The doctor refers the patient for examinations and prescribes medication using various means. There are different drugs for therapy, some are used in oncology. If drug treatment is not effective, surgery is performed to replace the damaged joint with a high-tech prosthesis.
Rheumatoid arthritis is characterized by an infectious and inflammatory process. As a result of inflammation, connective tissue undergoes irreversible changes. To stop the inflammatory process and preserve cartilage tissue, doctors prescribe non-steroidal anti-inflammatory drugs. They are less toxic and are excreted from the body, reducing the risk of side effects.
Movalis is used in drug therapy. Rheumatoid arthritis, osteoporosis and other pathologies are treated with the use of this medicine. Movalis is classified as a non-hormonal, anti-inflammatory substance used as a drug treatment to eliminate inflammatory processes in the joint area.
In the first days after starting treatment, intramuscular injections are used. After 2-3 days, the injections are replaced. Continue to take Movalis tablets. Movalis in ampoules is not suitable for intravenous administration. Use with caution for problems with the gastrointestinal tract. Movalis is the cause of internal bleeding of the stomach in cases of ulcerative damage.
These are hormonal drugs that do not lose ground. Hormones are prescribed by rheumatologists for drug therapy along with other methods that are used in the treatment of rheumatoid arthritis. Among them are:
Basic therapy includes cytotoxic drugs used to treat rheumatoid arthritis and antitumor therapy for cancer patients. In rheumatology, drugs of this class are used in lower dosages. With proper use of the products, a stable period of remission is observed; they have a beneficial effect on the tissues of damaged joints. Side effects occurred in 15-20 percent of cases when taking these inhibitors. A positive effect occurred in 70 percent of patients who underwent such treatment.
It makes sense to weigh the pros and cons; if menopausal arthritis is not treated, it will develop into rheumatoid arthritis. This means that the pathological changes have taken a chronic form and require long-term and labor-intensive treatment.
These drugs are considered an innovation in rheumatology and have recently been used as drugs that can activate a specific protein. The products act quickly and effectively. Aimed at eliminating the inflammatory process. This happens due to the stimulation of the body’s immune system, the formation of a specific response, and the transport of leukocytes to the areas of the affected tissue is observed.
This therapy is useful if the patient has autoimmune diseases that have caused the development of rheumatoid arthritis. Biological treatment includes:
The greatest effect in eliminating pathology is achieved with complex treatment. That is, combining the use of medications and physical therapy. It is necessary to influence cartilage tissue using all methods in order to speed up the healing process. A good effect is achieved by performing exercise therapy developed by a doctor. You can do exercise therapy at home.
Joint damage caused by rheumatoid arthritis can cause disability. Doctors are familiar with the symptoms of the disease, but the disease makes itself felt when it is too late to start treatment. It is impossible to get rid of the signs of the disease, but you can alleviate the condition and slow down the progression of rheumatoid arthritis.
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The hormones used depend on the stage of connective tissue damage. If the therapy does not have an effect within a few weeks, the doctor will change the medicine to another. Non-steroidal drugs include:
These drugs are classified as low-toxic and are used as a systemic treatment, which takes place together with the basic one. For rheumatoid arthritis, heavy substances that have anti-inflammatory and analgesic effects are also used:
Such medications are prescribed less frequently, they are non-hormonal therapy, and the risk of side effects when taken is high.
Movalis is prescribed for adults; use during pregnancy or lactation is not recommended.
Movalis is good in the treatment of rheumatoid arthritis and other diseases. This medicine, in addition to its inflammatory effect, is an anesthetic and antipyretic. Positive dynamics are visible a few days after the start of treatment. Movalis has a beneficial effect on cartilage tissue, which was confirmed by clinical trials of the drug on rats and mice.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
It is difficult to say how hormones will affect the body. It is possible that the side effects will outweigh the benefits of taking these medications. Hormonal therapy has many contraindications. Corticosteroids are steroid drugs, which means they entail a lot of changes in the state of the body. But steroid medications can quickly relieve pain and improve the patient’s condition and well-being.
Basic therapy for rheumatoid arthritis uses slow-acting medications. This kind of pill affects the cause of the disease, the so-called basis. Taking such drugs, a person feels the onset of remission, that is, the course of the disease slows down, there is no progress. Such drugs stop the destruction of joint cartilage tissue, but do not have an anti-inflammatory effect.
In addition to corticosteroids, when we are not talking about rheumatoid arthritis, therapy using estrogens and gestagens is used. This pathology develops in women and is associated with menopause. The disease is characterized by thinning of cartilage tissue, impaired motor activity and pain during habitual movements. The disease is associated with instability of a woman’s hormonal levels and occurs against the background of the usual changes during menopause.
Treatment of the pathology lasts no more than a year using the following means:
A versatile approach to methods of eliminating pathology will relieve excruciating pain and return the limbs to their former mobility in a short time. It is better to entrust your health to a doctor; it is not recommended to correct the situation on your own.
