Drug Treatment Rheumatoid Arthritis
Drug Treatment Rheumatoid Arthritis
Rheumatoid arthritis is a chronic progressive autoimmune inflammatory disease that affects multiple organ systems, but the joints in particular. Rheumatoid arthritis also damages and erodes away the cartilage and bones in the affected joints. This erosion cannot be seen by physical examination and is measured by x-rays. More erosion on an x-ray usually means that the disease is progressing or worsening.
Glucocorticoids or corticosteroids such as prednisone are used by some arthritis patients to reduce inflammation and suppress immune system activity. Synthetic corticosteroids, like prednisone, are designed to mimic cortisol action in body. Cortisol is a natural corticosteroid produced by the adrenal glands.
Glucocorticoids have been shown to improve the symptoms of rheumatoid arthritis. There is some debate as to whether glucocorticoids can slow the progression of the disease.
There is also concern about the long term side effects, such as heart problems, when taking glucocorticoids.
Glucocorticoid use in rheumatoid arthritis (RA) is common. Two Cochrane Reviews have been published examining the short term clinical benefit of low dose glucocorticoids compared to non-steroidal anti-inflammatory drugs. They have demonstrated good short term and medium term clinical benefits. The possibility that glucocorticoids may have a “disease modifying” effect in RA, which would be seen by a reduction in the rate of radiological progression, has been suggested by several investigators.
The objectives of the current review was to evaluate glucocorticoid efficacy in inhibiting the progression of radiological damage in rheumatoid arthritis.
This summary of a Cochrane review presents what we know about the effect of low dose glucocorticoids, such as prednisone, on the progression of rheumatoid arthritis.
The studies that were reviewed looked at people who had rheumatoid for up to 2 years. Low doses of glucocorticoid pills were taken and usually with a disease-modifying anti-rheumatoid drug (DMARD).
X-rays were periodically used to assess the progression of joint erosion and other signs of joint damage. Of the studies which were reviewed, all but one concluded that glucocorticoids given along with standard arthritis treatments significantly reduced the rate of joint erosion in rheumatoid arthritis patients. It did not necessarily correlate with long-term improvement in function however.
Bottom line: In people with rheumatoid arthritis, low dose glucocorticoids reduce the progression of RA over a 1 one to two year period.
This benefit occurred in people already taking a disease-modifying anti-rheumatoid drug (DMARD) and therefore this benefit is over and above any benefits from the DMARDs.
These results were true in people that had rheumatoid arthritis for less than 2 years. It seems possible that glucocorticoids would have the same effect in people who have had rheumatoid for 3 to 4 years, but it is not known whether this is true in people who have had it for longer.
The evidence that glucocorticoids, given in addition to standard therapy, can substantially reduce the rate of erosion progression in rheumatoid arthritis is convincing. There is concern about potential long-term adverse reactions to glucocorticoid therapy, such as increased cardiovascular risk and osteoporosis.
(Kirwan JR, Bijlsma JWJ, Boers M, Shea BJ. Effects of glucocorticoids on radiological progression in rheumatoid arthritis. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD006356. DOI: 10.1002/14651858.CD006356).
Nathan Wei, MD, FACP, FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland (http://www.aocm.org). He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and consultant to the National Institutes of Health. For more info: Arthritis Treatment
Do have any prescription drug suggestions for Rheumatoid Arthritis? What do you think about Enbrel?
I am currently unsatisfied with my treatment. I am taking hydroxychloriquine & asulfasalizine [spelling is most definately wrong]. I was hopeful when I saw an ad for Orencia, however it is not yet covered under my health plan. I am looking for suggestions for treatments that have worked for other RA sufferers.
haven’t found any thing ,Enbrel has draw backs badly.
