Advances in non-biological drugs for the treatment of rheumatoid arthritis

ABSTRACT

Introduction

Rheumatoid arthritis (RA) is a complex autoimmune disease that affects millions of people worldwide, with a systemic impact. This review explores the role of non-biological conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) in its management.

Areas covered

We discuss the effectiveness and safety of key csDMARDs such as Nonsteroidal anti-inflammatory drugs, corticosteroids, Hydroxychloroquine, Sulfasalazine, Methotrexate, and Leflunomide in relieving symptoms and slowing the progression of the disease. We also highlight the importance of combination therapy using csDMARDs, supported by clinical studies demonstrating the benefits of various csDMARD combinations. Early intervention with these drugs is emphasized to prevent joint damage, improve clinical symptoms, and enhance patient outcomes.

Expert opinion

Overall, csDMARDs have proven pivotal in managing RA, providing cost-effective and versatile treatment options. We acknowledge the advantages of biologics but highlight the associated challenges, making the choice between non-biological and biological drugs a personalized decision. This comprehensive overview aims to provide a deeper understanding of RA treatment strategies, contributing to improving the quality of life for patients with this chronic condition.

KEYWORDS:

• Corticosteroids
• Hydroxychloroquine
• Leflunomide
• methotrexate
• non-biological drugs
• conventional synthetic disease-modifying antirheumatic drugs
• rheumatoid arthritis
• Sulfasalazine

Article highlights

• Physicians should consider disease severity and previous treatments when treating RA while sharing decision-making with patients.

• Non-biological drugs effectively reduce disease activity, improve clinical symptoms, and provide both short- and long-term structural benefits.

• Early treatment with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) is crucial to reduce structural damage and achieve clinical remission or low disease activity in RA.

• csDMARDs are cost-effective and easy to administer orally.

• MTX is a fundamental DMARD and can be used as initial therapy or combined with other DMARDs.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.