Rheumatoid arthritis (RA) is one of the most common forms of arthritis.

RA是一种炎症和自身免疫性疾病。当您的身体攻击自己的健康关节组织时，就会发生这种情况。这会导致发红，炎症和疼痛。

RA药物的主要目标是阻塞炎症以防止关节损害。

继续阅读以了解RA的许多治疗选择。

DMARDs

疾病改良的抗疾病药物（DMARD）用于减少炎症。与其他暂时缓解疼痛和炎症的药物不同，DMARDS可以减慢RA的进展。这意味着您的症状可能更少，随着时间的推移伤害较小。

用于治疗RA的最常见的DMARD包括：

  • hydroxychloroquine (Plaquenil)
  • Leflunomide（Arava）
  • methotrexate (Trexall)
  • sulfasalazine (Azulfidine)

Biologics

生物制剂是可注射药物。它们通过阻止免疫细胞制定的特定炎症途径来起作用。这减少了由RA引起的炎症。医生在仅单独使用DMARD的时候就不足以治疗RA症状时开出生物制剂。

Biologics aren’t recommended for people with compromised immune systems or an infection. This is because they can raise the risk of serious infections.

The most common biologics include:

  • abatacept (Orencia)
  • adalimumab (Humira)
  • certolizumab pegol (Cimzia)
  • Etanercept（Enbrel）
  • Golimumab（Simponi）
  • infliximab (Remicade)
  • rituximab (Rituxan)
  • Tocilizumab（Actemra）

Your doctor may prescribe JAK inhibitors if DMARDs or biologics aren’t treating your RA as well. These medications affect genes and the activity of immune cells in the body. They help prevent inflammation and stop damage to joints and tissues.

JAK抑制剂包括：

  • Baricitinib（Olumiant）
  • tofacitinib（Xeljanz，Xeljanz XR）
  • Upadacitinib（Rinvoq）

Before starting a JAK inhibitor, ask your doctor to ensure you’re up to date on all immunizations, including prophylactic zoster vaccinations (shingles vaccine).

这些药物的更常见的副作用包括：

  • 上呼吸道感染，如鼻窦感染或普通感冒
  • congested nose
  • runny nose
  • sore throat
  • influenza
  • shingles
  • cystitis (urinary bladder infection)

对乙酰氨基酚可在柜台（OTC）上找到无处方。它是一种口服药物和直肠栓剂。

Other drugs are much more effective at reducing inflammation and treating pain in RA. This is because acetaminophen can treat mild to moderate pain, but it doesn’t have any anti-inflammatory activity. So, it doesn’t work very well to treat RA.

This drug carries the risk of serious liver problems, including liver failure. Only take one drug that contains acetaminophen at a time.

NSAIDs are among the most commonly used RA drugs. Unlike other pain relievers, NSAIDs seem to be more effective in treating symptoms of RA. This is because they prevent inflammation.

有些人使用OTC NSAID。但是，有处方可提供更强的NSAID。

Side effects of NSAIDs include:

  • 对胃的刺激
  • 溃疡
  • erosion or burning a hole through your stomach or intestines
  • 胃会流血
  • kidney damage

In rare cases, these side effects can cause death. If you use NSAIDs for a long time, your doctor will monitor your kidney function. This is especially likely if you already have kidney disease.

Ibuprofen (Advil, Motrin IB, Nuprin)

OTC ibuprofen is the most common NSAID. Unless instructed by your doctor, don’t use ibuprofen for more than several days at a time. Taking this drug for too long can cause stomach bleeding. This risk is greater in older adults.

Ibuprofen is available in prescription strengths as well. In prescription versions, the dosage is higher. Ibuprofen may also be combined with opioids, another type of pain drug. Examples of these prescription combination drugs include:

  • 布洛芬/氢可酮（Vicoprofen）
  • 布洛芬/羟考酮（Combunox）

Naproxen sodium (Aleve)

萘普生钠是OTC NSAID。它通常被用作布洛芬的替代品。这是因为它导致副作用稍小。该药物的处方版本提供更强的剂量。

Aspirin (Bayer, Bufferin, St. Joseph)

