Battling Rheumatoid Arthritis: What are your medication options?

There are many RA medications out there. Some are pills, others are injections, some are prescribed, others are available over the counter. With so many options, how do you determine which one of the RA medications is right for you?

Of course the first place to start is with an open and honest conversation with your Rheumatologist. Your Rheumatologist can help you weigh the pros and cons of many RA medications (and non medication treatment options).

Goals of RA Medications

The goal of rheumatoid arthritis medication treatment is to achieve the lowest possible level of arthritis disease activity(remission, ideally) minimizing joint damage, and improving quality of life.

Types of RA Medications

NSAIDs or Nonsteroidal anti-inflammatory drugs are available over-the-counter and by prescription. They are used to help ease arthritis pain and inflammation.  NSAIDS are used primarily to ease the symptoms of RA; not to slow or stop the course of the disease. Examples: ibuprofen and naproxen sodium.

Corticosteroids  May be used to get potentially damaging inflammation under control, while waiting for other treatments to take effect. Because of the risk of side effects with these drugs, doctors prefer to use them for as short a time as possible and in doses as low as possible. Example: Prednisone.

DMARDs or disease-modifying antirheumatic drugs, are drugs that work to modify the course of the disease. These medicines can be taken by mouth, be self-injected, or given as an infusion in a doctor’s office. Example: Plaquenil (hydroxycholorquine)

Biologics are a subset of DMARDs. They target specific steps in the inflammatory process, therefore they don’t wipe out the entire immune response as some other RA treatments do. A biologic can slow, modify or stop the disease – even when other treatments haven’t worked.

JAK inhibitors block the Janus kinase, or JAK, pathways, which are involved in the body’s immune response. These are a newer subset of DMARDs.

Most Common RA Medications

  • Prednisone: A steroid used not only for RA, but many other conditions such as lupus, Crohn’s, headaches, and even itching
  • Mobic / Meloxicam: A pain relieving (NSAID) pill.
  • Celebrex: Is also a pain relieving (NSAID) pill.
  • Aleve / Naproxen: Is a pain relieving (NSAID) that is available over that counter. It is commonly used to treat fevers as well as aches and pains
  • Remicade: Is an Immunosuppressant that is taken as an injection. It is also used to treat other autoimmune conditions like Crohn’s.  
  • Plaquenil: Or generically as Hydroxychloroquine, is a Immunosuppressant and anti-parasite that is taken as a pill. It is also used to treat and prevent malaria
  • Rituxan: is an injection that is used in arthritis and cancer.
  • Enbrel: or Etanercept is an injection that is used in arthritis
  • Humira: is an injection that is used in arthritis and IBD.  
  • Arava: or generically as Leflunomide is Immunosuppressant that is taken as a pill for rheumatoid arthritis in adults
  • Orencia: or Abatacept is an injection used to treat rheumatoid arthritis
  • Methotrexate: is a Chemotherapy and immunosuppressant drug that is used to treat rheumatoid arthritis as well as many types of cancer.

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