Arthritis: Disease-Modifying Medications

Anti-malaria Drugs (Plaquenil)

Plaquenil is a drug used to treat malaria. It was discovered that it worked for arthritis when people taking the drug for malaria reported improvements in their arthritis. The drug affects the immune system, although doctors do not know exactly how it works.

Usually Plaquenil is used when other RA treatments fail. It can be given along with steroid treatment to reduce the amount of steroid needed. It is also given to treat the facial rash of lupus.

Plaquenil is given by mouth daily. Side effects include low white blood cell counts, blood or protein in the urine, nausea, and skin rashes. High doses can rarely cause injury to the back of the eye; therefore, patients on this drug should see an eye doctor every six to 12 months.

Gold

Gold has been used as a medical treatment for centuries and was a mainstay of RA treatment from the 1920s to around 1985. Currently it is a rarely used treatment for RA.

Gold works by decreasing inflammation in the joints, although doctors don't know how it does this. Gold is given orally or by injection into the muscle. The injection is more effective than the oral version.

Possible side effects include skin rash, anemia, low white blood cell count, or liver and kidney problems.

Cyclosporine (Neoral)

Cyclosporine is a pill that's best known as a drug given to transplant recipients to prevent rejection of the transplanted organ. It works by stopping an overactive immune system from attack. Therefore, it's effective in stopping joint inflammation and destruction caused by RA.

The side effects include high blood pressure, headache, kidney problems, nausea, diarrhea, and heartburn.

Azulfidine

This anti-inflammatory drug is used for treatment of rheumatoid arthritis, arthritis associated with anklyosing spondylitis, and arthritis associated with inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. It may be used alone or in combination with other medications.

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