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Lecture notes

Introduction to DMARD

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Detailed notes of the two classes of DMARDs that treat rheumatoid arthritis and we speak about the many different types of drugs and the mechanism of action and the different strategies taken to treat the problems of arthritis and how DMARDs can treat cancer too. There are learning objects that target what you need to know and detailed notes and diagrams with colour and annotations.

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LO1 ·
Define DMARDs




Disease
- Rheumatic drugs
modifying
Y ·
used for rheumatoid arthritis


used to control symptoms · used for other chronic inflammatory diseases


AND slow/stop progression of


the disease




What is rheumatoid arthritis ?




· chronic inflammatory conditions


· common cause of disability (1 in 100 people)


· Autoimmune >
- immune system attacks healthy cells in the
body - persistent inflammation (mainly joints) - joint damage


·
affected joints are swollen , painful , deformed and immobile




Treatment




·
NSAIDs and corticosteroids used mainly for symptom control/relive

· DMARD, - both symptom control and slow/stop progression of the disease


↳ this changed the life of patients and help treat the disease




classes of DMARDs




. Conventional
1 synthetic DMARDs : CSDMARDs


.
2 Biological DMARDS : bDMARDs




LO2 Discuss conventional synthetic DMARDs and give examples




Conventional synthetic DMARDS-CSDMARD,

methotrexate

small synthetic molecules
·




· most
commonly used : methotrexate

, methotrexate




&
stops it


Initially designed to inhibit the enzyme



dihydrofolate reductase


↓ Y
very


de important in
DNA and
involved in folate
RNA
tetrahydrofale
↓ Synthesis
metabolism
less DNA
RNA
synthesis


Cancer > as
-
a consequence inhibits cell proliferation and cell death



that's it
why was used in cancer




it can also inhibit enzyme AICAR



transformylase (ATIC)




antiinflammatory effect



nea
o

concentration inside the cell

which is then transported outside the cell- and activate

a GPCR called adenosine receptor
Y
activation of this will lead
Conventional DMARDs
to the activation
of adenosine

signalling pathways
Y this lower the
· small synthetic molecules
inflammation

· M O A is not
. .
fully understood like methotrexate so uses different strategies to target inflammation


non-specific mechanism of action





* memorize 2SDMARD


the strategies


in the box



you don't need

to know the names


I
inhibit
Y cytokines
can affect
expression
other cells

non-specific

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February 5, 2026
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Written in
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Iulia blesneac
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