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https://www.readbyqxmd.com/read/27855242/biologic-or-tofacitinib-monotherapy-for-rheumatoid-arthritis-in-people-with-traditional-disease-modifying-anti-rheumatic-drug-dmard-failure-a-cochrane-systematic-review-and-network-meta-analysis-nma
#1
REVIEW
Jasvinder A Singh, Alomgir Hossain, Elizabeth Tanjong Ghogomu, Amy S Mudano, Peter Tugwell, George A Wells
BACKGROUND: We performed a systematic review, a standard meta-analysis and network meta-analysis (NMA), which updates the 2009 Cochrane Overview, 'Biologics for rheumatoid arthritis (RA)'. This review is focused on biologic monotherapy in people with RA in whom treatment with traditional disease-modifying anti-rheumatic drugs (DMARDs) including methotrexate (MTX) had failed (MTX/other DMARD-experienced). OBJECTIVES: To assess the benefits and harms of biologic monotherapy (includes anti-tumor necrosis factor (TNF) (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab) or non-TNF (abatacept, anakinra, rituximab, tocilizumab)) or tofacitinib monotherapy (oral small molecule) versus comparator (placebo or MTX/other DMARDs) in adults with RA who were MTX/other DMARD-experienced...
November 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27722215/jak-inhibitors-a-broadening-approach-in-rheumatoid-arthritis
#2
S Lam
Pfizer's Xeljanz (tofacitinib citrate) was the first Janus kinase (JAK) inhibitor to reach the market for rheumatoid arthritis (RA) following its U.S. approval in November 2012, and it has since gained approval in more than 45 countries as a second-line therapy for RA after failure of disease-modifying antirheumatic drugs (DMARDs). This emerging category has heralded an attractive new class of oral treatment options in RA, with a notable opportunity in patients who stop responding to DMARDs, but they are facing a challenging market...
August 2016: Drugs of Today
https://www.readbyqxmd.com/read/27721905/combination-therapy-with-biologic-agents-in-rheumatic-diseases-current-and-future-prospects
#3
Kentaro Inui, Tatsuya Koike
Strategies in rheumatoid arthritis (RA) based on 'treat to target' aim to control disease activity, minimize structural damage, and promote longer life. Several disease-modifying antirheumatic drugs (DMARDs) have been shown to be effective including biological DMARDs (bDMARDs). Treatment guidelines and recommendations for RA have also been published. According to those guidelines, conventional synthetic DMARDs (csDMARDs), as monotherapy or combination therapy, should be used in DMARD-naïve patients, irrespective of the addition of glucocorticoids (GCs)...
October 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/27518855/-the-first-biologic-for-rheumatoid-arthritis-factors-influencing-the-therapeutic-decision
#4
D Pattloch, A Richter, B Manger, R Dockhorn, L Meier, H-P Tony, A Zink, A Strangfeld
BACKGROUND AND AIMS: Biologics (disease modifying antirheumatic drugs, bDMARD) have been in use in Germany for the treatment of rheumatoid arthritis (RA) since 2001, usually after failure of at least one conventional synthetic (cs)DMARD. We analyzed temporal changes in factors that influence the decision for either a first bDMARD or a further csDMARD. MATERIAL AND METHODS: We analyzed data from 9513 bDMARD-naive RA patients in the German biologics register RABBIT who switched to a new therapy...
August 12, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27443588/cardiovascular-safety-findings-in-patients-with-rheumatoid-arthritis-treated-with-tofacitinib-an-oral-janus-kinase-inhibitor
#5
Christina Charles-Schoeman, Pierre Wicker, Miguel A Gonzalez-Gay, Mary Boy, Andrea Zuckerman, Koshika Soma, Jamie Geier, Kenneth Kwok, Richard Riese
OBJECTIVES: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). The implications of treatment with tofacitinib on cardiovascular (CV) risk in RA are unknown. Therefore, CV adverse events (AEs), and blood pressure and lipid level changes, in tofacitinib-treated patients with RA were evaluated. METHODS: Data were pooled from six Phase (P)3 studies (24 months) and two open-label long-term extension (LTE) studies (60 months) of tofacitinib in patients with RA and inadequate response to DMARDs...
June 2, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27030256/serum-calprotectin-levels-as-a-marker-of-arthritis-an-italian-experience
#6
Valentina Grossi, Maria Infantino, Mariangela Manfredi, Francesca Meacci, Emanuele Bellio, Valerio Bellio, Francesca Li Gobbi, Simone Ugolini, Stefano Catani, Piercarlo Sarzi-Puttini, Fabiola Atzeni, Maurizio Benucci
BACKGROUND: The identification and validation of soluble markers provide significant opportunities for managing patients with rheumatic diseases, and calprotectin may be an alternative laboratory biomarker of inflammatory rheumatoid arthritis (RA) and psoriatic arthritis (PsA) even though its levels may vary considerably. The aim of this study was to propose a calprotectin cut-off value that would be useful for distinguishing patients with inflammatory arthritis or non-inflammatory arthritis (NIA) in clinical practice...
March 31, 2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/26545940/2015-american-college-of-rheumatology-guideline-for-the-treatment-of-rheumatoid-arthritis
#7
REVIEW
Jasvinder A Singh, Kenneth G Saag, S Louis Bridges, Elie A Akl, Raveendhara R Bannuru, Matthew C Sullivan, Elizaveta Vaysbrot, Christine McNaughton, Mikala Osani, Robert H Shmerling, Jeffrey R Curtis, Daniel E Furst, Deborah Parks, Arthur Kavanaugh, James O'Dell, Charles King, Amye Leong, Eric L Matteson, John T Schousboe, Barbara Drevlow, Seth Ginsberg, James Grober, E William St Clair, Elizabeth Tindall, Amy S Miller, Timothy McAlindon
OBJECTIVE: To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA). METHODS: We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional)...
