Disease-modifying anti-rheumatic drugs (DMARDs)

This group of drugs includes gold, hydroxychloroquine, methotrexate and sulfasalazine.

They are used mainly in the treatment of rheumatoid arthritis but also in some other rheumatic diseases. They reduce pain, swelling and stiffness. They do not work at once but may take several weeks to work. If you do not do well on one of these drugs, or if you develop any side-effects, then your doctor may try one of the others.

Immunosuppressant drugs

Another group of disease-modifying drugs are immunosuppressant drugs. They are termed ‘immunosuppressant’ because they suppress the immune system (the body’s own defence system).

They include azathioprine, ciclosporin, cyclophosphamide, leflunomide and mycophenolate. Methotrexate also has effects on the immune system. Because these drugs affect the immune system they may produce side-effects, and so need careful monitoring. Immunosuppressant drugs are often used to treat cancer but you can be reassured that your arthritis has nothing to do with this disease, and when used for arthritis lower doses of the drugs are administered.

Biologicals

A newer group of drugs are the so-called ‘biologicals’. These include the anti-TNF drugs (adalimumab, certolizumab pegol, etanercept and infliximab), rituximab and tocilizumab.

These drugs can reduce joint inflammation in people with rheumatoid arthritis and may also be used in some other inflammatory diseases. These drugs are currently only being used in people who have not responded to other disease-modifying drugs.

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