Remaining active, in spite of the pain, has beneficial effects on future physical functioning. This recognition has lead to the use of substances to specifically block the pathway of the disease. Given the compelling evidence that pro-inflammatory cytokines are involved in the pathogenesis of RA, interference with the cytokine cascade earlier in the course of the disease may be a therapeutic benefit. The goals of Rheumatoid Arthritis treatment are to decrease pain and inflammation, preserve joint function and prevent deformity. Non drug treatment includes such general measures as rest together with a controlled program of physical therapy and exercise.
Nonsteroids are the traditional first-line drug treatment for rheumatoid arthritis.
They relieve pain and suffering and reduce joint inflammation, but do not alter the disease progression and can cause gastric mucosal injury, thus calling for co-administration of other drugs. Leflunomide is an oral agent and entanercept is administered parenterally. Most common adverse effects were diarrhea, respiratory infections, hair loss, rash, nausea, and increase risk of hepatotoxicity. Response to medication usually occurs in one to two weeks after initiation of therapy and nearly always occurs within three months. It improves joint pain and swelling and morning stiffness.