Video Q & A:

DMARDs

Question:

What is a DMARD?

Expert:   Linda Russell, MD, Hospital for Special Surgery »

Disease-modifying anti-rheumatic drugs, or DMARDs, are at the base of almost every rheumatoid arthritis treatment plan. Watch this to learn about how they work.

Transcript: DMARDs, or disease-modifying anti-rheumatic drugs, are the ONLY drugs that are able to slow –and even stop--the progression of rheumatoid arthritis. They work by reducing inflammation that erodes both tissue and bone over time. There are MANY disease-modifying drugs that are used to treat rheumatoid arthritis. Several of them were initially used to treat other problems, such as malaria and transplant rejection, but were also found to be effective against rheumatoid arthritis. Methotrexate is likely the FIRST DMARD your doctor will prescribe for you. It’s one of the most effective and most popular drugs in RA treatment. In higher doses it is used to treat cancer. Researchers are not sure exactly how methotrexate helps ease RA, but it appears to calm down immune system hyperactivity, which leads to less joint inflammation. Other traditional DMARDs also impact the overactive immune system that accompanies rheumatoid arthritis, but with VARIED approaches. Some BLOCK the formation of certain acids; others INTERFERE with protein interactions or communications. Regardless of their method, all DMARDs work to suppress the immune system, which in turn slows the progression of rheumatoid arthritis. There’s a NEW class of drugs out there that are also DMARDs, but they’re UNIQUE in that they are created with proteins from living human cells. Called biologic response modifiers, or, more simply, BIOLOGICS, they are designed to control the renegade immune system cells that trigger RA. Common biologics include infliximab, adalimumab and etanercept – which you may know as Remicade, Humira, or Enbrel, respectively. Both biologics and traditional DMARDs are used alone or in combination with each other. Sometimes, corticosteroids are prescribed along with DMARDs, at least initially, since it often takes a few months for the full benefits of disease modifying drugs and biologics to kick in. Some DMARDs may be taken orally. They also come in self-administered injection form, and some are only available in INTRAVENOUS form in a doctor’s office or hospital. Check out other videos in this series for more answers to your DMARD questions. More »

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