RECLASSIFICATION OF ANTIRHEUMATIC AGENTS - HOW AND WHY

A proposed new classification of antirheumatic therapy nominates two m ajor categories, as follows. 1. Symptom-modifying antirheumatic drugs (SM-ARDs) improve the symptoms and clinical features of inflammatory s ynovitis. They can be further categorised as: (I) nonsteroidal anti-in flammatory drugs; (II) corticosteroids; and (III) slower-acting drugs, e.g. antimalarials, gold, penicillamine, antimetabolites and cytotoxi c agents. 2. Disease-controlling antirheumatic therapy (DC-ART) change s the course of rheumatoid arthritis. These agents (a) improve and sus tain function in association with decreased inflammatory synovitis, an d (b) prevent structural joint damage, or significantly decrease its r ate of progression. Changes must be sustained for a minimum period of 1 year. The classification must include reference to the time for whic h criteria have been satisfied, e.g. a 2-year DC-ART. All currently av ailable therapeutic agents are SM-ARDs. DC-ARTs are a new group and a new concept. The development of therapies in this category represents a major challenge to drug developers.