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Arthritis
(Page 3)
Prescription medicines include:
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Cyclo-oxygenase-2 (COX-2) inhibitors
-- These drugs block an
inflammation-promoting enzyme called COX-2. This class of drugs was initially
believed to work as well as traditional NSAIDs, but with fewer stomach problems.
However, numerous reports of heart attacks and stroke have prompted the FDA to
re-evaluate the risks and benefits of the COX-2s. Rofecoxib (Vioxx) and valdecoxib
(Bextra) have been withdrawn from the U.S. market following reports of heart attacks
in patients taking the drugs. Celecoxib (Celebrex) is still available, but labeled
with strong warnings and a recommendation that it be prescribed at the lowest
possible dose for the shortest duration possible. Talk to your doctor about whether
COX-2s are right for you.
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Corticosteroids ("steroids")
-- these are medications that suppress the
immune system and symptoms of inflammation. They are commonly used in severe cases
of osteoarthritis, and they can be given orally or by injection. Steroids are used
to treat autoimmune forms of arthritis but should be avoided in infectious
arthritis. Steroids have multiple side effects, including upset stomach and
gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and
increased infections. The risks are most pronounced when steroids are taken for long
periods of time or at high doses. Close supervision by a physician is essential.
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Disease-modifying anti-rheumatic drugs
-- these have been used
traditionally to treat rheumatoid arthritis and other autoimmune causes of
arthritis. These drugs include gold salts, penicillamine, sulfasalazine, and
hydroxychloroquine. More recently, methotrexate has been shown to slow the
progression of rheumatoid arthritis and improve your quality of life. Methotrexate
itself can be highly toxic and requires frequent blood tests for patients on the
medication.
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Anti-biologics
-- these are the most recent breakthrough for the
treatment of rheumatoid arthritis. Such medications, including etanercept (Enbrel),
infliximab (Remicade) and adalimumab (Humira), are administered by injection and can
dramatically improve your quality of life.
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Immunosuppressants --
these drugs, like azathioprine or
cyclophosphamide, are used for serious cases of rheumatoid arthritis when other
medications have failed.
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