Drugs for rheumatoid arthritis

Article Abstract:

Drugs used to treat rheumatoid arthritis are usually grouped in two categories: first-line drugs, which include aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS), and second-line or disease-modifying drugs. NSAIDS are relatively safe and have both analgesic and anti-inflammatory effects; second-line drugs seem to control symptoms and delay disease progression. Constant monitoring for side effects is especially important with the second-line agents. Aspirin, in high doses, is one of the most effective and cheapest NSAIDS. While other NSAIDS are better tolerated, none is more effective than the others on a consistent basis. All NSAIDS may cause gastrointestinal toxicity, including bleeding of the upper digestive tract, ulcers and perforation. These problems may occur without warning symptoms. Anti-ulcer drugs, such as ranitidine and sucralfate, may prevent NSAID-related ulcers and relieve stomach upset. NSAIDS also prolong bleeding time and may cause abnormal kidney function. Steroids, such as prednisone, have anti-inflammatory effects; injection into inflamed joints is often helpful. However, long-term steroid use is associated with osteoporosis, elevated blood glucose levels, gastrointestinal bleeding, and other adverse effects. The second-line agents are often administered when there has been no response to six months of treatment with first-line drugs. Hydroxychloroquine is the most commonly used second-line drug for rheumatoid arthritis. Side effects are rarely serious and are often associated with the dosage of the drug. Methotrexate may be well tolerated, or it may cause anorexia, vomiting, liver dysfunction and bone marrow suppression. Injectable gold is more effective than the oral preparation. Gold seems to delay the progression of joint erosion, but it causes many adverse effects, such as proteinuria. Enterocolitis, pneumonitis, and aplastic anemia are rare, but can be fatal. Penicillamine may be effective, but it is limited by side effects similar to those of gold therapy. Cyclosporin and antibody therapies are under investigation for the treatment of rheumatoid arthritis. Tables of dosages and costs of first- and second-line drugs are presented. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Methotrexate, Immunotherapy, Steroids (Drugs), Hydroxychloroquine

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Drugs for rheumatoid arthritis

Article Abstract:

Rheumatoid arthritis is the inflammation of the joints, associated with stiffness, swelling, overgrowth of the cartilage, and pain. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen, and diclofenac, provide immediate relief of pain and inflammation and are relatively safe. Second-line drugs used to treat rheumatoid arthritis include hydroxychloroquine, gold, penicillamine, azathioprine, sulfasalazine, and methotrexate. These drugs may improve symptoms and delay the progression of the disease, but many have serious side effects. NSAIDs are taken with slow-acting second-line agents; this results in a delay of months before a therapeutic effect becomes evident. The dose regimens and side effects of agents used to treat rheumatoid arthritis are described. Severe rheumatoid arthritis and vasculitis, the inflammation of the blood and lymph vessels, may be treated with corticosteroids and cyclophosphamide. When rheumatoid arthritis does not respond to aspirin or other NSAIDs, hydroxychloroquine or gold may be added to the treatment regimen. Methotrexate, azathioprine, or sulfasalazine are also effective and well-tolerated. Low-dose corticosteroids, which are less toxic than penicillamine, may be used for disease that is refractory, or does not respond to most drugs used to treat rheumatoid arthritis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aspirin, Anti-inflammatory drugs, Anti-inflammatory agents

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Drugs for rheumatoid arthritis

Article Abstract:

Most of the drugs used to treat rheumatoid arthritis fall into two categories: painkillers and disease-modifying drugs. Painkillers include non-steroidal anti-inflammatory drugs, including COX-2 inhibitors. Disease-modifying drugs include hydroxychloroquine, methotrexate, sulfasalazine, gold, leflunomide, azathioprine, cyclosporine, corticosteroids, and tumor necrosis factor inhibitors. Lists of NSAIDs and disease-modifying drugs are included, providing dosage and cost information.

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