Today's Treatment for Rheumatoid Arthritis

New and better treatment for rheumatoid arthritis (RA) is on the horizon. In this article, physicians from the New York Hospital for Joint Diseases review current and future drugs used in the treatment of RA.

Research has made it clear that early treatment of RA has the best results. And if the drugs used aren't working, a switch is advised without delay. A new class of drugs called disease-modifying antirheumatic drugs (DMARDs) has made a big difference in the outcome of this condition.

DMARDs actually slow the disease progression. Treatment improves symptoms and quality of life. Daily activities and function are improved. Even long-term effects are better.

Methotrexate (MTX) was the first DMARD used in the mid-1980s. Then in the late 1990s, tumor necrosis factor (TNF) inhibitors were discovered. TNFs used along with MTX made remission from RA possible.

More recently, new drugs to modify the immune system response to RA have been introduced. Abatacept and Rituximab are two promising medications for RA management.

Other new agents are still in clinical trials. These immune system modifiers include HuMax-CD20, Belimumab, Atacicept, Tocilizumab, Centrolizumab, and Golimumab. The authors of this article discuss the mechanisms by which each of these drugs works. Research results with each one are summarized to date.

Most likely, these newer drugs will help the 10 to 15 per cent of patients who do not get good results from MTX combined with TNF inhibitors. Aggressive treatment is the new standard for RA. Early intervention does reduce long-term problems, including death.