The treatment for rheumatoid arthritis consists of many medications. Most patients administer a combination of drugs, including basic antirheumatic drugs (DMARDs) that modify the disease, biological drugs, analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids. Corticosteroids for rheumatoid arthritis are a highly effective but powerful treatment for inflammation and pain. They are used in short-term situations and may not be suitable for all patients.
What are corticosteroids
Corticosteroids are steroids given to patients with rheumatoid arthritis to reduce inflammation and help regulate autoimmune activity. Corticosteroids have been used for five decades to help treat the symptoms of rheumatoid arthritis. Often you hear corticosteroids called glucocorticoids.
Many rheumatoid arthritis treatment strategies still use corticosteroids in combination with NSAIDs and BPD, as they not only reduce inflammation but also help protect joints and organs from future damage.
How do corticosteroids work?
The human body naturally produces cortisol hormones from the adrenal glands, which are located above the kidneys. Corticosteroids mimic the effects of these hormones on the body, and when they are prescribed in a sufficiently high dose, they reduce inflammation in the patient.
Corticosteroids prescribed to patients with rheumatoid arthritis reduce the levels of inflammation that cause joint pain, stiffness, and deterioration of bones and cartilage. Corticosteroids also act as immune inhibitors, suppressing autoimmune attacks that cause inflammation in patients with rheumatoid arthritis.
In addition to rheumatoid arthritis, corticosteroids are used to treat a number of inflammatory and autoimmune diseases, such as lupus, asthma, skin condition and various allergic reactions.
There are several types of corticosteroids for rheumatoid arthritis. Sometimes they are also called glucocorticoids.
Here are common forms of corticosteroids used to treat the symptoms of rheumatoid arthritis:
- Dexamethasone (Decadron).
- Methylprednisolone (Depot – Medrol, Medrol).
Prednisone is the most commonly used corticosteroid in the treatment of rheumatoid arthritis.
How are corticosteroids used for rheumatoid arthritis?
Corticosteroid treatment for rheumatoid arthritis is available in several formats. These formats include:
- Pills (tablets, capsules, and syrups).
- Intra-articular injection (into the joint).
- Intravenous injection.
- Intramuscular injection
Formulations of corticosteroid tablets are usually taken orally once a day in small doses. Most types of corticosteroids are taken when the patient wakes up in the morning. This is due to the fact that steroids mimic a natural increase in body activity. Patients also take corticosteroids upon waking to relieve symptoms of morning stiffness.
It has been proven that intra-articular injections of steroids are highly effective because they deliver the drug directly to the inflamed area. Corticosteroid injections are usually given after a few months. Doctors may recommend that patients receive only three or four injections of corticosteroids per year.
Typically, corticosteroids are prescribed in low dosage for a short period of time. Because corticosteroids are so effective, it is best to slowly and gradually reduce the dose over several weeks to prevent withdrawal symptoms. This, in contrast to stopping corticosteroids, is sudden, which can sometimes cause negative reactions in patients.
When to take corticosteroids
Corticosteroids are usually taken along with DMARDs. For most patients, DMARDs may take several weeks to get started. At this time, it is important to try to control the disease as much as possible. The use of corticosteroids during this waiting period is a highly effective method for reducing inflammation and alleviating pain and stiffness for the patient.
Corticosteroids can also be prescribed during periods of outbreaks in which the disease becomes very active and serious symptoms appear. Corticosteroids are used to soothe symptoms and provide immediate relief for patients.
In general, corticosteroids are considered as a “bridge therapy” option for treating patients with rheumatoid arthritis. This means that they are used in individual cases for a short period of time at lower doses. This is primarily due to the number of serious side effects associated with the use of corticosteroids.
So, here’s how corticosteroids are used in rheumatoid arthritis:
- As an interim treatment or “bridge therapy”, waiting for the BPRP to take effect.
- During painful outbreaks, when inflammation becomes active.
- Like short-term inflammation and pain relief.
- For longer periods of time at low doses for patients not responding to DMARDs.
- For serious inflammatory symptoms affecting the heart and blood vessels.
Side effects of corticosteroids
Although corticosteroids can be very effective in reducing inflammation and alleviating pain, they carry many serious side effects. Side effects of corticosteroids more often occur when they are used as a regular treatment for a longer period of time. That’s why doctors are trying to limit long-term dependence on corticosteroids in the treatment of rheumatoid arthritis.
Side effects in patients may include:
- Increased risk of viral or bacterial infection.
- Sudden withdrawal symptoms such as weakness and fatigue.
- High blood pressure.
- Elevated blood sugar.
- Swelling in the legs.
- Cataract Risk
- Weight gain.
- Dyspepsia, including depression and anxiety.
Usually, intraarticular injections of a corticosteroid do not produce strong side effects as oral corticosteroids do. However, corticosteroid injections may cause distinct side effects than oral corticosteroids. For example, many patients develop skin irritation and rashes at the injection site.
Today, many doctors prefer to avoid using corticosteroids as a reliable treatment for rheumatoid arthritis. Many doctors will try to minimize its use and ultimately completely exclude it from the treatment strategy.
Corticosteroid Treatment Results
Patients taking corticosteroids have an almost immediate relief of symptoms. Corticosteroids quickly migrate to inflammation, relieving pain and stiffness, which helps restore the quality of life.
As a temporary and short-term treatment, corticosteroids usually give a very positive result for patients with rheumatoid arthritis and can help suppress the progression of the disease and maintain joint function.
In some cases, corticosteroids are prescribed to reduce inflammation in rheumatoid arthritis, which began to affect vital organs. In these situations, corticosteroids can be critical and even vital.
Corticosteroids for rheumatoid arthritis are one element of the overall treatment strategy, which is comprehensive and personalized for each patient.