Rheumatoid Arthritis Antiinflammatory Medications

Aka: Rheumatoid Arthritis Antiinflammatory Medications

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II. Indications: Rheumatoid Arthritis

  1. Symptom relief and improved function
  2. No change in Rheumatoid Arthritis progression
  3. DMARDs are first line agents
    1. The anti-inflammatory agents shown here are adjuncts to DMARD therapy
    2. Limit use of NSAIDs and COX2 Inhibitors once on DMARD >1 month
      1. Decrease to lowest effective dose (preferably use only as needed)
      2. Best use is limiting NSAIDS and COX2 Inhibitors for exacerbations

III. Management: First Choice

  1. NSAID (Propionic Group)
    1. Naproxen
    2. Ibuprofen
    3. Fenoprofen
  2. NSAID (Heterocyclic Group)
    1. Tolmetin
    2. Sulindac
  3. NSAID (Oxicam/Indole Group)
    1. Piroxicam
    2. Indomethacin
  4. Aspirin
  5. Prednisone 10 mg qd
    1. Use as bridge therapy to DMARDs
    2. Consider Osteoporosis prophylaxis for longterm use

IV. Management: Second Choice: Non-acetylated Salicylates

  1. Trilisate
  2. Salsalate

V. Management: Local remittive agents

  1. Indicated for Rheumatoid Arthritis flares
  2. Corticosteroid Injection

VI. References

  1. Pincus (1993) Rheum Dis Clin North Am 19:123-151 [PubMed]
  2. Scott (2010) Lancet 376(9746):1094-108 [PubMed]
  3. Wasserman (2011) Am Fam Physician 84(11): 1245-52 [PubMed]

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