Different types of drugs can be used to treat palindromic rheumatism:
|Non-steroidal anti- inflammatory drugs (NSAIDs)
||NSAIDs are used to reduce pain and inflammation during the attacks. Examples include diclofenac, naproxen and ibuprofen.
||Steroid injections can bring fast relief to an inflamed joint.
|Disease-modifying anti-rheumatic drugs (DMARDs)
||Drugs such as hydroxychloroquine, sulfasalazine and occasionally methotrexate can be used to prevent attacks or reduce their frequency in people with more serious disease.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Non-steroidal anti-inflammatory drugs block the inflammation that occurs in the lining of your joints and can be very effective in controlling pain and stiffness. Your symptoms will improve when you take these drugs, but the effects aren’t long-lasting so you have to take the tablets regularly. You’ll need to take them as soon as an attack starts and then continue until after it’s finished. Some people who have a lot of attacks find it works better to take them all the time.
If you find that a particular NSAID works well for a while but then becomes less effective, it sometimes helps to try a different NSAID. There are many NSAIDs available, and your doctor will advise you on the best choices for you.
Your doctor might recommend steroid injections if your joints are particularly painful or your ligaments and tendons have become inflamed.
Injections aren’t given regularly, but you may be given them if you have one or more very inflamed joints/tendons. They usually work within a few days. Some GPs give them but they’re usually given by your consultant team in hospital.
Disease-modifying anti-rheumatic drugs (DMARDs)
Disease-modifying anti-rheumatic drugs help by tackling the causes of joint inflammation. In palindromic rheumatism they’re used to reduce how often you have attacks and how bad they are.
DMARDs aren't usually used as a first-choice treatment in palindromic rheumatism. The decision to use them will depend on many factors, including how much effect NSAIDs have had, how often you have attacks and how bad they are. It may be some time before DMARDs start to have an effect on your joints, so you should take them regularly.
The most common DMARDs used to prevent attacks in palindromic rheumatism are hydroxychloroquine and sulfasalazine because they have fewer side-effects than some other DMARDs. However, people with severe disease may need stronger DMARDs like methotrexate.
When taking DMARDs you’ll generally need to have regular blood monitoring to check for possible side-effects, including problems with your liver, kidneys or blood count.
You can take NSAIDs along with DMARDs.