HOW DO 2ND-LINE AGENTS WORK

The pathogenesis of rheumatoid arthritis remains unknown, Disease modi fying anti-rheumatic drugs are commonly used to treat rheumatoid arthr itis patients, Their use in rheumatoid arthritis was discovered serend ipitously and their modes of action remain unknown. This article revie ws current hypotheses on the mechanisms of action of established DMARD s, Most of them have anti-inflammatory properties and some are immunom odulators, We also discuss a number of novel agents which are potentia l new DMARDs.