Rheumatoid arthritis is a common autoimmune disease, the incorrect treatment which leads to joint deformities and disability. Thanks to modern pharmacological therapy fails to maintain a high quality of life for patients.
The effect of the medication is proved in numerous clinical studies.
|Group of drugs||Impact on the course of the disease||The negative side|
|Basic||Slow the progress of rheumatoid arthritis, prevent joint deformity. The long-term effect||Slow acting|
|Genetic engineering (new generation)||Have high efficiency and selectivity||Decrease and antitumor immunity against infectious|
|Corticosteroids||Quickly stop the inflammatory process||A large number of side effects. The appointment requires constant monitoring of the doctor|
|Nonsteroidal anti-inflammatory drugs (NSAIDs)||These medications stop the symptoms of inflammation in the acute phase of the disease||Damage the mucosa of the digestive tract, have a nefro toxicity|
The basic drug used in all patients with rheumatoid arthritis, unless they have contraindications. They belong to slow-acting drugs. An important condition for successful treatment is early assignment. The action is aimed at preventing the deformation of the limbs, preserve function.
The properties of drugs include:
Drugs have different mechanisms of action and characteristics of admission are conditional division into first and second series.
The amount of the first series have the best balance of effect and minimum adverse effects. In numerous studies of these drugs proved reliable suppression of symptoms and prevention of deformation processes in the joint.
Have a lower efficiency but more toxic in comparison with first-line drugs. The duration of therapy means the number 2 is not less than six months.
The point of application of such drugs are specific components that affect the occurrence and progression of the disease. Drugs created for the treatment of rheumatoid arthritis resistant to standard treatment. With their help it is possible quickly to achieve clinical remission.
To biological drugs for the treatment of arthritis with an autoimmune component include medications, performing point blocking inflammatory factors. This is achieved through artificially created antibodies, soluble receptors of cytokines and other molecules with biological activity.
The action of biological agents aimed at the "target molecules" and suppression of the immune inflammation. New drugs have a high specificity and selectivity. Acting on the immune system, which is involved in the development of the disease.
Patients for which treatment was applied to the above medications, note the rapid onset of effect. There is the evidence base on the inhibition of the destructive process in the joint. The disappearance of symptoms of disease exacerbation can occur just a few days after insertion.
The combination of biologics has the potential effect of (strengthening of the action of one in combination with others).
The phenomenon of resistance to base treatment successfully overcome biological means.
Biologics are highly effective in the treatment of rheumatoid arthritis. However, their use has undesirable side:
The patient before therapy was examined for the presence of tuberculosis by the method of fluoroscopy. Other methods of prevention of complications include vaccination, which is aimed at establishing active immunity. It should be noted that live vaccines are contraindicated patients, as drugs possess immunosuppressive action.
The tumor necrosis factor alpha is a biologically active substance, which in high concentrations causes degenerative processes. In patients with rheumatoid arthritis occurs excessive accumulation of TNF-a in synovial fluid. New generation drugs are composed of antibodies against TNF-a, which possess potent anti-inflammatory effect. Blocking the synthesis of TNF-and prevents destructive processes (destruction) of cartilage and bone.
Before therapy the patient is required to exclude tuberculosis. For this purpose a radiographic study of the thorax, specific probes.
Duration of therapy the rheumatologist determines on an individual basis, an average of one year.
In the treatment of diseases are widely used tools glucocorticosteroid, mechanism of action of which is caused by blocking the production of inflammatory mediators (cytokines and prostaglandins).
There is a high rate of onset of effect from steroids. The degree of response to therapy depends on the dose of injected hormones.
Glucocorticoids can cause:
Threatening side effects and the high frequency of their occurrence lead to the need for strict medical control taking steroids.
Hormone treatment in rheumatoid arthritis are assigned internally and topically. When your system purpose increase manifold the risks of adverse effects. Start treatment with minimal doses.
When complications arise, as well as severe rheumatoid arthritis glucocorticoids prescribed in medium or high doses. Widely used pulse therapy, the essence of which consists in intravenous administration of drugs. This injection mode ensures the prevention of side effects. Used in the treatment of complications of rheumatoid arthritis hemolytic anemia, cutaneous vasculitis, fever. After pulse therapy, if necessary, the patient is administered a maintenance dose of steroids.
For the local treatment of the disease using a microcrystalline forms of the hormones that are injected into the joint cavity (Betamethasone, Triamcinolone). The advantage of this method of introduction is the most pronounced anti-inflammatory effect in the affected joint.
Patients note relief of symptoms of the disease after one to three days. Re-injection inside the joint shall be appointed not earlier than in a month.
With frequent administration of the drug in the same joint may develop local osteoporosis, strengthening of destructive processes in the cartilage tissue, suppuration.
Local application of glucocorticoids is recommended for the treatment of acute arthritis as an additional therapeutic effect.
Homeopathic remedies are aimed at regulating Central processes of self-government, the stimulation of self-healing of the body. This is achieved by individual selection of drugs.
ASD officially used in veterinary medicine, but is used as a means of alternative medicine, including rheumatoid arthritis.
When inflammation applying a second fraction ASD.
Directions: inwards in the form of drops or topically using compresses. Used as a Supplement to the basic treatment.
ASD promotes elimination of an inflammation and stabilize the immune system.
Selection of pharmacological agents for the elderly should be especially careful due to the frequent presence of renal and liver failure. Drugs are prescribed a short course in the period of exacerbation. To prevent anemia, prescribe folic acid.
In the period of exacerbation to relieve pain and signs of inflammation apply a non-steroidal anti-inflammatory drugs. Significant impact on the course of the disease do not have, are symptomatic.
Unwanted side effects include lesions of the gastric mucosa, kidneys. The duration of administration in each individual case.
Disease with insufficient treatment leads to disability. For patients some groups of drugs are available for the expense of the state budget. These are means of basic therapy and corticosteroids.