In the article, we consider drugs for the treatment of rheumatoid arthritis.
Drug therapy is the cornerstone with the active development of pathology. It is necessary to achieve remission (lowering the activity of pathological processes), and, in addition, to prevent subsequent damage to the joints and the loss of their mobility. But against this background, persistent, and at the same time unacceptable, adverse reactions are extremely undesirable.
Drugs for the treatment of rheumatoid arthritis are constantly being improved.
Drugs for this pathology
The methods and intensity of drug treatment for rheumatoid arthritis directly depend on the individual characteristics of the patient and undesirable reactions to certain medications. Often prescribed high doses of the drug until the relief of inflammation or until adverse reactions from the drug become unacceptable. In drug therapy, the most difficult thing is to find a middle ground. After all, it is important to overcome the inflammatory process and at the same time to prevent adverse reactions.
In the process of tracking complications, all patients with rheumatoid arthritis who are taking medications must be under the supervision of a doctor and regularly take tests. Detected adverse reactions should be minimized or eliminated by lowering the dosage or prescribing an alternative drug. Drugs for the treatment of rheumatoid arthritis can belong to the following categories:
- Use in the treatment of non-steroidal anti-inflammatory drugs.
- The use of drugs that affect the course of rheumatoid arthritis.
- Treatment with biological response modifiers.
- Glucocorticoid Therapy (hormonal medication)
- If necessary, use of analgesics.
The following is a list of next-generation drugs for the treatment of rheumatoid arthritis.
Treatment with non-steroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs are prescribed to relieve pain and reduce minor inflammation. However, the long-term effects of the destructive effects of rheumatoid arthritis are not eliminated by such means.
In order for the anti-inflammatory effect of non-steroidal drugs to treat rheumatoid arthritis to be established, they must be taken regularly, in a strictly defined dosage. But even with the right dosage, it should take up to four weeks before the effect of their use arises. In the event that the initial dosage does not eliminate the symptoms, then the consultant doctor may recommend a gradual increase in it or prescribe another drug from the same category. Do not use two or more non-steroidal drugs at the same time.
Many such drugs have pronounced side effects, lead to digestive bleeding, fluid retention in the body and an increased risk of developing heart and vascular diseases. Next, consider the treatment of this disease with the help of basic drugs.
The basic drugs for the treatment of rheumatoid arthritis
Medicines that affect the course of rheumatoid arthritis (also called basic drugs) can significantly reduce inflammation. They reduce or prevent damage to joints while maintaining their structural and functional integrity. These rheumatoid arthritis medications (basic remedies) provide patients with the opportunity to return to daily activities. Such medicines act slowly, but with them glucocorticoids can be taken in small doses in order to reduce pain and inflammation.
The basic drugs for the treatment of rheumatoid arthritis include “Hydroxychloroquine” along with “Methotrexate”, “D-penicillamine”, “Sulfasalazine”, “Azathioprine”, “Leflunomide”, “Cyclosporin” and “Neoral”. When using Methotrexate, it may take four to six weeks to alleviate the symptoms of the disease. The use of sulfasalazine usually takes up to two months. If we are talking about treatment with "Hydroxychloroquine", then it may take up to three months. And in order for the therapeutic effectiveness of these drugs to be fully manifested, even longer therapy may be required.
The best drugs for the treatment of rheumatoid arthritis from this group include Minocycline.
The medicine "minocycline"
Some patients with rheumatoid arthritis in the initial stage may feel relief if they take an antibiotic called Minocycline. Such therapy can be a reasonable alternative to the use of "Hydroxychloroquine" and "Sulfasalazine."
Biological products
Biological response modifiers in medicine are also known as biological agents for the treatment of rheumatoid arthritis, that is, drugs designed to prevent or reduce inflammation that affects the joints. Biological agents selectively act on molecules that can cause inflammatory and destructive processes. These medicines are part of immunity cells and articular structures, and in addition, they are secreted directly in the joints.
There are several types of biological preparations for the treatment of rheumatoid arthritis, each of which targets specific molecules that are involved in the pathological process. The biological medicines that bind the tumor necrosis factor include Etanercept, along with Adalimumab and Infliximab. They are called tumor necrosis factor blockers.
