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Author: Admin | 2025-04-28
Control inflammation. If inflammation is due to a systemic inflammatory disease, such as polymyalgia rheumatica or rheumatoid arthritis in the back, your health care provider may prescribe oral corticosteroids. If inflammation is limited to an inflamed joint in the spine, you may receive a corticosteroid injection directly into the inflamed joint.Disease-modifying antirheumatic drugs. Disease-modifying antirheumatic drugs (DMARDs) work slowly to modify the course of inflammatory disease. Different DMARDs may be useful for a number of different forms of arthritis that may affect the spine, including rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis.Biologic response modifiers. These are also disease-modifying medications, but unlike other DMARDs, each biologic or its biosimilar blocks a step in the inflammation process without suppressing the entire immune system. Biologics and biosimilars are approved to treat RA, PsA, ankylosing spondylitis, gout, lupus, juvenile arthritis and nonradiographic axial spondylitis. While numerous biosimilars are in use around the world and many have been approved in the U.S., only those for rituximab and adalumumab are available so far in the U.S.Janus kinase inhibitors. These drugs, like biologics, target specific parts or pathways in the immune system instead of suppressing the whole system. Unlike biologics, they are synthetics and are taken orally. Janus kinase inhibitors (JAKi) are approved to treat psoriatic arthritis and psoriasis, rheumatoid arthritis, ankylosing spondylitis, juvenile arthritis and nonradiographic axial spondyloarthritis.Osteoporosis medications. Osteoporosis medications are those used to slow the loss of bone (antiresorptive drugs, including bisphosphonates, calcitonin, the biologic denosumab [Prolia], estrogen and estrogen antagonists) or help the body build new bone (anabolic drugs, including teriparatide (Bonsity, Forteo) and abaloparatide (Tymlos). Although they are not used specifically to treat back problems, strong bones are less prone to fracture. Bisphophonates are also used to treat Paget's disease of the bone, which can also affect the spine.Fibromyalgia medications. Doctors prescribe medications from a variety of drug classes to treat fibromyalgia. Only three of these drugs — the anti-seizure medication pregabalin (Lyrica) and two antidepressants, duloxetine (Cymbalta) and milnacipran (Savella) — are FDA-approved to treat fibromyalgia. Many others are used off-label in fibromyalgia treatment because they have been shown in clinical
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