Therapeutic approach in rheumatology: NSAID, corticosteroid, disease modifying drugs (DMARD): conventional synthetic, biological and targeted synthetic DMARDs

1. Big picture

Rheumatologic therapy has two different goals:

1. Control symptoms quickly → non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, local/intra-articular corticosteroids, short systemic corticosteroids.

2. Stop immune-mediated damage and prevent disability → disease-modifying antirheumatic drugs (DMARDs).

The key exam logic is:

NSAIDs and corticosteroids reduce inflammation and pain, but they usually do not prevent structural progression. DMARDs modify the disease course.

In rheumatoid arthritis (RA), modern treatment follows a treat-to-target strategy: start DMARDs early, reassess regularly, and aim for remission or low disease activity