to take effect. Side effects of DMARDs include lung infections, liver damage and inhibition of bone marrow.

– Tumor Necrosis Factor (TNF)-alpha inhibitors reduce pain, joint tenderness, morning stiffness and joint swelling characterized by RA. TNF-alpha inhibitors include golimumab (Simponi), etanercept (Enbrel), certolizumab (Cimzia) and adalimumab (Humira). Side effects include increased risk of specific cancers, heart failure and lethal bodily infections.

Analgesic Drugs (chronic narcotic therapies) are an option for those patients who experience severe pain and joint destruction and are not candidates for surgical treatment. These drugs do not offer anti-inflammation treatment, nor do they slow the progression of the disease. Such treatment is not commonly applied. Side effects include impaired mental status, addiction and constipation.

– Surgery may be performed to replace joints, insert prosthesis, perform joint fusion and repair joint-surrounding tendons impaired by RA.

Pain Management and de-stressing are useful tools in dealing with hurting joints. Studies show that stress contributes to autoimmune disease, and stress reduction correlates with healing and pain management. Hypnosis and breathing exercises may also help in dealing with pain.

Weight loss can be accomplished by diet, exercise and surgery. Losing weight provides less strain for the joints as less fat presses and weighs upon the already painful joints.

Rheumatoid arthritis is painful, but it is manageable. Talk with your doctor to plan the appropriate course of remedial action for your case of RA. Together, you and your physician can select the best combination of the above treatments so that you can take control of your RA.