Table 1

Current therapeutic options for management of autoimmunity

TherapyMode of action
Insulin, thyroxine, etc.Replacement therapy
Paracetamol, opiatesAnalgesia
Non-steroidal anti-inflammatory drugs: aspirin, ibuprofen, diclofenac, naproxen, etc.Anti-inflammatory
COX-2 inhibitors: celecoxib, etc.Anti-inflammatory
Glucocorticoids: prednisolone, prednisone, dexamethasone, etc.Anti-inflammatory, immunosuppressive
DMARDS: MTX, sulphasalazine, leflunomide, hydroxychloroquine, azathioprine, mycophenolate mofetil, ciclosporin, etc.Various, generally not well defined. Anti-inflammatory, immunosuppressive, possibly immunomodulatory. Some, such as MTX, may have more than one mode of action.
Cytokine blockade (anti-TNF, anti-IL6 receptor)Anti-inflammatory and immunosuppressive, immunomodulatory
B-cell depletion/modulation (anti-CD20, anti-BLyS)Immunosuppressive, immunomodulatory
Costimulation blockade (abatacept)Immunosuppressive, immunomodulatory
Janus kinase inhibitors (tofacitinib, baricitinib, others in development)Anti-inflammatory, immunosuppressive, immunomodulatory
Intravenous immunoglobulinsImmunomodulatory (via Fc receptor interactions)
PlasmapheresisImmunosuppressive, immunomodulatory (by removing (auto)antibodies and other soluble mediators)
  • For several therapies, particularly DMARDs, the precise mode of action is not known. Immunomodulation denotes that the treatment has a specific and defined effect on the immune system.

  • DMARDs, disease-modifying anti-rheumatic drugs; MTX, methotrexate.