Medicamentos Antirreumáticos Modificadores de la Enfermedad

Los LOS Neisseria medicamentos antirreumáticos modificadores de la enfermedad son medicamentos antiinflamatorios que se utilizan para tratar la artritis reumatoide. Los LOS Neisseria medicamentos retrasan, pero no curan, la progresión de la enfermedad. Los LOS Neisseria medicamentos se clasifican como agentes sintéticos o biológicos y cada uno tiene mecanismos de acción y efectos secundarios únicos. Los LOS Neisseria efectos secundarios comunes entre los LOS Neisseria medicamentos antirreumáticos modificadores de la enfermedad incluyen supresión de la medula ósea y hepatotoxicidad. La leflunomida, el metotrexato y los LOS Neisseria inhibidores del factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral ( TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF))-ɑ se deben evitar durante el embarazo debido a su potencial teratogénico. La hidroxicloroquina y la sulfasalazina son seguras para su uso durante el embarazo.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Contents

Descripción General de los Medicamentos Antirreumáticos

Inhibidores del TNF-ɑ

Comparación de Medicamentos Antirreumáticos

Referencias

Descripción General de los Medicamentos Antirreumáticos

Definición

Los LOS Neisseria medicamentos antirreumáticos se utilizan para tratar la artritis reumatoide al AL Amyloidosis retrasar la progresión de la enfermedad.

Indicaciones generales

Se administran medicamentos antirreumáticos para:

Artritis reumatoide
Psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis
Artritis psoriásica
Lupus eritematoso sistémico y condiciones vasculíticas
Artritis idiopática juvenil
Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa
Enfermedad de Crohn
Espondilitis anquilosante

Clasificación

Medicamentos sintéticos:
- Leflunomida
- Metotrexato
- Sulfasalazina
- Hidroxicloroquina
Agentes biológicos: inhibidores del factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral ( TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF))-ɑ

Leflunomida

**Tabla: Leflunomida**
Mecanismo de acción	Inhibe la dihidroorotato deshidrogenasa Interrumpe la síntesis de novo de pirimidinas. Inhibe la proliferación de células inmunes
Efectos fisiológicos	Efecto antiinflamatorio Efecto antiproliferativo
Metabolismo	Conversión hepática en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum metabolito activo (teriflunomida) Metabolismo posterior en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum metabolitos inactivos
Eliminación	Tiempo de concentración máxima: 6–12 horas Vida media: 18–19 días
Indicaciones específicas	Artritis reumatoide Artritis psoriásica
Contraindicaciones específicas	Deterioro hepático grave Anafilaxia previa
Complicaciones/efectos secundarios	Cefalea Erupción cutánea Diarrea Supresión de medula ósea con pancitopenia Hepatotoxicidad Teratogenicidad Se debe realizar una prueba de embarazo antes de comenzar el tratamiento con leflunomida para descartar un embarazo y se debe aconsejar el uso de métodos anticonceptivos eficaces durante el tratamiento con leflunomida.

Metotrexato

**Tabla: Metotrexato**
Mecanismo de acción	Análogo del folato Inhibe la DHF: ↓ Conversión de DHF en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum THF ↓ Síntesis de pirimidinas y purinas ↓ Proliferación de células inmunes
Efectos fisiológicos	Inmunosupresor
Metabolismo	Inicio de acción: 3–6 semanas Tiempo de concentración máxima: 0,75–6 horas
Eliminación	Vida media: Niños: 0,75–5,8 horas Adultos: 3–15 horas (la vía intravenosa (IV) tiene una vida media mayor que la oral)
Indicaciones específicas	Enfermedades neoplásicas tratadas con metotrexato: Leucemia (e.g., leucemia linfoblástica aguda) Linfoma Sarcoma Coriocarcinoma Enfermedades no neoplásicas tratadas con metotrexato: Artritis reumatoide Aborto médico (junto con misoprostol Misoprostol A synthetic analog of natural prostaglandin e1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties. Eicosanoids) Embarazo ectópico Enfermedad inflamatoria intestinal Vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus
Contraindicaciones específicas	Lactancia materna o embarazo Antecedente de anafilaxia Alcoholismo Enfermedad crónica del hígado Inmunodeficiencia Discrasia sanguínea (e.g., anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types grave)
Complicaciones/efectos secundarios	Supresión de medula ósea con pancitopenia: Reversible con rescate de leucovorina (ácido folínico) Las dosis altas de metotrexato deben seguirse con leucovorina. Hepatotoxicidad Estomatitis Fibrosis Fibrosis Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. Bronchiolitis Obliterans pulmonar Nefrotoxicidad Teratogenicidad

