Most people who have rheumatoid arthritis take some type of medication. Medications for RA typically fall into five categories: Non-steroidal anti-inflammatory drugs (NSAIDs); steroids; disease-modifying anti-rheumatic drugs (DMARDS); biologics; and janus kinase (JAK) inhibitors.
When prescribing a medication, a physician will take into account the patient’s age, disease activity, and other medical conditions, but each patient is unique. Figuring out which medication or combination of medications work best for an individual can be challenging and often requires a process of trial and error.
Most people with RA are advised to take a non-steroidal anti-inflammatory drug to decrease pain and inflammation. NSAIDs are sold over-the-counter, under such names as Advil and Aleve, as well as by prescription, under names such as Mobic and Celebrex.
2. Steroids (Corticosteroids)
Fast-acting steroids, such as prednisone, are particularly useful during initial treatment, before other RA medications have had a chance to take effect (often 12 weeks or more).
One advantage of steroids is that they can be injected into joints. Injected steroids can provide targeted pain relief to one or two painful joints with limited side effects.
Experts recommend taking the lowest possible dose of steroids and advise against relying on them longer than necessary. Steroids’ effectiveness often diminishes over time—meaning the longer a person takes a steroid, the less likely it is to relieve symptoms. In addition, people who take steroids continuously for several months or years can experience side effects such as weight gain, increases in blood pressure, diabetes, and heart disease.
3. Methotrexate and Other Traditional DMARDs
Disease-modifying antirheumatic drugs (DMARDs) are used used to slow or stop rheumatoid arthritis by suppressing the immune system. The generic names for commonly used DMARDs include:
Methotrexate is often the first drug prescribed for people newly diagnosed with rheumatoid arthritis. RA patients take this medication weekly, alone or in combination with other medications.
High dose methotrexate is also used to treat some cancers. RA patients take significantly lower doses than cancer patients.