DISEASE-MODIFYING
ANTIRHEUMATIC DRUGS
While NSAIDs alleviate the
pain and inflammation of rheumatoid arthritis, they do nothing to halt the loss
of bone associated with this disease. The DMARDs are a chemically diverse class
of agents, all of which have varying capacities to slow the progression of
joint ero-sion. Their actions manifest over the course of weeks to months; they
are usually employed in combination with NSAIDs and sometimes other DMARDs.
Until the mid-1990s, DMARDs were reserved for treatment of the later stages of
the disease in which significant joint erosion had already occurred. These
agents were added individually, in slow succession (more than 6 months), as the
disease progressed. More recent therapies em-ploy certain DMARDs early in the
treatment of dis-ease, since they are effective in slowing the joint
deteri-oration that occurs at this stage.
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