Rheumatoid arthritis (RA) is an inflammatory chronic disease that progresses over time and has no known cure. Rheumatoid arthritis medications will help to stop or slow inflammation, preventing your symptoms from getting worse and avoiding future complications. However, each person is unique, and finding out which medications work best for you can be challenging, and often requires a process of trial and error.
What are the main types of RA medications?
There are many different types of rheumatoid arthritis medications. Some of these drug types can be used together to achieve a better outcome.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticoids help to reduce inflammation, while disease-modifying anti-rheumatic drugs (DMARDs) slow down the progression of the disease, preventing it from getting worse.
1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
– diclofenac (Voltaren), ibuprofen (Advil), ketoprofen (Actron), naproxen (Naprosyn), celecoxib (Celebrex)
Your doctor may prescribe you a non-steroidal anti-inflammatory drug to decrease pain and inflammation. Anti-inflammatory drugs ease the swelling and pain you might feel, helping you to maintain your quality of life.
These drugs act as a short-term solution to relieve painful symptoms, but are not effective in treating the disease. Therefore, they need to be taken in combination with other rheumatoid arthritis medications.
– dexamethasone (Dexpak, Hexadrol), hydrocortisone (Cortef, A-Hydrocort), methylprednisolone (Medrol), prednisone (Deltasone)
Corticosteroids are also anti-inflammatory medications, but they are stronger and act faster than NSAIDs. Your doctor may prescribe them to you as a quick way to keep inflammation under control while waiting for other medications (such as NSAIDs and DMARDs) to take effect.
That being said, these drugs are extremely potent and should only used for brief periods, and in doses as low as possible. They are available by pill or injection.
3. Disease-modifying anti-rheumatic drugs (DMARDs)
– hydroxychloroquine (Plaquenil), leflunomide (Arava), methotrexate (Trexall), minocycline (Minocin), sulfasalazine (Azulfidine)
DMARDs can slow the progression of RA. This means that you may have fewer symptoms and less damage over time.
Disease-modifying anti-rheumatic drugs (DMARDs) are designed to modify rheumatoid arthritis’ course. This means that they can slow the progression of the disease. They do it by suppressing the immune system and interrupting the immune attacks that cause the inflammation in the joints.
All types of DMARDs (including biologics and JAK inhibitors described below) can weaken your immune system and make you more susceptible to infections. Be aware of possible signs of infection and maintain healthy habits if you are taking these drugs.
– abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), tocilizumab (Actemra)
Biologics, or biological response modifiers, are a subset of DMARDs. They are a newer form of RA medications that also target the immune system to prevent inflammation of the joint tissue.
Biologics are often effective even when other treatments have not shown to work, so your doctor may prescribe them to you if DMARDs alone aren’t enough to treat your rheumatoid arthritis symptoms.
Biologics can also be taken in conjunction with other DMARDs, and can only be administered by injection.
5. Janus associated kinase inhibitors (JAK Inhibitors)
– tofacitinib (Xeljanz, Xeljanz XR)
The JAK inhibitor tofacitinib is the newest form of DMARDs available, approved by the FDA in 2012. It works by blocking Janus kinase (JAK) enzymes. JAK enzymes play an important role in rheumatoid arthritis because they cause immune responses that trigger inflammation. Tofacitinib binds to these enzymes, and is capable of stopping the inflammatory process.
Tofacitinib is an oral medication taken twice daily. Your doctor may prescribe it if the other traditional DMARDs don’t work for you.
Will these medications help me feel better?
These rheumatoid arthritis medications won’t cure your disease, but will allow you to have a better quality of life by alleviating your chronic pain. They prevent disease progression and reduce the frequency of flares. Work with your doctor to find the treatment that works best for you.