Antirheumatic drugs: clinical pharmacological and therapeutic aspects

There are many current concepts of the pathogenesis of rheumatic diseases which incorporate immunological, infectious and hereditary factors. Rheumatic diseases may sometimes become apparent after trauma, be associated with certain diseases and may be induced by nerve damage and serum sickness. Systemic lupuserythematosus may result from the use of a variety of drugs. At present the body of evidence tends to incriminate immunological factors as well as infectious agents as principal factors in the pathogenesis of rheumatoid arthritis and systemic lupus erythematosus. Just as there is uncertainty regarding the pathogenesis of rheumatic diseases, knowledge of the mechanism of action of the various drugs used to treat these diseases is also incomplete. Recent progress indicates that inhibition of prostaglandin biosynthesis and possibly lysosomal membrane stabilization are primary modes of action of the anti-inflammatory agents. Certain antirheumatic drugs have also been shown to exert some of their therapeutic effect by interfering with the kallikrein-kinin-kininase system...