3 effective types of medication for rheumatoid arthritis
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:
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.
Common NSAIDs include:
- fenoprofen (Nalfon)
- meloxicam (Vivlodex, Mobic, Qmiiz ODT)
- nabumetone (Relafen DS)
- naproxen (Naprosyn)
- oxaprozin (Daypro)
Corticosteroids are synthetic drugs that mimic natural human steroid hormones produced by the endocrine glands.
Corticosteroids come in the form of:
- topical preparations
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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Unlike NSAIDs, DMARDs may slow the progression of RA and help you manage symptoms.
Commonly prescribed DMARDs include:
Methotrexate is also available as Rheumatrex and Trexall.
Methotrexate is effective in treating RA. Your health team will be able to advise you of possible side effects.
Hydroxychloroquine may help prevent damage to your joints and reduce the possibility of developing severe RA symptoms.
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This RA medication comes in the form of tablets.
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.
B-cell depleting agents
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:
Side effects of RA medications
You may experience some of these side effects when taking RA prescription medications:
|RA medication||Side effects|
gastrointestinal ulcers and bleeding
high blood pressure
kidney and heart problems
increased muscle and bone weakness
glaucoma and cataracts
high blood pressure
depression, confusion, or anxiety
|methotrexate||increased chance of infections|
skin rash and sores
cirrhosis of the liver
shortness of breath
|hydroxychloroquine||nausea and diarrhea|
rash or skin discoloration
changes or loss of vision
changes in the heart rhythm
increased sunlight sensitivity
changes in skin and urine color
lowered white blood cell count
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
common colds and sore throat
low blood pressure
shortness of breath
severe allergic reactions
increased chance of serious infections
|rituximab||low blood pressure|
rash and itchiness
nausea or upset stomach
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.
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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.
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- Petta I, et al. (2019). Risks and benefits of corticosteroids in arthritic diseases in the clinic. https://www.sciencedirect.com/science/article/abs/pii/S0006295219301443
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- Treatments. (n.d.). https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments