Rheumatoid arthritis is a chronic disorder for which there is no known cure. It therefore requires a comprehensive program that combines medical, social, and emotional support for the patient. It is essential that the patient and the patient's family be educated about the nature and course of the disease. The major goals of treatment of the arthritis are to reduce pain and discomfort, prevent deformities and loss of joint function, and maintain a productive and active life. Inflammation must rheumatoid arthritis pictures rheumatoid arthritis pictures be suppressed and mechanical and structural abnormalities corrected or compensated by assistive devices. Treatment options include reduction of joint stress, physical and occupational therapy, drug therapy, and surgical intervention. Pharmacological Strategies There are three general classes of drugs commonly used in the treatment of rheumatoid arthritis: non-steroidal anti-inflammatory agents (NSAIDs), corticosteroids, and remittive agents or disease modifying anti-rheumatic drugs (DMARDs). NSAIDs and corticosteroids have a short onset of action while DMARDs can take several weeks or months ankle pain rheumatoid arthritis pictures to demonstrate a clinical effect. DMARDs include leflunomide (AravaT), etanercept (EnbrelT), infliximab (RemicadeT), antimalarials, methotrexate, gold salts, sulfasalazine, d-penicillamine, cyclosporin A, cyclophosphamide and azathioprine. Because cartilage damage and bony erosions frequently occur within the first two years, rheumatologists now move more aggressively to a DMARD agent. A summary table of how to monitor drug treatment in rheumatoid arthritis is included (see table in ACR Guidelines). Non-steroidal Anti-inflammatory Agents Corticosteroids Disease Modifying Anti-rheumatic Drugs (Agents with Delayed Onset of Action) Analgesic Drugs joints in the body rheumatoid arthritis pictures Non-steroidal Anti-inflammatory Agents The major effect of these agents is to reduce acute inflammation thereby decreasing pain, improving function and hopefully preventing joint destruction. All of these drugs also have mild to moderate analgesic properties independent of their anti-inflammatory effect. Aspirin is the oldest drug of the non-steroidal class, and it remains an economical, effective choice. However, because of its higher rate of GI toxicity, its narrow window between toxic and anti-inflammatory serum levels and the inconvenience of multiple daily prosorba column therapy for rheumatoid arthritis rheumatoid arthritis pictures doses, aspirin's
