How Methotrexate Works To Help Fight Inflammation
Methotrexate is thought to work by causing cells to release a molecule that block chemicals that promote inflammation, according to the Arthritis Foundation. Reducing inflammation helps prevent pain and joint damage otherwise experienced by people with the disease.
Scientists realized early on that the drug could be useful for RA. By the 1980s, well-designed gold-standard studies began to confirm its value for this condition.
Initially, as with many medicines for RA, methotrexate was primarily given late in the course of the disease, when damage to joints were already done. In 2010, the American College of Rheumatology, along with its European counterparts, revamped their diagnostic criteria for the disease so that people could be diagnosed earlier. Their aim was to refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy, the scientists wrote in Annals of the Rheumatic Diseases that October.
Early Diagnosis And Appropriate Treatment
Now the good news: treatment has come a long way in recent years.
There are a number of good treatment paradigms for psoriatic arthritis, and the likelihood of severe deformity like there was in the past is close to zero with the new therapies we have, Hylland says.
There are also effective treatments for managing rheumatoid arthritis. And while its possible to have both psoriatic arthritis and rheumatoid arthritis at the same time, that wont necessarily complicate your treatment plan.
The initial treatments are the same for both, says Bauer, noting that tumor necrosis factor inhibitors work well for both types of arthritis, especially for people who cant take methotrexate, which is another first-line treatment.
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Another med that can be used to treat either RA or psoriatic arthritis is a Janus kinase inhibitor, or JAK inhibitor, like tofacitinib. This type of drug interrupt your immune systems urge to overproduce lots of inflammation-causing proteins called cytokines. They may work better for you than other kinds of drugs and they have the bonus of being available in pill form, rather than an injection or infusion.
With either condition, its crucial that you dont ignore the symptoms until they become very severe. Early diagnosis is critically important for slowing the progression of these diseases.
The earlier we catch it, the less we have to do to quiet itthe less medication we have to use it quite it, says Hylland.
Methotrexate For Rheumatoid Arthritis: Is It Safe And How Does It Work
Methotrexate is a medication thats often used to treat rheumatoid arthritis , which can cause symptoms like red, painful, and swollen joints. If youve heard of methotrexate before, you probably already know its a medication thats taken long term to help lessen the symptoms of RA. But what about side effects? And how does it compare to other medications? Heres what you should know about this popular medication and why its still considered to be the first choice among rheumatoid arthritis treatments.
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What Causes Rheumatoid Arthritis
The causes of RA are unknown, but it is more common in people who smoke or have a family history of this disease.
We know how the condition attacks the joints, but it is not yet known what triggers the initial attack. Some theories suggest that an infection or a virus may trigger RA, but none of these theories has been proven.
RA can run in families but having a family member with RA does not necessarily mean that you will inherit the condition. Even an identical twin of someone with RA only has a small chance of developing it, so genes do not explain much of the risk.
RA is 3 times more common in women than in men. Research has suggested that the female hormone oestrogen may be involved in the condition, but this has not been conclusively proven.
RA is an autoimmune condition. Normally, your immune system makes antibodies that attack bacteria and viruses, helping protect your body against infection. If you have RA, your immune system sends antibodies to the lining of your joints, where instead of attacking harmful bacteria, they attack the tissue surrounding the joint.
When you have RA, antibodies attack the synovium, a membrane that covers each of your joints. The synovium becomes sore and inflamed, which causes chemicals to be released and synovium to thicken. These chemicals can also damage bones, cartilage , tendons and ligaments . The chemicals gradually cause the joint to lose its shape and alignment and, eventually, can destroy the joint.
Get An Accurate Diagnosis
If you have pain, stiffness or swelling in or around a joint for more than two weeks, it’s time to see your doctor, physiotherapist or health professional. These symptoms can develop suddenly or slowly. Only a well-trained health professional doctor can tell if it’s arthritis. But “you have arthritis” is not a diagnosis. Ask for a specific diagnosis of the type of arthritis you have. There are more than 100 types including osteoarthritis and rheumatoid arthritis each of which has different treatments. Getting the proper treatment requires getting the correct diagnosis.
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Rheumatoid Arthritis Vs Osteoarthritis
Many people confuse rheumatoid arthritis with osteoarthritis due to their similar symptoms, but the two diseases are caused by different factors.
What is Osteoarthritis?
Whereas rheumatoid arthritis is an autoimmune disease that causes joint malfunction due to inflammation, osteoarthritis is a mechanical disease brought on by the destruction of joints through wear and tear.
Osteoarthritis is the most common form of arthritis, with approximately 27 million Americans over the age of 25 having been diagnosed with it. Osteoarthritis is also most commonly seen in people middle-aged to elderly and is the top cause of disability in those age groups, though it can also appear in younger people who have sustained joint injuries.
With osteoarthritis, the cartilage, joint lining, ligaments, and bone are all affected by deterioration and inflammation. When the cartilage begins to break down due to stress or changes in the body, the surrounding bones slowly get bigger and begin to fail.
