Editing Arthritis (section)

=== Medications ===
There are several types of medications that are used for the treatment of arthritis. Treatment typically begins with medications that have the fewest side effects with further medications being added if insufficiently effective.<ref>{{cite web|url= http://www.arthritistoday.org/treatments/drug-guide/index.php|title=Arthritis Drugs|work=arthritistoday.org|access-date=5 July 2010| archive-url= https://web.archive.org/web/20100722013235/http://www.arthritistoday.org/treatments/drug-guide/index.php| archive-date= 22 July 2010 <!--DASHBot-->|url-status = live}}</ref>

Depending on the type of arthritis, the medications that are given may be different. For example, the first-line treatment for [[osteoarthritis]] is [[acetaminophen]] (paracetamol) while for [[inflammatory arthritis]] it involves [[non-steroidal anti-inflammatory drug]]s (NSAIDs) like [[ibuprofen]]. [[Opioid]]s and NSAIDs may be less well tolerated.<ref>{{cite journal | vauthors = Reid MC, Shengelia R, Parker SJ | title = Pharmacologic management of osteoarthritis-related pain in older adults | journal = The American Journal of Nursing | volume = 112 | issue = 3 Suppl 1 | pages = S38–S43 | date = March 2012 | pmid = 22373746 | pmc = 3733545 | doi = 10.1097/01.NAJ.0000412650.02926.e3 }}</ref> However, topical NSAIDs may have better safety profiles than oral NSAIDs. For more severe cases of osteoarthritis, intra-articular [[corticosteroid]] injections may also be considered.<ref>{{Cite journal |last1=McAlindon |first1=Timothy E. |last2=LaValley |first2=Michael P. |last3=Harvey |first3=William F. |last4=Price |first4=Lori Lyn |last5=Driban |first5=Jeffrey B. |last6=Zhang |first6=Ming |last7=Ward |first7=Robert J. |date=2017-05-16 |title=Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial |journal=JAMA |language=en |volume=317 |issue=19 |pages=1967–1975 |doi=10.1001/jama.2017.5283 |issn=0098-7484 |pmc=5815012 |pmid=28510679}}</ref><ref>{{cite journal | vauthors = Taruc-Uy RL, Lynch SA | title = Diagnosis and treatment of osteoarthritis | journal = Primary Care | volume = 40 | issue = 4 | pages = 821–36, vii | date = December 2013 | pmid = 24209720 | doi = 10.1016/j.pop.2013.08.003 | s2cid = 43061687 }}</ref>

The drugs to treat [[rheumatoid arthritis]] (RA) range from [[corticosteroid]]s to [[monoclonal antibodies]] given [[Intravenous therapy|intravenously]]. Due to the [[autoimmune]] nature of RA, treatments may include not only pain medications and anti-inflammatory drugs, but also another category of drugs called [[disease-modifying antirheumatic drug]]s (DMARDs). csDMARDs, TNF biologics and tsDMARDs are specific kinds of DMARDs that are recommended for treatment.<ref>{{cite journal | vauthors = Donahue KE, Schulman ER, Gartlehner G, Jonas BL, Coker-Schwimmer E, Patel SV, Weber RP, Bann CM, Viswanathan M | display-authors = 6 | title = Comparative Effectiveness of Combining MTX with Biologic Drug Therapy Versus Either MTX or Biologics Alone for Early Rheumatoid Arthritis in Adults: a Systematic Review and Network Meta-analysis | journal = Journal of General Internal Medicine | volume = 34 | issue = 10 | pages = 2232–2245 | date = October 2019 | pmid = 31388915 | pmc = 6816735 | doi = 10.1007/s11606-019-05230-0 }}</ref> Treatment with DMARDs is designed to slow down the progression of RA by initiating an [[adaptive immune system|adaptive immune response]], in part by CD4+ T helper (Th) cells, specifically Th17 cells.<ref name="pmid23383714">{{cite journal | vauthors = Kurebayashi Y, Nagai S, Ikejiri A, Koyasu S | title = Recent advances in understanding the molecular mechanisms of the development and function of Th17 cells | journal = Genes to Cells | volume = 18 | issue = 4 | pages = 247–265 | date = April 2013 | pmid = 23383714 | pmc = 3657121 | doi = 10.1111/gtc.12039 }}</ref> Th17 cells are present in higher quantities at the site of bone destruction in joints and produce inflammatory cytokines associated with inflammation, such as interleukin-17 (IL-17).<ref name="Chabaud_2000" />