Rheumatology Treatment and Management

• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Medications like ibuprofen, naproxen, or celecoxib. They reduce pain and inflammation but do not stop the progression of the disease.
• Corticosteroids (Glucocorticoids): Drugs like Prednisone. They are fast-acting, potent anti-inflammatories used to bridge the gap until other medicines take effect or to control acute flares. Due to side effects (weight gain, osteoporosis), they are used at the lowest possible dose for the shortest time.
• DMARDs (Disease-Modifying Antirheumatic Drugs): The cornerstone of treatment. These drugs suppress the overactive immune system.
  • Conventional Synthetic DMARDs: Methotrexate is the “gold standard” anchor drug for RA and other inflammatory arthritis types. Others include Hydroxychloroquine (Plaquenil) for Lupus and Sulfasalazine.
• Biologics (Biologic DMARDs): These are genetically engineered proteins that target specific parts of the immune system. They are usually given by injection or IV infusion.
  • TNF Inhibitors: Block Tumor Necrosis Factor, a primary inflammatory substance.
  • IL-17 and IL-23 Inhibitors: Highly effective for Psoriatic Arthritis and Ankylosing Spondylitis.
  • B-Cell Depletors: (e.g., Rituximab) used for RA and vasculitides.

Targeted Synthetic DMARDs (JAK Inhibitors): A newer class of oral medications that block signaling pathways inside the cell.