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Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints1

RA IS A COMMON TYPE OF ARTHRITIS, AFFECTING OVER 1 MILLION PEOPLE IN THE UNITED STATES1

Signs and symptoms of RA include2:

  • Pain, stiffness, and swelling in multiple joints
  • The same symptoms on both sides of the body (such as both hands or both knees)

Inflammation causes the signs and symptoms of RA3

  • The release of inflammatory chemicals causes joint swelling, increased joint fluid and inflammation of the synovial membrane4

Treatment should aim to relieve both the inflammation and pain associated with RA

DRAG TO SEE RA INFLAMMATION & PAIN

NSAIDS ARE COMMONLY USED FOR EFFECTIVE SYMPTOMATIC RELIEF IN RA5

First-line recommendations for early and established RA are patient dependent and include non-NSAID treatments including disease-modifying antirheumatic drugs (DMARDs) and biologics.6

NSAIDS RELIEVE THE INFLAMMATION AND PAIN ASSOCIATED WITH RA5

  • NSAIDs inhibit the cyclooxygenase (COX-1 and COX-2) enzymes from producing prostaglandins which are mediators of inflammation and pain5,7,8
  • NSAIDs are also known to have an analgesic effect7-9
  • Without
    NSAIDs
  • With
    NSAIDs
  • COX-1 or COX-2 binds to arachidonic acid.
  • COX-1 and COX-2 are enzymes that convert arachidonic acid into prostaglandins.
  • This leads to the creation of prostaglandins, which mediate inflammation and pain.5,7,8
  • NSAIDs bind to COX-1 or COX-2 so it cannot bind to arachidonic acid.5,7,8
  • COX-1 or COX-2 cannot trigger prostaglandin creation. Prostaglandin-induced inflammation and pain is reduced.5,7,8

DRAG TO SEE HOW NSAIDs REDUCE INFLAMMATION & PAIN

For illustrative purposes only.

Choose the most appropriate treatment option for your RA patients

Things to keep in mind when considering opioids

Get the facts

Consider the need for gastroprotection with NSAID therapy

See the data

REFERENCES

  1. What Is Rheumatoid Arthritis? Arthritis Foundation website. https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/what-is-rheumatoid-arthritis.php. Accessed January 25, 2019.
  2. Rheumatoid Arthritis. Centers for Disease Control and Prevention website. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html. Accessed January 15, 2019.
  3. Derksen VFAM, Huizinga TWJ, van der Woude D. The role of autoantibodies in the pathophysiology of rheumatoid arthritis. Semin Immunopathol. 2017;39(4):437-446.
  4. Arthritis Pain. Arthritis Foundation website. https://www.arthritis.org/toolkits/arthritis-pain/about-pain/inflammatory-joint-pain.php. Accessed January 15, 2019.
  5. Crofford LJ. Use of NSAIDs in treating patients with arthritis. Arthritis Res Ther. 2013;15(suppl 3):S2.
  6. Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2016;68(1):1-25.
  7. VIMOVO (naproxen/esomeprazole magnesium) [prescribing information] Horizon.
  8. Ricciotti E, FitzGerald GA. Prostaglandins and Inflammation. Arterioscler Thromb Vasc Biol. 2011;31(5): 986-1000.
  9. Cashman JN. The mechanisms of action of NSAIDs in analgesia. Drugs. 1996;52(suppl 5):13-23.