Medications for Rheumatoid Arthritis
TOCILIZUMAB (TOE si LIZ ue mab) is a monoclonal antibody. It is used to treat rheumatoid arthritis, juvenile idiopathic arthritis, giant cell arteritis, and cytokine release syndrome due to chimeric antigen receptor (CAR) T-cell treatment.
CERTOLIZUMAB (SER toe LIZ oo mab) is used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, and plaque psoriasis.
ETANERCEPT (et a NER sept) is used for the treatment of rheumatoid arthritis in adults and children. The medicine is also used to treat psoriatic arthritis, ankylosing spondylitis, and psoriasis.
ADALIMUMAB (a dal AYE mu mab) is used to treat rheumatoid and psoriatic arthritis. It is also used to treat ankylosing spondylitis, Crohn’s disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa, and uveitis.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disease that primarily affects the small joints in your hands and feet. Rheumatoid arthritis results in chronic inflammation when your immune system mistakenly attacks your body’s own tissues.
Approximately 1.3 million Americans have rheumatoid arthritis. It most commonly starts between the ages of 40 and 60 years old. Rheumatoid arthritis is three times more common in women than men.
More Information about Rheumatoid Arthritis
You will likely experience pain, swelling, tenderness, and warmth in your joint(s) affected by rheumatoid arthritis. Smaller joints may be affected first such as your fingers, hand, wrist, feet, toes, or ankle joints.
Your symptoms will probably occur symmetrically on both sides of your body. So if one wrist is swollen, it is likely that the other will be as well. As the disease progresses, it can advance and develop in your hips, shoulders, elbows, knees, neck, and jaw. Eventually, rheumatoid arthritis may also result in bone erosion and joint deformity.
Rheumatoid arthritis symptoms will have periods of activity and inactivity. Your symptoms generally fade or disappear during the inactive periods. The periods of activity are called flare-ups or flares, at which time you may experience:
- Joint pain and stiffness
- Joint swelling
- Joint deformity
- Morning stiffness
- Lumps (nodules) under the skin
- Poor appetite
Rheumatoid arthritis is an autoimmune disease caused when your immune system mistakenly attacks the lining of the joints causing inflammation. Over time, this ongoing inflammation can damage the cartilage and bone in the joint.
It seems likely that a person inherits a tendency to develop rheumatoid arthritis and then an environmental factor, such as a viral or bacterial infection triggers the disease. Tobacco use increases your risk of rheumatoid arthritis.
Hormones may also play a role in rheumatoid arthritis since the disease tends to improve during pregnancy and flare again after pregnancy and during breastfeeding.
The diagnosis of rheumatoid arthritis will start with your doctor taking a medical history and giving you a physician examination. After that, several additional tests might be used to confirm a diagnosis of rheumatoid arthritis:
Blood tests might check for anemia or signs of infection. A blood test to check for markers of inflammation is useful, since many people with rheumatoid arthritis have high levels of erythrocyte sedimentation rate (called a sed rate). Your doctor might also test for rheumatoid factor or anti-cyclic citrullinated peptide (anti-CCP) antibodies.
An X-ray, MRI, or ultrasound may be performed to look for and track bone damage around the involved joints.
Your doctor might take a sample of fluid from one of your joints to confirm the diagnosis.
Your doctor will rule out other joint diseases in your diagnosis process, such as osteoarthritis, gout, fibromyalgia, or lupus. Because many joint diseases have similar symptoms, an accurate diagnosis is often missed early on. In fact, the average time between the onset of symptoms and the official diagnosis of rheumatoid arthritis is almost nine months.
Although there is no sure way to prevent rheumatoid arthritis, the next best thing is to prevent further joint damage by starting treatment as early as possible. Quitting smoking reduces your risk of developing rheumatoid arthritis.
The joint damage caused by rheumatoid arthritis can make it difficult or even impossible to complete tasks needed for daily life. This, in turn, can contribute to feelings of depression. Early detection to prevent, slow down, or stop joint damage can allow you to continue the activities you enjoy.
Rheumatoid arthritis can involve almost all organs, not just joints. It can affect the eyes, lungs, skin, heart, blood vessels, and other organs.
Although there is no known cure for rheumatoid arthritis, there are a growing number of treatment options that can lessen your joint inflammation, relieve pain, and prevent or slow joint damage.
- Anti-inflammatory medications
- Disease-modifying antirheumatic drugs (DMARDs)
- Biologic medications (such as monoclonal antibody)
Some people with rheumatoid arthritis eventually need joint replacement surgery if the joint pain, stiffness, and deformity interfere greatly with daily life. Surgery can relieve pain and improve joint function. Arthroscopy to repair abnormal tissues, tendon reconstruction, joint fusion and surgery to correct deformities may also be recommended.
Quitting smoking can improve your symptoms; for this and many other reasons you should quit smoking. Your doctor might suggest that you do exercises to strengthen supporting muscles around your joints. However, you should avoid exercising a sore or inflamed joint. Your doctor may recommend exercises such as resistance training, low-impact aerobics, swimming, water aerobics, and/or stretching. Occupational and physical therapy can teach you how to protect your joints and approach tasks in a way that takes stress off your painful joints.
You might find some symptom relief from heat or cold on your affected joint. Acupuncture or relaxation techniques can also help to relieve your pain.
Avoid foods high in fat, such as ice cream, cheese, and butter, to help reduce inflammation in your body. However, foods high in omega-3 fatty acids, such as flaxseeds, walnuts, and salmon, can help reduce inflammation.