Drug Discovery pp 221-233 | Cite as


  • Robert A. Maxwell
  • Shohreh B. Eckhardt


According to Lipsky (1985), rheumatoid arthritis in most patients is a mild to moderate and intermittent affliction with little permanent destruction of articular structures. However, in a small percentage of sufferers, the course of the disease can be “aggressively destructive” with severe damage to articular structures and consequent deformation and reduced function. The first-line agents for most cases of rheumatoid arthritis, the nonsteroidal antiinflammatory drugs (NSAIDs), are not adequate for sustaining this small group of severely-afflicted patients, since their main role is only to ease joint pain and stiffness, thus enabling patients to begin exercise programs or other long-term measures (Calabro, 1975). d-Penicillamine, along with gold compounds and antimalarials (and possibly the antiproliferative agents, azathioprine, methotrexate, and cyclophosphamide), compose a group of agents that have become known as disease-modifying antirheumatic drugs (DMARDs). Unlike NSAIDs (which are demonstrably potent, specific, acutely acting antiinflammatory and analgesic agents), DMARDs elicit, at most, only minimal, nonspecific, acute antiinflammatory or analgesic effects. Instead, with slow onset, they exert clinical benefit that is often associated with improvement of serologic abnormalities and, on occasion, even with improvement of joints.


Rheumatoid Arthritis Rheumatoid Arthritis Patient Rheumatoid Factor Megaloblastic Anemia Gold Compound 
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Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Robert A. Maxwell
    • 1
  • Shohreh B. Eckhardt
    • 2
  1. 1.The Wellcome Research Laboratories ResearchTriangle ParkUSA
  2. 2.University of Vermont College of MedicineBurlingtonUSA

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