The new generation of drugs for the treatment of rheumatoid arthritis: a detailed overview
Treatment of rheumatoid arthritis with new generation drugs
Rheumatoid arthritis (RA) is a systemic disease, which usually affects the peripheral small joints. On the assumption that the disease with the destruction of the tissues of the joints and is characterized by progressive course, treatment of rheumatoid arthritis carried out comprehensively, that is, using the most modern methods of therapy and drugs of the new generation.
The main objective in the treatment of RA
Rheumatoid arthritis affects primarily small joints. The main symptoms of the disease are expressed in deformation of the affected area, restriction of mobility, the emergence of pain syndrome. Most patients lose the ability to lead a normal lifestyle and employment. Almost 75% of them doctors put disability in the sixth year after the appearance of the first symptoms of the disease.
Even successful treatment does not guarantee that the life expectancy of the patient is reduced, because the disease is chronic and prone to relapse. On average, people suffering from RA, live 5 years less than healthy.
How long will the treatment of the disease in a particular case, once it is impossible to say. One can be noted that interruptions in treatment and failure to comply with the recommendations of a physician the maximum delay desired recovery. The main tasks which put doctors in the treatment of disease are:
- to relieve the patient from pain, swelling, General malaise;
- to restore mobility to the affected joints;
- to prevent deformation, and further destruction of joints;
- to increase the duration and quality of life;
- extend the periods of remission.
To achieve these goals in the treatment of rheumatoid arthritis prescribed tools of a new generation and standard, time-tested drugs.
Modern drug treatment
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The most common drugs of new generation, which is prescribed for the treatment of rheumatoid arthritis, are immunomodulators and biological agents.
The main objective of immunomodulators – a decrease in intensity and stop further progression of the inflammatory process that is achieved through suppression of the amount of leukocytes, thus reducing their active life. One of those drugs called Methotrexate, which is used in the treatment of diseases in both adults and children.
If you have previously Methotrexate combined with Prednisone, today is the interaction of the drugs is not practiced by assigning a different drug – Leflunomide, which also has immunosuppressive action and assigns a one-time. In some cases, take in combination with Methotrexate and Metipred. Drugs, even in conjunction quite well tolerated by the body.
Biological agents are required in severe RA development, that is, in the case when in the pathological process involves more than 5 joints, and if the standard medication is extremely inefficient. The main difference between biological drugs from the basic medicines – fast action.
Biological preparations of new generation bring marked relief of the General condition of the patient for about a week after the beginning of their application. In some cases, to achieve a significant reduction in symptoms of arthritis is possible after 2-3 days.
In their effectiveness, the agents can be compared with medications used in the ICU. Typically, biological agents administered in combination with a base, thereby increasing the therapeutic effect. In this case it is possible to achieve rapid slowing the progression of the inflammatory process, which cannot be achieved with basic therapy.
The most common biological agents used in the treatment of rheumatoid arthritis are:
- Remicade. This drug helps eliminate erosive and inflammatory process in the joint, slowing the reduction of the joint space. At the time of therapy of a biological agent within 6 months after the end of its use, women are recommended to use reliable contraceptives. This is necessary due to the fact that the drug pathological effects on the immune system of the fetus, causing irreversible consequences.
- Kinneret. The drug is prescribed for severe disease.
- Enbrel. The medication helps to suppress inflammation and achieve remission of the disease as the first and last stages.
- Humira. Used to treat arthritis of moderate and severe forms, is combined with the intake of basic anti-inflammatory drugs.
According to numerous studies, it follows that up to a third of patients had achieved stable remission after treatment with biological agents.
Immediately after diagnosis, the doctor will prescribe a standard medication of rheumatoid arthritis, which is a nonsteroidal anti-inflammatory drugs, glucocorticoids, chondroprotectors and basic drugs. Intake of complex medicines allows you to:
- to reduce, and even eliminate the symptoms of the pathology;
- to prevent the destruction of joint tissue;
- to achieve persistent and prolonged remission;,
- to increase life expectancy and quality.
As the RA treatment should be comprehensive, together with the necessary medication and proper diet and carrying out physiotherapy.
What method of physiotherapy is most effective in a particular case, is determined by the physician on the basis of such information:
- the variety and nature of the disease;
- its severity;
- existing contraindications;
- the age of the person.
May require the use of electrophoresis, phonophoresis, magnetic therapy, manual therapy, ultraviolet irradiation, balneotherapy.
An integral part of physiotherapy is a health-sports complex. In the most severe cases performed surgery.
Nonsteroidal anti-inflammatory drugs
NSAID prescribed to eliminate pain and reduce inflammation in the affected joints. It is worth noting that analgesics, as a rule, are of no effect in the development of disease at later stages. The most effectiveness of drugs of this group is observed at the initial stage of the disease. Marked improvement occurs already at 2-3 days of treatment. To achieve stable effect, non-steroidal therapy should be systematic, that is to be carried out daily.
First, the doctor will prescribe drugs with less toxicity, which have the best absorption and quick release of the organism. Examples of such are: Diclofenac, Ibuprofen, Ketoprofen etc.
In that case, if rheumatoid arthritis runs in moderate or severe stage, a reception of stronger drugs, such as Piroxicam, Indomethacin, etc. in Addition to high efficiency, these tools affect the gastrointestinal tract, urinary system, heart. Excretion from the body is longer. Of the side symptoms include: stomach or intestinal bleeding, a violation of the process of urination, heart rate, etc.
Glucocorticoid drugs are more effective than NSAIDs. For this reason, they are administered at advanced stages of pathology development. Often, the medications in this group used concurrently with DMARDs.
Due to hormonal remedies to remove the inflammatory process and slow down the destruction of bone tissue. Although effective, may cause side symptoms:
- steroid diabetes;
- drug-induced Cushing’s syndrome;
- dysfunction of the gastrointestinal tract;
- bleeding in the stomach.
Commonly prescribed drugs from the group of corticosteroids are: Prednisolone, Betamethasone, Dexamethasone, etc.
These drugs are divided into funds 1 and 2 of the series. The first type of drugs prescribed most often, because they have better tolerability and greater efficacy. Through basic preparations 1 row, you can quickly suppress the erosive process in the joint.
Medicine 2 number needed to treat rheumatoid arthritis if medications 1 ineffective or poorly tolerated by the body.
To the base facilities include the following:
- Gold salts: Auranofin, Kenazol etc. in Addition to high efficiency in rheumatoid arthritis, these drugs be the cause of adverse symptoms: inflammation in the region of the mucous membranes of the mouth, allergic rash, disorders of functioning of the hematopoietic system and kidneys.
- Antimalarial drugs: Plaquage, Delagil, etc. due to slow action means must be taken for a long period, which is determined by the attending physician. Prescribed if other basic tools are ineffective.
- Sulfasalazine. Has antimicrobial activity, but less efficient than the above basic medications. In rare cases, there is a side symptoms: an allergic reaction on the skin, violation of the chair.
- Penicillamine. Has increased toxicity and in many cases causes complications.
There are many medicines, which focus on the treatment of RA, but have the greatest efficiency it is the new generation of drugs with which we can delay and further stop the progression of the disease. RA needs to be treated comprehensively, because the only way to achieve a speedy recovery.