How well do the drugs work?
All the drugs used to treat rheumatoid arthritis have been tested and have been
proven useful in patients who have the disease.
All of the NSAIDs are similarly effective, making it difficult for doctors to
strongly recommend one over the other.
Methotrexate is among the drugs that are most effective in providing
long-term benefits for people with rheumatoid arthritis.
Are the drugs dangerous?
The effectiveness and the risks of drugs are considered when your rheumatologist
plans your treatment.
If a drug is very effective in treating an illness but causes a lot of side
effects, it is not an ideal treatment. For example, high doses (15 to 20 mg or
more per day) of corticosteroids can make people with rheumatoid arthritis feel
dramatically better. However, high doses of corticosteroids may cause serious
side effects when taken over many months or years.
In addition, NSAIDs are no more effective than full doses of uncoated
aspirin, yet they are often prescribed because they are not as irritating to the
stomach. Coated aspirin, such as Ecotrin®,
is much less irritating to the stomach than the same uncoated medicine.
What are some of the side effects of the drugs?
Since no drug is entirely safe, your doctor will talk to you about the possible
benefits from the drugs as well as the risks and side effects. The occurrence of
side effects depends on the dose, type of medication, and length of treatment.
Some of the side effects of each type of drug used to treat rheumatoid
arthritis are listed below.
PLEASE NOTE: The following side effects are the most common. All possible
side effects are not included. Always contact your doctor if you have questions
about your personal situation.
NSAIDs may cause the following side effects:
HeartburnStomach painUlcersNausea and vomitingDiarrhea and/or constipationFluid retentionWorsened high blood pressure and/or kidney problemsMethotrexate can cause the following side effects:
Upset stomachMild hair lossMouth soresTemporary decrease in red blood cells, white blood cells, and plateletsLiver damageInflammation of the lungs (rare)NOTE: Methotrexate may not be recommended for people who have kidney, lung,
or liver problems.
Corticosteroids (often called steroids) can cause the following side
effects:
Easy bruisingOsteoporosis (bone-weakening disease)CataractsWeight gainIncreased risk of infectionsDiabetesHigh blood pressureNOTE: Many of the side effects (as well as the benefits) of steroids are
directly related to the dose that is prescribed. Certain people with rheumatoid
arthritis can take daily low doses of cortisone with minimal risk and great
benefits.