Acronyms of arthritis 1: Treatments

Being diagnosed with inflammatory arthritis—like ankylosing spondylitis, rheumatoid arthritis, juvenile idiopathic arthritis, and psoriatic arthritis—can seem like being thrown into a world made of cryptic letters. Acronyms are everywhere. Acronyms for types of arthritis like RA, AS, SpA, JIA; acronyms for tests like RF, ESR, CRP; acronyms for treatments like NSAID, DMARD, MTX—it seems to never end! Let’s unravel some of these tricky terms, starting with common drugs you might hear about to treat arthritis. Soon you’ll be using them like a pro!

OTC

OTC (over-the-counter) medications don’t require a prescription from your doctor. In the US, some fairly effective first-line arthritis treatments are available OTC, such as ibuprofen (Motrin) and naproxen (Aleve).

NSAIDs

NSAIDs (non-steroidal anti-inflammatory drugs) are medications used to treat arthritis and many other conditions. These include over-the-counter drugs like ibuprofen (Motrin), naproxen (Aleve), and aspirin. These medicines are used for everyday aches and pains as well as arthritis.

Some common prescription NSAIDs include Celebrex, diclofenac, and nabumetone, and these are more specifically designed for use with arthritis. They often last longer and work better for arthritis than over-the-counter NSAIDs.

NSAIDs can cause stomach problems and, in severe cases, stomach ulcers, so it might be important to take an antacid or take NSAIDs with food. Follow the advice given by your doctor or pharmacist if you notice stomach issues with NSAIDs.

You also shouldn’t double up on NSAIDs for this reason. If you take a prescription NSAID, be careful not to take over-the-counter drugs that contain ibuprofen, naproxen, or aspirin. Tylenol (acetaminophen) is not an NSAID.

DMARDs

DMARDs (disease-modifying anti-rheumatic drugs) are medications used to alter the disease course of inflammatory arthritis. They slow down progression of arthritis by altering some part of the immune response to reduce pain, swelling, and damage. They can bring your arthritis into remission!

DMARDs fall into two main categories: biologic and non-biologic. Biologic DMARDs are usually just referred to as biologics, while non-biologic DMARDs are more commonly referred to as DMARDs.

Synthetic (non-biologic) DMARDs

These are the group most often referred to as DMARDs. They include methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine (Plaquenil). Some of these, like methotraxate, can be taken by injection, but largely they’re taken as pills. There are also some DMARDs that are abbreviated further:

• MTX: a common abbreviation for methotrexate.
• SSZ: a common abbreviation for sulfasalazine.

DMARDs all affect the body in different ways to slow disease progression. Some of them, like methotrexate, are known to cause nausea and similar side effects, so other medications may be prescribed with them.

In the past, non-biologic DMARDs were often tried before moving to a biologic DMARD, but it’s now common to go straight to a biologic in confirmed cases of inflammatory arthritis.

Biologic DMARDs

Biologics are technically DMARDs, but they’re not usually referred to that way. Biologics are typically taken by injection or infusion because they have to be delivered straight to the bloodstream to function most effectively. They inhibit parts of the immune response to reduce inflammation, swelling, pain, and damage from arthritis. Common biologics are Humira, Enbrel, Cimzia, Cosentyx, and Remicade.

Biologics used to be reserved as a last line of treatment for people whose arthritis didn’t respond to other medication, but they’re more often being used earlier after new evidence suggests this is the most effective way to prevent damage and achieve remission.

Biologics are also very expensive and require special storage in a refrigerator. They can seem scary at first. I’ve taken a lot of biologics, and honestly, I wish I had started on them sooner.

For more information about biologics, I have a lot of past posts on what makes something a biologic, my experiences injecting Humira, my experiences with the Enbrel Mini, and the research I did when I was worried about starting biologics.

I hope this covered the questions you had! In the future, I’ll be continuing this series with posts on acronyms for types of arthritis, tests for arthritis, and anatomy related to arthritis!

-Bri

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