Treatment for Rheumatoid Arthritis: USMLE Immunology

Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation in the joints of hands, feet, knees, etc. In this quick and easy lesson, we explain the standard medical treatment for patients with rheumatoid arthritis at the USMLE immunology level, including DMARDS (synthetics and biologics), NSAIDS, and glucocorticoids.

NSAIDS Treatment for Rheumatoid Arthritis: USMLE

NSAIDS stand for non-steroidal anti-inflammatories. They are medications, such as ibuprofen, that reduce inflammation for patients with rheumatoid arthritis. However, NSAIDS do not affect the progress of the disease. These only help reduce inflammation.

Glucocorticoids or Corticosteroids Treatment for Rheumatoid Arthritis: USMLE

Glucocorticoids , also known as corticosteroids, are common treatment for rheumatoid arthritis as well by reducing both inflammation and pain in patients. Unlike NSAIDS, glucocorticoids reduce both inflammation and pain, but similar to NSAIDS, glucocorticoids do not slow down the progress of rheumatoid arthritis.

DMARDs Disease-modifying Antirheumatic Drugs for Rheumatic Arthritis: USMLE

DMARDs also known as disease-modifying antirheumatic drugs slow down and delay the progress the rheumatic arthritis. DMARDs for rheumatic arthritis consist of 2 main classes including 1) Synthetics and 2) Biologics.

Synthetic DMARDs for Rheumatoid Arthritis

Synthetic DMARDs include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, to name a few. Methotrexate is a very important DMARD drug to know for Rheumatoid Arthritis treatment because Methotrexate is the 1st Choice Drug for treatment. Methotrexate suppresses inflammation, pain, and disease progression.

Biologics or biologicals in DMARD treatment for Rheumatoid Arthritis include different types that target specific factors of the immune system. In general, there are TNF-alpha inhibitors, B-cell inhibitors, T-cell inhibitors, IL-6 Inhibitor, and IL-1 inhibitors.

Abatacept –| T-cells or specifically inhibits T-cell activation

Rituximab –| B-cells

Adalimumab (Humira), etanercept, infliximab, golimumab, and cortolizumab –| TNF-alpha or Tumor necrosis factor

Anakinra –| IL-1 receptor, and usually co-administered with methotrexate

Tocilizumab –| IL-6

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