Dr. Roach: RA patient hasn't found a medication that alleviates joint pain

Key Points:

• Rheumatoid arthritis (RA) is an autoimmune disease affecting joints and potentially other organs, treated initially with conventional immune-suppressing drugs like methotrexate or hydroxychloroquine.
• Biological medications for RA are made from live cells and mainly include monoclonal antibodies targeting cytokines such as TNF, interleukin-6, and interleukin-1, or proteins that block these cytokines; they are usually reserved for patients who do not respond to other treatments.
• Biologicals carry risks of serious infections but allergic reactions are uncommon; treatment decisions depend on disease activity and require expert rheumatologist management.
• For a 99-year-old patient experiencing hip pain potentially linked to PCSK9 inhibitors used after a heart attack, doctors should first rule out other causes like arthritis or injury before attributing pain to the medication.
• If PCSK9 inhibitors are confirmed as the cause of pain, trying different inhibitors or alternative treatments such as bempedoic acid, which has fewer muscle-related side effects, may be recommended, with quality of life as a key consideration.