Dec 22, 2000

Renal toxicity associated with disease-modifying antirheumatic drugs used for the treatment of rheumatoid arthritis

Seminars in Arthritis and Rheumatism
M H Schiff, A Whelton

Abstract

To provide a review of the renal toxicity of disease-modifying antirheumatic drugs (DMARDs) currently used for the treatment of rheumatoid arthritis. Papers in American and European medical journals related to renal toxicity of DMARDs used for the treatment of rheumatoid arthritis were reviewed. Specific DMARDs reviewed were cyclosporine, gold, D-penicillamine, methotrexate, azathioprine, antimalarials, sulfasalazine, leflunomide, etanercept, infliximab, and DMARD combination therapy. The renal toxicity of DMARDs varies widely. Cyclosporine, gold, and D-penicillamine all have a serious potential for renal side effects, particularly in the elderly or in patients with compromised renal function. Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the potential for renal damage. In contrast, methotrexate, azathioprine, antimalarials, sulfasalazine, leflunomide, etanercept, and infliximab have relatively little renal toxicity. The potential for renal toxicity should always be considered when determining which DMARD to use for RA therapy. DMARDs that combine efficacy with negligible renal adverse effects should be used for the treatment of patients susceptible to DMARD-associated renal damage.

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Mentioned in this Paper

Leflunomide
Kidney Function Tests
Antirheumatic Drugs, Disease-Modifying
Penicillamine
Toxic Nephropathy
Restasis
Cyclosporine
Anti-Inflammatory Agents, Non-Steroidal
Kidney
Adverse Effects

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