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Reclassification of Antirheumatic Agents

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  • Review Article
  • Disease Treatment Review
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Summary

A proposed new classification of antirheumatic therapy nominates two major categories, as follows.

  1. 1

    Symptom-modifying antirheumatic drugs (SM-ARDs) improve the symptoms and clinical features of inflammatory synovitis. They can be further categorised as: (I) nonsteroidal anti-inflammatory drugs; (II) corticosteroids; and (III) slower-acting drugs, e.g. antimalarials, gold, penicillamine, antimetabolites and cytotoxic agents.

  2. 2

    Disease-controlling antirheumatic therapy (DC-ART) changes the course of rheumatoid arthritis. These agents (a) improve and sustain function in association with decreased inflammatory synovitis, and (b) prevent structural joint damage, or significantly decrease its rate of progression. Changes must be sustained for a minimum period of 1 year. The classification must include reference to the time for which criteria have been satisfied, e.g. a 2-year DC-ART.

All currently available therapeutic agents are SM-ARDs. DC-ARTs are a new group and a new concept. The development of therapies in this category represents a major challenge to drug developers.

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References

  1. Brooks PM. The use of suppressive agents for the treatment of rheumatoid arthritis. Aust NZ J Med 1993; 23: 193–204

    Article  CAS  Google Scholar 

  2. Sigler JW, Bluhm GB, Duncan H, et al. Gold salts in the treatment of rheumatoid arthritis. Ann Intern Med 1974; 80: 21–6

    PubMed  CAS  Google Scholar 

  3. Currey HLF, Harris J, Mason RN, et al. Comparison of azathioprine, cyclophosphamide and gold in the treatment of rheumatoid arthritis. Br Med J 1974; 3: 763–6

    Article  PubMed  CAS  Google Scholar 

  4. van der Heijde DMFM, van Riel PL, Nuver-Zwart IH, et al. Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumatoid arthritis. Lancet 1989; 1: 1036–8

    Article  PubMed  Google Scholar 

  5. van der Heijde DMFM, van Riel PL, Nuver-Zwart IH, et al. Sulphasalazine versus hydroxychloroquine in rheumatoid arthritis: 3-year follow-up. Lancet 1990; 335: 539–41

    Article  PubMed  Google Scholar 

  6. Burg G, Allander E, Lund B, et al. Auranofin inproves outcome in early rheumatoid arthritis results from a 2-year double blind, placebo controlled study. J Rheumatol 1988; 15: 1747–54

    Google Scholar 

  7. WHO Report of the Fourth Joint WHO/ILAR Task Force Meeting on Rheumatic Diseases; 1991 8–10 July; Geneva. WHO/DBO/TFRD/91.1: 1–33

  8. Development of testing protocols for antirheumatic drugs; NSAIDs. WHO Report of the Fourth Joint WHO/ILAR Task Force Meeting on Rheumatic Diseases; 1991 8–10 July; Geneva. WHO/DBO/TFRD/91.1: 25–31

  9. Paulus HE, Scott DL, Edmonds JP. Classification of antirheumatic drugs: a new proposal. Arthritis Rheum 1992; 35: 364–5

    Article  PubMed  CAS  Google Scholar 

  10. Edmonds JP, Scott DL, Furst DE, et al. New classification of antirheumatic drugs: the evolution of a concept. J Rheumatol 1993; 20: 585–7

    PubMed  CAS  Google Scholar 

  11. Edmonds JP, Scott DL, Furst DE, et al. Antirheumatic drugs: a proposed new classification [editorial]. Arthritis Rheum 1993; 36: 336–9

    Article  PubMed  CAS  Google Scholar 

  12. WHO Report of the Fifth Joint WHO/ILAR Task Force Meeting on Rheumatic Diseases; 1993 29 June–2 July; Geneva. In preparation

  13. Boers M, Tugwell P, Felson DJ, et al. WHO and ILAR core endpoints for symptom modifying antirheumatic drugs in rheumatoid arthritis clinical trials. J Rheumatol. In press

  14. Scott DL, Symmons DPM, Coulton BL, et al. Long term outcome of treating rheumatoid arthritis: results after twenty years. Lancet 1987; 1: 1108–11

    Article  PubMed  CAS  Google Scholar 

  15. Pincus T, Callahan L. Taking mortality in rheumatoid arthritis seriously — predictive markers, socioeconomic status and comorbidity. J Rheumatol 1986; 13: 841–5

    PubMed  CAS  Google Scholar 

  16. Choy EHS, Kingsley GH. Immunotherapy, past, present and future. Br J Rheumatol 1993; 32: 89–92

    PubMed  CAS  Google Scholar 

  17. Pinals RS, Masi AT, Larsen RA, et al. Preliminary criteria for clinical revision in rheumatoid arthritis. Arthritis Rheum 1981; 24: 1308–15

    Article  PubMed  CAS  Google Scholar 

  18. Fries JF, Spitz P, Kraines RG, et al. Measurement of patient outcome in arthritis. Arthritis Rheum 1980; 23: 137–45

    Article  PubMed  CAS  Google Scholar 

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Edmonds, J. Reclassification of Antirheumatic Agents. Clin. Immunother. 1, 110–116 (1994). https://doi.org/10.1007/BF03258497

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  • DOI: https://doi.org/10.1007/BF03258497