Rheumatoid arthritis is a painful, chronic disease that causes inflammation in the lining of the joints. Over time, this can cause severe damage to the joints and result in limited movement. Since rheumatoid arthritis is also an autoimmune disease, it affects the entire body and can have serious complications if it's not monitored and treated. Doctors need to do regular blood tests in order to prescribe medication for rheumatoid arthritis.
Diagnosis
To diagnose rheumatoid arthritis and begin to prescribe medication for it, a doctor will use a combination of test results. The most important is a blood test for the rheumatoid factor. The higher the level of the rheumatoid factor in the blood, the more severe rheumatoid arthritis is. Another initial test used is the anti-CCP. The level of antibodies binding the citrulline modified proteins is usually only elevated in those with rheumatoid arthritis, even in its developmental stages.
Anti-Inflammatories
There are many different drugs that are used to reduce inflammation in rheumatoid arthritis patients. NSAIDs (non-steroidal anti-inflammatories) like Motrin or the COX-2 inhibitor Celebrex can be taken long term. For severe inflammation, Glucocorticoids or Prednisone are used. There are two different blood tests most often used done to diagnose and monitor inflammation for prescribing medication for rheumatoid arthritis. Both the sed (erythrocyte sedimentation) rate and CRP (C-reactive protein) measures the amount of inflammation that is in the body.
Analgesics
Analgesics are used in some rheumatoid arthritis patients to control pain. Acetaminophen (Tylenol) can be purchased over the counter, but sometimes it is not enough. It can be given by prescription with codeine, hydrocodone (Vicodin) or propoxyphene (Darvon). The use of acetominophen, however, has been linked to liver problems. Blood tests must be done regularly to test liver functions when any medications with acetaminophen are used for rheumatoid arthritis.
DMARDs
Disease modifying antirheumatic drugs (Imuran, Plaquenil) help stop the immune system from causing damaging inflammation in the rheumatoid arthritis patient. Unfortunately, by doing this, they also leave the patient prone to infection. Anyone taking DMARDs must be monitored for illness. A white cell count blood test is taken before prescribing the medication for rheumatoid arthritis and periodically after to keep an eye on the patient's immune system.
Biologic Response Monitors
Enbrel, Humira and Remicade are part of a class of drugs to treat rheumatoid arthritis called biologic response monitors. They target the cytokines in the immune system which triggers inflammation. Taking biologic response monitors can slow the progression of the disease. Like DMARDs, these drugs can also increase risk of infection so white cell counts need to be done repeatedly.
Considerations
Sed rates and CRP levels are done continually on rheumatoid arthritis patients to monitor inflammation so necessary medication changes can be made. While these blood tests are important, there are other factors in prescribing. Exact treatment for rheumatoid arthritis will vary depending on the patient. A patient's ability to function physically, extent of joint deterioration, mental well-being, allergies, additional conditions (like gastrointestinal problems that prevent the use of some drugs) and quality of life are taken into consideration when medications are chosen for rheumatoid arthritis.
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