Treatment is usually initiated by a specialist, but GPs play an important role in monitoring patients for adverse effects and drug interactions. This article includes a pull out DMARD monitoring table and information on tumour necrosis factor (TNF) inhibitors. Plaquenil who takes it Plaquenil use and weight Plaquenil and dental work Chloroquine brands in pakistan Early, aggressive disease management is critical for halting disease progression and joint destruction in patients with rheumatoid arthritis. Combination therapy with at least two disease-modifying antirheumatic drugs, such as methotrexate MTX, sulfasalazine, or hydroxychloroquine, is often more effective than monotherapy in reducing disease activity. Conventional DMARDs that have been paired with methotrexate include sulfasalazine, hydroxychloroquine, cyclosporine, leflunomide and azathioprine. Although studies of these combinations have shown differing levels of benefit, the combinations of methotrexate plus leflunomide and methotrexate plus sulfasalazine are among the most effective. Traditional DMARDs Methotrexate, Leflunomide, Sulfasalazine, Hydroxychloroquine, and Combination Therapies Amy C. Cannella, James R. O’dell Key Points Methotrexate is one of the most durable and frequently used disease-modifying antirheumatic drugs DMARDs in monotherapy as well as the cornerstone of combination therapy for rheumatoid arthritis RA. Dr Andrew Harrison, Senior Lecturer, Rheumatology, Wellington School of Medicine, University of Otago, Wellington Dr Rebecca Grainger, Rheumatologist and Clinical Research Fellow, Malaghan Institute of Medical Research, Wellington The aim of treatment for rheumatoid arthritis is to achieve minimal joint inflammation (a therapeutic remission). Key reviewers: Professor John Highton, Head of Section, Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago. Hydroxychloroquine methotrexate sulfasalazine azathioprine lefludomide Considerations for patients aged 70-79 who are on DMARDs and., DMARDs Arthritis Foundation Plaquenil tevaHow long to take plaquenil for lupusPlaquenil brand name covered by insurance aetnaHydroxychloroquine lupus mechanism Background/Purpose The combination of methotrexate MTX, sulfasalazine SSZ and hydroxychloroquine HCQ triple therapy is a highly effective and well-tolerated treatment in rheumatoid arthritis RA. While MTX is the cornerstone of most successful combination therapies, not all patients are candidates for, or tolerate, MTX. Leflunomide, a disease-modifying anti-rheumatic drug DMARD. Leflunomide, Sulfasalazine and Hydroxychloroquine for.. Traditional DMARDs Methotrexate, Leflunomide.. Treating Lupus with Immunosuppressive Medications Johns.. Other DMARDs include sulfasalazine Azulfidine®, leflunomide Arava®, hydroxychloroquine. One of the side effects of leflunomide Arava, like methotrexate, is the potential for liver toxicity. Azathioprine Imuran® is indicated for rheumatoid arthritis. It is used very rarely to treat psoriatic arthritis. Methotrexate is one of the most durable and frequently used disease-modifying antirheumatic drugs DMARDs in monotherapy as well as the cornerstone of combination therapy for rheumatoid arthritis RA. Leflunomide, sulfasalazine, and hydroxychloroquine are effective therapies in RA and are commonly employed in combination therapy. Commonly used oral DMARDs include methotrexate, sulfasalazine, hydroxychloroquine, low-dose prednisone and a newer agent, leflunomide. Other less commonly used DMARDs include azathioprine, cyclosporin and sodium aurothiomalate intramuscular gold. Biological DMARDS, tumour necrosis factor TNF inhibitors, are discussed below.