3 effective types of medication for rheumatoid arthritis
Nonsteroidal anti-inflammatory agents (NSAIDs), corticosteroids, and disease-modifying antirheumatics (DMARDs) are the main types of medication for rheumatoid arthritis (RA). Some may relieve pain, while others help slow down the condition.
Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD
Rheumatoid arthritis is an autoimmune condition that leads to joint pain, stiffness, and progressive degeneration.
Autoimmune means your body’s defense mechanism mistakes healthy cells for unhealthy cells, leading the immune system to work against your tissues and organs. In the case of RA, it affects your joints.
While there is no permanent cure for RA, health professionals usually prescribe specific medications to manage pain and inflammation. Some RA prescription medications may also help slow down the condition’s progression.
Selecting the best medication for RA may be difficult because the effects and benefits may depend on your overall health, current symptoms, and RA stage.
These are the three most common medication groups used to treat RA:
1. NSAIDs
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NSAIDs may reduce inflammation and pain in your joints. These medications can ease the discomfort you may experience with RA. They cannot slow down the progression of the disease, though.
NSAIDs come in different forms. Some are available over the counter, while others require a prescription.
You and your health team will work together to identify the most effective medication for your RA symptoms and overall health status.
Doctors usually prescribe a type of corticosteroid called glucocorticoids to treat RA. This medication has anti-inflammatory and immunosuppressive properties. This means they can put your immune system on pause to slow down its work against your joints.
Your medical professional may recommend glucocorticoids to manage RA flare-ups. Prolonged use of corticosteroids may lead to serious side effects. You and your health team can discuss the pros and cons of taking these medications for RA.
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Methotrexate is effective in treating RA. Your health team will be able to advise you of possible side effects.
Hydroxychloroquine
Hydroxychloroquine is also available as Plaquenil and usually comes in tablet form. It can reduce the swelling in your joints and help to relieve pain.
Hydroxychloroquine may help prevent damage to your joints and reduce the possibility of developing severe RA symptoms.
Sulfasalazine
Sulfasalazine is also available as Azulfidine. This is generally a more affordable RA medication that may help improve your symptoms and slow down the progression of the condition.
This RA medication comes in the form of tablets.
Leflunomide
Leflunomideis also available as the brand-name drug Arava. The medication may slow down cartilage and bone degeneration caused by RA and help you find relief from symptoms.
Your medical professional may recommend this medication if you cannot take methotrexate or have experienced no improvement from that medication.
Tumor necrosis factor (TNF) inhibitors
Joints affected by RA have a higher amount of TNF, a protein your immune system produces that causes inflammation.
As the name indicates, TNF inhibitor medications reduce the production of this protein and can relieve inflammation in your joints as well as stop RA progression.
Commonly prescribed TNF inhibitors for RA include:
etanercept (Enbrel)
adalimumab (Humira)
certolizumab pegol (Cimzia)
golimumab (Simponi)
infliximab (Remicade)
T-cell costimulatory blocking agents
T cells are a type of white blood cell that help the immune system protect you from infections and unhealthy growths.
T-cell blocking agents can interfere with the immune cells involved in the RA inflammatory response.
The most common T-cell costimulatory blocking agent drug is abatacept (Orencia), and it’s usually given as an intravenous (IV) or subcutaneous injection.
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B cells are also part of the immune system and work in the production of antibodies.
B-cell depleting agents such as rituximab (Rituxan) target these cells, reducing their role in joint damage. This drug may be the most effective medication for RA to slow down joint degeneration and related symptoms.
Doctors may prescribe rituximab when other DMARD therapies have shown no improvement.
Other immunomodulatory and cytotoxic agents
Your health team may prescribe these immunosuppressing agents when there’s no relief from other treatments or in the case of RA complications.
Other types of immunomodulatory and cytotoxic agents include:
You may experience some of these side effects when taking RA prescription medications:
RA medication
Side effects
NSAIDs
rash swelling nausea gastrointestinal ulcers and bleeding high blood pressure kidney and heart problems
corticosteroids
increased appetite increased urination increased muscle and bone weakness diabetes glaucoma and cataracts high blood pressure stomach ulcers depression, confusion, or anxiety
methotrexate
increased chance of infections skin rash and sores diarrhea cirrhosis of the liver hair loss persistent cough shortness of breath
hydroxychloroquine
nausea and diarrhea rash or skin discoloration hair changes muscle weakness anemia changes or loss of vision changes in the heart rhythm
sulfasalazine
nausea headache abdominal discomfort stomach ulcers increased sunlight sensitivity changes in skin and urine color lowered white blood cell count
leflunomide
diarrhea nausea stomach pain rash hair loss lowered blood cell count cough and shortness of breath
TNF inhibitors
skin reaction at the injection site area increased risk of severe infections increased risk of heart failure in people with heart disease
abatacept
headaches nausea common colds and sore throat low blood pressure shortness of breath hives severe allergic reactions increased chance of serious infections
rituximab
low blood pressure rash and itchiness back pain flu-like symptoms nausea or upset stomach sweating numbness muscle stiffness mild throat tightening
People taking these RA medications may experience side effects differently. You and your doctor can discuss each medication’s possible side effects and benefits.
NSAIDs, corticosteroids, and DMARDs are the most common medications for managing RA symptoms.
Doctors may prescribe NSAIDs to improve pain and inflammation, but they don’t slow down the progress of the disease. Corticosteroids and DMARDs can both improve symptoms and reduce the progression of RA.
It’s possible to experience mild to severe side effects when taking these RA medications. In most cases, the benefits may outweigh the side effects. Discussing all the possibilities with your health team may help you make the best decision for your specific symptoms.
