Open AccessSafety of Long-Term Use of Four Common Conventional Disease Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis
Author(s) -
Arun Kumar Kedia,
Kavitha Mohansundaram,
Mohit Goyal,
Vinod Ravindran
Publication year - 2021
Publication title -
journal of the royal college of physicians of edinburgh/the journal of the royal college of physicians of edinburgh
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.275
H-Index - 26
eISSN - 2042-8189
pISSN - 1478-2715
DOI - 10.4997/jrcpe.2021.306
Subject(s) - medicine , leflunomide , sulfasalazine , rheumatoid arthritis , hydroxychloroquine , methotrexate , antirheumatic drugs , drug , intensive care medicine , disease , antirheumatic agents , pharmacology , covid-19 , ulcerative colitis , infectious disease (medical specialty)
Conventional disease-modifying antirheumatic drugs (DMARDs) have been used in the management of rheumatoid arthritis for a long time. Whereas methotrexate (MTX) is the anchor drug, leflunomide, hydroxychloroquine and sulfasalazine are used along with MTX either in combination or sequentially. Together these four drugs are the most commonly used DMARDs. They are also used in combination with biological DMARDs (bDMARDs) to enhance their efficacy and MTX in particular to reduce antibodies against anti-tumour necrosis factor. Despite their widespread use, concerns regarding their safety especially when used long-term hinder their optimum use in clinical medicine. In this narrative review we have critically appraised the available literature regarding the safety of these four DMARDs when used long-term.