Arthritis means inflammation of joints. Many different drugs are used in its treatment. Different types of arthritis are treated with different drugs. For example, for gout and arthritis due to an infection in a joint (septic arthritis) there are very specific drugs. For other types of arthritis, such as rheumatoid arthritis, there is at present no drug to cure the disease.
Many different drugs can help significantly and may halt the progress of the arthritis. So, for rheumatoid arthritis, your doctor will often need to give you two or more drugs together, or to try one drug first and if this does not work to try another. Painkillers (called ‘analgesics’) and anti-inflammatory drugs are used to relieve the symptoms of degenerative, or ‘wear and tear’, arthritis (osteoarthritis).
Drugs used to treat arthritis: Some drugs control symptoms; for example, analgesics reduce pain and anti-inflammatory drugs reduce swelling and stiffness; other drugs work on the disease itself. A combination of drugs may be used to treat arthritis.
Drugs used to treat arthritis can be divided into four broad groups:
1. Painkillers (analgesics)
These relieve pain. They are used for many different types of arthritis and are often used together with other drugs.
2. Non-steroidal anti-inflammatory drugs (NSAID)
These arthritis drugs reduce inflammation of the joint as well as pain. They are used for many different types of arthritis, often with other drugs. If one type does not work, your doctor may try another. They are usually given by mouth but may also be given by suppository or in slow-release preparation. ‘Slow-release’ means that the drug is gradually absorbed by the body a little at a time, rather than all at once. NSAID creams or gels may also be used by rubbing onto the skin over a painful joint or muscle.
3. Disease-modifying anti-rheumatic drugs (DMARDs)
This group of arthritis drugs includes gold, hydroxychloroquine, leflunomide, penicillamine and sulfasalazine. They are used mainly in the treatment of rheumatoid arthritis but also in some other rheumatic diseases. They reduce pain, swelling and stiffness.
Another group of disease-modifying drugs are immunosuppressant drugs. They are termed ‘immunosuppressant’ because they suppress the immune system. They include azathioprine, ciclosporin, cyclophosphamide and methotrexate. Because they affect the immune system they may produce side-effects, and may need careful observing. Immunosuppressant drugs are often used to treat cancer but be sure that your arthritis has nothing to do with this disease.
A new group of drugs are the anti-TNF drugs, adalimumab, etanercept and infliximab. Anti-TNF drugs and anakinra can reduce inflammation in people with rheumatoid arthritis. These drugs are now only being used in people who have not responded to other disease-modifying drugs.
Corticosteroids are very effective in controlling inflammation and may have some disease-modifying effects. But, if used for a long time or in high doses they produce side-effects. For this reason doctors try to use them in as low a dose as possible.
Osteoporosis (thinning of the bones) can be caused by steroids and for this reason your doctor may prescribe treatment to protect your bones while taking steroids. However, they do have an important role to play in many different rheumatic diseases. For example, if one particular joint is inflamed, your doctor may inject it with a steroid preparation. Steroids can also be injected into a vein or a muscle.