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Treatment Options for Rheumatoid Arthritis

Summary & Participants

Rheumatoid arthritis can be a painful and debilitating disease. Although there is no cure, there are effective treatment options.

Medically Reviewed On: July 18, 2008

Webcast Transcript

ERIC RUDERMAN, MD: The most common disease-modifying drug we use these days is methotrexate. It’s effective. It tends to work very well in combination with other medicines if we need to add other things, and most patients tolerate it and do very well on it. It is a drug, however, that does have side effects. It can cause liver damage in a small percentage of people. It can cause effects on blood counts. There are some lung issues with effects on breathing and cough that come up. And so when people are on methotrexate, we do need to monitor them very closely.

ANNOUNCER: A new, highly effective class of DMARDs referred to as biologic response modifiers have been developed to treat rheumatoid arthritis.

ALISA KOCH, MD: We’re currently in the age of biologic therapies, or targeted therapies, as they’re often referred to. And these therapies were developed specifically to target pathways we think are important in how rheumatoid arthritis develops. Specific pathways that help perpetuate the disease.

CLIFTON O. BINGHAM, MD: The biological DMARDs that came first to rheumatoid arthritis were TNF antagonists. The three that are currently approved are a medication called etanercept or Enbrel, a medication called adalimumab or Humira and a medication called infliximab or Remicade. All of these are very effective in inhibiting the activity of tumor necrosis factor. They each do it in slightly different ways, but they're directed against specifically the tumor necrosis factor molecule and they're either given by injection or by infusion.

ANNOUNCER: Potential side effects of these TNF blockers can range from less severe, like reactions at the site of injection and infusion reactions, to infections including reactivating latent tuberculosis. Other serious concerns include a potential increase in malignancies and lymphoma.

STEVEN ABRAMSON, MD: I think it’s an important point that most people with rheumatoid arthritis are not on a single drug. They’re on three, four, sometimes five medicines. In fact, the recent evidence, certainly with the TNF blockers, is that the combination of methotrexate plus a TNF blocker is better than either alone.

ANNOUNCER: Early diagnosis and treatment of rheumatoid arthritis is important in order to prevent joint damage and deformities.

ERIC RUDERMAN, MD: I think the odds of completely treating this disease have really improved in the last few years. With the number of treatments that we have available, when I see a new patient with rheumatoid arthritis right now, I can confidently tell them that there’s a better than even chance that I can get them to a place where they have no active disease, where it’s not impacting their life at all.

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