Second-Line Drug Therapy for Rheumatoid Arthritis

Three major classes of drugs are used in the treatment of patients with rheumatoid arthritis: nonsteroidal antiinflammatory drugs, corticosteroids, and drugs that are thought to modify fundamental pathologic processes responsible for the chronic inflammation. The agents in the last group have been classified according to their alleged benefit (as disease-modifying or remission-inducing), their onset or duration of action (slow-acting or long-acting), or their presumed mechanism of action (cytotoxic, immunosuppressive, or antiproliferative). Although they probably have properties in common, from a clinical standpoint each of these categories of drug has some unique effects on the clinical course of rheumatoid arthritis and, . . .