Arthritis Drugs for Rheumatoid Arthritis and Osteoarthritis
Monday, June 6, 2011
Arthritis treatments aim to relieve pain, reduce inflammation, and slow or stop joint damage to maintain or restore the patient's functional ability and quality of life. Arthritis therapies generally used today address the medical needs of many patients. However, these therapies are occasionally associated with harmful side effects ranging from mild to severe. Medical research continues to search for effective, fast-acting treatments with fewer side effects. New arthritis drugs designed to meet these treatment needs are presently available or awaiting approval by the U.S. Food and Drug Administration (FDA). The foundation for these new drugs was laid in basic biomedical research supported by the National Institutes of Health. Drug Category: Biological Response Modifiers for Rheumatoid Arthritis Description: One class of drugs in this category reduces inflammation in the joints by blocking the action of a substance called tumor necrosis factor (TNF). TNF is a protein of the body's immune system that triggers inflammation during normal immune responses; however, when overproduced, TNF can lead to excessive inflammation such as that experienced by patients with rheumatoid arthritis. Medication (drug name): Kineret® (anakinra) Description: Kineret® is the first direct and selective blocker of interleukin-1 (IL-1), a protein seen in excess in patients with rheumatoid arthritis. By blocking IL-1, Kineret® inhibits the inflammatory response in rheumatoid arthritis. How taken: Daily subcutaneous (under the skin) injections by the patient or health care provider Most common side effects: mild injection-site reactions (redness, pain, swelling) Drug status: approved by the FDA; can be used alone or in combination with disease-modifying antirheumatic drugs that are not tumor necrosis factor (TNF) blocking agents For more information: Medication (drug name): Enbrel® (etanercept) How taken: twice-weekly subcutaneous (under the skin) injections by the patient or health care provider Most common side effects: mild to moderate injection-site reactions (itching, pain, swelling) Drug status: approved by the FDA; not recommended for patients with active infections; caution should be used in patients with a history of infections or those who develop new infections while taking Enbrel®; not recommended for pregnant women. For more information: Medication (drug name): Remicade® (infliximab) How taken: intravenous (in the vein) injections by the health care provider once every 8 weeks Most common side effects: mild infusion reactions Drug status: approved by the FDA for use in combination with methotrexate; not recommended for pregnant women For more information: Drug Category: Disease-Modifying Antirheumatic Drugs (DMARDs) for Rheumatoid Arthritis Description: These are the mainstay arthritis drugs that are known to relieve painful, swollen joints and to slow joint damage. Medication (drug name): Arava® (leflunomide) How taken: orally, once daily Most common side effects: diarrhea, hair loss, rash Drug status: approved by the FDA; not recommended for pregnant women For more information: Drug Category: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Specifically Cyclo-Oxygenase-2 (COX-2) Inhibitors, for Rheumatoid Arthritis and Osteoarthritis Description: COX-2 inhibitors, like traditional NSAIDs, block COX-2, an enzyme in the body known to stimulate an inflammatory response. Unlike traditional NSAIDs, however, they do not block the action of COX-1, an enzyme known to protect the stomach lining. Therefore, drugs in this category reduce joint pain and inflammation with reduced risk of gastrointestinal ulceration and bleeding. Medication (drug name): Celebrex® (celecoxib) for rheumatoid arthritis and osteoarthritis How taken: orally once or twice daily, dosage determined by the physician Most common side effects: abdominal pain, nausea, indigestion, diarrhea Drug status: approved by the FDA For more information: Medication (drug name): Vioxx® (rofecoxib) for rheumatoid arthritis and osteoarthritis, as well as acute pain associated with primary dysmenorrhea (painful menstruation) and postsurgical pain How taken: orally, once daily Most common side effects: abdominal pain, diarrhea, indigestion, insomnia, edema Drug status: approved by the FDA For more information: Description: Hyaluronic acid viscosupplementation products for osteoarthritis. These products mimic a naturally occurring substance in the body called hyaluronic acid by providing lubrication to the knee joint, thus permitting flexible joint movement without pain. Medication (drug name): Hyalgan® (hyaluronan) How taken: a series of five injections per knee by a health care provider over 4 weeks Most common side effects: some pain and swelling at the injection site Drug status: approved by the FDA For more information: Medication (drug name): Synvisc® (hylan G-F20) How taken: a series of three injections per knee by a health care provider over a 15-day period Most common side effects: some pain and swelling at the injection site Drug status: approved by the FDA For more information: Description: Blood filtering device for severe rheumatoid arthritis. This device is designed to remove harmful antibodies from the patient's immune system, thus lowering disease activity associated with severe rheumatoid arthritis. Device (device name): Prosorba Column® (apheresis) How used: The device consists of a catheter, tubing, and a column. The catheter and tubing are used to filter the patient's blood through the column (which is coated with protein A, a substance that attracts harmful antibodies), then reinfuse it into the patient's body. The procedure takes 2 hours and is performed weekly at a health care facility for 12 weeks. Most common side effects: flu-like symptoms (chills, fever, nausea, and joint/muscle pain) Drug status: approved by the FDA For more information: Additional Resources To find out more about these drugs and devices, including dosage, full range of side effects, and study results, check the following resources: NOTE: Brand names included in this document are provided as examples only, and their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory. Publication Date March 2000
Amgen Inc.
One Amgen Center Drive
Thousand Oaks, CA 91320-1799
1-866-Kineret
World Wide Web Address: http://www.kineretrx.com
Immunex Corporation
51 University Street
Seattle, WA 98101
(800) 436-2735
World Wide Web Address: http://www.enbrelinfo.com/
Centocor
200 Great Valley Parkway
Malvern, PA 19355
(800) 457-6399
World Wide Web Address: http://www.centocor.com/
Aventis
P.O. Box 9627
Kansas City, MO 64134-0627
(816) 966-4000
World Wide Web Address: http://www.aventis.com/
G.D. Searle & Company
5200 Old Orchard Road
Skokie, IL 60077
World Wide Web Address: http://www.searle.com/
Merck & Co., Inc.
One Merck Drive
Whitehouse Station, NJ 08889-0100
World Wide Web Address: http://www.merck.com/product/usa/
Drug Category: Other Products
Sanofi~Synthelabo, Inc.
90 Park Avenue
New York, NY 10016
(800) 446-6267
World Wide Web Address: http://www.hyalgan.com/
Genzyme Biosurgery
One Kendall Square
Cambridge, MA 02139
(800) 666-7248
World Wide Web Address: http://www.synvisc.com or http://www.genzymebiosurgery.com
Frenesius HemoCare, Inc.
6675 185th Avenue NE, Suite 100
Redmond, WA 98052
(800) 909-3872 or 425-497-1197
World Wide Web Address: http://www.freseniushc.com/
World Wide Web Address: http://www.nlm.nih.gov/
World Wide Web Address: http://www.fda.gov/cder/
Updated August 2001
Last Update: January 2002
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