Anyone who has been diagnosed with an inflammatory disease knows the importance of reducing inflammation to keep the condition at bay. Often, that means taking a pain reliever or other medication that also reduces swelling. Such an approach, though, only treats the symptoms–not the underlying cause of the inflammation. However, a class of drugs called “disease-modifying antirheumatic drugs” actually works to change the body’s immune system so it significantly reduces inflammation or pain in the first place. While a disease such as rheumatoid arthritis may not have a cure currently, these drugs can modify the disease to reduce symptoms and prolong functionality for longer.
Inflammatory arthritis drugs (DMARDs)
Inflammatory arthritis drugs, also called disease-modifying antirheumatic drugs (DMARDs), preserve joints by blocking the inflammation that causes rheumatoid arthritis. With an autoimmune disease such as rheumatoid arthritis, the immune system begins to identify the body’s own cells as invaders and attacks. Part of that response includes inflammation, which leads to damage and eventual destruction of joint tissues over the years. Rheumatoid arthritis drugs are aimed at modifying your immune system’s response to the disease so the initial attack from the immune system does not occur.
Taking inflammatory arthritis drugs
Rheumatoid arthritis drugs come in two categories: traditional and biologics. They are administered in three ways: either given orally with a pill, administered intravenously, or infused by being injected into a vein. Both work to modify, rather than cure, the disease by inhibiting two types of immune cells: T cells and B cells. These are types of white blood cells that are activated when a pathogen, or disease, is detected. In the case of a person with rheumatoid arthritis, those white blood cells continue to attack the person’s normal cells, causing inflammation. A DMARD is designed to shut off such an immune over-response.
Common inflammatory arthritis drugs are adalimumab (Humira), azathioprine (Zasan, Imuran), etanercept (Enbrel), infliximab (Remicade), leflunomide (Arava), and methotrexate (Rheumatrex, Trexall). These drugs can be prescribed individually or in combination with other drugs to best reduce symptoms and modify a person’s response to disease.
When inflammatory arthritis drugs begin working
Disease-modifying antirheumatic drugs often take between six to 12 weeks to begin having an effect on a person’s immune system. The drugs take time to begin stopping the production of T cells and B cells or causing other changes to a person’s immune response. It takes patience for the drugs to begin working, but a person with inflammatory arthritis does not have to suffer while they wait for the new drugs to take effect. As a person waits for the drugs to begin working, a medical provider may prescribe other medications to manage symptoms. Some possible medications could include a steroid, such as prednisone, or a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen.
Possible side effects
Like most medications, inflammatory arthritis drugs can have side effects. The most common side effects are:
- Injection Site Reactions
- Redness
- Swelling
- Itching
- Pain
- Infusion Reactions
- Headache
- Nausea
- Flushing
- Rash
If a more serious infusion reaction involves difficulty breathing, chest pains, fever, chills, or anaphylaxis, the treatment would be stopped at the infusion center and the person would be treated immediately. The risk of getting certain infections or certain types of cancer can increase by taking some DMARDs. Your healthcare provider likely will run blood tests, perform X-rays, and/or order other tests to create a baseline before you begin the new drug and then monitor you throughout your treatments. It is important to provide full information on all of the medications and supplements a person is taking before beginning a disease-modifying antirheumatic drug to prevent unwanted drug interactions.
Written by Sheena McFarland