Drug Treatments for Rheumatoid Arthritis

Analgesics or pain killers do not alter the disease course in rheumatoid arthritis but they can be useful to manage symptoms and flares. 

• Paracetamol is often the first painkiller used.  This can be taken alone or in a combined tablet with opioid analgesics e.g co-codamol.
• Non-Steroidal Anti-inflammatory drugs (NSAIDs) can help to reduce inflammation in the joints and thereby reduce the pain. There are many different NSAIDs and your doctor will help you find the one that suits you.

As with all drugs there are potential side effects so generally these drugs are intended for occasional use or short courses. 

For more information on pain relief in arthritis visit:
Arthritis Research UK www.arthritisresearchuk.org/arthritis-information/conditions/rheumatoid-arthritis/treatments/painkillers-and-nsaids.aspx

Healthtalkonline.org healthtalkonline.org/peoples-experiences/bones-joints/rheumatoid-arthritis/anti-inflammatory-drugs

Injection of steroid and local anesthetic into joints can be used in rheumatoid arthritis to help reduce inflammation and pain in persistently troublesome joints. This is typically carried out by a rheumatologist, but many GPs are also able to inject some joints. Sometimes injections are done under ultrasound or X-ray guidance by a radiologist.  Following an injection it is advisable to rest the joint for 24-48 hours and if possible avoid driving soon after an injection especially of the knees or feet.

For more information on joint injections visit:
Arthritis Research UK www.arthritisresearchuk.org/Arthritis-information/Drugs/Local-steroid-injections.aspx

Disease modifying anti rheumatic drugs (DMARDs) treat the arthritis itself. They improve symptoms but this often takes several weeks to months, therefore analgesia is often used alongside these drugs initially. DMARDs are often used together as combination therapy in order to get the inflammation under control and prevent long-term damage to joints. As with all medication there is the potential for side effects and sometimes a few different drugs have to be trialed to find the treatment that suits the individual patient. Many of these drugs require regular blood test monitoring.

For more information on Disease modifying anti rheumatic drugs visit:
Arthritis Research UK www.arthritisresearchuk.org/arthritis-information/conditions/rheumatoid-arthritis/treatments/dmards.aspx

Healthtalkonline.org healthtalkonline.org/peoples-experiences/bones-joints/rheumatoid-arthritis/disease-modifying-anti-rheumatic-drugs-dmards

Biological therapies or biologics are newer drugs that target specific molecules involved in causing rheumatoid arthritis. These drugs are used when conventional disease modifying drugs (DMARDs) have not been sufficient to control the arthritis. The majority are given by injection, often used in combination with methotrexate or other DMARDs. 

For more information on Biological therapies visit:
Arthritis Research UK www.arthritisresearchuk.org/arthritis-information/conditions/rheumatoid-arthritis/treatments/dmards.aspx

Healthtalkonline.org healthtalkonline.org/peoples-experiences/bones-joints/rheumatoid-arthritis/biologic-treatments-anti-tnf-and-b-cell-therapy

Steroids are fast acting anti-inflammatory drugs that reduce the inflammation in rheumatoid arthritis. They can be given in a variety of different ways. Most commonly they are given in tablet form - prednisolone.  Intramuscular injections are also used or steroids can be given by injection directly into affected joints.  Steroids are usually given to provide rapid relief from inflammation while waiting for disease modifying drugs (DMARDs) to take effect or during flare ups of rheumatoid arthritis.  They can be associated with side effects in the long term therefore they are often reduced or stopped once the arthritis is under control. 

For more information on steroids visit:
Arthritis Research UK www.arthritisresearchuk.org/arthritis-information/conditions/rheumatoid-arthritis/treatments/steroids.aspx

Healthtalkonline.org healthtalkonline.org/peoples-experiences/bones-joints/rheumatoid-arthritis/steroid-tablets-injections-intravenous-pulses