DHF: dihidrofolato
THF: tetrahidrofolato

Estructura del metotrexato Fármacos antirreumáticos modificadores de la enfermedad — Estructura del metotrexato: un medicamento que se usa para tratar el cáncer y, como medicamento inmunosupresor, para afecciones como la artritis reumatoide.
Imagen por Lecturio. Licencia: CC BY-NC-SA 4.0

Sulfasalazina

**Tabla: Sulfasalazina**
Mecanismo de acción	Se descompone en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sulfapiridina y mesalamina por las bacterias del colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy. El 5-ASA (también llamado mesalamina) inhibe la producción de prostaglandinas inflamatorias Suprime el TNF-ɑ e IL-1
Metabolismo	Se convierte en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sulfapiridina y 5-ASA para su absorción.
Eliminación	Vida media promedio de eliminación: 7,5 horas Tiempo promedio de concentración máxima: 6 horas
Indicaciones específicas	Artritis reumatoide juvenil Artritis reumatoide Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa
Contraindicaciones específicas	Hipersensibilidad conocida Obstrucción Porfiria
Complicaciones/efectos adversos	Anafilaxia Hepatotoxicidad Estomatitis Oligospermia reversible Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica

5-ASA: ácido 5-aminosalicílico
TNF: factor de necrosis tumoral
IL-1: interleuquina-1

Hidroxicloroquina

**Tabla: Hidroxicloroquina**
Mecanismo de acción	Altera las vacuolas digestivas: Aumenta el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance. Interfiere con la degradación lisosomal de la hemoglobina.
Efectos fisiológicos	Suprime el TNF-ɑ e IL-1. Disminuye la inflamación.
Metabolismo	La absorción es incompleta.
Eliminación	Eliminada por los LOS Neisseria riñones, excretada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina. Vida media de eliminación: 40 días
Indicaciones específicas	Lupus Malaria Malaria Malaria is an infectious parasitic disease affecting humans and other animals. Most commonly transmitted via the bite of a female Anopheles mosquito infected with microorganisms of the Plasmodium genus. Patients present with fever, chills, myalgia, headache, and diaphoresis. Plasmodium/Malaria Artritis reumatoide
Contraindicaciones específicas	Hipersensibilidad conocida
Complicaciones/efectos adversos	Retinopatía Prurito en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum personas de piel oscura Prolongación del intervalo QT con riesgo de torsades de pointes Torsades de pointes A malignant form of polymorphic ventricular tachycardia that is characterized by heart rate between 200 and 250 beats per minute, and QRS complexes with changing amplitude and twisting of the points. The term also describes the syndrome of tachycardia with prolonged ventricular repolarization, long qt intervals exceeding 500 milliseconds or bradycardia. Torsades de pointes may be self-limited or may progress to ventricular fibrillation. Ventricular Tachycardia

TNF: factor de necrosis tumoral
IL-1: interleuquina-1

Inhibidores del TNF-ɑ

**Tabla: Inhibidores del TNF-ɑ**
Agentes	Anticuerpos monoclonales: Adalimumab Adalimumab A humanized monoclonal antibody that binds specifically to tnf-alpha and blocks its interaction with endogenous tnf receptors to modulate inflammation. It is used in the treatment of rheumatoid arthritis; psoriatic arthritis; Crohn’s disease and ulcerative colitis. Disease-Modifying Antirheumatic Drugs (DMARDs) Golimumab Golimumab Disease-Modifying Antirheumatic Drugs (DMARDs) Certolizumab Certolizumab Disease-Modifying Antirheumatic Drugs (DMARDs) Infliximab Infliximab A chimeric monoclonal antibody to tnf-alpha that is used in the treatment of rheumatoid arthritis; ankylosing spondylitis; psoriatic arthritis and Crohn’s disease. Disease-Modifying Antirheumatic Drugs (DMARDs) Proteína de fusión del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors: etanercept Etanercept A recombinant version of soluble human tnf receptor fused to an IgG Fc fragment that binds specifically to tumor necrosis factor and inhibits its binding with endogenous tnf receptors. It prevents the inflammatory effect of tnf and is used to treat rheumatoid arthritis; psoriatic arthritis and ankylosing spondylitis. Immunosuppressants
Mecanismo de acción	Desactivan el TNF-ɑ Disminuyen la inflamación.
Indicaciones específicas	Artritis reumatoide Enfermedad de Crohn Ciertos cánceres (e.g., infliximab Infliximab A chimeric monoclonal antibody to tnf-alpha that is used in the treatment of rheumatoid arthritis; ankylosing spondylitis; psoriatic arthritis and Crohn’s disease. Disease-Modifying Antirheumatic Drugs (DMARDs) para el cáncer de células renales)
Nota	Se debe realizar una prueba cutánea de tuberculina antes de recetar inhibidores del TNF-ɑ.
Complicaciones/efectos adversos	Insuficiencia cardíaca Desmielinización Infección Malignidad (linfoma hepatoesplénico de células T) Reactivación de tuberculosis Tuberculosis Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex bacteria. The bacteria usually attack the lungs but can also damage other parts of the body. Approximately 30% of people around the world are infected with this pathogen, with the majority harboring a latent infection. Tuberculosis spreads through the air when a person with active pulmonary infection coughs or sneezes. Tuberculosis Reactivación de infección por HBV HBV Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Hepatitis B virus is transmitted by exposure to infectious blood or body fluids. Examples of types of exposure include sexual intercourse, IV drug use, and childbirth. Hepatitis B Virus Lupus inducido por medicamentos ( etanercept Etanercept A recombinant version of soluble human tnf receptor fused to an IgG Fc fragment that binds specifically to tumor necrosis factor and inhibits its binding with endogenous tnf receptors. It prevents the inflammatory effect of tnf and is used to treat rheumatoid arthritis; psoriatic arthritis and ankylosing spondylitis. Immunosuppressants)

