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Question: Which immunosuppressive drugs are effective as DMARDs?

Immunosuppressive drugs have been shown to be effective DMARDs in RA. To a large degree their use is restricted by their toxicities. Chlorambucil and cyclophosphamide are generally reserved for severe disease including the development of extra-articular features such as vasculitis. Azathioprine has been studied in RA, but its greater toxicity risk and lack of efficacy advantage over methotrexate make it a less common therapeutic choice. Cyclosporine has been used in the treatment of RA with good effect. Unfortunately, when used as a single agent, the doses required confer a high risk of hypertension and renal insufficiency. It has been used synergistically in combination with methotrexate, allowing lower doses of each drug.

Reference: Hochberg MC (ed). Rheumatology, 3rd ed. St. Louis, Mosby, 2003

2 Responses to “Question: Which immunosuppressive drugs are effective as DMARDs?”

  1. Latrisha Altheimer Says:

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