Disease-modifying antirheumatic drug
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Disease-modifying antirheumatic drugs (DMARDs) is a category of drugs used in many autoimmune disorders 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, lupus erythematosus (SLE), idiopathic thrombocytopenic purpura (ITP), myasthenia gravis and various others.
Some of these drugs are also used in the treatment of ulcerative colitis which may not, strictly speaking, be an autoimmune disorder. (See List of Autoimmune Diseases.)
Some DMARDs are mild chemotherapeutics but use a side-effect of chemotherapy - immunosuppression - as its main therapeutical benefit.
[edit] Members
| Drug | Mechanism |
|---|---|
| adalimumab | TNF inhibitor |
| azathioprine | Purine synthesis inhibitor |
| chloroquine and hydroxychloroquine (antimalarials) | |
| cyclosporine (Cyclosporin A) | inhibit calcineurin |
| D-penicillamine | Reducing numbers of T-lymphocytes etc. |
| etanercept | TNF inhibitor |
| gold salts (sodium aurothiomalate, auranofin) | |
| infliximab | TNF inhibitor |
| leflunomide | Pyrimidine synthesis inhibitor |
| methotrexate (MTX) | Antifolate |
| minocycline | 5-LO inhibitor |
| sulfasalazine (SSZ) |
[edit] Alternatives
When treatment with DMARDs fails, cyclophosphamide or steroid pulse therapy is often used to stabilise uncontrolled autoimmune disease. Some severe autoimmune diseases are being treated with bone marrow transplants in clinical trials, usually after cyclophosphamide therapy has failed.
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