Pharmacologic management of rheumatoid arthritis has been a subject of extensive research within the last several years. Novel nonsteroidal anti-inflammatory drugs have entered the arena offering equal efficacy with an improved toxicity profile. The selective cyclooxygenase-2 inhibitors, celecoxib and rofecoxib, are described. New disease modifying antirheumatic drugs include leflunomide, etanercept, and infliximab. Methotrexate, a widely used antirheumatic agent, has been continuously studied with other disease modifying therapies, such as sulfasalazine, hydroxychloroquine, and cyclosporin. Therapeutic principles of rheumatoid arthritis therapy, as well as the role of new treatment modalities is discussed in this review.
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