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| Autoimmune Diseases: Rheumatoid Arthritis (RA) | | This page was written by Shelley Ensz, and has not yet been medically edited. See Disclaimer. | | | |
| Treatments for Rheumatoid Arthritis |
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| Overview of Rheumatoid Arthritis Treatments |
| Treatments for Rheumatoid Arthritis include medications such as immunosuppressants and biologics, alternative therapies and supplements, and exercise. Many patients respond to a combination of medication and alternative therapies. ISN. |
| 25 Years in Arthritis: New Treatments, New Hope. Biologics, other advancements have helped those with the painful condition of Rheumatoid Arthritis. John Gever. ABC News / Health. 01/02/10. |
| Rheumatoid Arthritis Treatments. It is essential that the patient and the patient’s family be educated about the nature and course of the disease. The major goals of treatment of the arthritis are to reduce pain and discomfort, prevent deformities and loss of joint function, and maintain a productive and active life. Johns Hopkins University. |
| Treatments for Rheumatoid Arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs); COX-2 inhibitors; corticosteroids; disease-modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine (Plaquenil), the gold compound auranofin (Ridaura), sulfasalazine (Azulfidine), minocycline (Dynacin, Minocin), methotrexate (Rheumatrex); immunosuppressants; tumor necrosis factor (TNF) blockers; and joint replacements. Immunosuppressants include leflunomide (Arava), azathioprine (Imuran), cyclosporine (Neoral, Sandimmune) and cyclophosphamide (Cytoxan). Mayo Clinic. |
| Clinical Trial: Pain and Stress Management for People With Rheumatoid Arthritis. Self-management of rheumatoid arthritis (RA) symptoms using written emotional disclosure (ED), coping skills training (CST), or a combination of both may benefit people with RA. The purpose of this study is to determine the benefits of these therapies together in adults with RA. This study will be conducted at Wayne State University in Detroit, Michigan and Duke University Medical Center in Durham, North Carolina. NIH. Study dates 2005-2009. |
| Alternative Therapies |
| Alternative treatments for rheumatoid arthritis include relaxation techniques, meditation, hypnosis, acupressure, acupuncture, yoga, and nutritional supplements such as fish oils, bromelain and pancreatin, and vitamins A, C, and E, selenium, and zinc. A diet rich in fish and berries may also be helpful. If your flare-ups of rheumatoid arthritis have been linked to food allergies, work with an allergy specialist to determine which foods you need to avoid. Milton S. Hershey Medical Center, College of Medicine. |
| The use of fish oil in the community: results of a population-based study. Fish oil has been demonstrated to have symptomatic benefits and improve disease activity in Rheumatoid Arthritis. C. Hill. Rheumatology. January 27, 2009. (Also see: Alternative Therapies) |
| Green Tea Protects Rats against Autoimmune Arthritis by Modulating Disease-Related Immune Events. The polyphenolic compounds from green tea (PGT) possess anti-inflammatory properties. Green tea induced changes in arthritis-related immune responses. We suggest further systematic exploration of dietary supplementation with PGT as an adjunct nutritional strategy for the management of Rheumatoid Arthritis. Hong Ro Kim. The Journal of Nutrition. November 2008. |
| Why Should Rheumatologists Consider Vitamin D Supplementation for their Patients? Given the low cost of vitamin D, its excellent tolerability, combined musculoskeletal- and suggested antiinflammatory/ cardio-vascular benefits, vitamin D supplementation holds a significant public health potential. IngentaConnect. Current Rheumatology Reviews, Vol 3, No 2, May 2007, pp. 129-134(6). (Also see: Causes of Scleroderma: Vitamin D Deficiency) |
| Exercise |
| A dynamic exercise programme (DEP) to improve patients’ disability in rheumatoid arthritis (RA): a prospective randomized controlled trial. DEP was effective on functional status assessed by health assessment questionnaire (HAQ), quality of life and aerobic fitness at 1 month. A. Baillet. Rheumatology Advance Access. February 11, 2009. |
| Rheumatoid arthritis (RA), cardiovascular disease and physical exercise: a systematic review. There is strong evidence suggesting that exercise from low to high intensity of various modes is effective in improving disease-related characteristics and functional ability in RA patients. Rheumatology 2008 47(3):239-248. |
| Medications |
| Like many rheumatic diseases, not all rheumatoid arthritis patients respond to the same medication; therefore, patients try several different medications in hopes that one will eventually relieve their symptoms and slow the progression of the disease. ISN. |
| Hydroxychloroquine for Rheumatoid Arthritis, Lupus Linked to Retinopathy. In patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), long-term hydroxychloroquine therapy increases the risk of retinopathy, according to a February 12th online publication in Arthritis Care & Research. David Douglas. Medscape Today. (Reuters) 03/04/10. (Also see: Lupus and Medications) |
| Phosphodiesterase inhibitors (PDEis) in the management of autoimmune disease. The emerging trends make it necessary to exploit the full therapeutic potential of PDEis in various autoimmune diseases like rheumatoid arthritis, scleroderma, profibrotic conditions and PAH. (PubMed) P. Shenoy. Autoimmun Rev. February 8 2010. Also see: (SD Treatments) |
