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We demonstrated that, at low doses (ng), local (intraplantar) or systemic (intraperitoneal) injections of thymulin resulted in hyperalgesia with an increase in proinflammatory mediators, and that this peptide could act directly on the afferent nerve terminals through prostaglandinE2 (PGE2)dependent mechanisms, thus forming a neuroimmune loop involving capsaicinsensitive primary afferent fibers

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There is a newer group of DMARDS called JAK inhibitors

doi: 10.1016/j.rbmo.2019.06.011 170 LuXWuZWangMChengW