Numerous types of medications for rheumatoid arthritis can only be taken after consultation with a specialist. Under no circumstances should you experiment and diagnose yourself! Drugs for rheumatoid arthritis are quite strong, however, despite this, it is impossible to completely cure rheumatoid arthritis.
Rheumatoid arthritis is a systemic connective tissue disease that is chronic in nature. In rheumatoid arthritis, small joints are most affected. The disease entails deformation of the joints and disruption of their function. It is most often observed in people over 35 years of age. Currently, cases of rheumatoid arthritis are also found in younger people.
Doctors prescribe treatment measures only after a complete examination and confirmation of the diagnosis. Thanks to the combined use of medications, long-term remission can be achieved. Goals of treatment:
To provide adequate therapy, the following subgroups of medications are used:
Nonsteroidal anti-inflammatory drugs are used to relieve pain and reduce inflammation in the joint. If a person has a difficult course of this disease, then taking this subgroup of drugs will not have a significant effect. NSAIDs are not able to eliminate the destructive effects of rheumatoid arthritis.
Medicines are taken daily, and the dosage must be strictly observed. The improvement is noticeable within a few days of starting to take the medicine. There are several rules for taking NSAIDs for rheumatoid arthritis:
They rarely cause side effects from the stomach, intestines, urinary system, and heart. It takes much longer for drugs to be eliminated from the body.
Basic drugs are the main method of treatment for rheumatoid arthritis. Scientists believe that they significantly influence the cause of the disease.
Thanks to basic therapy, long-term remission can be achieved and the destructive effect on joints can be prevented. But these medications do not provide the anti-inflammatory effect that is so necessary for rheumatoid arthritis.
The following subgroups of medications are considered the most used:
Cytostatics are drugs that are used to treat rheumatoid arthritis and various cancers. Cytostatics are used in small dosages (unlike in the treatment of oncology). Side effects are very rare. After taking cytostatics, the result is observed after 2-4 weeks.
Medicines in this group of drugs:
With the help of these funds, doctors are effectively fighting tropical fever in other countries. In the 20th century, scientists discovered that antimalarial drugs also have a fairly good effect in the treatment of rheumatoid arthritis. But the positive effect of taking medications is not observed quickly. The first positive changes can be noticed only 6 months after starting to use the medicine. The drugs are well tolerated by patients.
Antimalarial medications used for rheumatoid arthritis include:
Medicines of the sulfonamide subgroup have an antimicrobial effect and are highly effective in rheumatoid arthritis. The drugs are strong and not inferior to cytostatics.
They are well tolerated and have virtually no side effects. There is one drawback - taking sulfonamides is long-term, at least 3 months.
The drug has a synonym - cuprenil. It is prescribed if there is no effect from taking cytostatics for rheumatoid arthritis. Cuprenil is very toxic and often causes side effects.
Biological response modifiers are a biological group of drugs. They have been developed recently and are considered the newest drugs. They prevent the process of inflammation and reduce it. The main effect of these drugs is the destruction of tumor necrosis factors (this is a special protein that plays a leading role in the development of inflammation).
The effectiveness of the intake is high. A positive effect in the treatment of rheumatoid arthritis is observed after 2-4 weeks.
Usually the drugs are used in combination with:
Combinations of two drugs belonging to this group at once are unacceptable. You can use only one MBO drug, without combining it with drugs from other groups.
Medicines for rheumatoid arthritis are administered intramuscularly. The most commonly used drugs are:
Modifiers significantly reduce the body's immune defense. Experts recommend these medications only for dangerous forms of rheumatoid arthritis.
Glucocorticoid drugs are often used to treat rheumatoid arthritis. They provide a powerful anti-inflammatory effect. The most common drugs in this group are:
They are good at eliminating the symptoms of rheumatoid arthritis. The main action of glucocorticoids:
Medicines are used in three ways: through intramuscular injection, the use of tablet forms, and injection into the affected joints.
Glucocorticoids are quite strong, so they are recommended in severe stages of rheumatoid arthritis. Drugs in this group also have disadvantages:
Glucocorticoids for rheumatoid arthritis are prescribed in very small dosages for a short period. It is not recommended to take them for a long time.
It is the analgesic effect that improves the condition of a sick person with rheumatoid arthritis. But not all drugs can have two effects at once - pain relief and reduction of inflammation.
Non-narcotic analgesics include:
Sometimes doctors prescribe tramadol, although it is classified as a narcotic drug. It should not be taken for a long period. Before prescribing it, you need to familiarize yourself with all its possible side effects and contraindications.
