To stop the erosion of hope: the DMARD category and the place of semantics in modern rheumatology
Jonas Kure Buer sheds light on a pivotal moment in the history of rheumatology, while modelling an anthropological approach to drug categories as meaning-making Devices
In the late 20th century, rheumatology reoriented towards pharmaceuticals. In the process, the category of disease-modifying anti-rheumatic drugs (DMARDs) emerged to describe drugs capable of altering the long-term destructive course of arthritis. By examining the earliest uses of the term “disease-modifying” in scientific publications, Buer identifies the drugs that the category described when it first emerged. Leaning on systematic reviews of the drugs towards the end of their career in rheumatology, he then demonstrates that the notion of disease-modifying drugs initially categorized drugs that were not disease-modifying. Buer argues that the DMARD category gained currency not despite this fact, but because of it, as the category offered to conjure prospects of disease-modifying effects regardless of each drug’s actual capacities. It thus enabled rheumatologists and others to semantically solve a deep-seated tension that existed between desperate needs and limited means.
The article is a continuation of Jonas Kure Buer’s previous work on the history of the term DMARD.