Patient Education

Source: American College of Rheumatology

Anakinra (Kineret) is used to treat rheumatoid arthritis, neonatal-onset multisystem inflammatory disease (NOMID), and other autoimmune diseases. It is a “biologic” medicine. This means that it is man-made through genetic-engineering techniques and closely related to a protein that occurs naturally in the body. It helps decrease inflammation in arthritis. 

Source: American College of Rheumatology

Anti-tumor necrosis factor (anti-TNF) drugs are a class of drugs that are used worldwide to treat inflammatory conditions such as rheumatoid arthritis (RA), psoriatic arthritis, juvenile arthritis, inflammatory bowel disease (Crohn’s and ulcerative colitis), ankylosing spondylitis and psoriasis. These drugs are able to reduce inflammation and stop disease progression.

Source: American College of Rheumatology 

Azathioprine (Imuran) is a drug used to suppress the immune system and help treat symptoms like joint pain and swelling in certain autoimmune conditions. The most common diseases treated with Imuran are dermatomyositis, systemic lupus erythematosus (lupus), inflammatory bowel disease and vasculitis (inflammation of the blood vessels). Azathioprine can also be used to treat rheumatoid arthritis, but it is not used as commonly as other DMARDs like methotrexate.

Azathioprine (Imuran) can be used to treat many other inflammatory conditions like inflammatory muscle diseases (dermatomyositis and polymyositis), multiple sclerosis, myasthenia gravis, autoimmune hepatitis and inflammatory bowel disease. It is also used in combination with other medications to suppress the immune system after organ transplantation to prevent rejection of transplanted organs.

Azathioprine (Imuran) belongs to a class of medications called disease-modifying antirheumatic drugs (DMARDs) or immunosuppressants. This class of medicines can decrease joint damage and disability.

Source: American College of Rheumatology

Doctors use a variety of different medications to treat patients who have arthritis and other rheumatic diseases. Before any of these medicines can be prescribed, the federal Food and Drug Administration (FDA) has required strict testing to be sure they are safe and effective at treating a particular disease. Most of this testing and evaluation process is done through clinical trials.

At any given time, dozens of clinical trials conducted by licensed health care professionals are underway. These trials, lasting from a few weeks to many years, determine just how safe and effective new treatments may be. Participating in a clinical trial is completely voluntary, but it isn’t for everyone.

Source: American College of Rheumatology

Interested in Learning More About Clinical Trials at The Center for Rheumatology? Click here to learn more or call us at 518-489-4471. 

Cyclophosphamide (Cytoxan) belongs to a class of drugs known as alkylating agents, which have been used to treat some types of cancer. It is also considered a potent immunosuppressant—a medicine that can decrease the immune response.

Cyclophosphamide blocks the production of the deoxyribonucleic acid (DNA) in cells. This prevents cells from dividing, leading to cell death. Some of the cells affected by this medication are immune cells. These play a key role in autoimmune diseases such as rheumatoid arthritis, lupus, scleroderma or vasculitis.

Source: American College of Rheumatology

Cyclosporine (Neoral, Sandimmune, Gengraf) is a potent immunosuppressant drug that is considered a disease modifying anti-rheumatic drug (DMARD), because it not only decreases the pain and swelling of arthritis, but it may also prevent joint damage and reduce the risk of long term disability. It helps with pain and swelling and also slows the progression of arthritis over time. 

Source: American College of Rheumatology

Despite new and more effective treatments, many arthritis patients live with chronic pain and disability. Some people turn to herbal medicines and other "natural" remedies in the belief that they are effective and safer than conventional medications. Unfortunately, most information available to the public about these remedies in the media and on the internet is misleading. It is not based on the quality of scientific evidence required by the Food and Drug Administration (FDA) for approval of conventional medications. The purpose of this patient fact sheet is to provide you with objective, sound information so that you can make informed decisions, and to enable you to discuss with your physician the benefits and risks of natural remedies. 

Source: American College of Rheumatology

Hydroxychloroquine (Plaquenil) is considered a disease-modifying anti-rheumatic drug (DMARD), because it can decrease the pain and swelling of arthritis, and it may prevent joint damage and reduce the risk of long-term disability. 

Source: American College of Rheumatology

Joint injections or aspirations (taking fluid out of a joint) are performed in an office or hospital setting, often with a cold spray or other local anesthesia. After the skin surface is thoroughly cleaned, the joint is entered with a needle attached to a syringe. At this point, either joint fluid can be obtained (aspirated) and used for appropriate laboratory testing or medications can be injected into the joint space. This technique also applies to injections into a bursa or tendon sheath to treat bursitis and tendonitis, respectively.

Commonly injected joints include the knee, shoulder, ankle, elbow, wrist, base of the thumb and small joints of the hands and feet. Hip joint injection may require the aid of an ultrasound or X-ray called fluoroscopy for guidance. Some small joints may also be more easily aspirated or injected with aid of ultrasound.

Source: American College of Rheumatology

Joint replacement surgery is typically recommended to patients who have tried non-surgical treatment but still have joint pain. While this is an extremely effective surgical treatment, total joint replacement should be considered as the last, rather than the first, treatment option for patients with advanced arthritis of the hip, knee or shoulder.

Modern joint replacement surgery involves removal of the worn cartilage from both sides of the joint, followed by resurfacing of the joint with a metal and plastic replacement implant that looks and functions much like your normal joint. Although nearly every joint in the body can be replaced, most replacement surgeries involve the hip or knee.

Over the last 30 years, improved surgical techniques and new implant materials have been developed, making total joint replacement one of the most reliable and durable procedures in any area of medicine.

