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Arthritis Drugs for Rheumatoid Arthritis and Osteoarthritis


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:
Amgen Inc.
One Amgen Center Drive
Thousand Oaks, CA 91320-1799
1-866-Kineret
World Wide Web Address: http://www.kineretrx.com


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:
Immunex Corporation
51 University Street
Seattle, WA 98101
(800) 436-2735
World Wide Web Address: http://www.enbrelinfo.com/


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:
Centocor
200 Great Valley Parkway
Malvern, PA 19355
(800) 457-6399
World Wide Web Address: http://www.centocor.com/


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:
Aventis
P.O. Box 9627
Kansas City, MO 64134-0627
(816) 966-4000
World Wide Web Address: http://www.aventis.com/


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:
G.D. Searle & Company
5200 Old Orchard Road
Skokie, IL 60077
World Wide Web Address: http://www.searle.com/


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:
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

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:
Sanofi~Synthelabo, Inc.
90 Park Avenue
New York, NY 10016
(800) 446-6267
World Wide Web Address: http://www.hyalgan.com/


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:
Genzyme Biosurgery
One Kendall Square
Cambridge, MA 02139
(800) 666-7248
World Wide Web Address: http://www.synvisc.com or http://www.genzymebiosurgery.com


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:
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/


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:

  • National Library of Medicine's (NLM's) Internet Grateful Med is a computer system that allows users to search through 15 of the NLM's databases for bibliographic references and abstracts on medical and scientific information pertaining to rheumatic diseases, including treatments.
    World Wide Web Address: http://www.nlm.nih.gov/

  • U.S. Food and Drug Administration (FDA), Center for Evaluation and Research, provides information on drugs that have been approved, as well as those undergoing the approval process.
    World Wide Web Address: http://www.fda.gov/cder/

  • The Arthritis Foundation offers The Drug Guide, a reprint from Arthritis Today. World Wide Web Address: http://www.arthritis.org/

  • Local public university libraries have journals on rheumatic diseases and pharmaceutical (drug) therapies, as well as reference books such as the Physician's Desk Reference, an annually updated guide that describes the use, effects, dosages, and administration of FDA-approved drugs, as well as warnings, side effects, and precautions. Many libraries also provide computers with public access to the Internet.

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
Updated August 2001
Last Update: January 2002