Traditional Treatments For Rheumatoid Arthritis

Long standing and effective treatments for RA follow the severity of the disease, when it has been diagnosed and at what particular stage you may be relative to progression of this disease.

There are three classes of conventional treatment for rheumatoid arthritis that include fast acting drugs also known as "first-line" drugs, slower acting drugs also known as "second-line drugs and newer or "other" drugs and therapies.

First-Line Drugs

First-line drugs can include aspirin, naproxen, ibuprofen (Advil, Motrin, etc) and etodolac. These are all examples of a family of drugs called nonsteroidal anti-inflammatory drugs or, NSAIDS. NSAIDS are fast acting drugs that focus on pain, swelling and inflammation.

Your Rheumatologist may prescribe any of these drugs for you in early stages of RA or combine them with corticosteroid therapy such as cortisone injections or oral prednisone.

Second-Line Drugs

For more severe cases of RA and for rapid progression of the disease, your Rheumatologist may prescribe a second-line drug. Second-line drugs are known as 'disease-modifying anti-rheumatic drugs' or DMARDs. Some DMARDs are occasionally referred to as 'chemo' drugs because they can fall in the low-dose chemotherapy class of drugs.

Some traditional second-line drugs include Plaquenil, Azulfidine, Rheumatrex and Trexall (methotrexate), Imuran, Leukeran, and Sandimmune. These drugs also act as an immune system suppressant. A web search on any of these will give you plenty of additional information to make informed decisions.

DMARDs are slower acting, often taking weeks or months before providing any real benefit, and require careful administration by a Rheumatologist. Frequent blood work is necessary with these drugs to monitor and avoid some possible very serious side effects.

DMARDs are usually used in conjunction with first-line drugs to help with pain and inflammation.

Newer Drugs

Over the last several years a new class of RA drug therapy has been introduced called biologics. Biologics intercept a protein called the tumor necrocis factor (TNF) which is involved with the process of inflammation.

Biologics can act very quickly in reducing the symptoms of RA and many people have had excellent results using this new class of drug. Biologics are usually administered via self-injection once or twice a week.

Biologics include Enbrel, Remicade and Humira.

As with the DMARD treatments, biologics can produce some very serious side effects including a much lower immune system response, slower healing, heart and stroke issues and other serious issues.

As a side note: I was involved in an Enbrel clinical study about 4 years ago and noticed improvement after one injection. Within about 6 hours of receiving my first injection I noticed that I didn't feel like I had a low grade fever. For me, that in itself was such a relief! Unfortunately after about 4 months of treatment I had to stop due to complications with the drug.

Enbrel does work...I know this first hand. The problem with these new biologics is they are VERY expensive and many insurance companies will only cover part of the cost, if they cover the treatment at all.

Click Here for an in depth discussion of traditional treatment options by the Mayo Clinic.