DMARDS

Question 1

Disease Modifying Anti-Rheumatic Drugs:

• Sulfasalazine
• Methotrexate

(M.O.A for both)

Answer 1

Sulfasalazine:
- may act by scavenging toxic oxygen metabolites from neutrophils

Methotrexate
- folic acid antagonist with cytotoxic and immunosuppressant activity and potential anti-rheumatoid action

Question 2

Biological DMARDS:

• TNF-a inhibitor - Adalimumab
• IL-1 inhibitor - e.g. anakinra
• IL-6 inhibitor - Tocilizumab

Answer 2

TNF-a, IL-1 and IL-6 are the key cytokines in RA inflammation

• Adalimumab - prevents TNF’s interaction with p55 and p75 cell surface receptors
• Anakinra - inhibits NO induction and PGE2 and/or collagenase production
• Tocilizumab - inhibits T cell activity, immunoglobulin secretion