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Iguratimod is a small molecule, disease-modifying anti-rheumatic drug (DMARD) used primarily for the treatment of rheumatoid arthritis, particularly in Japan and China. It acts as an anti-inflammatory and immunoregulatory agent by inhibiting the activation of nuclear factor kappa B (NF‑κB), which leads to reduced production of inflammatory cytokines such as interleukin‑1, interleukin‑6, interleukin‑8, and tumor necrosis factor (TNF). Iguratimod also inhibits cyclooxygenase‑2 (COX‑2), suppresses immunoglobulin production, regulates B cell subpopulations, reduces pro-inflammatory T cell proliferation, and exerts anabolic effects on bone metabolism by stimulating osteoblastic differentiation while inhibiting osteoclastogenesis. It is typically used alone or in combination with methotrexate for patients with active rheumatoid arthritis who have not responded adequately to other therapies[2][5][7][8].
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