Disease modifying antirheumatic drugs (DMARDs) is a category of drugs which is 
used as medication in various arthritic conditions to arrest the progression of 
disease along with relief from pain. About 83% of population worldwide uses 
DMARDs. Withdrawal of COX-2 inhibitors because of cardiovascular side effects 
and short-term action associated with glucocorticoids provided a motivation for 
development of newer DMARDs. Currently non- biological DMARDs like methotrexate, 
sulfasalazine, hydroxychloroquine and azathioprine serve the purpose of 
relieving pain and inhibiting the progression of disease. Biological DMARDs like 
toclizumab, adalimumab, infliximab, golimumab and abatacept have shown more 
efficacy and lesser side effects as compared to non- biological DMARDs but their 
access to patient is less because of higher cost. DMARDs act by different 
mechanisms against inflammation like inhibition of tumor necrosis factor, 
suppression of IL-1 and TNF-α, induction of apoptosis of inflammatory cells, by 
increasing chemotactic factors, inhibition of purine synthesis, pyrimidine 
metabolism or purine embolism. DMARDs have important applications in diseases 
like rheumatoid arthritis, Crohn's disease, juvenile idiopathic arthritis, 
psoriatic arthritis and myasthenia gravis. Present review mainly focuses on 
DMARDs and their clinical applications giving an overview of their mechanism of 
action, pharmacokinetic properties, advantages over conventional therapies, 
shortcomings and recent trends.