Nonsteroidal anti-inflammatory drugs, NSAIDs, are medicines designed to reduce pain and swelling. Higher doses of NSAIDs require a prescription and can be used to treat the joint inflammation of arthritis. Lower doses are available over the counter and relieve minor aches and pains. NSAIDs work by targeting an enzyme called COX. There are 2 forms of the COX enzyme in the body:
Nonselective NSAIDs relieve pain and reduce swelling. However, nonselective NSAIDS target both forms of the COX enzyme. By affecting the COX-1 enzyme, it is believed, these NSAIDs may cause serious side effects such as stomach ulcers.
COX-2–selective inhibitors work to relieve arthritis pain by specifically targeting the COX-2 enzyme in the body. The COX-2 enzyme plays a key role in causing both pain and inflammation. The body also makes an enzyme called COX-1. This enzyme helps protect the lining of the stomach. Most pain relievers work by blocking the actions of both COX-1 and COX-2 but COX-2–selective inhibitors are different because, when taken at suggested doses, they target only the COX-2 enzyme, but not the COX-1.
Disease-modifying antirheumatic drugs (DMARDs) are used to treat rheumatoid arthritis (RA). These drugs not only treat RA symptoms, but actually slow the course of the illness. The American College of Rheumatology (ACR) recommends that most patients diagnosed with RA start DMARD therapy within 3 months of diagnosis to prevent or delay the progression of the disease. Patients should be reassessed periodically to monitor disease progression and possible toxic effects of these medications.
Recently, a new kind of DMARD has been developed that targets a specific protein involved in inflammation. Members of this class of drugs are called biologic response modifiers, or biologic DMARDs.
Drugs that target specific parts of the immune system are being developed as scientists learn more about the complicated steps that lead to rheumatoid arthritis. Several new drugs known as biologic response modifiers work by blocking the action of tumor necrosis factor (TNF), a substance produced by the body that promotes inflammation. Studies confirm that these drugs can slow the progression of joint damage in rheumatoid arthritis.
Steroids such as cortisol are anti-inflammatory hormones naturally made by your body. They can also be man-made and used as medicine. They can then be used to treat the swelling of arthritis. Some of these steroids come as pills and other have to be injected. If you only have a few joints affected by arthritis, your doctor may inject a steroid directly into those joints for fast, temporary relief of arthritis pain. Steroids can have serious side effects, including an increased risk of osteoporosis and hypertension. They are not recommended for long-term use. If you take steroids, your doctor will need to monitor you very closely.
Reference:
1. Celebrex.com