TNF: factor de necrosis tumoral

Comparación de Medicamentos Antirreumáticos

La siguiente tabla compara y contrasta los LOS Neisseria medicamentos antirreumáticos:

**Tabla: Medicamentos antirreumáticos modificadores de la enfermedad**
Medicamento	Mecanismo de acción	Efectos secundarios
Leflunomida	Inhibe la dihidroorotato deshidrogenasa. Interrumpe la síntesis de novo de pirimidinas.	Supresión de medula ósea con pancitopenia Hepatotoxicidad Teratogenicidad
Metotrexato	Análogo del folato Inhibe la dihidrofolato reductasa: disminuye la producción de THF. Interrumpe la síntesis de novo de pirimidinas y purinas.	Supresión de medula ósea con pancitopenia Hepatotoxicidad Estomatitis Fibrosis Fibrosis Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. Bronchiolitis Obliterans pulmonar Nefrotoxicidad Teratogenicidad
Sulfasalazina	El 5-ASA (mesalamina) inhibe la producción de prostaglandinas inflamatorias. Suprime el TNF-ɑ e IL-1	Alergia a las sulfas Hepatotoxicidad Estomatitis Oligospermia reversible Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica
Hidroxicloroquina	Suprime el TNF-ɑ e IL-1.	Retinopatía Prurito en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum personas de piel oscura Prolongación del intervalo QT con riesgo de torsades de pointes Torsades de pointes A malignant form of polymorphic ventricular tachycardia that is characterized by heart rate between 200 and 250 beats per minute, and QRS complexes with changing amplitude and twisting of the points. The term also describes the syndrome of tachycardia with prolonged ventricular repolarization, long qt intervals exceeding 500 milliseconds or bradycardia. Torsades de pointes may be self-limited or may progress to ventricular fibrillation. Ventricular Tachycardia
Inhibidores del TNF-ɑ	Inactiva el TNF-ɑ	Insuficiencia cardíaca Desmielinización Infección Malignidad Reactivación de tuberculosis Tuberculosis Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex bacteria. The bacteria usually attack the lungs but can also damage other parts of the body. Approximately 30% of people around the world are infected with this pathogen, with the majority harboring a latent infection. Tuberculosis spreads through the air when a person with active pulmonary infection coughs or sneezes. Tuberculosis Reactivación de infección por HBV HBV Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Hepatitis B virus is transmitted by exposure to infectious blood or body fluids. Examples of types of exposure include sexual intercourse, IV drug use, and childbirth. Hepatitis B Virus Lupus inducido por medicamentos ( etanercept Etanercept A recombinant version of soluble human tnf receptor fused to an IgG Fc fragment that binds specifically to tumor necrosis factor and inhibits its binding with endogenous tnf receptors. It prevents the inflammatory effect of tnf and is used to treat rheumatoid arthritis; psoriatic arthritis and ankylosing spondylitis. Immunosuppressants)

TNF: factor de necrosis tumoral
5-ASA: ácido 5-aminosalicílico
IL-1: interleucina-1
HBV: virus de la hepatitis B

Referencias

Lexicomp. Hydroxychloroquine: Drug information. UpToDate. Retrieved May 31, 2021, from https://www.uptodate.com/contents/hydroxychloroquine-drug-information
Kirkham, B. (2020). Tumor necrosis factor-alpha inhibitors: An overview of adverse effects. UpToDate. Retrieved May 31, 2021, from https://www.uptodate.com/contents/tumor-necrosis-factor-alpha-inhibitors-an-overview-of-adverse-effects

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Medicamentos Antirreumáticos Modificadores de la Enfermedad

Descripción General de los Medicamentos Antirreumáticos

Definición

Indicaciones generales

Clasificación

Related videos

Leflunomida

Metotrexato

Sulfasalazina

Hidroxicloroquina

Inhibidores del TNF-ɑ

Comparación de Medicamentos Antirreumáticos

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Referencias

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