The drug "Anakinra" inhibits interleukin-1. For the vast majority of patients with rheumatoid arthritis, this drug is a much less effective drug compared to TNF-blockers. It is occasionally prescribed to individual patients who are not helped by drugs that bind tumor necrosis factors. You can not use "Anakinra" in parallel with TNF-blockers, as due to weakened immunity increases the risk of infectious pathologies.
Abatacept prevents the activation of t-cells. Usually it is prescribed only to patients with moderate or severe manifestations of rheumatoid arthritis, that is, for patients for whom the treatment with Methotrexate and TNF-binding drugs has been ineffective.
The medicine "Rituximab" can counteract B cells. This medication is usually prescribed only to patients with moderate or severe manifestations of rheumatoid arthritis, who are not helped by therapy with TNF blocker and Methotrexate.
Unlike basic drugs, the effect of which is only months later, the effects of biological preparations can manifest themselves quickly enough: within two (if it is Enbrel, Remicade or Humira) or four days when it comes to “ Rituxan ”or“ Orentia ”. Biological drugs are used alone or in combination with other drugs, for example, they are used with basic drugs ("Methotrexate") or with glucocorticoids.
Due to the high cost, biological medicines are often reserved for those cases when the basic funds are not sufficiently effective or are simply not tolerated by patients in large dosages necessary to treat inflammation.
All biological medicines are administered parenterally, i.e. in the form of injections. Humira preparations along with Enbrel and Kineret are administered subcutaneously directly by the patient himself, or by someone from his closest relatives or a nurse. Drugs such as Remicade, Orentia, and Rituxan must be administered intravenously. The procedure is usually performed in the doctor’s office or in the clinic, usually it takes from one to several hours.
Side effects and contraindications for taking biological drugs
Biological response modifiers can have an immunosuppressive effect, that is, they suppress immunity, therefore they cannot be used to treat patients with dangerous infections.
Before prescribing TNF blockers to the patient, it is necessary to perform a tuberculosis test. Patients in whom tuberculosis is confirmed as the primary pathology must necessarily be treated, since during therapy with the help of TNF-binding drugs, the risk of activation of mycobacteria increases.
Genetically engineered drugs for the treatment of rheumatoid arthritis from the group of TNF blockers are strictly contraindicated in those with lymphoma and those previously treated for this disease. Regardless of the therapy being undertaken, patients with rheumatoid arthritis, especially those suffering from its severe forms, are predisposed to the development of lymphoma. According to several studies, the use of TNF-blockers further increases the susceptibility of patients to a dangerous ailment. But further research is required to clarify the extent of this risk.
Rheumatoid arthritis is also treated with hormonal drugs.
Glucocorticoid drugs (hormonal therapy)
Glucocorticoid drugs, also called glucocorticosteroids, have a fairly strong anti-inflammatory effect. This category of drugs includes Prednisone and Prednisolone. Glucocorticoids are used orally, and in addition, intravenously or administered directly into the joints. They quickly soften the manifestation of the ailment in the form of pain and stiffness, while swelling with pain in the joints decreases.
These are the most popular drugs for treating rheumatoid arthritis of the hands.
However, with single use, these medications very slightly reduce the damage to cartilage and bone tissue that is caused by rheumatoid arthritis. As a rule, the indications for their appointment are severe forms of pathology, greatly limiting the patient's ability to lead a normal life. For such patients, treatment with glucocorticoids leads to amelioration of symptoms and helps to remain operational right up to the moment when the beneficial effects of other drugs that are slower appear. Now find out what side effects can be detected when using such medical drugs.
Side effects of hormonal drugs
Glucocorticosteroids can cause many different undesirable reactions, especially weight gain, along with exacerbation of diabetes, the development of cataracts, rarefaction of bone tissue (we are talking about osteopenia and osteoporosis). Also, the use of such drugs increases the body's exposure to infectious diseases. Thus, they must be prescribed in the lowest effective dosages, minimizing the duration of the course of therapy.
In the treatment of rheumatoid arthritis, drugs from the group of non-narcotic analgesics are used.
