Medical "Alternatives"
When Drugs Aren't Enough

Medications, while important, don't work for everyone. Luckily, there are other options in arthritis treatment. Here are the facts about two FDA-approved non-drug therapies, one of which may work for you.

Protein-A immunoadsorption (Prosorba) therapy: Prosorba therapy has been approved for people whose moderate to severe rheumatoid arthritis hasn't responded to DMARDs. The procedure involves drawing blood from your arm, separating plasma from red blood cells and treating plasma through a Prosorba column (a soup can-size cylinder that holds a sand-like substance coated with Protein A, a molecule that binds antibodies.) Treated plasma is then rejoined with red blood cells and returned to your body through your other arm.

Therapy is given in 12 weekly sessions lasting between two and two-and-a-half hours each. It takes as long as 12 to 16 weeks after beginning weekly sessions to feel the benefits of the therapy. Side effects associated with Prosorba include flu-like symptoms, such as chills, fever, nausea and fatigue. But the good news is that it can bring remission of RA. In best cases, RA becomes inactive for a year and a half after therapy completion.

Viscosupplements: Now knee osteoarthritis (OA) patients have another option for pain relief: a new class of products known as viscosupplements (or joint fluid therapy). The two products in the class, sodium hyaluronate (Hyalgan, Supartz) and hylan G-F 20 (Synvisc) are believed to work as lubricants by supplementing hyaluronic acid, the substance that gives joint fluid its viscosity.

Hyalgan and Supartz is administered in a series of five shots, while Synvisc is given in three. Pain relief lasts as long as six to 13 months in some people.

The therapies have proven most effective for people with mild to moderate knee OA. While this is good news for people with knee OA, viscosupplements have not been approved for OA of other joints. Associated side effects include pain, heat or redness at the injection site. The therapies are not advised for people with joint or skin infections, as well as allergies to eggs or other bird products.

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