Rheumatoid Arthritis Treatment and Life Style Changes
Treatment goals: – Goals in Rheumatoid arthritis management
To prevent or control joint damage
To avoid loss of performance
To ease the pain
Maintaining the quality of life of the patient
To prevent or minimize the adverse effects of treatment
Therapy:- Non Biological and Biological Disease Modifying Drugs. Non-pharmacological therapy (e.g., exercise, joint care, Physical therapy) and NSAIDs are not included in the report because they do nothing to change the course of the disease or prevent joint destruction.
However, these may be considered as supportive therapies for mild to moderate pain relief.
Corticosteroids: – Low-dose systemic corticosteroids (e.g. prednisone, methylprednisolone) have excellent anti-inflammatory activity and are immune. Due to adverse effects (e.g. hyperglycemia, GI toxicity, osteoporosis), a less effective dose should be used.
These agents have been shown to slow joint damage; however, the patients are diseased Begin on disease-modifying antihypertensive drugs (DMARDs) or during acute RA inflammation.
No biological disease-modifying anti-rheumatic drugs (NBDMARDs) are used to reduce or prevent joint damage and preserve joint function and should be considered within 3 months of diagnosis.
Pharmacological Treatment Chart:-
Methotrexate: – First-line DMARD, used in combination with anti-inflammatory NSAID such as ibuprofen (Motrin, Advil) or naproxen (Alive).
Methotrexate is usually taken orally (tablet or liquid) or injection once a week. Its effects are to reduce joint inflammation and preserve joint function.
The maximum recommended weekly dose to limit toxicity is 20 mg, but the usual dose of RA is very low at 7.5 mg per week.
It reduces symptoms and slows joint damage. It is taken 2-4 times a day as an oral tablet. It can be combined with other DMARDs if wanted.
Avoid you are allergic to sulfasalazine drugs.
Hydroxychloroquine: – is antimalarial drug, is effective in the handling of rheumatoid arthritis.
Additionally it is commonly used in combination with methotrexate and sulfasalazine for additional purposes. It can also be combined with corticosteroids or NSAIDs.
»It is taken as an oral tablet one to two times a day.
It is taken as an oral tablet one to two times per day.
An eye examination is usually required before starting hydroxychloroquine, and may be needed annually while taking it, as it may damage the retina with high doses or for long periods of time.
Leflunomide:- shows similar effects to methotrexate and can only be used in patients who cannot take methotrexate.
It is taken by Oral in once a daily.
It can also be used with MTX or a biologic.
Biological DMARDs (BDMARDs): – Joint damage can be reduced or prevented, preserving joint integrity and function with the patient in a severe and moderate RA.
They are mainly used in those who fail adequate testing of patients with one or more NBDMARD or high disease
These drugs are recommended if high disease activity is present early in the disease course with poor prognosis. These drugs are usually considered when patients do not give an acceptable response to Methotrexate MTX or other NBDMARDs.
Abatacept (Orencia):- is the first T-cell costimulation blocker. It is used as monotherapy or NBDMARDs. Repatriation with MTX is recommended. NBDMARD does not work in the presence of moderate disease with poor immunity.
Rituximab (Rituxan):- is a CD-CD20 monoclonal antibody. Deficiency of CD20B cells affects the autoimmune response and helps with RA-associated chronic synovitis.
It is used when the patient fails MTX and / or multiple DMARDs and has a high disease burden and poor prognosis. Severe, even fatal, infusion reactions have been reported.
Anakinra (Crane):- is an IL-1 receptor antagonist. It is used in combination with immunotherapy or any DMARD except for TNF-inhibitors.
Tocilizumab (Actemra):- is an IL-6 receptor monoclonal antibody. It is indicated for moderate to severe RA for adults who have not responded with one or more TNF-antagonists. This Can be used as monotherapy or MTX or other NBDMARDs.
The Surgical treatment:- (e.g. carpal tunnel release, total joint arthroplasty, joint fusion) may occur. In severe pain, range of motion is lost, or joint function is impaired.
Life style changes:-
In the event that you smoke, proceeding to do as such will expand RA manifestations. Smoking triggers provocative procedures that influence each cell in the body.
In the event that you have RA, stopping smoking will have a prompt positive effect on your general wellbeing.
A stimulating eating routine is significant for by and large prosperity and keeping up a solid weight. Make sure to get sufficient measures of calories, protein, and calcium.
When all is said in done, eat not so much soaked but rather more mono-and polyunsaturated fats. Increment admission of natural products, vegetables, and entire grains.
Abundance weight can put additional weight on your joints. In the event that you are overweight, converse with your primary care physician or a dietitian about dietary choices.
Remember that times of rest might be fundamental during times when indications erupt, however complete bed rest isn’t prescribed. Sensible physical movement can help improve versatility and adaptability.
Fixed status can exacerbate your joints.
Stress can exacerbate torment. Attempt to maintain a strategic distance from or oversee pressure, particularly when indications flare.
There are a few different ways to lessen pressure, for example, reflection, yoga, or other unwinding systems.
Maximum Alcohol Intake:-
A few prescriptions taken for rheumatoid joint pain may expand the danger of liver harm in individuals who devour liquor consistently.
In case you’re taking prescriptions, converse with your primary care physician about how much and how as often as possible you drink wine, brew, or other mixed refreshments.
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