阿司匹林是一种口服疼痛缓解剂。它用于治疗轻度疼痛，发烧和炎症。它也可以用来防止心脏病发作和中风。

Prescription NSAIDs

When OTC NSAIDs don’t relieve your RA symptoms, your doctor may prescribe a prescription NSAID. These are oral drugs. The most common options include:

  • Celecoxib（Celebrex）
  • 布洛芬（处方强度）
  • nabumetone (Relafen)
  • 萘普生（Naprosyn）
  • naproxen sodium (Anaprox)
  • Piroxicam（Feldene）

其他NSAID包括：

  • 双氯芬酸（Voltaren，双氯芬酸钠XR，Cataflam，Cambia）
  • 差异
  • 吲哚美辛（indocin）
  • ketoprofen (Orudis, Ketoprofen ER, Oruvail, Actron)
  • etodolac (Lodine)
  • Fenoprofen（Nalfon）
  • flurbiprofen
  • ketorolac (Toradol)
  • meclofenamate
  • mefenamic acid (Ponstel)
  • meloxicam (Mobic)
  • oxaprozin (Daypro)
  • sulindac (Clinoril)
  • salsalate（分质，amigesic，prharthitic，salflex，单盖，anaflex，salsitab）
  • oltmetin（耐受蛋白）

Diclofenac/misoprostol (Arthrotec)

这是一种口服药物，将NSAID双氯芬酸与米索前列醇相结合。NSAIDS会导致胃溃疡。这种药物有助于防止他们。

Topical capsaicin (Capsin, Zostrix, Dolorac)

辣椒素局部OTC霜可能会缓解RA引起的轻度疼痛。您在身体疼痛的区域上擦这种霜。

Diclofenac sodium topical gel (Voltaren 1%)

Voltaren gel 1% is an NSAID for topical use. This means you rub it on your skin. It’s approved to treat joint pain, including in your hands and knees.

This drug causes similar side effects to oral NSAIDs. However, only about4％of this drug is absorbed into your body. This means you may be less likely to have side effects.

双氯芬酸钠局部溶液（PENNSAID 2％）

双氯芬酸钠（PENNSAID 2％）和1.5％是用于膝盖疼痛的局部解决方案。您将其擦在膝盖上以减轻疼痛。

Opioids are the strongest pain drugs on the market. They’re only available as prescriptions.

阿片类药物采用口服和可注射的形式。它们仅用于严重的RA，这会导致严重的疼痛，因为阿片类药物会导致依赖性。如果您的医生开了阿片类药物，他们会密切监视您。

People with RA who take opioids should also use other treatments. This is because opioids only change the way you experience pain. They don’t slow down the disease or prevent inflammation.

阿片类药物包括：

  • 对乙酰氨基酚/可待因
  • 可待因
  • fentanyl
  • hydrocodone (Vicodin)
  • hydromorphone
  • Mepredine（Demerol）
  • methadone
  • morphine
  • oxycodone (OxyContin)
  • oxymorphone (Opana, Opana ER)
  • 曲马多（Ultram）

皮质类固醇也称为类固醇。它们作为口服和可注射的药物。这些药物可以帮助减少RA的炎症。它们还可能有助于减轻炎症引起的疼痛和损害。这些药物不建议长期使用。

副作用可能包括：

  • 高血糖
  • 胃溃疡
  • 高血压
  • emotional side effects, such as irritability and excitability
  • 白内障或眼睛中镜头的阴影
  • 骨质疏松症

Steroids used for RA include:

  • 替当塞米松
  • 可的松
  • 地塞米松(Dexpak Taperpak、Decadron Hexadrol)
  • 氢化可的松（Cortef，A-Hydrocort）
  • methylprednisolone (Medrol, Methacort, Depopred, Predacorten)
  • prednisolone
  • prednisone (Deltasone, Sterapred, Liquid Pred)

These drugs fight the damage caused by autoimmune diseases such as RA. However, these drugs can also make you more prone to illness and infection. If your doctor prescribes one of these drugs, they’ll monitor you closely during treatment.

这些药物以口服和可注射的形式，例如环磷酰胺（Cytoxan）。

与您的医生合作，找到最适合您的RA治疗方法。有了很多可用的选择，您和您的医生很可能会找到一种缓解RA症状并改善生活质量的选择。