disease-modifying bantirheumatic drugs

The disease-modifying bantirheumatic drugs - A group of antirheumatic drugs, known as DMARDs, that are used in the treatment of rheumatoid arthritis. Certain antimalarial drugs, anticancer drugs, and immunosuppressant drugs are used for this purpose. Examples of DMARDs are sulfasalazine, chloroquine, methotrexate, gold compounds (for example auranofin), and penicillamine.

DMARDs not only improve the symptoms and signs of inflammatory joint disease, but they also slow the course of the illness. (In contrast, nonsteroidal antiinflammatory drugs relieve symptoms but do not alter the progress of the disease.) Some DMARDs are cytotoxic, which means that they kill rapidly dividing cells. Gold compounds and penicillamine may impede the immune system from producing specialized proteins called antibodies (see antibody) that contribute towards damage to joints. Sulfasalazine interferes with a variety of inflammatory processes in the body, and chloroquine suppresses the effects of arthritis.

In general, DMARDs may need to be used for several months before the full effects are felt. For this reason, many specialists recommend starting therapy early to prevent or delay the progression of joint damage. Treatment with a combination of DMARDs may be more effective than a single drug, and may enable lower doses of each drug to be used, reducing the risk of adverse effects.

Possible side effects depend on the drug taken. They include diarrhoea, rash, anaemia (a reduced level of the oxygen-carrying pigment haemoglobin in the blood), leukopenia (a low white blood cell count), and increased susceptibility to infection. Regular blood tests and urine tests (see urinalysis) are needed during treatment to monitor the effects of DMARDs on the bone marrow, kidneys, and liver.