Rheumatoid arthritis (RA) is a chronic, symmetrical inflammatory autoimmune disease that initially affects small joints, progressively involving larger joints and potentially impacting the skin, eyes, heart, kidneys, and lungs. The primary goals in the treatment of RA are to control synovitis and prevent joint injury.
Methotrexate is typically the first-line drug for rheumatoid arthritis. For patients with moderate to high disease activity, especially those who haven’t previously used disease-modifying anti-rheumatic drugs (DMARDs), methotrexate is strongly recommended as the initial treatment. This recommendation is supported by robust evidence indicating its effectiveness in modifying the course of the disease.
In addition to methotrexate, there are three general classes of drugs commonly used in RA treatment:
Non-steroidal anti-inflammatory agents (NSAIDs), such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). These over-the-counter NSAIDs can help reduce pain and inflammation, although they may have side effects like stomach irritation, heart problems, and kidney damage.
Corticosteroids, like prednisone, are effective in reducing inflammation and pain, and slowing joint damage. However, they also carry risks of side effects.
DMARDs, which include biologic agents such as tumor necrosis factor inhibitors, are generally considered as second-line agents or can be added to the treatment regimen in certain cases.
It’s crucial to understand that RA is a potentially debilitating condition where the bone and cartilage of joints are often destroyed, and tendons and ligaments weaken. Therefore, early and aggressive treatment is essential to prevent irreversible joint damage and disability.
For more in-depth information, you can refer to the following sources:
UpToDate
American Academy of Family Physicians (AAFP)
Johns Hopkins Arthritis Center
Mayo Clinic
American Academy of Family Physicians (AAFP) Update
Arthritis Foundation
