Despite the development of targeted therapies, conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) remain the cornerstone of treatment of rheumatoid arthritis (RA). A literature search was conducted on treatment recommendations and relevant papers regarding new insights on therapeutics in rheumatoid arthritis. Methotrexate is considered the “anchor drug” due to its high efficacy as monotherapy and in combination with other conventional and targeted agents. Leflunomide and sulfasalazine are sound alternatives, whereas (hydroxy)chloroquine is primarily used in combination with other csDMARDs.<br />
Their use is encouraged in all treatment phases – in combination with targeted agents, and with other csDMARDs. Combining different csDMARDs is especially attractive in lower income settings given the evidence proving (almost) equal efficacy and safety of the csDMARD combination approach compared to the combination of targeted agents with a csDMARD.<br />
The aim of this review is to provide a clinically oriented insight into the pharmacology of each csDMARD and their place in treatment algorithms.
croatia / zavod za kliničku imunologiju i reumatologiju, klinika za unutarnje bolesti medicinskog fakulteta sveučilišta u zagrebu, klinički bolnički centar zagreb 2 department of physical medicine, rehabilitation, and rheumatology, national memorial Hospital vukovar, vukovar, croatia / odsjek za fizikalnu medicinu, rehabilitaciju i reumatologiju, nacionalna memorijalna bolnica vukovar, vukovar, Hrvatska corresponding author / Adresa autora za dopisivanje: Darija Čubelić, MD division of clinical immunology and rheumatology / zavod za kliničku imunologiju i reumatologiju department of internal medicine / klinika za unutarnje bolesti University of zagreb, school of medicine / medicinski fakultet sveučilišta u zagrebu University Hospital center zagreb / klinički bolnički centar zagreb kišpatićeva 12 10000 zagreb croatia / Hrvatska tel.
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