Use of non-narcotic analgesics
Non-narcotic analgesics help relieve pain, but not all of them, like acetylsalicylic acid, have anti-inflammatory properties. The drugs of this category include Paracetamol, acetylsalicylic acid, that is, Aspirin, and in addition, Analgin along with Capsaicin in the form of a cream or ointment.
What else does modern treatment for rheumatoid arthritis with drugs suggest?
Synthetic opioid "Tramadol" from the category of narcotic analgesics in standard doses does not cause any complications, but it is not indicated for all patients and is not recommended for long-term treatment. The use of narcotic analgesics in the form of the natural opioid codeine, semisynthetic oxycodone and hydrocodone is usually not approved due to the prolonged and protracted nature of rheumatoid arthritis, but also because of the threat of addiction and the development of a painful addiction to medicines.
But, nevertheless, the condition of patients with severe joint damage who are not available for reconstructive surgery can improve due to treatment under the strict supervision of a rheumatologist or pain medication specialist with long-term drugs.
Treatment of sudden exacerbation of rheumatoid arthritis
Against the background of the ongoing process of inflammation, the patient may experience sudden outbreaks of activity of this disease. As a rule, this is only a temporary exacerbation of rheumatoid arthritis. In patients already taking Methotrexate or glucocorticoid pills, a sudden exacerbation can often be eliminated by increasing the dosage of the drugs. Or they can be stopped with corticosteroid injections. In such periods, patients are shown absolute peace, rarely hospitalization is required.
The treatment of rheumatoid arthritis with new generation drugs should be under the supervision of a physician.
Therapy with antimalarial drugs
Medicines called Delagil along with Rezokhin, Chloroquine, Hingamine and Plaquenil have been used in medicine for a long time as a means of a tropical disease - malaria. But how does this relate to rheumatoid arthritis? The fact is that scientists who were looking for an effective medicine for the treatment of rheumatoid arthritis managed to try almost all varieties of anti-inflammatory drugs. This disease has long been considered a special kind of infection. Thanks to one of the studies, it was possible to prove that “Delagil” along with “Plaquenil” slow the flow of arthritis, reducing the severity of its manifestations.
Nevertheless, anti-malarial drugs in the modern basic treatment of rheumatoid arthritis occupy perhaps the most modest place, since they have only one advantage - good tolerance. They have one drawback, and a very serious one. They act very slowly, and immediate improvement occurs only after six months or a year. It is worth noting that even if successful, these medications give an extremely weak therapeutic effect.
The treatment of rheumatoid arthritis with new generation drugs shows very good results.
Treatment with selective anti-inflammatory drugs
The Movalis medicine, which is a relatively new drug, belongs to this category of drugs. It was created specifically for continuous long-term use in order to minimize possible side effects. Returning to the subjectivity of the assessment, it is worth saying that most patients with arthritis consider Movalis to be no less, and sometimes even a more effective pain medication. Moreover, Movalis is well tolerated and very rarely provokes negative reactions of the body. This can not be said about non-steroidal drugs, the intake of which is often accompanied by all kinds of digestive disorders.
Under the supervision of a doctor, “Movalis” can be consumed for several months, or even years in a row, if there is a similar need. It is also very convenient that one tablet that should be drunk in the morning or before bedtime is quite enough to achieve pain relief. Movalis in the form of rectal suppositories is also on sale. In the event that the pain syndrome is too intense, then you can always resort to injections of the drug. During periods of exacerbation of rheumatoid arthritis, patients often have to take injections for a whole week, and only then switch to taking pills. It should be noted that “Movalis”, firstly, helps almost all patients, and, secondly, it has practically no contraindications.
Reviews
As people write in the reviews, with the development of this disease, doctors resort to using a variety of medications. Basically, according to the stories of patients, medicines are prescribed to patients depending on the characteristics of the disease and the individual characteristics of a person’s health status.
Reviews on the treatment of rheumatoid arthritis with drugs should be consulted in advance.
In the comments you can read references to such medicines as “Abatacept”, “Leflunomide”, “Neoral” and “Cyclosporine”. People write that these remedies help in the fight against rheumatoid arthritis, but unfortunately there are a lot of side effects.
About biological drugs in reviews it is reported that they are also effective, but they have one extremely negative effect associated with the suppression of the body's immune functions.
We examined the treatment of rheumatoid arthritis with new generation drugs.