Rheumatoid Arthritis Treatment
Rheumatoid arthritis (RA) treatment is directed at controlling symptoms but more importantly at controlling the underlying disease process. Merely treating pain and stiffness may make a patient feel better for awhile, but unless the disease process is stopped, damage to the joints and other organs continues. Thus it is important that an expert manage the care of the patient with RA.
Once the diagnosis of RA was almost certain to lead to deformity and loss of mobility and function along with the complications of stomach, lung, and other organ dysfunction. Today, however, modern therapies can actually interrupt the progress of RA and put it into remission. This is done with drugs given during acute attacks, or “flares” as well as by giving maintenance medications all of the time.
In the beginning, not much more was done for RA patients than to give analgesics or pain killers. Physical therapy helped the joints somewhat, and NSAIDS even helped with some of the inflammation problem. (NSAIDS are non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen and Celebrex.) Later, steroids such as prednisone were given to help control inflammation and to relieve pain and swelling. Steroids in high enough doses to control symptoms of RA do have significant side effects.
Currently, two new classes of RA medications have radically changed life for people with RA. Combined with physical therapy and a healthy lifestyle these new drugs have meant most if not all RA patients can have normal or near normal lives. The two classes of medications are DMARDs, or disease-modifying anti-rheumatic drugs, and biologic disease modifiers.
DMARDs include drugs like methotrexate (Rheumatrex) or Arava used to turn down the immune system to stop the inflammatory reaction of this autoimmune illness. Prednisone also has this effect and hence is often used for disease modification as well as analgesic effect.
Biologic modifiers include drugs like Enbrel and Orencia. Some of these drugs are TNF-interfering medications. TNF, or tumor necrosis factor, is increased in people who have RA and these drugs bind to in and interrupt the inflammation that leads to organ and joint damage. Most of this class of drugs is given by injection or by IV infusions. Some of the drugs in this arthritis treatment can even be self-administered at home.
Along with medications, RA patients need to get
gentle exercise such as swimming to increase mobility without
straining affected joints. They need to eat a healthy diet and get
adequate rest and sleep as well. Co-factors such as depression and
stress also require management for the best control of RA. With good
health care and patient compliance, the outlook for RA treatment has
never been brighter.
Resources WebMD RA web pages: www.webmd.com/
Mayo Clinic RA pages: www.mayoclinic.com/
Arthritis Foundation information on RA: www.arthritis.org/
The Changing World of Rheumatoid Arthritis: www.RA.com
Information about Enbrel, a biologic modifier: www.enbrel.com/