Aurotherapy, or taking medications containing gold, has been used in medicine for about 100 years. These drugs were first used in the 20th century. Gold preparations are:
Previously, drugs of this group were actively used in the treatment of rheumatoid arthritis. But recently a drug called methotrexate was introduced, which was put in first place in the treatment of rheumatoid arthritis. Pros of methotrexate:
If the patient is not suitable for methotrexate, then doctors recommend gold medications.
Gold-based medicines are good for people with rheumatoid arthritis in the early stages of development. But such drugs have proven themselves well even at a progressive stage, severe pain in the joint. Gold preparations are mainly prescribed for seropositive rheumatoid arthritis.
Gold-based medicines are good at stopping the progression of the disease, thereby preventing the destruction of cartilage in the joints.
A positive effect is observed after 2-3 months of their use. The most significant effect will appear only after 6-12 months. If no positive dynamics are observed within 4 months, then gold preparations must be replaced with other medications.
Side effects are:
Many medications are free if the patient has a disability.
Additional points in the treatment of rheumatoid arthritis are:
If you have rheumatoid arthritis, you need to reduce your intake of these foods. It is necessary to eat as much seafood, fish, buckwheat, fresh vegetables and fruits as possible. Food should be boiled or stewed. Nutrition for rheumatoid arthritis is done in fractions and often.
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Treatment for rheumatoid arthritis can take many years. It is important to never take breaks or skip taking medications or performing prescribed procedures.
Objectives of complex treatment of rheumatoid arthritis:
The basic therapy method is the basis for the treatment of rheumatoid arthritis with other drugs. The action of medications included in this group is aimed at suppressing the source of pathology, the inadequate response of the immune system. In the vast majority of cases, the following drugs are prescribed for basic treatment.
Examples of drugs: methotrexate, cyclophosphamide, azathioprine, Remicade, leflunomide.
Main action: suppress the activity of cells of the immune system.
(if the table is not completely visible, scroll to the right)
Examples of medications: delagil (rezoquine, hingamine), plaquentil (hydroxychloroquine).
Main effect: reduce the severity of symptoms and slow down the progression of the disease.
Examples of drugs: salazopyridazine, sulfasalazine.
Examples of drugs: aurothiomalate, auronofin.
Examples of medications: Embrel, Orence, Rituxan, Remicade, Kineret, Humira.
Main action: these are genetically modified drugs that modify the reaction of enzymes of the immune system (biological reaction).
It is most effective to treat rheumatoid arthritis by prescribing several basic therapy drugs at the same time, since they enhance the effect of each other, accelerating the results. For example, the following treatment regimens showed excellent results:
Nonsteroidal anti-inflammatory drugs are an emergency aid for relieving pain and relieving joint inflammation. It is necessary to treat the disease with NSAIDs under the strict supervision of a rheumatologist. It is necessary to adjust the daily dosage of the drug after the onset of the effect of the basic therapy drugs.
The disease itself cannot be treated with non-steroidal drugs. But they effectively reduce unpleasant symptoms, thus significantly improving a person’s quality of life.
Examples of medications: piroxicam, butadione, indomethacin, ketanov (ketoprofen), ibuprofen (nurofen).
Effect of the drugs: relieve pain and reduce inflammatory processes in the tissues of the joints and periarticular bursae.
Corticosteroids are a lifesaver in difficult situations, when the manifestations of rheumatoid arthritis are so pronounced that they do not allow a person to make a single movement without pain. They can treat pain and inflammation with high efficiency. They are prescribed with extreme caution, since corticosteroids are stress hormones. When administered orally, they can cause a strong blow to all systems and organs, therefore, for the safe treatment of rheumatoid arthritis, local dosage forms are used.
Corticosteroids, injected directly into the tissue of the affected joint, instantly relieve pain, stop the inflammatory process and contribute to a general improvement in the patient's condition. But the therapeutic effect lasts no more than a month, and when the drug is discontinued, all negative manifestations return, in most cases with a vengeance.
Examples of drugs: prednisolone, triamcinolone, dexamethasone, methylprednisolone, betamethasone.
Forced movements that force painful joints to strain have a detrimental effect on the healing process. But special exercises are needed that help the surviving working tissues adapt to new operating conditions and partially restore the function of the affected tissues. Such exercises make rheumatoid arthritis therapy effective and progressive.
Physical therapy exercises should not overload the joints and cause additional damage to tissues. Their goal is to improve tissue nutrition and restore motor function of the joint.
Under no circumstances should physical therapy exercises be carried out in the acute period of any infectious disease, in case of respiratory failure and heart failure of degrees 2 and 3.
Physical therapy exercises in the treatment regimen for rheumatoid arthritis are an effective means of reducing morning recovery of movements, preserving the remaining functional abilities of the joints and partially restoring lost ones.
The technique of performing exercises for the treatment of rheumatoid arthritis is chosen strictly individually. It is necessary to take into account the patient's condition, the capabilities of the affected joints and the risk of unintentional injury.
