Which drugs are used?
The drug management of RA can be considered under two headings. The first is the relief of symptoms, with pain relief being the number one priority for patients. The second is modification of the disease process so that x-ray damage to bones and joints, which is closely correlated with progressive functional impairment, can be slowed down or stopped. This can include short term use of steroids which can be taken orally, injected into a particular joint or injected into the muscle.
Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) can be helpful in relieving pain and stiffness, where they are not contraindicated. In the last 10 – 15 years, a new group of drugs have been developed, called ‘biologics’, which work by specifically modifying the disease process by blocking key molecules within the immune system which are causing the trouble. You can find out more about the above drugs by reading the articles below, ringing our helpline and/or ordering our booklets.
The following is a table, with information on the different types of drugs used to treat rheumatoid arthritis, and links to articles on these drugs.
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Type/ examples
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Purpose
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Articles
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Analgesics (also known as painkillers)
e.g. Paracetamol,
Co-codamol,
Tramadol
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Help to control pain. There are different types that work in different ways. Some people respond better to one medication than another. If the first drug you’re offered doesn’t work when taken as prescribed, ask your doctor or nurse if you could try something else.
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Click on the following links to articles about pain management:
Managing the pain of RA
Talking about Pain
Pain in RA
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Non-steroidal anti-inflammatory drugs, or NSAIDs
e.g. Ibuprofen,
Naproxen
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Reduce inflammation. Can work quickly. They inhibit chemicals involved in inflammation.
Cox-2s are a newer type of NSAID that generally have fewer side effects on the stomach lining. Their anti-inflammatory effects (reduced stiffness & swelling) take longer to work (up to 10 days) so for best effect they should be taken in courses rather than ‘as required.’
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Information on NSAIDs can be found in the following pain articles:
Managing the pain of RA
Talking about Pain
There is also a useful ARC information sheet on NSAIDs.
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Corticosteroids, also called steroids
e.g. Prednisolone,
Depo-medrone
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Reduce inflammation. Can be injected into inflamed joints, into muscle, given intravenously or taken as tablets.
If you take steroids over a long period (more than three months) or at a high dose (more than 7.5mg daily) you should ask your doctor about additional medication to protect your bones.
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Click here for information on steroids
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Disease modifying anti-rheumatic drugs, or DMARDs
e.g. Methotrexate
Sulfasalazine
Leflunomide
Hydroxychloroquine
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Reduce joint inflammation and damage by ‘damping down’ the immune system in different ways. Can take time to work. A way of controlling the disease over the long term.
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Click here for information on DMARDs
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Biologics
e.g. anti TNF drugs
(etanercept,
adalimumab &
infliximab) and
rituximab, which
removes B cells.
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A relatively new kind of protein-based DMARD. They work by targeting specific chemical messengers or cells that activate inflammation in the body.
Some are delivered by a drip, in hospital and others by self-administered injection under the skin, in the way that diabetics give themselves insulin.
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Click here for information on biologics
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