Rheumatoid Arthritis Treatment
For the past 10 years, studies have shown that early, aggressive treatment for RA can delay the onset of joint destruction. In addition to rest, strengthening exercises, and anti-inflammatory agents, the current standard of care is to initiate aggressive therapy with disease-modifying anti-rheumatic drugs (DMARDs) once the diagnosis is confirmed.
Anti-inflammatory agents used to treat RA traditionally included aspirin and non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin, Advil), fenoprofen, indomethacin, naproxen (Naprosyn), and others.
These are widely used medications that are effective in relieving pain and inflammation associated with RA. However, side effects associated with frequent use of many of these medications include life-threatening gastrointestinal bleeding.
Similar drugs, called Cox-2 inhibitors, are now a mainstay of anti-inflammatory therapy because the risk of gastrointestinal bleeding is significantly reduced with these drugs. Currently, there are two available -- rofecoxib (Vioxx) and celecoxib (Celebrex).
As mentioned, DMARDs alter the course of the disease. Included in this group are gold compounds, which can be injectible (Myochrysine and Solganal) or oral (auranofin/Ridaura). Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis with good proven effectiveness.
Antimalarial medications, such as Hydroxychloroquine (Plaquenil), as well as Sulfasalazine (Azulfidine), are also beneficial, usually in conjunction with Methotrexate.
The benefits from these medications may take weeks or months to be apparent. Because they are associated with toxic side effects, frequent monitoring of blood tests while on these medications is imperative.
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