Treatment for rheumatoid arthritis is carried out using physiotherapy procedures. They reduce the activity of inflammatory processes, relieve pain, and promote the restoration of damaged tissues. Physiotherapy is prescribed only after pain has been relieved and inflammation has subsided.
Natural recipes in the treatment of rheumatoid arthritis are effective and safe. Most rheumatologists recommend that decoctions, infusions and ointments made from medicinal plants be included in the treatment regimen.
The first place in the treatment of rheumatoid arthritis at home is taken by ordinary potatoes. The composition of this popular vegetable helps to increase the effectiveness of the main treatment and helps the immune system return to normal functioning.
Preparation: Grate medium-sized potatoes. Pour the resulting mass with a glass of regular kefir.
Preparation: Grind a handful of buttercup flowers (25–30 pieces) in a mortar until the juice appears.
Preparation: 2 cups of juice squeezed from black radish, 2/3 cup of honey and half a glass of vodka, mix thoroughly until smooth.
Before using traditional recipes, be sure to consult your doctor. Knowing all the nuances of the course of your illness, a specialist will help you choose the most effective remedy and advise the most effective way to use it.
Rheumatoid arthritis is a disease that does not choose a person’s age. It can occur in both a child and a pensioner. Only careful attention to your health, timely contact with a rheumatologist, scrupulous implementation of all prescriptions and continuous treatment can get rid of negative manifestations, stop the processes of tissue destruction and make treatment for rheumatoid arthritis as effective as possible.
Author: Svetlana Kant
Rheumatoid arthritis is not easy to cure. As a matter of fact, it is possible to achieve a complete cure of this disease in very rare cases, since most of the drugs used in our time have only a symptomatic effect. Such drugs eliminate the manifestations of the disease (pain, inflammation of the joints), but do not affect its causes.
For example, the same “classical” non-steroidal anti-inflammatory drugs are used as first aid for joint pain. Although NSAIDs can significantly make a patient’s life easier, it is impossible to cure rheumatoid arthritis with non-steroidal anti-inflammatory drugs.
In addition to NSAIDs, to provide quick help to those suffering from rheumatoid arthritis, many doctors, especially foreign ones, without hesitation, prescribe anti-inflammatory corticosteroid hormones (prednisolone, methylpred, hydrocortisone, etc.).
The use of such hormones almost always leads to a clear improvement in the patient's condition. Joint pain immediately decreases, morning stiffness, weakness and chills disappear. Naturally, for such a quick result, any patient is willing to pay money, and considerable money at that, which is the main incentive of Western medicine.
Unfortunately, patients taking corticosteroid hormones are often unaware that they are receiving a fairly powerful blow to all body systems. After all, corticosteroids are stress hormones. And as long as the patient takes such hormones, he feels good. But as soon as they are canceled or the dose is reduced, the disease will literally attack the person with double or triple force.
You may ask: maybe then it’s worth not canceling hormones, but continuing to take them constantly? No, this is not an option. The fact that over time corticosteroids no longer relieve pain as well as at the beginning of their use is not so bad. The worst thing is that the side effects from their use gradually “accumulate”. And there are many such side effects - corticosteroids contribute to the development of diabetes mellitus, increased blood pressure, and increased body weight. In addition, such hormones reduce immunity, provoke the appearance of stomach ulcers and lead to edema.
As a result, sooner or later there comes a time when the patient is forced to stop taking hormones. But this is not so easy to do. The body can no longer cope without the supply of corticosteroids from the outside, and a rapid reduction in their dose leads to a sharp deterioration in well-being and exacerbation of joint pain. Therefore, the doses of hormones consumed must be reduced gradually, and their final withdrawal is delayed for several months. But even with a gradual reduction in the dose of hormones, the process is rarely painless for the body.
So, before prescribing hormone therapy to a patient, the doctor must weigh three times whether such treatment will cause more harm or benefit.
But if neither hormonal nor steroidal anti-inflammatory drugs for rheumatoid arthritis can give a long-term positive effect, then how should the patient be treated?
The main treatment for rheumatoid arthritis are the so-called basic drugs. They influence the soil that gives rise to the disease, its “base”. These remedies are used with an eye to the future, counting on their ability to influence the causes of the disease and interrupt its development. But you need to keep in mind that, unlike hormones and NSAIDs, basic drugs do not provide an immediate positive effect, that is, they do not eliminate the symptoms of the disease in the first days and weeks of using the drugs. As a rule, they are able to act no earlier than in a month - this is a significant drawback of basic drugs.
Currently, five groups of drugs are most often used as basic therapy: gold salts, antimalarial drugs, the antimicrobial drug sulfasalazine, immunosuppressive drugs and penicillamine.
Gold preparations (krizanol, auranofin) are the most popular group of basic drugs among rheumatologists for the treatment of rheumatoid arthritis. Gold preparations bring significant relief to approximately 70% of patients, but a third of patients may experience complications during treatment: allergic skin rash, inflammation of the oral mucosa, suppression of hematopoiesis and deterioration in kidney function.
