Overview of Rheumatoid Arthritis Medications
Rheumatoid arthritis is an autoimmune disease which causes chronic inflammation of the joints. The condition affects over 2 million people in the United States, most of whom are women between the ages of 30 and 60.
What Causes Rheumatoid Arthritis?
The root cause of the disease is currently unknown. Scientists suspect it may result from a combination of factors including hormones (more common in females), age, genetics, and smoking habits.
Rheumatoid arthritis is an autoimmune disease - meaning the body attacks itself - characterized by the misdirected attack of white blood cells on the membrane surrounding joints called the synovium. This membrane eventually becomes inflamed, resulting from fluid (containing cells and proteins involved in immunity) rushing to the area. This inflammation causes the joints to swell, limiting their movement and causing pain.
If left untreated, joints (including membranes, muscles, bone, nerves, blood vessels, tendons, and ligaments) can suffer extreme damage, and even lose function altogether. Progression of rheumatoid arthritis, however, can be slowed greatly by the many drug treatments available.
Drug Treatment Options
Because rheumatoid arthritis is a chronic inflammatory, autoimmune disease, most treatment focuses on limiting immune function and soothing inflammation.
Analgesics: Often the first line of defense, analgesics like acetaminophen, codeine, and opiates are used to treat the pain associated with joint inflammation. The risk of dependency increases with stronger analgesics.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs like ibuprofen, aspirin, and indomethacin are used to calm inflammation and subsequently relieve pain. When used often and in high doses, NSAIDs can cause many undesirable side effects including gastric ulcers, liver and kidney damage, as well as heart problems.
Steroids: Steroids, such as glucocorticoids, are often used in low doses and for the short-term. They are extemely potent drugs and greatly reduce inflammation, often completely halting joint damage. However, when used over a long period of time they often lose their effectiveness and can cause side effects like thinning of bones, weight gain, and diabetes.
Immune Suppressants: Rheumatic arthritis is an autoimmune disease and can therefore be treated with drugs that suppress the immune system. While immunosuppressants can relieve inflammation, taking them can have deadly side effects. Weakening your immune system also puts you at a much greater risk of contracting and being unable to fight off an infection, especially the more resistant infections found in hospitals.
Disease-Modifying Anti-Rheumatic Drugs (DMARDs): These drugs function to protect joint function by limiting the destruction of bone and cartilage in joints. DMARDS often take weeks or months to show results, during which time, patients may need to take fast-acting anti-inflammatory agents and pain relievers.
TNF-alpha Inhibitors: TNF-alpha is a protein released by cells of the immune system. It functions by making blood vessels leaky, allowing increased fluid (containing proteins and cells) to enter a site of infection. In rheumatoid arthritis, TNF-alpha functions to promote inflammation. Inhibitors of this cytokine, therefore, prevent this inflammation.
Rheumatoid arthritis can be devastating to mobility if left untreated, but early diagnosis and aggressive treatment can prevent much of the joint damage and discomfort associated with the disease.