DMARD Notation

Do you ever read medical articles (or your doctor’s notes) and ask, “What does THAT mean?!”  RA patients soon become adept at interpreting the special language used to discuss treatment of their disease. We have to keep current, though, because as science makes new discoveries, those discoveries will be incorporated into medical practice and into journal articles.  It can be startling to suddenly come across new terminology.

When we are first diagnosed, we quickly learn the term DMARD:   Disease Modifying Anti-Rheumatic Drug.  We learn that these are traditional pills whipped up in the laboratory, including things like hydroxycholorquine (hcq), methotrexate (mtx), and sulfasalazine (ssz).

When I was first diagnosed, there was a relatively new term BRM: Biologic Response Modifier. Biologics (enbrel, humira, remicade, etc.) are the big guns that doctors go to when traditional DMARDs aren’t enough.  They’re still DMARDs, just a more powerful kind. Things have changed, and although more and more biologics are available, we just don’t see the term BRM any more.

The terminology seen now tacks a few lower-case letters onto the front of the DMARD to designate specifically which type:

csDMARDconventional synthetic DMARDs are those traditional small-molecule medications synthesized chemically: methotrexate, sulfasalazine, hydroxychloroquine, leflunomide, gold salts, etc.

tsDMARDtargeted synthetic DMARDs target a specific molecule.

bDMARDbiologic DMARD is the term used instead of BRM. Biologics are living cells – think genetic engineering, rather than mixing chemicals in a beaker.  These can be broken down into two types of biologics:

  • boDMARDs are original biologics
  • bsDMARDs are biosimilars

It will be interesting to see what new discoveries await.  I wonder how the notation will have changed in another ten years.

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