Tumor necrosis factor (TNF) inhibitors are a relatively new class of medications used to treat autoimmune disease. They include etanercept (Enbrel), infliximab (Remicade), and adalimumab (Humira). Adalimumab and etanercept are injectable medications. Infliximab is given by IV.
Another relatively new medication is injectable anakinra (Kineret), which is a man-made protein that blocks the inflammatory protein interleukin-1. The drug is used to slow the progression of moderate to severe active RA in patients over 18 who have not responded to one or more of the DMARDs. Kineret can be used with other DMARDs or TNF inhibitors.
Other drugs that suppress the immune system, like azathioprine (Imuran) and cyclophosphamide (Cytoxan), are sometimes used in people who have failed other therapies. These medications are associated with toxic side effects and usually reserved for severe cases of RA.
Corticosteroids have been used to reduce inflammation in RA for more than 40 years. However, because of potential long-term side effects, corticosteroid use is usually limited to short courses and low doses where possible. Side effects may include bruising, psychosis,
Consult a health care provider before using any medication, including over-the-counter drugs.
SURGERY
Occasionally, surgery is needed to correct severely affected joints. Surgeries can relieve joint pain, correct deformities, and modestly improve joint function.
The most successful surgeries are those performed on the knees and hips. The first surgical treatment is a synovectomy, which is the removal of the joint lining (synovium).
A later alternative is total joint replacement with a joint
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