Rheumatoid arthritis, or RA, an autoimmune disease, attacks the joints, causing pain, inflammation and deformity. RA affects women two to three times more frequently than men and occurs most often between the age of 35 and 50, the Merck Manual reports. RA often affects joints symmetrically and progresses rapidly in the first six years, often leading to joint deformities within the first 10 years. Treatment decreases inflammation and suppresses the immune system to prevent permanent joint damage. Several classes of drugs are used to treat RA.
Nonsteroidal Anti-Inflammatory Medications
Nonsteroidal anti-inflammatory medications, commonly known as NSAIDS, are available in over-the-counter and prescription preparations. NSAIDS work by blocking prostaglandins, substances that can induce inflammation and pain. Aspirin doses high enough to decrease pain can cause toxic effects. NSAIDS, while effective for pain and inflammation, can have serious side effects, such as gastrointestinal irritation, headache, confusion, water retention, high blood pressure and low platelets, Merck warns.
Corticosteroids
Corticosteroids such as prednisone and methylprednisolone decrease inflammation and pain but can have serious side effects, especially when taken long term. Corticosteroids work by suppressing the immune system and reducing inflammation. Thinning skin, easy bruisability, mood changes, osteoporosis, fluid retention, weight gain, cataract formation and diabetes may occur in people taking corticosteroids, reports MayoClinic.com. Corticosteroids are often used short-term for acute flare-ups of RA and may be injected directly into a joint.
Disease-Modifying Anti-Rheumatic Drugs
Disease-modifying anti-rheumatic drugs, known as DMARDS, work more slowly and have more side effects than NSAIDS or corticosteroids, taking up to several months before improvement occurs, notes Johns Hopkins Arthritis Center. DMARDS can slow disease progression in up to two-thirds of patients, Merck claims, but the various drugs can have significant side effects. Rheumatrex, also prescribed as Trexall, the first-line DMARD therapy for RA in most cases, and Arava can cause liver toxicity, while Plaquenil, an anti-malarial drug, can damage the retina of the eye. Azulfidine may induce allergic reactions in patients allergic to sulfa drugs. Other medications suppress bone marrow and can cause serious lung infections.
Tumor Necrosis Factor-Alpha Inhibitors
Tumor necrosis factor-alpha inhibitors, known as TNF-Alpha inhibitors, block the effects of TNF-alpha, which causes inflammatory reactions in the body. Enbrel, Remicade and Humira are TNF-alpha inhibitors; the drugs start to work within one to two weeks. Serious side effects including blood disorders, congestive heart failure and lymphoma can occur, according to MayoClinic.com.
Immunosuppressants
Medications that suppress the immune system used to treat RA include cyclophosphamide, azathioprine and cyclosporine. Because they suppress the immune system's response to bacteria, serious infection can occur.
source : livestrong.com
No comments:
Post a Comment