[Immunosuppressant and immunomodulator]

Rheumatoid arthritis (RA) is characterized by deforming, destructive joint disease. It also accompanies multiple extra-articular symptoms. Although initial agent (s) has not been clearly delineated, understandings of joint destruction mechanism have made considerable progress. Initial rheumatoid inflammation takes a form of the proliferation of synovial lining cells and the perpetuation of inflammation leads to cartilage and bone destruction. These pathologic changes are mediated by immunological aberration. On the basis of these observations, suppression and/or modulation of such immunological aberration may be reasonable alternative way of treating patients with RA. Recent knowledge and several topics of immuno-suppressant and-modulator were introduced. Such immunotherapies are indicated in patients with early active RA but rather frequent occurrence of side effects makes us use cautiously such drugs.