Osteoarthritis is a slowly progressing disease and occurs in the joints of the hand, spine, hips, knees, and toes. Furthermore, risk factors of this disease most often stem from lifestyle or biological causes, such as:
- Obesity
Osteoarthritis sometimes occurs alongside rheumatoid arthritis or other disease, such as gout.
Medical Management Of Rheumatoid Arthritis
Medical management usually involves a combination of more than one treatment modality. The treatment options are:
- Medications
- Nonsteroidal anti-inflammatory drugs : NSAIDs can relieve pain and reduce inflammation.
- Steroids: Corticosteroid medications suppress the immune system, reduce inflammation and pain, and delay joint damage.
- Disease-modifying antirheumatic drugs : These drugs are extremely effective in the treatment of RA. They suppress internal swelling and relieve symptoms. They can slow the progression and prevent joint deformities and other complications. Some commonly prescribed DMARDs are Methotrexate, Sulfasalazine, and Hydroxychloroquine.
- Biological modifiers: These are a newer generation of DMARDs, and they are usually taken with DMARDs to suppress inflammation. Some examples are Infliximab, Rituximab, etc.
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Jak Inhibitors And Ra
- Tofacitinib is the first in a new class of “small molecule” medications used to treat rheumatoid arthritis called JAK inhibitors. Tofacitinib is a treatment for adults with moderate to severe active RA in which methotrexate was not very effective. Patients can take tofacitinib with or without methotrexate, and this prescription drug is taken by mouth two times a day. Tofacitinib is a “targeted” drug that only blocks Janus kinase, special enzymes of inflammation, within cells. This is why it is referred to as a JAK inhibitor. JAK inhibitors are not used with biologic medications.
When To Talk With Your Doctor
If youve been using a particular management strategy for your arthritis, but you feel like its not working as effectively as it once did, contact your doctor. Its possible that you will have more success with a different type of treatment.
If your symptoms are worsening or new symptoms develop, thats another opportunity to discuss other treatment options with your provider.
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Side Effects That Can Occur With Methotrexate
As with many drugs, people can experience unpleasant, and in rare cases dangerous, side-effects from methotrexate. If you experience anything that concerns you, be sure to speak with your healthcare provider.
Bothersome side effects include dizziness, headache, tiredness, gastrointestinal upset, mouth sores, rash, diarrhea, and the loss of hair.
According to the American College of Rheumatology, methotrexate may also lower the ability of the immune system to fight infections.
Determine If You Have Progressive Ra
Progressive rheumatoid arthritis is a more aggressive form of the disease. Treatment for PRA is different from the milder version. But determining if you have PRA can be tricky. There are specific signs to look for. Be sure to share any changes with your doctor so they can help determine if you have the more aggressive form of RA.
Here are the signs to keep an eye on:
- Youre having more flare-ups, or the active stages of RA are becoming more frequent and are lasting longer.
- Youre experiencing extreme inflammation of the tissue around the joints. This may be damaging the cartilage and the bone.
- Youre experiencing a marked decrease in mobility and muscle strength, and in some cases, you have no mobility at all.
- Youre experiencing increased pain and swelling in new joints and muscles that were previously unaffected.
- Youre developing rheumatoid
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Such Is Its Prevalence Particularly Among The Elderly That You’d Be Forgiven For Thinking Arthritis Is Something That Creeps Up On You Over The Years Along With Grey Hairs And Middle
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Take the first steps to beating arthritis with these simple guidelines
Fortunately there are many ways to reduce your risk and to minimise its effects if you become a sufferer.
Arthritis is not a single disease but an umbrella term for a group of conditions that cause pain and inflammation in and around the joints.
It affects people of all ages including children and there are many types with a range of symptoms.
The most common are pain, tenderness and stiffness around the joints, reduced movement and function, inflammation, redness and warmth and muscle weakness.
While there is no cure for arthritis there are various treatments that can successfully slow down its effects and minimise joint damage
The cartilage protecting the bones around a joint becomes thin leaving the ends of the bone exposed. This makes movement painful as the bones rub together. Osteoarthritis is most often found in the joints of the hands, knees, hips and spine.
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Seven easy ways to beat arthritis
The second most common form is rheumatoid arthritis which is more severe but less prevalent, affecting around 400,000 people. It is most likely to arise between the ages of 40 and 50 and is three times more common in women than men.
Rheumatoid arthritis is an autoimmune disease in which the immune system attacks the lining of the joints causing inflammation and pain. Movement may be reduced and bones and cartilage broken down.
1 WORK WITH YOUR HEALTHCARE TEAM
2 MANAGE YOUR WEIGHT
What Does Ra Feel Like
- The usual symptoms of rheumatoid arthritis are stiff and painful joints, muscle pain, and fatigue.
- The experience of rheumatoid arthritis is different for each person.
- Some people have more severe pain than others.
- Most people with rheumatoid arthritis feel very stiff and achy in their joints, and frequently in their entire bodies, when they wake up in the morning.
