Anti-Rheumatic Drugs

• Anti-Rheumatic Drugs: Include NSAIDs, corticosteroids, DMARDs, and biologics for inflammation control.
• Anti-Rheumatic Drugs: Used to treat rheumatoid arthritis and slow disease progression.
• Rheumatoid arthritis (RA) is a chronic inflammatory, autoimmune disorder affecting joints and sometimes extra-articular sites.
• Disease-Modifying Anti-Rheumatic Drugs (DMARDs): Slow disease progression, reduce joint destruction and disability.

Classification of Anti-Rheumatic Drug

 1. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):

• • Examples: Ibuprofen, Diclofenac, Naproxen
  • Mechanism of Action: Block prostaglandin synthesis by inhibiting COX enzymes, reducing inflammation and pain.
  • Use: Symptomatic relief but do not modify disease progression.
  • Side Effects: GI ulcers, cardiovascular risks.

2. Corticosteroids (Glucocorticoids):

• • Examples: Prednisone, Methylprednisolone
  • Mechanism of Action: Suppress inflammation and modulate the immune response.
  • Use: Short-term management of severe inflammation or flares.
  • Side Effects: Osteoporosis, diabetes, infections with long-term use.

3. Disease-Modifying Anti-Rheumatic Drug (DMARDs):

• • These drugs slow disease progression and prevent joint damage.
  • Conventional Synthetic DMARDs:
    • Methotrexate: Inhibits dihydrofolate reductase, suppressing T-cell activation. (Most commonly used).
    • Leflunomide: Inhibits pyrimidine synthesis, reducing lymphocyte proliferation.
    • Sulfasalazine: Anti-inflammatory and immunomodulatory effects.
    • Hydroxychloroquine: Inhibits antigen processing and cytokine release.
    • Side Effects: Liver toxicity, bone marrow suppression, GI distress, and lung toxicity.
  • Biologic DMARDs (Targeted Therapy):
    • Target specific immune mediators like TNF-alpha, IL-6, or B-cells.
    • Examples:
      • TNF Inhibitors: Etanercept, Infliximab, Adalimumab
      • IL-6 Inhibitor: Tocilizumab
      • B-cell Depleter: Rituximab
      • T-cell Inhibitor: Abatacept
    • Side Effects: Risk of infections (e.g., tuberculosis reactivation), malignancies, injection site reactions.
  • Targeted Synthetic DMARDs (JAK Inhibitors):
    • Examples: Tofacitinib, Baricitinib
    • Mechanism of Action: Inhibit Janus kinase (JAK) enzymes, blocking cytokine signaling pathways.
    • Side Effects: Blood clots, infections, and malignancies.

Key Differences Between Antigout and Anti-Rheumatic Drug:

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