Anti rheumatoid Drugs

By:
Dr.Reenu Bajpai
 Rheumatoid Arthritis
What is it?

Rheumatoid arthritis is a chronic disease, mainly

characterized by inflammation of the lining, or
synovium, of the joints. It can lead to long-term joint
damage, resulting in chronic pain, loss of function and
disability.

RA is an autoimmune disease.
 Rheumatoid arthritis (RA)
progresses in three stages
• The first stage is the swelling of the synovial lining,
causing pain, warmth, stiffness, redness and swelling
around the joint
• Second is the rapid division and growth of cells, or
pannus, which causes the synovium to thicken
• In the third stage, the inflamed cells release enzymes
that may digest bone and cartilage, often causing the
involved joint to lose its shape and alignment, more pain,
and loss of movement
 Cont….

• It can affect any joint but is common in the wrist and

fingers.
• More women than men get rheumatoid arthritis.
• It often starts between ages 25 and 55.
• RA can affect body parts besides joints, such as your
eyes, mouth and lungs.
• No one knows what causes rheumatoid arthritis. Genes,
environment and hormones might contribute. Treatments
include medicine, lifestyle changes and surgery. These
can slow or stop joint damage and reduce pain and
swelling.
 Drug Therapy

The aim of drug therapy is

. To ameliorate pain, swelling and joint pain

. Prevent articular cartilage damage and bony erosions.
. Prevent deformity and preserve joint function
Early diagnosed cases treated with NSAIDS
But currently it is added with DMARDs (disease
modifying antirheumatic drugs)
 Drug prescribed:

1.DMARDs

2.Biologic response modifiers(BRMs)

3.Adjuvant drugs
 DMARDs
a.Immunosuppressants Drugs
Methotrexate (MTx) : Neotrexate,Biotrexate
Azathioprine : Imuran
b.Sulfasalazine
Salazo Pyrin
c.Chloroquine and hydroxychloroquine
d.Leflunomide
Lefra
e.Auranofin
Ridaura ,Goldar
 2.Biologic Response Modifiers

These are recombinant protiens antibodies that bind and

inhibit cytokines .
a.TNF alpha inhibitors
b.IL antagonist

3.Corticosteroids
 Adverse effects of Immunosuppresents
Oral ulceration
GI upset
Cirrhosis of liver
Contraindication of immunosuppressant
Pregnency
Breast Feeding
Liver disease
Leukopenia
Peptic ulcer
 Adverse effects of Chloroquine

Skin Rashes
Irritable Bowel Syndrome
Neuropathy
Myopathy
 Adverse Effects of Lefunomide
Headache
Nausea
Loss of hair
Thrombocytopenia
Cytopenia
Leucopenia

Contraindication
Pregnant women ,children , lactating women
 Adverse effect of Auranofin

Diarrhoea

Abdominal cramps