Castro Domínguez Francisco

Synthetic Disease-Modifying Antirheumatic Drugs (sDMARDs) are a class of medications used in the treatment of various autoimmune and inflammatory rheumatic diseases. These drugs are designed to modify the course of the disease by suppressing or modulating the immune system, thereby reducing inflammation and preventing joint damage. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, which primarily provide symptomatic relief, DMARDs target the underlying disease process.

Types of Synthetic Disease-Modifying Antirheumatic Drugs:

• Methotrexate: One of the most commonly prescribed DMARDs, methotrexate has immunosuppressive and anti-inflammatory properties. It is used in a variety of rheumatic conditions, including rheumatoid arthritis, psoriatic arthritis, and juvenile idiopathic arthritis.
• Leflunomide: Leflunomide inhibits the synthesis of pyrimidines and has immunomodulatory properties. It is used in rheumatoid arthritis and psoriatic arthritis.
• Hydroxychloroquine: This antimalarial drug also has immunomodulatory effects and is used in diseases like rheumatoid arthritis and systemic lupus erythematosus.
• Sulfasalazine: This DMARD is used in conditions such as rheumatoid arthritis and spondyloarthritis. It has anti-inflammatory effects and may also modulate the immune response.

Mechanism of Action:

Synthetic Disease-Modifying Antirheumatic Drugs work through various mechanisms, including suppression of immune cell activity, inhibition of inflammatory pathways, and modulation of the immune response to reduce the production of proinflammatory cytokines.

Indications:

• Rheumatoid Arthritis: Synthetic Disease-Modifying Antirheumatic Drugs are often used as first-line treatments in rheumatoid arthritis to control inflammation, improve symptoms, and prevent joint damage.
• Spondyloarthropathies: Conditions like ankylosing spondylitis and psoriatic arthritis may be treated with Synthetic Disease-Modifying Antirheumatic Drugs to reduce inflammation and manage symptoms.
• Juvenile Idiopathic Arthritis (JIA): In children with JIA, Synthetic Disease-Modifying Antirheumatic Drugs like methotrexate are commonly used to control disease activity.
• Other Autoimmune Diseases: Synthetic Disease-Modifying Antirheumatic Drugs may also be used in systemic autoimmune diseases such as lupus and inflammatory myopathies.
• Combination Therapy: In some cases, Synthetic Disease-Modifying Antirheumatic Drugs are used in combination with other DMARDs or biologic agents to achieve better disease control.

Monitoring and Safety:

Regular monitoring of blood parameters, liver function, and other potential side effects is often required during Synthetic Disease-Modifying Antirheumatic Drugs therapy. This helps ensure the safety of the treatment and allows for adjustments as needed.

It's important to note that the choice of Synthetic Disease-Modifying Antirheumatic Drugs depends on the specific disease, its severity, and individual patient factors.

Treatment decisions are typically made by rheumatologists or other specialists in autoimmune and inflammatory diseases based on a thorough assessment of the patient's condition.