DMARD | Efficacy against inflammation* | Efficacy against structural involvement* | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
<6 m | <1 y | <2 y | <5 y | Any duration | <6 m | <1 y | <2 y | <5 y | Any duration | ||
*Level of evidence as defined by Shekelle et al.7A: based on evidence from at least one randomised controlled trial (RCT) or meta-analyses of RTC. B: based on evidence from at least one controlled but not randomised trial, another type of experimental study, or extrapolated recommendations from RCT or meta-analyses. C: based on non-experimental descriptive studies—for example, comparative, correlational and case–control studies, which are extrapolated from RCT, non-RTC, or other experimental studies. D: based on expert committee reports or clinical experience of respected authorities or both, or those in levels B and C. | |||||||||||
DMARD, disease modifying antirheumatic drug; m, months; y, years. | |||||||||||
Hydroxychloroquine | A | A | A | ||||||||
Gold salts | A | A | A | A | A | A | |||||
Auranofin | A | A | A | ||||||||
D-Penicillamine | A | A | A | ||||||||
Tiopronin | B | ||||||||||
Minocycline | A | A | |||||||||
Sulfasalazine | A | A | A | A | |||||||
Azathioprine | A | C | |||||||||
Ciclosporine | C | C | C | C | A | C | C | C | A | ||
Methotrexate | A | A | A | ||||||||
Leflunomide | B | A | D | A | |||||||
Etanercept | A | A | A | A | |||||||
Infliximab | D | D | A | D | D | A | |||||
Adalimumab | D | A | D | A | |||||||
Anakinra | A | A | |||||||||
Corticosteroids | A | A | A | A | A | A |