Signs Your DMARD Isn’t Working

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Usually with rheumatoid arthritis, DMARDs are the first line of therapy for a lot of patients. DMARDs are Disease-Modifying Antirheumatic Drug that are usually oral. And they basically work by modulating the immune system. So they ultimately reduce inflammation and are very beneficial in treatment of rheumatoid arthritis. These are slow-acting drugs, so the action is not instantaneous. They usually start working within a few weeks.

So if you've started them on a DMARD and given it a few weeks, one to two months, at least, and the disease is still active, or they don't feel good, then maybe the drug isn't working. But what we need to understand is, is the patient taking the drug the right way?

So if we've decided that the medication is not working and not a problem with compliance, then the next step would be to change the DMARD or add another DMARD. The other thing is if the patient has very aggressive rheumatoid arthritis and is otherwise young and healthy, then the other option is to just maybe add on a biologic. So both approaches are valid. It just depends on the patient and their situation.