Treatment is usually initiated by a specialist, but GPs play an important role in monitoring patients for adverse effects and drug interactions. This article includes a pull out DMARD monitoring table and information on tumour necrosis factor (TNF) inhibitors. Antimalarials hydroxychloroquine Plaquenil while pregnant risks Chloroquine contraindications Hydroxychloroquine and anemia Hydroxychloroquine Plaquenil is considered a disease-modifying anti-rheumatic drug DMARD. It can decrease the pain and swelling of arthritis. It may prevent joint damage and reduce the risk of long-term disability. Hydroxychloroquine is in a class of medications that was first used to prevent and treat malaria. Background/Purpose The combination of methotrexate MTX, sulfasalazine SSZ and hydroxychloroquine HCQ triple therapy is a highly effective and well-tolerated treatment in rheumatoid arthritis RA. While MTX is the cornerstone of most successful combination therapies, not all patients are candidates for, or tolerate, MTX. Leflunomide, a disease-modifying anti-rheumatic drug DMARD. Leflunomide is a new drug with a different mechanism of action than other DMARDs such as methotrexate, antimalarial drugs chloroquine and hydroxychloroquine, sulfasalazine, gold, azathioprine, d. Dr Andrew Harrison, Senior Lecturer, Rheumatology, Wellington School of Medicine, University of Otago, Wellington Dr Rebecca Grainger, Rheumatologist and Clinical Research Fellow, Malaghan Institute of Medical Research, Wellington The aim of treatment for rheumatoid arthritis is to achieve minimal joint inflammation (a therapeutic remission). Key reviewers: Professor John Highton, Head of Section, Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago. Hydroxychloroquine methotrexate sulfasalazine azathioprine lefludomide Methotrexate vs Sulfasalazine Comparison -, Leflunomide, Sulfasalazine and Hydroxychloroquine for. Who should not take plaquenilDoes plaquenil work for osteoarthritisWhat stage of infection did the chloroquine treatPlaquenil sideceffects In combination with methotrexate for active disease in adult patients when the response to disease-modifying anti-rheumatic drugs DMARDs including methotrexate has been inadequate, or the treatment of severe, active and progressive disease in adults not previously treated with methotrexate or other DMARDs. Ankylosing spondylitis. DMARDs - NICE CKS. Is Leflunomide as Safe and Effective in the Treatment of.. ARA - Medication Information. It can either be prescribed alone or in combination with other treatments, such as methotrexate; often leflunomide is prescribed for patients who do not respond well to methotrexate. Leflunomide works by blocking the formation of DNA in the cells of your body, including those of the immune system. Commonly used oral DMARDs include methotrexate, sulfasalazine, hydroxychloroquine, low-dose prednisone and a newer agent, leflunomide. Other less commonly used DMARDs include azathioprine, cyclosporin and sodium aurothiomalate intramuscular gold. Biological DMARDS, tumour necrosis factor TNF inhibitors, are discussed below. Sulfasalazine may be considered Recommendation #7a – Azathioprine If hydroxychloroquine and/or methotrexate, corticosteroids, leflunomide, or sulfasalazine WEAK Sjögren’s, azathioprine may be considered. a better choice than leflunomide or sulfasalazine for the treatment of all complications including inflammatory musculoskeletal pain.