Disease-modifying anti-rheumatic drugs are a heterogeneous group of drugs that acts on different components of the immune system. They suppress the immune system and slow down the progression of inflammatory and autoimmune diseases, through a variety of mechanisms.
They were initially named anti-rheumatic for their potential treatment of RA, but they are useful for the treatment of many chronic inflammatory and autoimmune diseases.
Classification
DMARDs are divided into synthetic (sDMARDs) which are human-made chemical compounds, and biologic (bDMARDs) DMARDs, which are substances (antibodies and other proteins) produced by living organisms (simply known as biologics).
sDMARDs can be further subdivided into:
- Conventional synthetic (csDMARDs)
- Targeted synthetic (tsDMARDs)
Older DMARDs such as gold salts are no longer in use in most of the world, as newer, safer, and more effective drugs are available.
Conventional synthetic DMARDs
This group of drugs includes small molecules, usually