enzymes involved in the inflammatory process.
Anti-TNFs are MONOCLONAL ANTIBODIES(MABS) that
block the release of TUMOR NECROSIS FACTORS
(TNFs), CYTOKINES that influence inflammation
during the immune response.
Therapeutic Applications
Because DMARDs can have significant and serious
side effects, doctors prescribe them when other
therapies are no longer effective. The most com-
mon use of DMARDs is to treat rheumatoid arthri-
tis. Doctors also may prescribe DMARDs to treat
another degenerative autoimmune arthritis, anky-
losing spondylitis, and sometimes to treat other
autoimmune conditions such as MYASTHENIA GRAVIS
and SYSTEMIC LUPUS ERYTHEMATOSUS(SLE).
Risks and Side EffectsDMARDs can have significant and harmful side
effects including DIARRHEA, RASH, ANEMIA, LEUKOPE-
NIA, and increased risk for INFECTION, particularly
OPPORTUNISTIC INFECTION, as a consequence of
immunosuppression. Methotrexate can cause irre-
versible CIRRHOSISand lung damage. A rare and
potentially fatal adverse reaction to methotrexate
is TOXIC EPIDERMAL NECROLYSIS(also called Stevens-
Johnson syndrome). Chloroquine and hydroxy-
chloroquine can cause vision disturbances and
RETINOPATHY (permanent damage to the RETINA,
resulting in VISION IMPAIRMENT).
DMARDs may also interfere with the actions of
other medications. It is important to check with
the doctor before using any additional medica-
tions, incuding over-the-counter products. Because
of the potential risks these side effects have, doc-
tors prescribe most non-MAb DMARDs for people
whose conditions are not responding to other
treatments.
See also CORTICOSTEROID MEDICATIONS; NON-
STEROIDAL ANTI-INFLAMMATORY DRUGS(NSAIDS).disease-modifying antirheumatic drugs (DMARDs) 259