Disease-modifying antirheumatic drug

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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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.

Members

• adalimumab
• azathioprine
• chloroquine and hydroxychloroquine (antimalarials)
• cyclosporine (Cyclosporin A)
• D-penicillamine
• etanercept
• gold salts (sodium aurothiomalate, auranofin)
• infliximab
• leflunomide
• methotrexate (MTX)
• minocycline (a tetracycline antibiotic)
• sulfasalazine (SSZ)

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.