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Dr. M Listens

DMARDS AND BRM’S

Today is the last in the series of discussions about the autoimmune disorders, particularly Rheumatoid Arthritis. Almost all of the compounds discussed previously, appear to work by attacking the symptoms of the problem such as the progression of joint erosion and or pain, swell etc.  The DMARDS (Disease  Modifying Anti-Rheumatic Drugs), also some known as  BRM’s ( Biologic Response  Modifiers) approach the problem by attempting to STOP or at least slow down the progression of the problem .The DMARDS and other biologics have been so successful that their use has spread, to the benefit of the patient.

The results being achieved differ by compound. However, the bottom line is that they appear to be working.  Unfortunately like almost all newer meds that come to market there are downsides and drawbacks. Some require injection administration. Some have to be taken daily. Some are used monthly, and some have severe side effects such as nausea, vomiting pain etc.  For these reasons, there is no “ONE SIZE FITS ALL”.Following is a list of some of these pharmaceuticals.. Please note that some are older, and have more detailed classifications, and those ending in “mab” appear to have similar mechanisms of actions.  It is beyond the scope of this piece to be more specific and the reader is referred as always to his/her own medical provider.

Chemical name                                                 Retail name

hydroxychloroquine                                                      Plaquennil

leftunomide                                                                   Arava

methotrexate                                                                 Trexall

sulfasalazine                                                                  Azulidine

minocycline                                                                   Minocine

abatocept                                                                     Orencia

rituximab                                                                      Rituxan

tocioizumab                                                                  Actemra

anakinra                                                                       Kineret

adalimmab                                                                    Humira

etanercept                                                                    Embrel

infliximab                                                                      Remicade

certolizumab     pegol                                         Cimzia

gulimumab                                                               Simponi

This concludes the coverage on the Auto Immune maladies. Next week starts a sharing of notes from the Journal of the American Medical Society. (JAMA.)