Corticosteroids are hormones that are effective at treating arthritis, but which can cause many side effects. Corticosteroids can be taken by mouth or given by injection. Prednisone is the corticosteroid most often given by mouth to reduce the inflammation of rheumatoid arthritis. In people with both rheumatoid arthritis and osteoarthritis, the doctor also may inject a corticosteroid into the affected joint to stop pain. Because frequent injections may cause damage to the cartilage, they should be done only once or twice a year. Corticosteroids by mouth may not be effective for all types of arthritis.
Disease-Modifying Antirheumatic Drugs (DMARDs)
DMARDs are drugs used to treat people with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, or juvenile rheumatoid arthritis who have not responded to NSAIDs. These drugs are thought to influence and correct abnormalities of the immune system responsible for the disease. This can cause a slowing of joint damage that can occur with these conditions. During treatment with these medications, the physician should carefully monitor the affected person to avoid side effects.
Various DMARDs used as an arthritis treatment include:
- Azathioprine (Imuran®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- Hydroxychloroquine (Plaquenil®)
- Gold sodium thiomalate
- Leflunomide (Arava®)
- Methotrexate (Rheumatrex®)
- Sulfasalazine (Azulfidine®).
Biological Response Modifiers
These new drugs are used for the treatment of several types of arthritis, including rheumatoid arthritis, ankylosing spondylitis, juvenile rheumatoid arthritis, and psoriatic arthritis. They can reduce inflammation in the joints by blocking the reaction of a substance called tumor necrosis factor, an immune system protein involved in immune system response. These medications can include:
Two other biological response modifiers, abatacept (Orencia®) and anakinra (Kineret®), are approved for the treatment of rheumatoid arthritis.
(Click Arthritis Medications for more information.)