Mode of Actions of DMARDs

Messengers mediating information between cells or affecting their activities are so-called cytokines. Cytokines are critical in the pathogenetic process of rheumatoid arthritis, particularly tumour-necrosis-factor (TNF)-╬▒, interleukin (IL)-1 and IL-6. Biologic disease modifying antirheumatic drugs (bDMARDs) inhibit these messengers and thereby influence the disease course.

 

TNF-α inhibiting biologic DMARDs: Benepali® (etanercept), Cimzia® (certolizumab pegol), Enbrel® (etanercept), Erelzi® (etanercept), Flixabi® (infliximab), Humira® (adalimumab), Inflectra® (infliximab), Remicade® (infliximab), Remsima® (infliximab), Simponi® (golimumab)

IL-1 inhibiting biologic DMARDs: Kineret® (anakinra)

IL-6 inhibiting biologic DMARDs: Kevzara® (sarilumab), RoACTEMRA® (tocilizumab)

 

 

Further essential players in the rheumatic inflammatory cascade are B and T lymphocytes. Activity of these cells can be also blocked by biologic DMARDs.

B cell inhibiting biologic DMARD: Rixathon® (rituximab), MabThera® (rituximab)

T cell inhibiting biologic DMARD: Orencia® (abatacept)

 

 

The targeted synthetic disease modifying antirheumatic drugs (tsDMARDs) inhibit the activity of Januskinase enzymes.

Januskinase inhibitors: Olumiant® (baricitinib), Xeljanz® (tofacitinib)

 

Please find further information on the modes of action and the use of DMARDs on the websites of the German Society of Rheumatology (www.dgrh.de), of the Competence Network Rheumatology (www.rheumanet.org) or on www.rheuma-online.de.