Iguratimod

<p>Rheumatoid arthritis (RA), Sj&ouml;gren&#39;s syndrome, ankylosing spondylitis, systemic lupus erythematosus (SLE)</p>

<p>Rheumatoid Arthritis</p> <p>Often used alone or in combination with methotrexate or other DMARDs.</p> <p>Adult Dose&nbsp;<br /> 25 mg orally twice daily (morning and evening) after meals.<br /> In some cases, may start with 25 mg once daily for 1-2 weeks to improve tolerance, then increase to 25 mg twice daily.</p>

<p>Safety and efficacy not established</p>

<p>Renal impairment<br /> Use with caution; monitor renal function.</p> <p>Dose adjustments are usually not required in mild renal/hepatic impairment, but the drug should be used with caution.</p>

<p>Hypersensitivity to Iguratimod or formulation components.<br /> Severe hepatic impairment.<br /> Pregnancy and breastfeeding (teratogenic risk and not enough safety data).</p>

<p>Liver toxicity<br /> May cause elevated liver enzymes (ALT, AST).<br /> Requires regular liver function tests (LFTs) (baseline, then periodically).<br /> Stop if significant hepatotoxicity occurs.</p> <p>Bone marrow suppression<br /> Can cause leukopenia, neutropenia, anemia, or thrombocytopenia.<br /> Monitor CBC regularly.</p> <p>Infections<br /> Being an immunomodulator, it can increase risk of infections (respiratory, urinary, etc.).<br /> Avoid use in patients with active infections (e.g., TB, hepatitis).</p> <p>Gastrointestinal effects<br /> Nausea, dyspepsia, diarrhea may occur.<br /> Take after meals to reduce GI upset.</p>

<p>Pregnancy &amp; breastfeeding<br /> Contraindicated; may cause fetal harm.<br /> Effective contraception is required during treatment and for some time after discontinuation.</p>

<p>Use caution with other immunosuppressants, DMARDs, hepatotoxic drugs, or anticoagulants.<br /> Combination with methotrexate is common but needs close monitoring.</p>

<p>Common side effects<br /> Gastrointestinal: nausea, stomach pain, diarrhea, indigestion<br /> General: headache, dizziness, tiredness<br /> Laboratory findings: mild increase in liver enzymes (ALT, AST), sometimes mild decrease in blood counts</p>

<p>Immunomodulatory Effects: Iguratimod works by acting on both T and B lymphocytes to suppress the immune response. &nbsp;</p> <p>Anti-inflammatory Action: It inhibits the production of pro-inflammatory cytokines, such as TNF-&alpha;, IL-1&beta;, IL-6, and IL-17, which contribute to inflammation. &nbsp;</p> <p>Osteoprotective Activity: Iguratimod promotes bone formation while inhibiting the differentiation and activity of bone-resorbing osteoclasts.</p>