Treatment of inflammatory rheumatic diseases

Main groups of drugs for rheumatic diseases:
 * Nonsterodial rheumatic drugs (non-steroidal anti-inflammatory drugs) – NSA
 * Disease modifying drugs – DMARDs (Disease modifying antirevmatic drugs)
 * Glucocorticoids
 * Other

NSA

 * relieve inflammation, swelling and pain, but they do not improve the prognosis in the long term – treat only symptoms
 * e.g. : ibuprofen, diclofenac, naproxen, nimesulide, celecoxib
 * side effects: gastrotoxicity (GIT – ulcers, NSA – gastropathy)

DMARDs

 * in the long term they have a positive effect on the process of the disease, but they do not improve the X-ray prognosis, the onset of action lasts 6-12 weeks
 * wide group of drugs:
 * 1) 	Hydroxychloroquine
 * 2) 	Leflunomide
 * 3) 	Ciclosporin
 * 4) 	Sulfasalazin
 * 5) 	Methotrexate
 * 6) 	Azathioprine
 * 7) 	Cyklofosfamid
 * 8) 	Biological treatment

Glucocorticoids

 * anti-inflammatory and rapid effect, but in monotherapy it is not enough to induce remission
 * to overcome the phase, before DMARDs starts working
 * they have a positive effect on the X-ray progression of the disease

Biological treatment of rheumatic diseases
Mainly used for diseases:
 * Rheumatoid arthritis
 * Juvenile idiopathic arthritis (Still's disease)
 * Psoriasis
 * Bechterew's disease
 * Systemic lupus erythematosus
 * Systemic scleroderma
 * Systemic vasculitis
 * Polymyositis, dermatomyositis

Used drugs:
 * TNF-α inhibitors: infliximab (REMICADE), etanercept (ENBREL) and adalimumab (HUMIRA)
 * IL–6 inhibitors: tocilizumab (ROACTEMRA)
 * IL–1 inhibitors: anakinra (KINERET)

Other drugs

 * Antibiotics (reactive arthritis, to the side effects of immunosuppression)
 * tars, calcitriol, retinoids... (psoriasis)