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Thursday, 14 December 2017

Rheumatology Medications

A number of types of drugs are used to treat arthritis and connective tissue disease. These generally fall into the following groups:

Rheumatology Medications FAQs

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Immunosuppressives

Many arthritic conditions are controlled by drugs which suppress the body's immune system, thereby reducing the degree of inflammation and slowing down progression of the disease. Commonly used immunosuppressive drugs include methotrexate, leflunomide, azathioprine, mycophenolate, ciclosporin and cyclophosphamide. These drugs may take several weeks to be effective and you should continue with all other prescribed medication until advised otherwise.

Side effects sometimes occur, particularly in the first few weeks of treatment. The most common include nausea, diarrhoea, mouth ulcers, bruising and occasionally skin rashes. You will be fully counselled regarding possible side effects prior to starting any new medication and given written information to support this. Often side effects are mild and resolve spontaneously, however, occasionally side effects may be serious and it is important to seek advice from the rheumatology team or from your GP if you experience any side effects, whether listed or not.

As with some DMARDs, immunosuppressives can affect the blood and the liver or kidneys and regular blood tests and/or urine tests will be necessary whilst on treatment. Results of all blood tests are reviewed by the rheumatology team and are also copied to your GP. If problems occur you may be advised to stop the drug responsible, or to reduce the dose to prevent more serious side effects occurring. Some drugs have other potential side effects, for example leflunomide may cause a rise in blood pressure and this should be monitored regularly whilst on treatment. Rarely, methotrexate causes respiratory problems such as a dry cough and/or shortness of breath so a chest X-ray is usually performed before starting treatment with this drug. If such side effects occur, this may be repeated and lung function tests and/or a CT scan may also be requested.

Although patients often worry about potential side effects of treatment, it is important to realise that if left untreated, your rheumatic condition may cause you greater harm than the drugs prescribed to control it. Most patients do derive considerable benefit from treatment, with minimal side effects.

Further information about specific immunosuppressives and their side effects is available from the Arthritis Research Campaign.

If you are prescribed methotrexate and/or leflunomide you should, ideally, avoid alcohol, or at least keep this to a minimum, as this increases the likelihood of liver damage whilst on these treatments.

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