The management of rheumatic and musculoskeletal diseases has transformed over two decades of exciting discoveries regarding pathogenesis and innovative drug development. The introduction of sophisticated immunomodulatory therapies has given renewed hope to many patients, but notable challenges remain within the field of rheumatology. Before the advent of biologic therapies, conventional synthetic DMARDs (csDMARDs) provided effective disease control for some patients, although a comprehensive understanding of the mechanisms by which these drugs exert their effects remained elusive. Reflecting upon the efficacy and mechanisms of action of csDMARDs can provide intriguing insights. First, contemplating past approaches brings our remarkable current approaches concerning pathogenesis-driven discovery and drug development into sharper focus. Second, increased understanding of the mode of action of these older drugs might in turn provide exciting opportunities for the understanding of disease and for the development of future therapies.

中文翻译：

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关于“旧”药物的思考：学习风湿病学的新课程。

风湿病和肌肉骨骼疾病的管理已经改变了二十多年有关发病机理和创新药物开发的令人兴奋的发现。先进的免疫调节疗法的引入给许多患者带来了新的希望，但风湿病领域仍存在显着挑战。在生物疗法问世之前，传统的合成DMARD（csDMARD）为某些患者提供了有效的疾病控制，尽管对这些药物发挥作用的机制的全面了解仍然难以捉摸。对csDMARDs的功效和作用机制的反思可以提供有趣的见解。首先，考虑过去的方法将我们关于致病机理驱动的发现和药物开发的非凡的当前方法更加突出。第二，