Source: American College of Rheumatology

Leflunomide (Arava) is a drug used approved to treat adult moderate to severe rheumatoid arthritis. It belongs to a class of medications called disease-modifying antirheumatic drugs (DMARDs). This class of medicines can decrease joint damage and disability caused by rheumatoid arthritis.

Leflunomide blocks the formation of deoxyribonucleic acid (also known as DNA), which is important for developing cells, such as those in the immune system. It suppresses your immune system to reduce inflammation that causes pain and swelling in rheumatoid arthritis. However, it is not completely clear how this medication works in rheumatoid arthritis.

Source: American College of Rheumatology

Methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo) is one of the most effective and commonly used medicines in the treatment of several forms of arthritis and other rheumatic conditions. It is known as a disease-modifying anti-rheumatic drug (DMARD), because it not only decreases the pain and swelling of arthritis, but it also can decrease damage to joints and long-term disability. 

Source: American College of Rheumatology

Minocycline (Minocin) is an antibiotic sometimes used to treat rheumatoid arthritis (RA). It is part of the group of antibiotics known as tetracyclines. Although RA is not thought to be caused by an infection, minocycline may improve the signs and symptoms of this disease. Minocycline also belongs to the class of drugs known as DMARDs (disease-modifying anti-rheumatic drugs). 

Source: American College of Rheumatology

Mycophenolate Mofetil (CellCept) and Mycophenolate Sodium (Myfortic) are immunosuppressant drugs (a class of drugs that reduce the strength of the body’s immune system) used in the treatment of several autoimmune diseases. Mycophenolate was used originally in the management of patients with organ transplants, but is now recommended in the treatment of some autoimmune diseases. 

Source: American College of Rheumatology

Millions of Americans have arthritis and other painful health problems affecting the musculoskeletal system: the joints, muscles and bones. A mainstay of treatment for these conditions for more than three decades has been a class of medications known as nonsteroidal anti-inflammatory drugs or NSAIDs.

Traditional NSAIDs include aspirin, ibuprofen (Advil, Motrin, etc.), naproxen (e.g., Aleve) and many other generic and brand name drugs. Celecoxib (Celebrex) belongs to a newer class of NSAIDs, which doctors call a “COX-2 inhibitor” or a “COX-2 selective” NSAID.

Source: American College of Rheumatology

Remicade is used to treat certain types of arthritis (rheumatoid arthritis, arthritis of the spine, psoriatic arthritis), certain bowel diseases (Crohn's disease, ulcerative colitis), and a certain severe skin disease (chronic plaque psoriasis). In these conditions, the body's defense system (immune system) attacks healthy tissues. Infliximab works by blocking the actions of a certain natural substance (tumor necrosis factor alpha) in the body. This helps to decrease swelling (inflammation) and weaken your immune system, thereby slowing or stopping the damage from the disease.

Rituximab (Rituxan and MabThera) is a drug used to treat rheumatoid arthritis that has not improved with other types of medications, as well as certain forms of vasculitis. It works by turning off a part of the immune system that is not working properly in autoimmune diseases. 

Source: American College of Rheumatology

SIMPONI ARIA^® (golimumab) is a prescription medicine. SIMPONI ARIA^® can lower your ability to fight infections. There are reports of serious infections caused by bacteria, fungi, or viruses that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor will test you for TB before starting SIMPONI ARIA^® and will closely monitor you for signs of TB during treatment. Tell your doctor if you have been in close contact with people with TB. Tell your doctor if you have been in a region (such as the Ohio and Mississippi River Valleys and the Southwest) where certain fungal infections like histoplasmosis or coccidioidomycosis are common.

STELARA^® is a prescription medicine approved to treat adults 18 years and older with moderate or severe plaque psoriasis that involves large areas or many areas of their body, who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills).

Sulfasalazine (Azulfidine) belongs to a class of drugs called sulfa drugs and is used to treat pain and swelling in arthritis. It is a combination of salicylate (the main ingredient in aspirin) and a sulfa antibiotic. Sulfasalazine is also known as a disease modifying antirheumatic drug (DMARD), because it not only decreases the pain and swelling of arthritis, but also may prevent damage to joints. In addition, it may reduce the risk of long term loss of function.

Source: American College of Rheumatology

Tocilizumab (Actemra) is a biologic drug approved to treat rheumatoid arthritis (RA) in adults and polyarticular juvenile rheumatoid arthritis (PJIA) and the systemic form of juvenile idiopathic arthritis (SJIA) in children. Biologic drugs are man-made through genetic engineering techniques and closely related to a protein that occurs naturally in the body. They are used to suppress the immune system in autoimmune disease.

Tocilizumab is used to treat inflammation. There are many pathways that can be blocked to stop the inflammation from harming the joints. Tocilizumab blocks the interleukin (IL)-6 receptor to stop the production of inflammation in the body. The medicine is injected once every 1-2 weeks or infused into your body through an IV each month.

Source: American College of Rheumatology

Tofacitinib citrate (Xeljanz®) is an oral, small molecule drug used to treat adults with moderate-to-severe, active rheumatoid arthritis who have not responded well to being treated with methotrexate. Methotrexate is a disease-modifying antirheumatic drug (DMARD) used to treat rheumatoid arthritis (RA).

Tofacitinib acts to block the body’s production of enzymes called Janus kinases (JAKs). JAKs play a role in joint inflammation in RA, which can cause pain, swelling and stiffness. If left untreated, RA inflammation could lead to joint erosions, and organ and tissue damage. It may be used alone or in combination with methotrexate or other DMARDs.

Tofacitinib is currently being studied for use in treating other autoimmune diseases, including psoriasis, psoriatic arthritis, ulcerative colitis, Crohn’s disease and ankylosing spondylitis.

Source: American College of Rheumatology