- Joints may be swollen, and fatigue is very common.
- It is frequently difficult to perform daily activities that require use of the hands, such as opening a door or tying one’s shoes.
- Since fatigue is a common symptom of rheumatoid arthritis, it is important for people with rheumatoid arthritis to rest when necessary and get a good night’s sleep.
- Systemic inflammation is very draining for the body.
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Pain Messages Travel Slower Than Other Nerve Stimulation
Nerves can also be categorised according to their diameter and whether a myelin sheath is present.
Three types of nerves are concerned with the transmission of pain:
A-beta fibres, which have a large diameter and are myelinatedA-delta fibres, which has a small diameter and also have myelinated sheaths.C fibres have small diameters, are non-myelinated , and are generally involved in transmitting dull, aching sensations.
Nerves with large diameters conduct impulses faster than those with a small diameter. The presence of a myelin sheath also speeds up the nerve conduction rate.
One method of easing your pain is to provide your nervous system with high speed “good feelings”, such as rubbing your injured area. This is the same principle that a tens machine utilises to provide pain relief.
Ways To Slow Down Arthritis
Many thinks arthritis is simply a part of growing older â along with grey hairs and better taste in music. Although this isnât quite true, it is of course very prevalent in older age groups. Fortunately, there are many ways to reduce your risk and to minimise its effects if you become a sufferer. Here are eight simple things that you can do at home.
1. Stretch is out
As long as it doesnât cause you more grief that itâs worth, itâs a good idea to stretch out your joints every day. Your flexibility routine doesnât have to be too complex and you certainly donât need to pay someone to tell you how to do it. Just listen carefully to your body. However, if you are already uncomfortable with this then you should consult your GP for a tips or advice on a stretching program.
2. Protect your joints
They always say prevention is the best cure. Even if you donât suffer from arthritis, try to minimise placing unnecessary stress on your joints. For example, bend with your legs and not your back, and avoid lifting heavy objects if you can drag them instead
3. Take a warm bath
Applying soothing heat to your joints will help relive rheumatoid pain associated with arthritis. Hoping in the bathtub is not only enjoyable but also liquid heat penetrates better than dry heat. If you donât have a bath in your home or itâs just not your style, you can also use moist heating pads for temporary relief.
4. Manage your weight
5. Watch what youâre eating
6. Try a cane
7. Exercise
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When Are Biologics An Option
Biologic drugs are made from living cell cultures. They work by, for instance, interfering with certain chemical messengers in the body’s immune system, and that influences the rheumatic inflammatory response. These drugs are sometimes also called biologic disease-modifying antirheumatic drugs .
Biologics are considered as a treatment option for rheumatoid arthritis when conventional DMARDs haven’t helped enough. Biologics are typically used in combination with methotrexate. People who don’t tolerate methotrexate well can start treatment with a biologic only. All of the biologics approved in Germany so far are given as an injection or an infusion . It’s also possible to inject the drug under your skin yourself.
The following biologic DMARDs have been approved for use in Germany and other countries:
- Abatacept
- Rituximab
- Tocilizumab
Biologics can reduce pain, swelling and morning stiffness, and also help against . But they can have various side effects too. For example, skin rashes, itching or pain can occur where the injection or infusion needle was inserted. They may lead to infections of the airways as well.
If a biologic is used in addition to basic therapy with methotrexate, within one year an extra 16 out of 100 people are symptom-free or experience a clear improvement in symptoms. But an extra 9 out of 100 people develop an infection of the airways, and 2 out of 100 have a severe infection.
The Best Ways To Minimize Methotrexate Side Effects
Some side effects from this drug result from a drop in folic acid levels in the body. To reduce these effects, doctors generally prescribe folic acid supplements along with the drug.
Many people find taking the oral medicine with food can prevent stomach upset, Tenpas says.
Some recommend splitting the dose, by taking half in the morning and the other half 12 hours later to ease these gastrointestinal side effects. If that doesnt help, talk to your doctor about switching from the oral to the injectable version of the drug.
To deal with mouth sores, the the Arthritis Foundation suggests using a saltwater rinse or special mouthwash containing a lidocaine pain reliever. If nausea is an issue, you can request a prescription for anti-nausea medicine.
Not all of the negative effects of the drug cause symptoms. This is why routine blood tests are regularly performed for people taking this medication.
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How Can I Slow The Progression Of Arthritis
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
How Is Rheumatoid Arthritis Diagnosed
Due to the variety of symptoms experienced by patients, diagnosing Rheumatoid Arthritis can be complex. Doctors will confirm the diagnosis based on your symptoms, a physical examination and the results of x-rays, scans and blood tests. Your doctor may also refer you to a specialist to confirm the diagnosis and receive treatment.
Blood tests, in this case, are used to measure inflammation. You may have one of these tests:
- Erythrocyte Sedimentation Rate
- C-Reactive Protein .
Both of these may show a high value when inflammation is present. These tests may be repeated from time to time to help monitor your arthritis.
Please seek the professional advice of your doctor or physiotherapist.
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