Disease Modifying Anti Rheumatic Drugs (DMARDs)

Disease Modifying Anti Rheumatic Drugs (DMARDs) are treatments that alter the condition itself, rather than just treat the symptoms.

DMARDs work by attacking the causes of inflammation in the joints. They lessen the activity of arthritis by reducing swelling and stiffness, reducing the pain as well. These treatments are different to anti-inflammatory medications, as they can help to stop the arthritis from getting any worse.

It can take a number of months for a DMARD to reach its full effect. However, they can often be taken at the same time as other first line medications, such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and painkillers, to help ease symptoms whilst the DMARD begins to work. Most DMARDs work on the immune system and are designed to be taken long-term, and therefore there is a possibility of more significant side effects than with painkillers and NSAIDs alone.

When should DMARDs be prescribed?

Psoriatic arthritis can cause irreversible damage to joints if effective DMARD treatment is not given when appropriate. There are two categories of DMARDs that are used for psoriatic arthritis – traditional systemics, and the newer biologic treatments.

Traditional systemic DMARDs (such as methotrexate, sulfasalazine, leflunomide) should be considered if:

  • There is active psoriatic arthritis (i.e. inflammation is present in several joints despite using NSAIDs)
  • The individual is unable to go about daily living, work or recreation easily
  • Many joints are affected.

Click on the links below to find out more about the different types of DMARDs available to treat psoriatic arthritis.




Otezla (Apremilast)


For more information, or for a list of resources used in the production of this information, please contact us.

October 2018 (Review: December 2020)