Rheumatoid Arthritis Treatment: Drugs
|
|
Sugar Town $1.98 Unimpassioned look at the lives of struggling L.A. scene rock stars follows main character, Gwen (Jade Gordon), on her quest for the top. Working as an assistant to a film production designer (Ally Sheedy), she tries to steal her boy friend (Larry Klein) who is a music producer by offering sexual favors. The producer meanwhile is trying to orchestrate a comeback for a former glam band played by Mi… |
|
|
Network Therapy for Alcohol and Drug Abuse: Effective Office-Based Treatment [VHS] $39.97 Treatment of substance abuse is challenging for all involvedAfor addicted patients, those close to them, and the treating therapists. This informative video shows how a therapist complements individual sessions with supportive meetings with the patient, family, and friends to surmount major obstacles to recovery. The video portrays reenacted therapy sessions using transcripts from actual sessions … |
|
|
Tough Love: Being Tough on Your Kid May Be the Most Loving Thing You Can Do $55.00 In this story, assistant high school principal Rob Charters (Bruce Dern) and his wife Jan (Lee Remick) are good suburban parents with one model child Scott (Eric Schiff) and a 17 year old son Gary (Jason Patric) who has been using drugs. Gary’s violent behavior convinces Rob and Jan that to save Gary they must lock him out, refuse to help him when he is jailed and let him live in poverty. For the … |
|
|
When a Man Loves a Woman $2.89 When a Man Loves a Woman is a dumb title (not another classic pop song, please) for a very smart movie. A kind of gender-switch take on The Lost Weekend, it’s about a woman (Meg Ryan) whose alcoholism almost destroys her family. That may sound like just another TV movie, but When a Man Loves a Woman is so authentic in detail and emotion, that everything about it seems fresh, urgent, and engrossing… |
|
|
28 Days (Special Edition) $2.93 To appreciate 28 Days, it’s best to be thankful that director Betty Thomas hasn’t forced Sandra Bullock into a remake of Clean and Sober. Instead Thomas has balanced her comedic sensibility (evident in Dr. Dolittle and Private Parts) with the seriousness of alcoholism and substance abuse, and she succeeds without compromising the gravity of the subject matter. Some critics have scoffed at the mov… |
|
|
Rebound: The Legend of Earl The Goat Manigault $3.03 He was one of the greatest basketball talents to ever come from the sidewalk courts of Harlem, but Earl “The Goat” Manigault’s abilities couldn’t save him from the brutal realities of life on the streets that kept him reaching the pros. Gritty sports drama, based on a true story, stars Don Cheadle, James Earl Jones, Loretta Devine, Forest Whitaker, and Eriq La Salle, who also directed. 111 min. St… |
|
|
Therabath Professional Paraffin Bath, Scentfree, Maximum Capacity, 9-Pound $148.97 For Hands, Feet, Face and Body since 1962 For over 90 years paraffin moist heat therapy has been used to relieve pain, inflammation and stiffness caused by arthritis. A form of thermotherapy, paraffin treatments effectively increase blood flow to aid in rehabilitation, or to warm an area of the body prior to other therapies or exercise. Warm paraffin is also used extensively to soften dry, crack… |
|
|
Glymed Plus Vital A About The Age Management Skin Care System: The Age Management Skin Care System addresses the individual challenges of chronologically injured, photo-aged and environmentally damaged skin. This System is a complete line of products that gently cleanse, actively treat, restore balance, and protect even the most sensitive skin for all skin types and all skin colors for cellular rehabilitation. Vital… |
|
|
Rehab Suggestion Humor Card 5 x 7 inch premium quality folded paper greeting card. 12 Step Addiction Recovery cards & photo 12 Step Addiction Recovery cards from Greeting Card Universe will bring a smile to your loved ones’ face. Make your loved ones feel special with a custom paper card. Look no further than Greeting Card Universe for your 12 Step Addiction Recovery card needs. This paper card includes the following themes:… |
|
|
Alcoholics Anonymous: The Big Book, 4th Edition $9.40 It’s more than a book. It’s a way of life. Alcoholics Anonymous-The Big Book-has served as a lifeline to millions worldwide. First published in 1939, Alcoholics Anonymous sets forth cornerstone concepts of recovery from alcoholism and tells the stories of men and women who have overcome the disease. With publication of the second edition in 1955, the third edition in 1976, and now the fourth edit… |
