Disease-modifying antirheumatic drugs is a category of drugs used in many autoimmune diseases to slow down disease progression. Their use was first propagated in rheumatoid arthritis (hence their name) but has come to include many other diseases, such as Crohn's disease and ulcerative colitis, SLE, ITP (immune thrombocytopenic purpura) - to mention a few.
Most DMARDS are mild chemotherapeutics but use a side-effect of chemotherapy - immune suppression - as its main therapeutical benefit.
DMARD regimens consisted of intramuscular gold (aurothioglucose, 50 mg/week; second choice D-penicillamine, 500 to 750 mg/day), hydroxychloroquine (400 mg/day; second choice auranofin, 6 to 9 mg/day), or oral methotrexate (7.5 to 15 mg/week; second choice sulfasalazine 2,000 to 3,000 mg/day), depending upon patient response after first year.
While patients receiving early DMARD treatment showed favourable results at early follow-up evaluations as compared to those on the pyramid approach, the clinical advantage was not apparent at later evaluations.
Furthermore, the percentage of patients showing clinically relevant individual improvement was significantly higher in the early DMARD group than in the pyramid group starting at 3 months (48% versus 25%) and up to 21 months (70% versus 55%).
Remember that DMARDs are designed to attack inflammation, they are not painkillers and it is therefore important that you should also be taking painkillers whilst you have pain.
Occasionally the side effects which the DMARD is causing may be treated by using another medication for that side effect, for example if the problem is nausea and sickness then it may be possible to successfully continue taking a drug with an anti-sickness pill to help you.
All DMARD therapies are capable of harm as well as good and it is important to know whether they are causing harm.
Feeds |
Contact