What are DMARDs? And give one or two examples that you have used or seen during your clinical rotations. 

💊What Are DMARDs?

DMARD stands for:

Disease-Modifying Antirheumatic Drugs

These are a class of medications used to slow or halt the progression of inflammatory autoimmune diseases, primarily:

  • Rheumatoid arthritis (RA)

  • Psoriatic arthritis

  • Ankylosing spondylitis

  • Lupus (SLE)

  • Other connective tissue diseases

They don’t just relieve symptoms like NSAIDs — they modify the disease process itself by suppressing the overactive immune response.

📚Two Main Types of DMARDs:

1.Conventional (Non-Biologic) DMARDs

  • Methotrexate ← 💥 Most commonly used

  • Sulfasalazine

  • Hydroxychloroquine

  • Leflunomide

2.Biologic DMARDs

  • Target specific immune pathways (e.g., TNF-alpha, IL-6)

  • Examples:

    • Etanercept (Enbrel) – a TNF inhibitor

    • Adalimumab (Humira) – also TNF inhibitor

    • Rituximab, Tocilizumab, Abatacept (other biologics)

Examples from Clinical Rotations:

✅Methotrexate

  • First-line for RA

  • Weekly dosing (not daily!)

  • Monitor liver function, CBC, renal function

  • Often co-prescribed with folic acid to reduce side effects

✅Hydroxychloroquine

  • Common in SLE or mild RA

  • Requires annual eye exams due to risk of retinal toxicity

⚠ Monitoring & Risks:

  • All DMARDs carry risk of immunosuppression

  • Biologics increase risk of infections (e.g., TB, hepatitis B reactivation)

  • Routine blood work is essential for safety