Such phenomena most often make themselves felt in the first months of treatment. Therefore, in order not to miss the so-called “golden” complications, the patient’s blood and urine should be examined at least once a month for six months and the condition of his skin and oral mucosa should be constantly monitored. At the first sign of complications, treatment with gold preparations should be stopped. And we must remember that gold preparations are contraindicated for patients suffering from diabetes, kidney disease and blood diseases.
The first positive changes after starting treatment can be seen within a month, and the best results should be expected after six months to a year. It is believed that it is achieved after the patient receives a dose of medicines containing a total of one gram of pure gold. In previous years, treatment was stopped when this equivalent was reached. However, in some patients, after some time, the disease worsened again, and repeated administration of gold preparations no longer brought relief. Alas, only one course of “golden” treatment is effective. Repeating it after a break does not give the patient anything. That is why, in our time, the initial use of “golden drugs” is continued indefinitely, literally for years - unless, of course, complications occur.
D-penicillamine (cuprenil) is usually prescribed in cases where gold therapy does not bring relief to the patient or when gold preparations have to be discontinued due to adverse reactions. However, D-penicillamine, which is not inferior in effectiveness to gold preparations, is no less toxic and causes complications much more often. They usually appear in the first two months of using the drug and, fortunately, quickly disappear after discontinuation of the drug.
Complications may include skin rash, disorders of the stomach and intestines, inflammation of the kidneys, jaundice resulting from stagnation of bile, as well as changes in blood composition. Therefore, when using D-penicillamine as a “basic” agent, the patient must initially undergo a blood test once a week and a urine test once every two weeks. It is important to consider that D-penicillamine is contraindicated in pregnant women and those patients who have blood and kidney diseases.
You may ask: if D-penicillamine is such a “heavy” drug, why do doctors continue to prescribe it? The fact is that sometimes other basic drugs turn out to be ineffective or they have to be canceled due to side effects, and the rheumatologist simply has no choice. You cannot leave a patient without help when the doctor has a strong drug in his arsenal, even if the risk of side effects is quite high. In the end, when the first signs of complications caused by taking D-penicillamine appear, you can stop this drug and quickly eliminate the unpleasant phenomena. In addition, there are cases when D-penicillamine should be prescribed first, for example, if arthritis has caused a rheumatoid complication in the lungs or heart.
If the drug is well tolerated and there are no contraindications, treatment with D-penicillamine is continued for up to 3-5 years. Then you can take a break for 1-2 years and continue treatment with D-penicillamine again for another 3-4 years. Fortunately, unlike gold preparations, this medicine does not lose its effectiveness even after a break in treatment. Although it must be borne in mind that 10% of patients taking D-penicillamine and experiencing an improvement in their condition may then experience an exacerbation of the disease - the so-called phenomenon of “secondary ineffectiveness” appears.
Sulfasalasia (salazopyridazine) is an antimicrobial drug, somewhat less effective than gold drugs, but successfully competes with D-penicillamine, especially since it is much better tolerated than these drugs. Side effects from sulfasalazine develop in only 10-20% of patients, and these complications are never severe. They manifest themselves mainly as stool disorders and skin rashes.
The only thing that detracts from the advantages of the drug is the slow development of its therapeutic effect. Improvement during treatment with sulfasalazine is usually observed only after three months of therapy, and the “peak form” is reached after six months, after which treatment with sulfasalazine is completed.
The antimalarial drugs delagil and plaquenil were once used by infectious disease specialists to treat dengue fever (malaria). However, in the 20th century, rheumatologists also paid attention to them. They noticed that with very long-term use, delagil and plaquenil can influence the activity of the rheumatoid process.
Although the effectiveness of these drugs is not very high and they act slowly, we are forced to use them to this day, since we feel a relative shortage of anti-rheumatoid drugs. After all, sometimes situations arise when other basic remedies are tried unsuccessfully and canceled due to ineffectiveness or severe side effects. Then it is necessary to use delagil and plaquenil, which are weak but still have a specific anti-arthritic effect.
Well, besides, one cannot help but mention the force of inertia, which often prompts rheumatologists even today to recommend antimalarial drugs. Apparently, the outdated and once established rule is working, which prescribed that patients with rheumatoid arthritis should be prescribed Delagil or Plaquenil first, then gold or D-lenicillamine, and, inevitably, hormones.
The concept is clearly outdated, and was controversial before. From my point of view, with actively progressing rheumatoid arthritis, waiting for Delagil or Plaquenil to work (and this is a period of six to nine months), without even trying to use stronger basic drugs, is simply criminal. When it is known that gold salts or immunosuppressants will take effect within a month or two, it is, to put it mildly, absurd to condemn the patient to long suffering while waiting for the therapeutic effect of antimalarials. Nevertheless, some rheumatologists are still guided by outdated textbooks and primarily prescribe delagil or plaquenil to patients.
