Konventionelle Basistherapie in der Rheumatologie

Zusammenfassung

Methotrexat ist nach aktuellen Leitlinien der DGRh, aber auch der internationalen Fachgesellschaften, die bevorzugte Erstlinientherapie der rheumatoiden Arthritis (RA). Andere konventionelle Basistherapeutika haben zwar an Bedeutung verloren, sind aber immer noch als Alternativ- und Kombinationspräparate im Einsatz. Leflunomid und Sulfasalazin werden auch als Monotherapie eingesetzt, Hydroxychlorochin spielt nur noch in der Kombinationstherapie der RA eine Rolle, gemeinsam mit Azathioprin gehört es v. a. zu den Therapeutika des systemischen Lupus erythematodes. Goldpräparate und D-Penicillamin haben keine Bedeutung mehr in der Rheumatologie.

Summary

According to national and international guidelines, methotrexate is the drug of choice for the first-line treatment of rheumatoid arthritis (RA). Other conventional DMARDs have received less attention over the last years. However, some of them are still in use as alternative drugs to MTX or as combination partners in conventional DMARD regimens. Leflunomide and sulfasalazine are also applied in the monotherapy of RA, whereas hydroxychloroquine is preferentially prescribed in DMARD combinations. The latter plays a very important role in the treatment of systemic lupus erythematosus, together with azathioprine. Today, intramuscular gold and penicillamine are of no importance for the treatment of RA in Germany.

Schlüsselwörter

Rheumatoide Arthritis - Leflunomid - Sulfasalazin - Azathioprin - Hydroxychloroquin

Keywords

Rheumatoid arthritis - leflunomide - sulfasalazine - azathioprine - hydroxychloroquine

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