Palindromic Rheumatism

Treatment for PR

Treatment for PR can start with Pain Killers and Anti-inflammatory drugs from your GP. NSAIDS = Non Steroid Anti Inflammatory Drugs (in the form of tablets or gels) don't usually help long term but can help short term with mild pain. The Dr may also start you on an Anti-depressant. The Dr should also refer you to a Rheumatologist for a diagnosis.

Treatment can be challenging because the attacks are so difficult to predict. Symptomatic treatments are the usual treatment. Symptomatic treatment is also called palliative treatment. This type of therapy eases the symptoms without addressing the basic cause of the disease, taken at the earliest part of an attack Anti Inflammatories may help. If attacks are frequent, long-term treatment with disease-modifying agents (DMARDS) such as hydroxychloroquine (Plaquenil), Sulfasalazine (Azulfidine), or other medications typically used in rheumatoid arthritis may be effective.

When you get to see the Rheumatologist he/she will start you on a course of DMARDS = (Disease-Modifying Anti-Rheumatic Drugs) As they don't know what causes PR they don't know how to cure it, so they treat it like Rheumatoid Arthritis "RA". As some people who have PR will go on to RA. They have found that the medication used for "RA" helps with the inflammation and pain and and can slow down the progression into RA (If you are likely to go on to develop RA).

All prescribed drugs can and usually do have some sort of side effect, this varies with what level of drug you take so your Rheumatologist will usually start you with something that has less of a side effect and see if that helps with your PR.

If/After you have tried the DMARDS to no affect or with too many negative side effects or just they aren't working like they used to, you are likely to start a combination. This is usually with another type of drug which may included an Anti-TNF.

Anti-TNF is a name given to a new class of drugs available for the treatment of severe rheumatoid arthritis. Currently this group consists of three drugs, infliximab (trade name Remicade), Etanercept (trade name Enbrel) and Adalimumab (trade name Humira). These drugs work by blocking the action of TNF (tumour necrosis factor) a molecule responsible for increasing levels of inflammation in people with rheumatoid arthritis.

There are other forms of treatment being used with RA and PR, one of which is Antibiotic Treatment. This is a new way of thinking for the medical world as "AP Advocates" believe this is a cure for Arthritis and not just a treatment to reduce pain and inflammation which other forms of treatments do. The antibiotics used are usually Minocycline (Minocin). This could work well with people with PR as its a good drug in terms of symptom relief and joint swelling relief (and improvement in laboratory measures of inflammation), but it is reported to have no important affect on joint damage therefore it may seem more suited to people that have PR as there is not usually any joint damage as in RA. However this doesn't account for people with PR that will go on to develop RA.

It has to be said to be made clear, no two people are the same nor is PR the same with every one. This is the same for medication you may take Methotrexate (for example) and have little or No side effects, but some people have problems taking it. This is the same for all forms of treatments and you shouldn't be scared to try a treatment that you think might help you nor should you be persuaded by others to take a treatment that isn't right. Only you can decide.

Medication Used And Likely Order - Depending On Your Situation

These drugs are in no particular order and were taken from a survey of PR Suffers and my own experience. The effectiveness is based on their overall experience and not based on a clinical survey. The more benefit a drug has the more the likelihood of side effects. Not everyone will experience the same side effects or benefits.

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