Azathioprine is used in the treatment of several different types of rheumatic disease, including rheumatoid arthritis and systemic lupus erythematosus (SLE). Azathioprine reduces the activity of the immune system. It may prescribed as a steroid sparing drug.
Azathioprine is often used in cobimation with other drugs to modulate the immune system.
Etanercept (Enbrel) is a biologic anti-TNF drug. It has been shown to be effective in rheumatoid arthritis and other inflammatory diseases. Anti-TNF drugs reduce inflammation and improve symptoms.
Golimumab is an anti-TNF (anti-tumour necrosis factor) drug. It blocks the action of TNF proteins and so reduces inflammation.
Hydroxychloroquine (trade name Plaquenil) is used in the treatment of rheumatic diseases as well as malaria. It reduces inflammation, pain, swelling and stiffness of joints and improve the SLE rash.
Infliximab (Remicade) is the first anti-TNF. It is effective in several rheumatic conditions.
Leflunamide (brand name Arava) is used to treat several rheumatic conditions including rheumatoid arthritis.
Methotrexate is used to treat many different rheumatic disease, such as rheumatoid arthritis. Methotrexate reduces inflammation and symptoms.
Mycophenolate mofetil (CellCept) is another immune modulating drug and is used in the treatment of SLE, vasculitis and organ transplantation.
Non-steroidal anti-inflammatory drugs (NSAIDs) include ibuprofen, diclofenac, naproxen, indometacin, ketoprofen. NSAIDs reduce pain (analgesics effect) and can reduce inflammation/swelling too. NSAIDs are the most widely used class of pharmaceutical. They are very effective drugs.
However NSAID use can be associated with side effects including:
- Gastrointestinal and renal
- Bronchospasm and pulmonary infiltrates with eosinophilia
- Bone marrow
- Central nervous system
- Skin reactions, and
- Stevens-Johnson syndrome.
NSAIDs should avoided in pregnancy and lactation and may delay bone fracture healing.
Rituximab (MabThera) is a new type of biologic drug which removes B cells which produce antibodies. Rituximab has been shown to improve symptoms and disease outcomes in rheumatic diseases.
Sulfasalazine is an DMARD (drug modifying anti-rheumatic drug). It is used in rheumatic diseases to reduces the inflammation in joints and decreases pain, swelling and stiffness. Enteric coated version – Salazopyrin EN-Tabs is used to reduce stomach effects.
Tocilizumab is used to treat rheumatoid arthritis. In this section we explain how tocilizumab works, what you should expect when you have it and what the possible side-effects are.