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Rheumatoid Arthritis (cont.)

JAK Inhibitors and RA

  • Tofacitinib (Xeljanz) is the first in a new class of "small molecule" medications used to treat rheumatoid arthritis called JAK inhibitors. Tofacitinib is a treatment for adults with moderate to severe active RA in which methotrexate was not very effective. Patients can take tofacitinib with or without methotrexate, and this prescription drug is taken by mouth two times a day. Tofacitinib is a "targeted" drug that only blocks Janus kinase, special enzymes of inflammation, within cells. This is why it is referred to as a JAK inhibitor. JAK inhibitors are not used with biologic medications.

Glucocorticoids and RA

Glucocorticoids: These very potent agents rapidly block inflammation and other immune responses. They are often called steroids. These agents all work in the same way; they differ only in their potency and in the form in which they are given. Steroids may be given as pills, intravenously, or as injections into a muscle or directly into a joint. In high doses, they can cause many serious side effects and are therefore given only for the shortest possible periods and at the lowest doses possible for the condition. These drugs generally tapered and not stopped abruptly.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and Analgesics for RA

Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs reduce swelling and pain but do not stop joint damage and alone are not sufficient to treat rheumatoid arthritis. These drugs work by blocking an enzyme called cyclo-oxygenase (COX) that promotes inflammation. There are at least two forms of the enzyme: COX-1 and COX-2. Some people with a history of stomach ulcers or liver problems should not take these drugs. This group includes aspirin, although aspirin is rarely used in rheumatoid arthritis because it is not as safe as other agents.

Analgesics: These medicines reduce pain but do not affect swelling or joint destruction.

  • Acetaminophen (Tylenol, Feverall, Tempra): This drug is often used by people who cannot take NSAIDs because of hypersensitivity, ulcers, liver problems, or interactions with other drugs.
  • Tramadol (Ultram)
  • Opioids: These drugs may be used to treat moderately severe to severe pain that is not relieved by other analgesics.

For more information on these medications, see Understanding Rheumatoid Arthritis Medications.

Medically Reviewed by a Doctor on 9/11/2017

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