Issues in Contemporary Drug Delivery

Abstract

Objective

To provide an overview of rheumatoid arthritis (RA) and the medications presently being used to treat the disease.

Data Sources

References have been selected from published articles, monographs, manufacturers’ product information, textbooks on therapeutics of rheumatic diseases, and specific computerized databases such as DRUGDEX.

Study Selection

Studies that establish the pharmacokinetics of the various drugs have been included, as have comparative studies of the various agents. Studies that gave specifics concerning the use of the various agents in the elderly were given priority in selection. Monographs from both United States Pharmacopeia Dispensing Information and American Hospital Formulary Service Drug Information ‘92 were used to ensure consistency in dosing and pharmacokinetic data.

Data Synthesis

A variety of medications are used to treat RA, and are classified according to their ability to alleviate the inflammatory process and symptomatology of the disease, or to actually slow down or halt the progression of the disease process itself. The long-established pyramidal approach to therapy is presently being challenged so as to employ the slow-acting or disease-modifying agents earlier in the process.

Conclusions

A wide variety of medications are presently available for treating RA. As the pathogenesis of the disease becomes better defined, it is hoped that less-toxic and more-specific and -effective therapies will become available. Medications remain the cornerstone of therapy; however, patient education, rest, and exercise are equally important.