From clinical pharmacology to clinical rheumatology: bench to bedside

The mainstay of management of rheumatic diseases is based on drug therapy. A number of drugs, from gold salts of yesteryear to methotrexate, leflunomide and the biologicals of today, are in vogue. These are used both singly and in permutations and combinations. Patient response varies enormously, from impressive results to abysmal failure. Why this great variability of response? The following factors would determine patient response: the choice of drug (factors in the drug and factors in the patient), the dosage forms, the dose, the pharmacokinetics, the pharmacodynamics, the drug interactions (synergism, additive effects, and antagonism), the adverse reactions, the pharmacoeconomics, and the patient education.

This presentation highlights nuances in drug therapy that will minimise failure rate, enhancing the success rate in the realm of rheumatology.