Do you wake up in the morning with stiff, swollen, and unbearable pain in your joints? Do your joints like your knees and elbows hurt? Maybe your doctor has told you to start a type of medication called 'DMARDs'. Did you feel a little scared when you heard that name? Did you think, 'What kind of medicine is this?'? Don't worry. Today, we will talk about these DMARDs in a very simple way that you can understand.
What are DMARDs in simple terms?
Imagine that there is a very smart guard inside our body. We call this guard the immune system . Its main job is to protect us from diseases by fighting disease-causing germs (like viruses and bacteria) that enter the body from outside.
But sometimes, very rarely, this watchman of ours makes a small mistake. He thinks that the healthy cells in his own body, especially in places like our joints, are the enemy and starts attacking them. It's like throwing stones at his own house. We call this condition an autoimmune disease .
This is where a class of medications called DMARDs come in. DMARDs stand for 'Disease-Modifying Antirheumatic Drugs'. The name may sound a bit long, but it's actually quite simple. What these medications do is calm down and control the immune system, which is overactive and attacking its own body.
There are several main benefits that this medicine provides to our body:
- Reduces inflammation and swelling in the joints.
- It helps you control the pain you feel.
- It slows down the spread or severity of the disease.
- Reduces or prevents permanent damage to joints and bones.
- It helps you keep your joints functioning well and perform daily tasks.
What diseases are DMARDs used for?
Doctors use these drugs, called DMARDs, primarily to control inflammation caused by autoimmune diseases. Here are a few examples:
- Rheumatoid arthritis
- Ankylosing spondylitis
- Psoriatic arthritis
- Lupus
- Juvenile idiopathic arthritis
- Scleroderma
- Multiple sclerosis
- Sjögren's syndrome
- Myositis
- Rheumatoid vasculitis
- Inflammatory bowel disease - for example, Crohn's disease
In addition, DMARDs can also be used to treat some rare types of cancer.
What are the main types of DMARDs?
DMARDs can be divided into two main groups. The way they work and how they are used is slightly different.
| DMARD type | A simple explanation | Commonly used examples |
|---|---|---|
| Traditional DMARDs | These drugs affect the entire immune system, reducing its function. This type of medication is usually the first to start with. They often come in the form of pills that are taken by mouth. |
|
| Biologics | These are a new, advanced class of drugs. They are like a 'guided missile'. They target and attack only a specific part of the immune system's cells that are causing the disease, without affecting the entire system. They are usually given as an IV infusion or as a subcutaneous injection. |
Your doctor will decide which of these two types to give you, or whether to give you both, based on your condition, its severity, and what works best for your body.
The story that everyone fears: Are there any side effects?
Like any medicine, DMARDs can cause some side effects. But don't be alarmed by this list. Not everyone will get all of these side effects. Your doctor will treat you in a way that minimizes this risk.
| Type of side effect | Description and what to know |
|---|---|
| Possible side effects common to both types of DMARDs | |
| Higher risk of infection | Because these medications suppress the immune system, you can easily get infections like colds and flu (the risk is slightly higher with biologics). So it's important to stay away from people who are sick in crowded places. |
| Decreased blood cells | White blood cell (leukopenia), red blood cell (anemia), and platelet (thrombocytopenia) counts may decrease. This is why the doctor will often do blood tests. |
| Elevated liver enzymes | Some DMARDs can affect the liver. This is also monitored through blood tests. |
| Possible side effects specific to traditional DMARDs | |
| Digestive problems | Loss of appetite, nausea, vomiting, stomach pain, and diarrhea may occur. |
| Skin rash | Some people may develop a skin rash. |
| Possible side effects specific to biologics | |
| Resurgence of old infections | If you have had previous illnesses such as tuberculosis, herpes, or hepatitis, these medications may reactivate them. Therefore, your doctor will check for this before starting the medication. |
| Injection site reactions | There may be redness, swelling, or pain at the injection site. |
The most important thing is to inform your doctor immediately if you develop any new symptoms or side effects.
How long does it take for this medicine to work?
This is a very important question. DMARDs are not a drug that you take as soon as you take it, like a painkiller. These drugs take a while to be absorbed into the body, control the immune system, and show results.
- Traditional DMARDs can take a month or more to work.
- Biologics usually start working within a few weeks .
Don't worry if the pain doesn't go away right away when you start taking this medication. It takes a while to see results, so it's important to be patient. Your doctor will prescribe other medications to help control the pain in the meantime.
When should I see the doctor again?
Once you start DMARDs, your doctor will monitor you regularly. So it's important to go to the clinic on time. You will usually experience the following:
- Regular blood tests: You will be asked to have regular blood tests to check if the medication is working properly and if there are any side effects (blood cell counts, liver function).
- Checking for infections: You will be checked regularly for infections, especially if you are taking biologics.
- Tests such as X-rays: Tests such as X-rays may be done periodically to check for damage to the joints.
If you experience any new side effects, feel like the medication isn't working, or if your symptoms worsen, talk to your doctor immediately, without waiting for the next clinic appointment.
Although DMARDs may sound like a scary and complicated class of medications, they can help control your disease, prevent joint damage, and help you live a normal life. Your doctor will choose the right combination of medications for you. So don't be afraid to ask your doctor any questions you may have.
Take-Home Message
- DMARDs are not painkillers. They are drugs that control the overactive immune system that is at the root of your disease.
- It can take several weeks or even a month for these medications to take effect, so patience is very important.
- Although side effects are possible, your doctor will monitor you closely with regular blood tests.
- Never stop taking medication or change the dosage without medical advice.
- If you develop any unusual symptoms (fever, cough, other infection), notify your doctor immediately.
- If used correctly, DMARDs can greatly improve your quality of life.
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