Medications for RA
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Medications for RA
Medications for RA fall into two broad groups. The first includes medications that help control the symptoms of RA. The second group of medications control the disease and prevent long-term joint damage.
Medications that Control Symptoms
Corticosteroids (prednisone), NSAIDs, and Analgesics are groups of medications that help control RA symptoms. These drugs can help make it easier to live with the disease.
Medications that Control RA and Prevent Long-term Damage
Disease Modifying Anti-Rheumatic Drugs (DMARDs) and Biologics are “two-for-one” medications that help control your symptoms and prevent long-term damage. Biologics are often prescribed with DMARDs to maximize the effect of treatment.
For more information about specific medications used to treat RA, refer to the “pictopamphlets” in the Medications section of this website.
Non-Steroidal Anti-Inflammatory Drugs or NSAIDs are medications that reduce the inflammation of joints caused by RA. They also help to reduce symptoms such as pain. Luckily there are about 20 different anti-inflammatory medications available. So if one doesn’t work for you, try another.
Medications like prednisone can help control inflammation. They may also prevent long-term damage in some people. Prednisone is a very effective medication to control the symptoms of RA. In the short-term, prednisone works very well to control symptoms. When used for long periods of time, prednisone can have side effects. You should to discuss the risks and benefits of using prednisone with your rheumatologist. Some patients also benefit from cortisone injections directly into a joint. This should be discussed with your rheumatologist.
Analgesic medications only control pain. They do nothing to control the disease or to prevent further joint damage. Analgesics can range from simple things like acetaminophen (Tylenol) to more potent narcotics like morphine.
The Disease Modifying Anti-Rheumatic Drugs (DMARDs) are medications that control symptoms and prevent long-term damage. Examples include methotrexate, sulfasalazine, hydroxychloroquine (Plaquenil), leflunomide (Arava), gold (Myochrisine), and azathioprine (Imuran).
DMARDs have been around for a long time and can work very well to control RA. Using two or three DMARDs together is called combination therapy. Today, we know that combination therapy works better than using a single DMARD alone. Common combinations include triple therapy with methotrexate, sulfasalazine and hydroxychloroquine.
Most DMARDs take some time before they begin to work (about 6-12 weeks). Some people might not feel any effect when they first start taking DMARDs. Even if this happens, it’s important to keep taking DMARDs to help put out the fire in the joints.
Biologics are the newest class of medications that have been around for about a decade. These medications were specifically designed to treat RA. They are very effective and can make a big difference for people living with RA. Like DMARDs, biologics control symptoms and prevent long-term joint damage.
Biologics are often given in combination with DMARDs. The most common combination is with methotrexate. This is because combination therapy has been shown to work better than treatment with either medication alone.
There are now 8 biologics available including Humira, Remicade, Enbrel, Cimzia, Simponi, Rituxan, Orencia and Acemtra. With 8 different biologics to choose from, if one doesn’t work, your rheumatologist may suggest another.
Natural Remedies / Complementary Therapies
There are no known natural remedies or complementary therapies that have been proven to help RA in any significant way. However, it’s important to check with your rheumatologist to make sure that nothing interacts with your medication if you choose to use natural remedies or complementary therapies.
In the most severe cases of RA, the joints can become so badly damaged that they no longer function. If this happens, surgery might help. Surgery usually involves replacing a damaged joint with an artificial joint. Surgery can help people with severe, advanced RA by reducing pain, improving their mobility and restoring their functioning.
Our Treatment Philosophy
You want to keep looking good for a long time!
It’s important to keep your joints looking good. Think of it like this – imagine you want to keep your face looking good for a long time. Putting on lipstick will help from day to day. But to make the wrinkles go away a facelift does a better job. The same is true with RA. DMARDs and biologic medications are like getting a face lift. They’ll protect your joints over the long run and keep them looking good for a long time. For day-to-day pain and discomfort then NSAIDs, prednisone, and analgesics can be used. They’re like lipstick – some days you need them and some days you feel pretty good without them. Of course, this analogy applies more to women than to men!
If you absolutely need to put on lipstick every day (in other words, you need to take NSAIDs, prednisone or analgesics daily) then you have to question just how well your RA is controlled. You should discuss this with your rheumatologist because not all pain is due to RA.