Current concepts regarding pharmacologic treatment of rheumatoid and osteoarthritis

Treating patients with osteoarthritis (OA) and rheumatoid arthritis (RA) re mains challenging; however, new agents offer the chance for an improved qua lity of life. As an alternative to traditional nonsteroidal antiinflammator ies, cyclooxygenase-2 inhibitors provide pain relief for OA and RA patients with possible fewer side effects. Otherwise, OA patients may opt for topic al agents, injections, or supplements. Rheumatoid arthritis research has le d to an improved understanding of the inflammatory cascade and an appreciat ion of the early tissue destruction. A new treatment philosophy has thus em erged along with the development of new biologic agents; the latter, along with combination therapy and a new disease modifying antirheumatic drug, le flunomide, have greatly expanded the chances for disease control in RA pati ents.