Drug and Therapeutics Bulletin 1998;36:3-6; doi:10.1136/dtb.1998.3613
Copyright © 1998 by the BMJ Publishing Group Ltd.

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content PubMed PubMed Citation

Modifying disease in rheumatoid arthritis

Relevant BNF section: 10.1.3

Rheumatoid arthritis affects about 1-2% of adults in the UK. Although the disease is sometimes mild, chronic synovitis, progressive destruction of articular cartilage and bone, and systemic manifestations commonly lead to marked disability and premature death.^1,2 Disease-modifying antirheumatic drugs (DMARDs) are given to try to arrest or slow this deterioration. Until quite recently, DMARDs were started only when simpler measures (analgesics, physical treatments and non-steroidal anti-inflammatory drugs) had failed. Used in this way, DMARDs can suppress markers of disease activity and improve function and some have been shown to slow the progress of joint erosions.³ However, their impact on long-term disability has been disappointing. We discuss how these observations, and a fuller understanding of the pathogenesis and natural history of rheumatoid arthritis, have led to changes in the way DMARDs are used.