Antirheumatic Drugs (DMARDs)

Key points

• • Rheumatoid arthritis is driven by an overactive immune attack on the joints, so disease-modifying antirheumatic drugs (DMARDs) target that process.
• • Methotrexate is the anchor drug; it interferes with the use of folate and the multiplication of immune cells, slowing joint damage.
• • Other conventional DMARDs include sulfasalazine, leflunomide and hydroxychloroquine.
• • Biological agents block specific immune messengers, such as tumour necrosis factor, or immune cells, and are used when conventional drugs are not enough.
• • Because they damp immunity, these drugs raise the risk of infection and need monitoring for harm to organs.