Short for disease-modifying anti-rheumatic drugs, DMARDs are medicines that either suppress the immune system or affect the way the immune system works to decrease inflammation.
Enzymes are proteins (mainly) that help speed up chemical reactions in the body. Methotrexate works mainly by blocking an enzyme called “dihydrofolate reductase” that is important in the production of new cells in the immune system. So, by decreasing the number of new immune cells that cause inflammation, methotrexate reduces inflammation. It also reduces the production of a number of other chemicals that cause inflammation, called cytokines (e.g., TNF-alpha, IL-1, IL-6, among others).
Like methotrexate, sulfasalazine works mainly by blocking an enzyme that is important in the production of new cells in the immune system, this time called “AICAR transformylase.” By decreasing the number of new immune cells that cause inflammation, sulfasalazine reduces inflammation.
Hydroxychloroquine works in a number of ways. Most importantly, it helps block receptors (called “toll-like receptors”) found on many cells of the immune system (e.g., dendritic cells, macrophages, natural killer cells). By blocking these receptors, cells are unable to get activated to produce inflammation. This medicine also has effects on neutrophils (a type of white blood cell) and B-cells (a type of lymphocyte, also a type of white blood cell). It also reduces the production of a number of other chemicals that cause inflammation, called cytokines (e.g., TNF-alpha, IL-1, IL-6, among others).
Like methotrexate, leflunomide works mainly by blocking an enzyme that is important in the production of new cells in the immune system, this time called “dihydroorotate dehydrogenase.” By decreasing the number of new immune cells that cause inflammation, leflunomide reduces inflammation.
