Rheumatoid arthritis (RA) is an autoimmune disorder that in addition to pain can be associated with deformed joints and disability. Early treatment after rheumatoid arthritis diagnosis can reduce the severity of symptoms and complications.
Drug treatments along with lifestyle changes are necessary to control this autoimmune disorder. In this article, we introduce the safest drugs to treat rheumatoid arthritis.
Rheumatoid arthritis is incurable, but a set of appropriate and early treatments will prevent the progression of symptoms and reduce severe damage and deformity of the joints.
What are the treatment options for rheumatoid arthritis?
- Lifestyle changes
- Effective drugs in the control and treatment of rheumatoid arthritis
- Effective surgeries in patients with rheumatoid arthritis
Medications in the treatment of rheumatoid arthritis:
Medications have a special place in controlling the inflammation caused by the disease and joint pain. Consultation with a rheumatologist is necessary to determine the appropriate medication program.
In the early stages of rheumatoid arthritis, symptom control begins with anti-inflammatory and analgesic drugs.
In the advanced stages, when the symptoms are severe and the pain is debilitating, stronger drugs are needed to suppress the immune system’s reactions, which unfortunately have unpleasant side effects.
Medications used in rheumatoid arthritis:
Drugs used in rheumatoid arthritis include:
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Morrtin IB) and naproxen (Aleve) are dispensed over-the-counter in pharmacies to reduce inflammation and control pain. More potent drugs in this category should be prescribed by a doctor.
Side effects of NSAIDs:
Side effects of these drugs are include the following:
- Increased heart problems
- Increased kidney problems
- Gastrointestinal injuries, ulcers and bleeding
The use of different types of this class of drugs is safer, such as Celexib or Celecoxib or Celebrex.
- Steroids, corticosteroids:
Another class of drugs that reduce inflammation are corticosteroids, which help reduce inflammation by suppressing the destructive activity of the immune system. Prednisone, prednisolone and methylprednisolone are some of the types of drugs that are associated with many side effects:
- Swelling of the legs
- Weight Gain
- Decreased body defenses against infections (increased incidence of opportunistic infections)
- Decreased bone strength
- Doctors usually use the following method to reduce the side effects of this group of complicated drugs:
Corticosteroids are used for a very short time and only to reduce the severity of symptoms. Then as the severity of symptoms reduced, corticosteroids are discontinued and safer drugs with less side effects, such as ibuprofen are replaced.
Disease-modifying antirheumatic drugs:
A variety of drugs in this class slow down the progression of rheumatoid arthritis by stopping the destructive activities of the immune system, The use of drugs in this category prevents the destruction of joints and prevents the deformity of the joints, reducing the pain of these drugs is not as fast as NSAIDs, but as they continue to be used, the pain decreases day by day.
Because of this, doctors usually use first and second category of drugs to control inflammation and reduce pain to quickly reduce the patient’s pain, then discontinue corticosteroids as well as a group of high-potency and high- complication NSAIDs but continue with DMARDs. Which over time and with continued use, the pain-reducing properties appear and also prevent the development of rheumatoid arthritis.
The types of these drugs include the following:
- Methotrexate (trexal)
- Hydroxychloroquine (plaquenil)
- Sulfasalazine (Azulfidine)
- Leflunomid or Arava
Liver involvement and increased susceptibility to infections are side effects of these drugs
Today, new classes of drugs have been introduced to control rheumatoid arthritis:
- biologic drugs:
- Biologic response modifiers:
This group also has similar effects to DMARDs, meaning they prevent the progression of rheumatoid arthritis and prevent injuries and joint deformities and unlike the previous class of drugs, they do not increase the risk of infections, so these drugs are safe and will not predispose a person to recurrent infections.
Drugs in this category are designed to act only on a specific area as a therapeutic target, meaning that they will only block specific parts of the immune system, which cause damage and destruction to joints and organs during rheumatoid arthritis. Therefore, other defense activities of the immune system against infectious agents will not be affected.
Doctors prescribe these drugs in combination with other medications.
The types of these drugs include the following:
- Infleximab (Remicade)
- Rituximab (Rituxan)
- Tocilizumab (Actemra)
- Etanercept (Enbrel)
- Adalimumab (Humira)
- Abatacept (orencia)
- Golimumab (Simponi)
- Certolizumab (Cimzia)
The following drugs also dramatically reduce inflammation and are usually given orally with DMARD drugs:
After getting acquainted with the practical drugs, the question arises which is the safest drug for rheumatoid arthritis?
Rheumatoid arthritis occurs when, for unknown reasons, a person’s immune system mistakenly begins to damage and destroy normal and healthy cells in the host body (for example, it destroys joints); rheumatoid arthritis is incurable and the person needs medication to control the immune system for a long time and to control inflammation and pain in disease attacks.
Therefore, considering the need for continuous use of the drug, it is important to know the safest drugs for rheumatoid arthritis.
Hydroxychloroquine is a drug that is well tolerated by patients and at the same time is considered as an immunosuppressive drug compared to other drugs.(??)
Sometimes the hydroxychloroquine family, also known as chloroquine, is used. Regular eye examinations are required for visual complications.
The DMARD group of drugs is one of the best drugs in the control of rheumatoid arthritis and in combination with modern biological drugs, they prevent the development of rheumatoid arthritis.
Aside from all of these drugs, the newest drug for autoimmune disorder, which has just been approved by the US Food and Drug Administration, is available under the following headings:
This new class of drugs dramatically controls inflammation in rheumatoid arthritis.
Apart from all these drugs, inflammation control drugs and pain relievers that are available in OTC form in pharmacies That is, acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB) or naproxen (Aleva), in the early stages of inflammation and pain with minimal side effects (in standard doses) can help people with arthritis to some extent.