Commonly used disease-modifying antirheumatic drugs in the treatment of inflammatory arthritis: an update on mechanisms of action.

Although disease-modifying drugs are extensively used in the treatment of inflammatory arthritides such as rheumatoid arthritis (RA), the actual underlying mechanisms of action of these agents remains somewhat unclear. Many investigators have studied the effects of these agents, often with particular attention being paid to alterations in inflammatory cytokine production, cell proliferation and activation, signal transduction pathways, and enzyme inhibition. By gaining a more complete understanding of these mechanisms, further information may be had regarding the pathophysiology of RA as well as other autoimmune diseases. In the following review we will examine some of the more recent studies of drug mechanisms, focusing on the most commonly used anti-rheumatic medications in the treatment of RA.