Clinical Scenarios-based guide for iguratimod in rheumatoid arthritis and ankylosing spondylitis

Iguratimod (IGU) is disease modified anti-rheumatic drug, it is a synthetic small molecule which is approved for treatment of Rheumatoid arthritis and autoimmune disease only in Japan and China. Immunomodulatory role of IGU in rheumatoid arthritis is by regulating T lymphocyte subsets, inhibiting the production of immune globulins and cytokines in the synovial tissue. IGU inhibit osteoclast differentiation, migration, and bone resorption also stimulate bone formation thus regulating bone metabolism. In clinical trials, it was shown that combined therapy of IGU with other disease-modifying anti-rheumatic drugs significantly improved disease activity also and IGU monotherapy was shown to be superior to placebo and not inferior to salazosulfapyridine. In patients of rheumatoid arthritis who showed inadequate response to methotrexate and biological disease-modifying anti-rheumatic drugs, IGU has good efficacy and tolerance as an additional treatment.