ERIC RUDERMAN, MD: There are nonsteroidal anti-inflammatory drugs, and that includes naproxen or ibuprofen or even some of the newer COX-2 inhibitors, like celecoxib or Celebrex. They treat the inflammation. They may reduce symptoms. But they have no impact whatsoever on the damage that occurs with the disease or the progression of disease. They can be useful drugs, although they have side effects. They can cause a lot of gastrointestinal problems; particularly they’re associated with a risk of ulcer or bleeding if not used carefully.
ANNOUNCER: Corticosteriods are another option available to patients.
ERIC RUDERMAN, MD: Steroids are really very potent anti-inflammatories. You can use steroids either orally, as prednisone tablets. You can get an injection, either an intramuscular injection or even an injection into a swollen joint. And they will rapidly improve pain and swelling and stiffness and the symptoms of arthritis.
ANNOUNCER: Corticosteriods should not be used for long periods of time. They can increase a patient’s risk for osteoporosis, cataracts, infection and hypertension.
CLIFTON O. BINGHAM, MD: NSAIDs and prednisone and steroids are adjunctive therapy. They're things that we use in addition, they're things that we use as a bridge until these more effective therapies kick in and start to work. We have a class of agents, though, that are called DMARDs or disease-modifying anti-rheumatic drugs. And these are drugs that have actually shown us that they can affect the long-term course of disease in preventing damage and preventing destruction.
ANNOUNCER: Prescribed DMARDs may include hydroxychloroquine, sulfasalazine, leflunomide, or the immunosuppressive agent methotrexate.
