Arthritis
Rheumatoid Arthritis (RA)
Between the ages of 30
and 50, eight times as many women as men develop this
crippling form of arthritis. Although we don't know why
it develops, researchers suspect that victims have a
genetic predisposition.
Unlike OA, RA symptoms
are more pronounced in the morning -- the joints and
muscles tend to stiffen up overnight as you sleep. RA
patients may develop swelling in the joints; and this
may lead to deformities and, ultimately, total
immobility. RA patients may also develop such related
symptoms as fever, fatigue, and loss of
appetite.
Drug treatment of RA
begins with the same types of medications used for OA:
aspirin, Celebrex, NSAIDs, and, occasionally, steroids.
If these drugs fail to control joint inflammation,
other, more potent medications are prescribed. Although
we don't know why, an antimalarial drug called
hydroxychloroquine (Plaquenil) is known to reduce RA
inflammation. While the drug seems to work well, it has
potentially serious side effects that can cause vision
problems, so careful monitoring by your physician and
eye doctor is important. Gold salts, injected on a
weekly or biweekly basis, or taken orally once or twice
a day can reduce joint inflammation, but, again,
serious side effects make them impractical for many
patients. Another drug -- penicillamine (Depen or
Cuprimine) -- works much like gold salts in reducing
symptoms and retarding disease in severe cases of RA,
and may cause fewer side effects.
Researchers today are
exploring the role that immunosuppressive drugs can
play in the treatment of RA. Azathioprine (Imuran) and
cyclosporine (Neoral) are approved for use in RA cases.
Methotrexate (Rheumatrex) is now frequently prescribed
as well. These drugs are extremely potent and are
usually reserved for very serious cases where all else
has failed. However, two newer drugs that also work
through the immune system may help a larger group of
patients. One, called leflunomide (Arava), not only
relieves the symptoms of RA but also staves off the
joint damage that accompanies the disease. The other, a
genetically engineered drug called etanercept (Enbrel),
works on just one element of the immune system, the
naturally occurring protein called tumor necrosis
factor (TNF). By blocking the inflammatory effects of
TNF, Enbrel provides significant relief to a majority
of patients with moderate to severe RA.
Like other forms of
arthritis, RA should be treated by both medication and
physical therapy, which can help restore some of the
lost joint function. Surgical procedures such as hip
and knee replacements have enabled many patients to
return to a more fully functional lifestyle.
See Also:
Gout |
Arthritis |
Osteoarthritis
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