According to the majority of leading modern rheumatologists, basic therapy should begin with antimalarial drugs only in cases where rheumatoid arthritis is very mild and there is no need for stronger drugs that have a better therapeutic effect, but can provoke numerous side effects. In contrast, antimalarial drugs are practically harmless. Only in rare cases, with long-term use, delagil or plaquenil can cause the development of eye pathology and a decrease in visual acuity, and even less often provoke nausea, tinnitus, headache and skin rash. However, all of the above phenomena, except eye pathology, quickly disappear after discontinuation of the medication. And in order not to “miss” eye problems, it is enough to follow certain precautions.
So, once every three months, a patient who has been taking Delagil or Plaquenil for a long time should be seen by an ophthalmologist. This doctor measures the patient's vision and makes a determination about the possibility of further use of antimalarial drugs. If the patient's lateral vision decreases, delagil or plaquenil should be discontinued. If the breadth of vision does not change, treatment continues.
Antimalarial drugs have been taken for several years.
Cytostatic drugs, or so-called immunosuppressants (methotrexant, azathioprine, cyclophosphamide, chlorobutin, leukeran), were borrowed by rheumatologists from oncologists. Cytostatics are used in oncology to suppress the immune system and inhibit cell division, including cancer cells. Moreover, these drugs are prescribed to cancer patients in huge doses, which leads to a large number of complications. In this regard, both doctors and patients are very wary of the use of cytostatics, fearing severe side effects.
However, when it comes to the use of these drugs in the treatment of arthritis, the danger is clearly exaggerated, because in arthrology, cytostatics are used in significantly lower doses than in oncology (doses are approximately 3-10 times less!). Such small amounts of immunosuppressive drugs rarely cause side effects, but the therapeutic effect is often significant. The use of cytostatics helps at least 70% of patients, and the greatest benefit comes from the drugs to those suffering from a rapidly progressing severe form of rheumatoid arthritis.
Side effects are possible in 15-20% of patients and are rarely severe. Most often these are allergic rashes, a sensation of “goosebumps” on the skin, stool upset and moderate urination problems. All these manifestations usually disappear immediately after stopping the drugs.
However, to avoid complications, it is necessary to monitor the condition of the patient taking immunosuppressants. Once a month you need to examine your urine, and most importantly, do a blood test taken from your finger once every two weeks in order to notice in time a possible inhibition of hematopoiesis.
If everything is in order and the patient easily tolerates cytostatic therapy, you can expect a clear improvement in well-being within 2-4 weeks after the start of treatment.
So, there are five groups of basic drugs to combat rheumatoid arthritis. We have just reviewed their advantages and disadvantages. But which medicine is preferable in each specific case? Only your treating rheumatologist can answer this question. Only he knows (in any case, he should know) when and what basic remedy should be used in your case. Although the disadvantage of basic drugs is precisely that it is difficult to guess with one hundred percent probability whether the medicine will have a therapeutic effect. Only after a month or two of using the drug can you get an answer to this question. And if the drug does not work, then you have to change it and again wait a month or two for the result.
Thus, it sometimes takes 4-6 months to select basic therapy. The period is, of course, extremely long for a sick person, but we have to accept it - we have no other choice. You can, however, try to improve the patient's condition for this period by means of local effects on the joints. For this purpose, dimexide applications, laser therapy, cryotherapy and intra-articular injections of corticosteroid hormones are used.
Applications with dimexide are applied to the most inflamed and painful joints. In rheumatoid patients, improvement is observed after 6-7 days of therapy with dimexide and becomes even more noticeable after a two-week series of applications. In total, the positive effect is expressed in 80% of patients.
Intra-articular administration of corticosteroid hormones (kenalog, hydrocortisone, dydrospan, flosterone) helps the patient survive a period of particularly acute inflammation of individual joints. When administered intra-articularly, hormones quite quickly relieve pain and reduce inflammation of the joint, but usually the therapeutic effect lasts only two to three weeks. Then the inflammation begins to gradually increase again.
As with arthrosis, it is advisable to carry out no more than two or three injections of corticosteroids into each joint. In addition, you need to remember that you cannot get too carried away with hormone injections and do them too often - otherwise the hormones will begin to have a negative effect on the entire body. Therefore, the intervals between such procedures should be at least 7-10 days. But, of course, intra-articular injections can significantly make life easier for the patient, even in particularly severe cases of rheumatoid arthritis.
Diseases of the lower extremities, more details...
It is difficult to identify the cause of rheumatoid arthritis. Most doctors believe that the disease is caused by a person’s genetic predisposition.
In this case, the person has several relatives with a similar diagnosis. This situation significantly increases the chances of developing arthritis. At the same time, many people without negative heredity are faced with this disease.
