Rheumatoid Arthritis (cont.)
What Medications Treat Rheumatoid Arthritis?
The medications for rheumatoid arthritis fall into several different categories. These RA medications include
- disease-modifying antirheumatic drugs (DMARDs),
- biologic response modifiers,
- JAK modifiers, glucocorticoids,
- nonsteroidal anti-inflammatory drugs (NSAIDs),
Disease-Modifying Antirheumatic Drugs (DMARDs) and RA
Disease-modifying antirheumatic drugs (DMARDs): This group of drugs includes a wide variety of agents that work in many different ways. What they all have in common is that they interfere in the immune processes that promote inflammation in rheumatoid arthritis. DMARDs can actually stop or slow the progression of rheumatoid arthritis. They can also suppress the ability of the immune system to fight infections. Anyone taking one of these drugs must be very vigilant to watch for early signs of infection, such as fever, cough, or sore throat. Early treatment of infections can prevent more serious problems. Conventional DMARDs include methotrexate (Rheumatrex, Rasuvo, and others), sulfasalazine (Azulfidine), leflunomide (Arava), and hydroxychloroquine (Plaquenil). These are used alone or in combination (most commonly for moderate to severely active rheumatoid arthritis).
- Methotrexate (Rheumatrex, Folex PFS): This drug relieves symptoms of inflammation such as pain, swelling, and stiffness. People taking methotrexate must have regular blood tests to measure whether the drug is having any adverse effects on the liver, kidneys, or blood cells. This drug is not suitable for some people with liver problems or women who are or may become pregnant.
- Sulfasalazine (Azulfidine): This drug decreases inflammatory responses by an effect similar to that of aspirin or NSAIDs. People taking sulfasalazine must have regular blood tests to measure whether the drug is having any adverse effects on blood cells.
- Leflunomide (Arava): This drug interferes with cells of the immune system and reduces inflammation. It reduces symptoms and may even slow the progression of rheumatoid arthritis. People taking leflunomide must have regular blood tests to measure whether the drug is having any adverse effects on the liver or blood cells. This agent is not suitable for some people with liver or kidney problems or women who are or may become pregnant.
- Hydroxychloroquine (Plaquenil): This drug was first used against the tropical parasite malaria. It inhibits certain cells that are necessary for the immune response that causes rheumatoid arthritis. People taking hydroxychloroquine must have eye examinations at least yearly to determine whether the drug is having any adverse effects on the retina.
- Gold salts (aurothiomalate, auranofin [Ridaura]): These compounds contain very tiny amounts of the metal gold. Apparently, the gold infiltrates into immune cells and interferes with their activities. People taking gold must have regular blood and urine tests to measure whether the drug is having any adverse effects on blood cells and the kidney. This medication is less commonly used today.
- Azathioprine (Imuran): This drug stops the production of cells that are part of the immune response associated with rheumatoid arthritis. Unfortunately, it also stops production of some other types of immune cells and thus can have serious side effects. It strongly suppresses the entire immune system and thus leaves the person vulnerable to infections and other problems. It is used only in severe cases of rheumatoid arthritis that have not gotten better with other DMARDs. People taking azathioprine must have regular blood tests to measure whether or not the drug is having any adverse effects on liver and blood cells.
- Cyclosporine (Neoral): This drug was developed for use in people undergoing organ transplantation or bone-marrow transplantation. These people must have their immune system suppressed to prevent rejection of the transplant. Cyclosporine blocks an important immune cell and interferes with the immune response in several other ways. People taking cyclosporine must have regular blood tests and blood pressure checks to measure whether the drug is having any adverse effects on blood cells and blood pressure. It is not used during pregnancy or in women who may become pregnant.
Medically Reviewed by a Doctor on 9/11/2017
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