Decades ago, many medications available today that successfully treat various kinds of inflammatory arthritis didn’t exist. But, if you’ve recently been diagnosed with rheumatoid arthritis, lupus, psoriatic arthritis or ankylosing spondylitis your physician can choose from many different DMARDs—disease-modifying antirheumatic drugs. These drugs actually target inflammation-causing reactions in your immune system to modify the disease process.

picture of doctor hands holding white pack and pills

picture of doctor hands holding white pack and pills

Traditional DMARDs work on the entire immune system, while newer biologic DMARDs target particular pathways inside immune cells and zoom in on cytokines, proteins that promote inflammation. DMARDs are used to only treat arthritis associated with rheumatic diseases; they aren’t effective against osteoarthritis, the “wear and tear” type of arthritis, which isn’t an immune system-related disease.

DMARDs prevent damage to your joints’ cartilage and bones by interrupting the autoimmune process. That’s when the disease misidentifies your body’s tissues as “foreign” and attacks them biochemically, resulting in damaging inflammation.

Traditional DMARDs often prescribed include

  • Methotrexate: Because it’s so effective and usually well tolerated, methotrexate is often the first DMARD prescribed when you have rheumatoid arthritis or another inflammatory arthritis. If necessary, other drugs can be taken with methotrexate, and negative interactions are rare.
  • Sulfasalazine and hydroxychloroquine: Often used together with methotrexate, these drugs (as well as methotrexate) are sometimes called anti-malarials, from their early use against malaria. They work on the acid level within cells to reduce inflammation.

Biologics such as etanercept, infliximab, adalimumab, certolizumab pegol and golimumab inhibit tumor necrosis factor-alpha, a cytokine that promotes inflammation in the synovium (lining) of joints. Abatacept and rituximab are the newer classes of T-cell co-stimulatory blockers and B-cell depleting agents, respectively.

These disease-modifying drugs help patients live more comfortably than in the past. They are especially effective when used in conjunction with physical therapy strategies we can design to help ease pain and improve joint flexibility. See us if you are taking these new medications so you can get the most out of your drug therapy.

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