The development of rheumatoid arthritis can begin as a result of disruption of the human immune system. For unknown reasons, immune cells can no longer resist the influence of infections and viruses.
In addition, with this type of arthritis, the immune system begins to perceive the body's cells as biological foreign and reject them.
These disturbances in the functioning of the body cause a lot of concern. Many viruses can provoke the onset of a pathological process. If viruses passively affect the body, then the immune system fights not against viral cells, but against healthy cells of the body.
In more than half of the cases, the cause of the violation is an acute respiratory disease, such as influenza or tonsillitis. Rheumatoid arthritis can develop against the background of viruses remaining in the body after an infection.
Rheumatoid arthritis can develop against the background of any other form of arthritis. An infectious or reactive type of disease can
cannot transform into the rheumatoid form if left untreated.
Among other things, rheumatoid arthritis occurs due to a serious nervous breakdown or prolonged depression in the patient. Constant depression and negative emotions result in the rapid development of the disease.
Arthritis caused by the above reasons occurs 4 times more often in women than in men. The provocateur of the disease is also irritation, which has been restrained and suppressed for a long time. This condition is recognized as the cause of arthritis in 7-10% of cases.
Regardless of which factor played a decisive role in the onset of the disease, it must be treated promptly and competently. Basic therapy is used, including the following stages:
It is customary to distinguish two main branches of therapy, depending on the cause of the disease. In the first case, it is important to block the deforming processes of the human immune system. In the second case, it is necessary to stop the inflammation that provokes the worsening of rheumatoid arthritis.
Since aggressive reactions of the immune system to the body’s own cells are provoked by a specific factor, it must be identified and eliminated first.
The medications prescribed by the doctor must act on the old virus that is still in the human body.
Basic drugs are used to eliminate the underlying cause of arthritis. The choice of medications for the patient is determined by the biological causes that caused rheumatoid arthritis.
Sometimes conventional anti-inflammatory drugs are used; they are enough to successfully fight respiratory or sore throat viruses.
But when the disease develops on the basis of another form of arthritis, treatment is usually delayed. In such cases, it is necessary to begin treatment by eradicating the original cause of the first disease.
Anti-inflammatory drugs are designed to:
This treatment can permanently relieve the painful symptoms of arthritis. But you need to know that these drugs do not affect deformation processes in cartilage, joints and tissues.
As a rule, the attending physician prescribes glucocorticosteroid medications to patients with this type of arthritis. New drugs are used to reduce pain and inflammation.
If you use these drugs in small doses for a long time, the patient will feel much better. Treatment of this joint disease is not complete without unconventional methods, for example, herbal treatment for rheumatoid arthritis is provided as a complex therapy.
Additional treatment involves the following procedures:
For rheumatoid arthritis, treatment should pursue 3 main goals:
If there is a sharp exacerbation or progression of the condition, then the work to eliminate the pathological processes comes to the fore, and only then the side symptoms are eliminated.
If a person seeks treatment in time and the disease is still at an early stage, then the deformation process in the joints can be stopped quite quickly. As is known, rheumatoid arthritis responds well to drug therapy at the initial stage.
Modern treatment makes it possible to completely cure up to 70% of arthritis patients. The remaining 30% show a noticeable decrease in destructive and inflammatory processes.
When rheumatoid arthritis is not treated within the first two years, the likelihood of a complete cure is quite low. The main goal in this case: some restoration of the patient’s vital functions, that is, the cessation of tissue deformation and their partial recovery.
Surgery helps relieve painful areas of the joint and reduces the risk of further development of arthritis.
Complex basic therapy is the basis of the fight against arthritis. If the patient is not allergic to these drugs and their components, then several courses of therapy are used.
It is important to prescribe treatment with basic drugs as quickly as possible. The sooner a person consults a doctor with complaints about primary symptoms, the higher the likelihood of a timely correct diagnosis.
If the patient has no complications, he is prescribed a course of basic treatment, which within a year will be able to improve the person’s condition and will prevent arthritis from progressing to the second stage.
Basic drugs have a certain set of characteristics. They can partially or completely prevent the negative effects of arthritis on healthy cells in the body.
In addition, these products have a positive effect on:
Basic agents delay the deformation processes of the affected tissues. This treatment does not completely stop the processes, but they are blocked for a long period.
Currently, a large number of basic agents are available, which have different mechanisms of action on the disease. All such drugs can be divided into two separate groups.
The drugs act more effectively on the disease and are used in its acute phase. These medications can not only effectively prevent inflammation, but also eliminate all symptoms for a long time.
In the first group is Methotrexate, which is part of the classic set of medications prescribed to a person for rheumatoid arthritis.
Treatment of rheumatoid arthritis is often not complete without the use of corticosteroids, the most common of which are prednisolone and dexamethasone. These drugs eliminate the symptoms of the disease:
Prednisolone and dexamethasone are often prescribed for severe forms of arthritis. However, the drugs have side effects; they can contribute to the appearance of cataracts, aggravate diabetes mellitus and increase body weight.
