Disease-modifying antirheumatic drug

The basic therapy ( with disease-modifying anti- rheumatic drugs, DMARD ) is a treatment option in inflammatory rheumatic diseases. This long-term therapy aimed at halting the further course of the disease and the associated symptoms and limitations.

The basic drugs used in rheumatic diseases are so-called slow-acting antirheumatic drugs, or second-line drugs, which must be used over a longer period. In contrast to the first-line drugs to which analgesics, nonsteroidal anti-inflammatory drugs and nonsteroidal anti-inflammatory drugs (corticosteroids ) are among the essential drugs each have specific effects on the disease process with short-and long-term positive impact on disease progression and improve not just the symptoms. Often a combination therapy with second- and first-line agents is necessary.


  • DMARDs usually do not act immediately
  • Long-term effect is in the foreground
  • Intervene actively in the course of disease
  • Slow the disease-related deformation and destruction of joints

Effectiveness characteristics

  • Pain is getting
  • Intensity and frequency of disease relapses leave after or stay completely out of
  • Inflammatory joint swelling, heat and sound from effusion
  • Stiffening ( morning stiffness ) of the joints after rest improves
  • Inflammation and signs of activity in laboratory diagnostics normalize


  • Methotrexate (now the first choice in patients with rheumatoid arthritis)
  • Azathioprine
  • Sulfasalazine
  • Chloroquine / hydroxychloroquine
  • Leflunomide
  • Cyclophosphamide
  • D -penicillamine
  • Ciclosporin
  • Gold compounds such as auranofin

Newer DMARDs are the " biologicals " (eg, adalimumab, etanercept, anakinra and infliximab ), which are directed in the form of antibodies, soluble receptors or antagonists to proinflammatory cytokines such as IL -1 or TNF -alpha.

Possible side effects

Possible side effects include: changes in the blood picture, gastrointestinal disorders, hair loss, tumors, allergic reactions, eye damage, skin reactions, headaches, liver damage, kidney damage and nausea. Consistent contraception is needed.