Antirheumatics: Uses, most common brand names, and safety information
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During the early 1900s, the treatment of rheumatoid arthritis was limited to medications that could only provide symptomatic relief such as salicylates, which were an early form of nonsteroidal anti-inflammatory drugs (NSAIDs).
Antirheumatics, or what we now call disease-modifying antirheumatic drugs (DMARDs) were established as treatments for rheumatic diseases starting with injectable gold in the 1930s. Today there are several DMARD treatment options that treat many diseases other than rheumatoid arthritis. They are used for other connective tissue diseases (lupus), autoimmune disorders, and some cancers. DMARDs are often prescribed with other medications such as corticosteroids or NSAIDs to help quickly relieve inflammation and pain.
The list below includes the most common DMARDs, combination products containing DMARDs, and their pricing:
List of Antirheumatics
|Trexall (methotrexate)||Trexall is indicated to treat certain types of cancer, rheumatoid arthritis, and psoriasis.
|Imuran (azathioprine)||Imuran is indicated to prevent transplant rejection and treat rheumatoid arthritis.
|Arava(leflunomide)||Arava is indicated to treat rheumatoid arthritis.
|Azulfidine (sulfasalazine)||Azulfidine is indicated to treat ulcerative colitis and rheumatoid arthritis.
|Plaquenil (hydroxychloroquine)||Plaquenil is indicated to treat malaria, rheumatoid arthritis, and lupus.
|Orencia (abatacept)||Orencia is indicated to treat rheumatoid arthritis, psoriatic arthritis, and graft versus host disease.
|Remicade (infliximab)||Remicade is indicated to treat rheumatoid arthritis, plaque psoriasis, and Crohn’s disease.
|Humira (adalimumab)||Humira is indicated to treat rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
|Cimzia (certolizumab)||Cimzia is indicated to treat rheumatoid arthritis, Crohn’s disease, and spondyloarthritis.
|Enbrel (etanercept)||Enbrel is indicated to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis.
|Simponi (golimumab)||Simponi is indicated to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis.
|Simponi Aria (golimumab)||Simponi Aria is indicated to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis.
|Rituxan (rituximab)||Rituxan is indicated to treat Non-Hodgkin’s lymphoma, leukemia, and rheumatoid arthritis.
|Actemra (tocilizumab)||Actemra is indicated to treat rheumatoid arthritis, giant cell arteritis, and COVID-19.
|Xeljanz (tofacitinib)||Xeljanz is indicated to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.
|Xeljanz XR (tofacitinib)||Xeljanz XR is indicated to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.
|Olumiant (baricitinib)||Olumiant is indicated to treat rheumatoid arthritis, alopecia areata, and COVID-19.
|Rinvoq (upadacitinib)||Rinvoq is indicated to treat rheumatoid arthritis, psoriatic arthritis, and atopic dermatitis.
|Kevzara (sarilumab)||Kevzara is indicated to treat rheumatoid arthritis.
|Kineret (anakinra)||Kineret is indicated to treat rheumatoid arthritis and cryopyrin-associated periodic syndromes (CAPS).
|Ridaura (auranofin)||Ridaura is indicated to treat rheumatoid arthritis.
What are Antirheumatics?
Disease-modifying antirheumatic drugs (DMARDs) are a group of medications that are used to reduce inflammation. DMARDs are also called immunosuppressants or immunomodulators because they change how your immune system functions. They are typically classified as:
- Conventional DMARDs. Sometimes called conventional synthetic, non-biologic, or traditional DMARDs, they are used to treat inflammatory conditions such as rheumatoid arthritis, psoriasis, and certain types of cancer. They are not indicated to treat osteoarthritis (OA). Conventional DMARDs work slowly and can take up to 12 weeks to see any improvements. Some commonly used examples include Trexall (methotrexate), Arava (leflunomide), and Plaquenil (hydroxychloroquine). These medications may be prescribed by themselves or as a combination therapy with other conventional or biologic DMARDs.
- Biologic DMARDs. Biologic DMARDs were first approved for use in the early 1990s for patients who had failed conventional DMARDs. They target specific receptors or cells in the immune system to reduce inflammation and prevent joint destruction. Biologic DMARDs tend to work faster than conventional DMARDs. Types of biologic DMARDs include monoclonal antibodies, tumor necrosis factor (TNF) inhibitors, interleukin-1 receptor antagonists, and targeted synthetic DMARDs, such as the Janus kinase inhibitors (JAK). Biological DMARDs are often given in combination with a conventional DMARD such as Trexall (methotrexate).
How do Antirheumatics work?
Conventional DMARDs suppress your body’s immune and inflammatory responses by inhibiting B cells and T cells in the immune system.
Biologic DMARDs work by blocking or modifying your immune system’s inflammatory response. They target specific cells or cytokines (proteins) to reduce pain, inflammation, and cartilage or joint damage.
What conditions are Antirheumatics used to treat?
DMARDs are prescribed to treat many conditions, including:
- Rheumatoid arthritis (RA)
- Psoriatic arthritis (PsA)
- Ankylosing spondylitis (AS)
- Systemic lupus erythematosus (SLE)
- Crohn’s disease
- Systemic sclerosis
- Multiple sclerosis
- Sjögren’s syndrome
- Inflammatory myositis
- Inflammatory bowel disease
- Certain types of cancer
Are Antirheumatics safe?
When taken as prescribed, DMARDs can be safe and effective. Before starting a DMARD, your doctor may take a baseline x-ray and blood tests. Your disease progression and potential side effects will also be monitored during treatment.
Your healthcare provider should also be aware of your current health conditions, including:
- Any active infections
- Leukopenia (low white blood cell count)
- Liver disease (methotrexate and leflunomide should be avoided)
- Cardiovascular disease
- Immunodeficiency disorders
- Are pregnant or plan on becoming pregnant
- Are breastfeeding or plan on breastfeeding
Can you take Antirheumatics while you are pregnant or breastfeeding?
Some of the most common DMARD therapies such as Trexall (methotrexate) and Arava (leflunomide) are contraindicated in pregnancy and lactation. Azulfidine (sulfasalazine) and Plaquenil (hydroxychloroquine) are generally considered safe to be used during pregnancy.
Among the biologic DMARDs, anti-TNF drugs such as Cimzia (certolizumab) are considered safe to use during pregnancy. There isn’t enough evidence to support the use of other biologic DMARDs during pregnancy or lactation. You should discuss the risks with your healthcare provider to determine if these medications should be included in your treatment plan.
What are the common side effects of Antirheumatics?
Some common side effects of DMARDs include:
- Decreased appetite
- Stomach pain
- Mouth sores
- Hair loss (alopecia)
- Weight loss
DMARDs can sometimes cause severe adverse effects, including:
- Increased risk of serious infections
- Increased risk of blood clots
- Liver impairment, increased liver enzymes, and cirrhosis
- Low blood counts from bone marrow suppression
- Worsening congestive heart failure
- Herpes zoster
- Hepatitis B and C
This is not a complete list of side effects and we encourage you to consult with your healthcare professional for medical advice about any possible side effects.
How much do Antirheumatics cost?
DMARDs are very expensive with an average cost of around $10,000 per year.
You can purchase antirheumatics for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.
Related resources for Antirheumatics
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.