| Depression in rheumatoid arthritis (RA) patients treated with anti-TNF is common and under-recognized in the rheumatology clinic. Patients with persistent depression tended to respond less well to anti-TNF, with smaller reductions in DAS28. Given that a significant reduction in DAS28 is a requirement for continuing therapy, recognition and appropriate management of depression may improve TNF effectiveness. Samantha L. Hider, PhD. Rheumatology. July 16, 2009. |
| Biologics |
| Discontinuation of etanercept in patients with rheumatoid arthritis (RA) who were in clinical remission. These findings indicate that clinical and radiographic remission is possible in some patients with RA after the discontinuation of etanercept. Tomoya Miyamura. (SpringerLink) Clinical Rheumatology. September 10 2009. |
| Treatment impact on estimated medical expenditure and job loss likelihood in rheumatoid arthritis: re-examining quality of life (QoL) outcomes from a randomized placebo-controlled clinical trial with abatacept. QoL findings for abatacept led to greater reduction in medical expenditure and likelihood of an inability to work. The strong effect sizes obtained for all significant analyses suggest that the results are clinically meaningful. J. C. Cole. Rheumatology Advance Access. May 17, 2008. |
| Cost-Effectiveness of Abatacept in Patients with Moderately to Severely Active Rheumatoid Arthritis (RA) and Inadequate Response to Tumor Necrosis Factor-α Antagonists (anti-TNF). Abatacept is cost-effective by current standards of medical practice in patients with moderately to severely active RA and inadequate response to an anti-TNF. Montserrat Vera-Llonch. J Rheumatol July 15 2008. (Also see: TNF Inhibitors) |
| Corticosteroids |
| Low-dose Prednisolone in Rheumatoid Arthritis (RA): Adverse Effects (AE) of Various Disease Modifying Antirheumatic Drugs (DMARD). Low-dose glucocorticoids retard radiological progression of RA and exhibit a differential effect on survival of DMARD and degree of AE due to DMARD. J Rheumatol April 15 2008. (Also see: Medications: steroids and DMARDS) |
| Glucocorticoids and cardiovascular events in rheumatoid arthritis: A population-based cohort study. RF-positive but not RF-negative patients were at increased risk of cardiovascular events following exposure to glucocorticoids. (Wiley InterScience) Arthritis and Rheumatism Vol 56, Issue 3, Pages 820 - 830. (Also see: Medications) |
| DMARDS |
| Indirect Comparison of Tocilizumab and Other Biologic Agents in Patients with Rheumatoid Arthritis and Inadequate Response to Disease-Modifying Antirheumatic Drugs (DMARD-IR). Among DMARD-IR patients, tocilizumab shows a pattern of response that differs from that of other biologic agents. Post-hoc analyses suggest that the difference lies in a higher likelihood of ACR70 response with tocilizumab. Gert J.D. Bergman, PhD. Arthritis and Rheumatism. 03/12/10. |
| Functional Improvement After Patients with Rheumatoid Arthritis (RA) Start a New Disease Modifying Antirheumatic Drug (DMARD) Associated with Frequent Changes in DMARD: The CORRONA Database. Our study demonstrates that in clinical rheumatologic practices, more frequent changes in DMARD are associated with greater improvement in function. Indirectly, these data support the concept that DMARD should be changed if optimal responses are not achieved within a specified time. Veena K. Ranganath. J Rheumatol First Release. Sept 1 2008. (Also see: DMARDs) |
| Changing patterns of medication use in patients with rheumatoid arthritis (RA) in a Medicaid population. The utilization of DMARDs increased in TennCare patients with RA, and by 2004, use of biologics was substantial. C. G. Grijalva. Rheumatology Advance Access. May 22, 2008. |
| Triple therapy in early active rheumatoid arthritis: A randomized, single-blind, controlled trial comparing step-up and parallel treatment strategies. Highly effective control of disease activity can be achieved using conventional DMARDs as part of an intensive disease management strategy. Within this setting, step-up therapy is at least as effective as parallel triple therapy. (Wiley Interscience) Arthritis & Rheumatism, 25 Apr 2008. |
| Immunosuppressants |
| Treatment of Psoriatic Arthritis (PsA) and Rheumatoid Arthritis (RA) with Disease Modifying Drugs: Comparison of Drugs and Adverse Reactions. For both diseases methotrexate (MTX) was the most frequently used disease modifying drug (39% of patients with PsA, 30% with RA), with over 70% of patients in both diseases still taking the drug. Journal of Rheumatology. Vol 35: No. 3 March 2008. (Also see: Psoriatic Arthritis) |
| Anti-rheumatic drug use and risk of serious infections in rheumatoid arthritis. In this large cohort of RA patients, the most heightened risk of serious infections was seen with the use of glucocorticoid agents and immunosuppressive DMARDs. Rheumatology. Volume 46, Number 7 Pp. 1157-1160. (Also see: Medications) |
| A Novel Predictor of Clinical Response to Methotrexate (MTX) in Patients with Rheumatoid Arthritis (RA): A Pilot Study of in Vitro T Cell Cytokine Suppression. An in vitro tumor necrosis factor-a suppression assay may help predict clinical response to MTX in RA. Nigil Haroon. J Rheumatol First Release May 1 2008. (Also see: Immunosuppressants) |
