TREATMENT OF RHEUMATOID ARTHRITIS: SECOND-LINE DRUGSThe purpose of second-line medications is to alter the course of rheumatoid arthritis (RA) – to control the arthritis process and prevent joint damage. Second-line drugs are commonly referred to as DMARDs, or disease-modifying anti-rheumatic drugs. They are also known as slow acting anti-rheumatic drugs (SAARDs) because it takes several weeks or months for them to work.All drugs classified as DMARDs or SAARDs have been proven to be effective in slowing down the process of RA. In some cases they may even induce a complete remission of the condition (which explains why they are sometimes referred to as remittive drugs). Their ability to affect the course of RA distinguishes this group of drugs from NSAIDs, which effectively treat symptoms such as pain and swelling but probably do not change the course of the disease. Although second-line medications do not provide fast pain relief, improved comfort is often a long-term benefit of using them to control the arthritis process.Five of the second-line medications – injectable gold, oral gold, hydroxychloroquine, penicillamine, and sulfasalazine – are categorized strictly as DMARDs. We do not fully understand how they work. Other second-line drugs are categorized as immunosuppressants. This group includes methotrexate, azathioprine, and cyclophosphamide, and we think we know how they work: immunosuppressants appear to change the course of RA by suppressing, or decreasing the activity of, the immune system.As we have seen, parts of the immune system are overactive in RA, so a drug that decreases the hyperactivity of the immune system is useful in controlling the disease. But to maintain health, a person must have a properly functioning immune system, since the immune system is designed to fight infection. For this reason, immunosuppressants must be prescribed with care. The immune system cannot be allowed to become suppressed to the point that it is unable to fight infection. Safe and effective treatment of RA with immunoby a physician experienced in their use, preferably a rheumatologist.*89/209/5*
The purpose of second-line medications is to alter the course of rheumatoid arthritis (RA) – to control the arthritis process and prevent joint damage. Second-line drugs are commonly referred to as DMARDs, or disease-modifying anti-rheumatic drugs. They are also known as slow acting anti-rheumatic drugs (SAARDs) because it takes several weeks or months for them to work.
All drugs classified as DMARDs or SAARDs have been proven to be effective in slowing down the process of RA. In some cases they may even induce a complete remission of the condition (which explains why they are sometimes referred to as remittive drugs). Their ability to affect the course of RA distinguishes this group of drugs from NSAIDs, which effectively treat symptoms such as pain and swelling but probably do not change the course of the disease. Although second-line medications do not provide fast pain relief, improved comfort is often a long-term benefit of using them to control the arthritis process.
Five of the second-line medications – injectable gold, oral gold, hydroxychloroquine, penicillamine, and sulfasalazine – are categorized strictly as DMARDs. We do not fully understand how they work. Other second-line drugs are categorized as immunosuppressants. This group includes methotrexate, azathioprine, and cyclophosphamide, and we think we know how they work: immunosuppressants appear to change the course of RA by suppressing, or decreasing the activity of, the immune system.
As we have seen, parts of the immune system are overactive in RA, so a drug that decreases the hyperactivity of the immune system is useful in controlling the disease. But to maintain health, a person must have a properly functioning immune system, since the immune system is designed to fight infection. For this reason, immunosuppressants must be prescribed with care. The immune system cannot be allowed to become suppressed to the point that it is unable to fight infection. Safe and effective treatment of RA with immunoby a physician experienced in their use, preferably a rheumatologist.
*89/209/5*