Disease-Modifying Antirheumatic Drugs

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.