Immunosuppressive/DMARD

These are more aggressive therapies that have the potential to modify the course of rheumatoid arthritis and other autoimmune diseases. Most do so by suppressing the white blood cells, whose function is to fight infection. These same white blood cells, however, have the potential in patients with rheumatic diseases to cause damage to joints and various organs of the body. Often, suppressing these cells not only treats the underlying disease but can result in an increased susceptibility to infection. Careful monitoring is required to strike a balance between treating the disease and lowering the patient’s resistance to infection. The drugs that fall under this heading include sulfasalazine, gold, leflunomide, methotrexate, azathioprine, cyclosporine, cyclophosphamide, chlorambucil, and mycophenolate mofetil.