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DMARDs Treatment in Broadway, Kolkata - Manipal Hospitals

DMARDs

DMARDs in Kolkata

Disease-modifying anti-rheumatic drugs (DMARDs) are a cornerstone in the treatment of chronic inflammatory conditions such as rheumatoid arthritis, psoriatic arthritis, and other autoimmune diseases. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, which primarily provide symptomatic relief, DMARDs aim to modify the underlying disease process, potentially leading to long-term remission and slowing disease progression.

At Manipal Hospitals in Broadway, Kolkata, our rheumatology specialists prescribe DMARDs to effectively manage and treat various rheumatic conditions. These medications work by targeting the immune system to reduce inflammation, prevent joint damage, and improve overall function and quality of life for patients.

FAQ's

DMARDs (Disease-Modifying Antirheumatic Drugs) are medications used to treat inflammatory arthritis, such as rheumatoid arthritis and psoriatic arthritis. They help reduce inflammation and slow the progression of the disease, aiming to prevent joint damage.

Conventional disease-modifying antirheumatic drugs (DMARDs) are a type of therapy used to treat inflammatory arthritis, including rheumatoid and psoriatic arthritis. If left untreated, persistent joint inflammation (swollen, sensitive, and painful joints) can cause joint damage. Once a joint gets damaged, it cannot be repaired. Early treatment to reduce inflammation is critical to preventing joint injury. 

This is where DMARDs can assist. DMARDs work to reduce inflammation and assist in avoiding joint injury. When a single DMARD treatment fails, combination therapy with two or more may be useful. Some studies suggest that commencing therapy with a mix of DMARDs is preferable to starting with only one medication. Your doctor may suggest a combined therapy to treat your inflammatory arthritis.

Disease-modifying medications diminish rheumatoid arthritis-induced joint inflammation, hence preventing joint degeneration. They are taken on a regular and continuing basis, even when there are no symptoms. It takes several weeks or months for them to have any obvious impact.

While some people may notice a benefit right away, most people will experience the results about two to eight weeks after starting the medicine, while others may take three to six months to get the full advantages.

Combination therapy with DMARDs is often used to enhance treatment efficacy for rheumatoid arthritis. One common and effective approach is to combine methotrexate with another DMARD. For instance:

  • Methotrexate and Leflunomide: This combination is known for its effectiveness in managing rheumatoid arthritis symptoms and slowing disease progression.

  • Methotrexate and Sulfasalazine: Another effective two-drug combination that can provide significant benefits in controlling inflammation and improving joint function.

Other possible combinations include methotrexate with azathioprine, cyclosporine, or hydroxychloroquine, though methotrexate with leflunomide or sulfasalazine is frequently noted as particularly effective.
 

  • NSAIDs: These medications, such as ibuprofen, help lower inflammation and pain rapidly but do not stop joint deterioration or alter the course of rheumatoid arthritis.

  • DMARDs: Drugs such as sulfasalazine and methotrexate not only aid in symptom management but also reduce or prevent further joint deterioration from the condition. They assist in maintaining long-term joint health, but they take a little longer to start working.

Doctors use blood tests, such as complete blood count (CBC), liver function tests (LFTs), and kidney function tests, to monitor the effects of DMARDs and adjust treatment as needed.

Hydroxychloroquine is considered one of the safer DMARDs and is commonly used to treat mild rheumatoid arthritis. It is also used to treat lupus-related problems. It is well-tolerated by many patients.

Risks: Although there aren't many major adverse effects associated with hydroxychloroquine, some people may initially have moderate gastrointestinal symptoms, including nausea or diarrhoea. Furthermore, it should be noted that hydroxychloroquine may have infrequent but potentially dangerous adverse effects, such as retinal damage, particularly at larger dosages or after prolonged usage. For this reason, it is advised to have regular eye exams.

Side effects vary depending on the DMARD you are taking. Each DMARD has unique side effects. Typical adverse effects of conventional DMARDs are: 

  • Loss of appetite
  • Nausea
  • Diarrhoea
  • Abdominal discomfort
  • Rash
  • An allergic reaction
  • Liver issues
  • An increased chance of infection
  • Low levels of white blood cells (leukopenia), red blood cells (anaemia), and platelets (thrombocytopenia)

Biologic DMARDs commonly cause the following negative effects: 

  • Increased susceptibility to common and dangerous bacterial, fungal, and viral infections
  • Reactivation of TB
  • Infections such as Herpes zoster, hepatitis B, and C
  • Increased cholesterol levels
  • Low blood cell count and elevated liver enzymes.

Yes, but it's crucial to let your doctor know about all other prescription drugs and dietary supplements you're using. Certain combinations may interact to modify the effectiveness of DMARDs or raise their risk of adverse effects.

Your doctor may change the DMARD you are taking, change the dosage, or think about combination therapy with other drugs if a DMARD is not working for you.

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