For rheumatoid arthritis, dexamethasone or prednisolone is prescribed in small doses. Their long-term use is contraindicated.
To provide quick help to a patient with rheumatoid arthritis, doctors often prescribe dexamethasone, prednisolone and other corticosteroid hormones, for example:
On the one hand, the listed drugs almost always have a positive effect on the patient’s condition. Prednisolone, dexamethasone and other corticosteroids immediately reduce joint pain, eliminate stiffness, chills and weakness.
Of course, all patients notice such obvious effects, thanks in every way to the doctor. However, corticosteroids are not a harmless treatment.
Dexamethasone, like prednisolone and other corticosteroid hormones, contribute to the appearance of Cushing's syndrome, in which sodium and water are retained in the body, which causes swelling and increased blood pressure.
If prednisolone or dexamethasone is taken for a long time, you may experience:
Prednisolone, dexamethasone and other corticosteroids suppress the body's production of its own hormones. Eventually, there comes a time when, due to side effects, a person is forced to stop taking such medications.
However, it is not easy to stop taking corticosteroid medications right away. The body gets used to the drugs and can no longer cope without receiving them from the outside.
If you reduce the dose quickly, this can lead to an immediate deterioration in the well-being of a patient with rheumatoid arthritis, which will significantly worsen joint pain.
It is necessary to slowly reduce the dosage of corticosteroid drugs, approximately a few milligrams every 7-8 days.
You can finally stop taking prednisolone or dexamethasone only after a few months.
Aurotherapy is the use of gold salts orally for medicinal purposes. It is best to take gold salts at the onset of rheumatoid arthritis.
If non-steroidal anti-inflammatory drugs do not benefit the patient for a long time, then the use of gold salts will be a timely solution to the problem.
Preparations with gold salts are also used for:
Gold preparations are almost always effective for the treatment of seropositive arthritis, but are almost useless for seronegative arthritis.
If you take gold salts for a long time, they will slow down the appearance of joint pain in people with seropositive rheumatoid arthritis.
Thus, gold salts:
Gold preparations are recommended for people with severe rheumatoid arthritis. Gold preparations are also used for inflammatory diseases, as well as malignant tumors. Gold salts block the growth of fungi and pathogenic bacteria, including Helicobacter.
Treatment, which includes the use of second-line agents, is not in great demand now. This is explained by the fact that the drugs in this group are more toxic with little effectiveness.
The drugs are prescribed to those patients who have complete intolerance to basic medications. The drugs can also be used as additional treatment.
The use of these drugs is the main action in getting rid of arthritis in approximately 70% of patients. Basic therapy is not recommended for patients with an extremely slow progression of the disease. In most cases, therapy with basic medications lasts about two years.
Complex treatment is carried out for a certain time, then you need to make a detailed diagnosis and decide whether to continue or stop treatment. During the period of using several medications, their dosage is reduced.
Often with rheumatoid arthritis, the doctor decides to prescribe NSAIDs. This is one of the most common means of pathogenetic therapy.
The drugs have been used for many years, but attitudes towards them are constantly changing. Now there are more modern and safer medications of this type.
NSAIDs are quite effective medications that affect the body through damage to the primary link of the inflammatory process.
Any non-steroidal anti-inflammatory drug first of all eliminates the main signs of the disease, we are talking about:
This treatment will relieve a person of high fever and excruciating pain. NSAIDs have an excellent anti-inflammatory effect.
However, such drugs do not have a sufficient effect on the source of inflammation. Drugs can only eliminate the irritating symptoms of the disease.
Currently, the use of only NSAIDs in the treatment of rheumatoid arthritis is considered incorrect. Provided the complex use of these drugs together with DMARDs, one can count on the patient’s full recovery.
Non-steroidal drugs, unlike DMARDs, have some side effects. They often provoke:
There are some characteristics of NSAIDs that you need to be aware of before you start taking them. The patient currently has access to various types of medications in this group.
Only a doctor can choose the right remedy that is most effective for a particular person. In a general sense, there are no particular differences between NSAIDs. The only peculiarity is how the patient’s body will react to a particular drug.
Different NSAIDs differ in the degree of negative impact on the human body, as well as in the level of individual tolerance.
The greater the amount of NSAIDs, the greater the risk of harm to the body. To reduce the risk of negative effects, NSAIDs can be combined with certain other drugs.
It is necessary to ensure that the patient has no potential individual acute intolerance to certain substances. For rheumatoid arthritis, medication dosages should be standard.
The duration of treatment with NSAIDs cannot be immediately determined. It depends on the body’s reactions and the severity of symptoms. If the rehabilitation processes proceed quickly, then NSAIDs can be excluded from treatment.