Immunomodulatory drugs. The rationale for the use of drugs with a similar effect (cyclophosphamide, chlorbutin, azothioprine) was not only theoretical prerequisites associated with the confirmation of the hyperactivation of the B-lymphoid system in YUHA and RA, but also observations indicating that the preservation of immunological changes (activity B – lymphocytes, circulation of immune complexes, etc.), even with seemingly good effect of anti-inflammatory drugs, always lead to the progression of the pathological process. The above drugs have a predominantly immunosuppressive effect. In adults, azothioprin is more popular, and in children – alkylating agents (cyclophosphamide, chlorine tin).
Considering the decrease in the suppressive function of T-lymphocytes in rheumatic diseases, attempts have been made to use immunostimulants such as levamylose (decariethimoline), timothin. However, the use of these drugs is in the stage of accumulation of experience.
When discussing the use of immunomodulatory therapy, one point should be emphasized: immunomodulatory therapy can only be used in special clinics that have the possibility of laboratory immunological control of the therapy that is far from indifferent to the patient.
Let us dwell in more detail on a number of drugs that are currently quite widely used in the treatment of YUHA and RA, and most researchers consider them to be based on the immunomodulatory effect, although their mechanisms of action are not fully understood.