Medications: Most people who have rheumatoid arthritis take medications. Some arthritis medications are used only for pain relief; others are used to reduce inflammation. Still others, often called disease-modifying antirheumatic drugs (DMARDs), are used to try to slow the course of the disease. The person's general condition, the current and predicted severity of the illness, the length of time he or she will take the arthritis drug, and the arthritis drug's effectiveness and potential side effects are important considerations in prescribing drugs for rheumatoid arthritis. The table below shows currently used rheumatoid arthritis medications, along with their uses and effects, side effects, and monitoring requirements.
Biologic response modifiers are new arthritis drugs used for the treatment of rheumatoid arthritis. They can help reduce inflammation and structural damage to the joints by blocking the action of cytokines, proteins of the body's immune system that trigger inflammation during normal immune responses. Three of these drugs, etanercept (Enbrel*), infliximab (Remicade), and adalimumab (Humira), reduce inflammation by blocking the reaction of TNF-a molecules. Another arthritis drug, called anakinra (Kineret), works by blocking a protein called interleukin 1 (IL-1) that is seen in excess in patients with rheumatoid arthritis.
For many years, doctors initially prescribed aspirin or other pain-relieving drugs for rheumatoid arthritis, as well as rest and physical therapy. They usually prescribed more powerful arthritis drugs later only if the disease worsened.
Today, however, many doctors have changed their approach, especially for patients with severe, rapidly progressing rheumatoid arthritis. Studies show that early arthritis treatment with more powerful drugs, and the use of drug combinations instead of one arthritis medication alone, may be more effective in reducing or preventing joint damage. Once the disease improves or is in remission, the doctor may gradually reduce the dosage or prescribe a milder arthritis medication.
