NSAIDs (non-steroidal anti-inflammatory drugs): These are the common pain relievers.
They are divided into COX-1 and COX-2 inhibitors (COX is cyclooxygenase enzyme).
Cox-2 inhibitors (i.e., coxibs) are safer than cox-1 inhibitors so far as gastric and
renal toxicities are concerned. The examples of cox-1 inhibitors are ibuprofen,
diclofenac, indomethacin, etc.
DMARDs (disease-modifying anti-rheumatic drugs): The common drugs are
methotrexate, hydroxychloroquine, sulphasalazine, leflunomide, etc. They are used
in persistent inflammatory synovitis present in different autoimmune diseases.
Biologics: These are revolutionary drugs to treat autoimmune diseases when
traditional DMARDs fail. The common drugs used are TNF- blockers (etanercept,
infliximab, adalimumab), abatacept (selective T-cell co-stimulation modulator),
rituximab (anti-CD 20) and tocilizumab (interleukin-6 inhibitor). These drugs are
used parenterally and are more expensive than DMARDs. Recently, an oral biologic
[janus kinase (JAK) inhibitor] has been introduced for treatment of RA i.e., tofacitinib.