January 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/26545825/2015-american-college-of-rheumatology-guideline-for-the-treatment-of-rheumatoid-arthritis
#8
REVIEW
Jasvinder A Singh, Kenneth G Saag, S Louis Bridges, Elie A Akl, Raveendhara R Bannuru, Matthew C Sullivan, Elizaveta Vaysbrot, Christine McNaughton, Mikala Osani, Robert H Shmerling, Jeffrey R Curtis, Daniel E Furst, Deborah Parks, Arthur Kavanaugh, James O'Dell, Charles King, Amye Leong, Eric L Matteson, John T Schousboe, Barbara Drevlow, Seth Ginsberg, James Grober, E William St Clair, Elizabeth Tindall, Amy S Miller, Timothy McAlindon
OBJECTIVE: To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA). METHODS: We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional)...
January 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/26456224/update-on-the-2012-brazilian-society-of-rheumatology-guidelines-for-the-treatment-of-rheumatoid-arthritis-position-on-the-use-of-tofacitinib
#9
Licia Maria Henrique da Mota, Bóris Afonso Cruz, Cleandro Pires de Albuquerque, Deborah Pereira Gonçalves, Ieda Maria Magalhães Laurindo, Ivanio Alves Pereira, Jozélio Freire de Carvalho, Geraldo da Rocha Castelar Pinheiro, Manoel Barros Bertolo, Maria Raquel da Costa Pinto, Paulo Louzada-Junior, Ricardo Machado Xavier, Rina Dalva Neubarth Giorgi, Rodrigo Aires Corrêa Lima
In 2014, tofacitinib, a target-specific, synthetic disease modifying anti rheumatic drug (DMARD) and a selective inhibitor of Janus kinase (JAK) was approved for use in Brazil. This position paper aims to update the recommendations of the Brazilian Society of Rheumatology (SBR) on the treatment of rheumatoid arthritis (RA) in Brazil, specifically regarding the use of target-specific synthetic DMARDs. The method of this recommendation consisted of a literature review of scientific papers held on the Medline database...
November 2015: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/26373561/increased-prevalence-of-diastolic-heart-failure-in-patients-with-rheumatoid-arthritis-correlates-with-active-disease-but-not-with-treatment-type
#10
COMPARATIVE STUDY
Thomas Schau, Michael Gottwald, Olga Arbach, Martin Seifert, Maren Schöpp, Michael Neuß, Christian Butter, Michael Zänker
OBJECTIVE: Although heart failure (HF) is a major cause of premature mortality, there is little information regarding its prevalence and associated risk factors in patients with rheumatoid arthritis (RA). In this study, we evaluated the prevalence of HF in a community-based RA cohort. Further, we investigated the effect of RA activity and present treatment on HF rate and cardiac structure. METHODS: A diagnostic workup for HF according to the European Society of Cardiology recommendations was performed in 157 patients with RA fulfilling the American College of Rheumatology/European League Against Rheumatism criteria (68% women, age 61 ± 13 yrs) from our outpatient clinic and in 77 age- and sex-matched controls...
November 2015: Journal of Rheumatology
https://www.readbyqxmd.com/read/26350484/low-rates-of-biologic-free-clinical-disease-activity-index-remission-maintenance-after-biologic-disease-modifying-anti-rheumatic-drug-discontinuation-while-in-remission-in-a-japanese-multicentre-rheumatoid-arthritis-registry
#11
MULTICENTER STUDY
Kazuki Yoshida, Mitsumasa Kishimoto, Helga Radner, Kazuo Matsui, Masato Okada, Yukihiko Saeki, Daniel H Solomon, Shigeto Tohma
OBJECTIVE: To examine in detail the outcomes of biologic DMARD (bDMARD) discontinuation while in remission occurring in daily clinical practice settings. We examined a multicentre longitudinal registry of RA patients. METHODS: We utilized data from the NinJa multicenter registry in Japan. Patients who used bDMARDs and had one or more successive visits in remission (defined by the clinical disease activity index (CDAI) ≤2.8) before discontinuation were included...
February 2016: Rheumatology
https://www.readbyqxmd.com/read/26001633/health-related-quality-of-life-in-patients-with-long-standing-rheumatoid-arthritis-in-the-era-of-biologics-data-from-the-german-biologics-register-rabbit
#12
COMPARATIVE STUDY
Kerstin Gerhold, Adrian Richter, Matthias Schneider, Hans-Joachim Bergerhausen, Winfried Demary, Anke Liebhaber, Joachim Listing, Angela Zink, Anja Strangfeld
OBJECTIVE: To compare the 24-month course of health-related quality of life (HRQoL) in patients with long-standing RA treated with a conventional synthetic (cs) or a first, second or third biologic (b) DMARD in daily rheumatological care. METHODS: Patients enrolled in the German biologics register RABBIT who were observed over at least 12 months were stratified according to the nth bDMARD started at enrolment. HRQoL was captured by the SF36 health survey. Within strata of sequential bDMARD therapy, we examined patients' HRQoL at baseline and at follow-ups in comparison with the general population, the 24-month course of HRQoL of different bDMARDs and the proportion of patients exceeding the minimal detectable improvement of physical and mental health sum scores...
October 2015: Rheumatology
https://www.readbyqxmd.com/read/25991396/concomitant-methotrexate-and-tacrolimus-augment-the-clinical-response-to-abatacept-in-patients-with-rheumatoid-arthritis-with-a-prior-history-of-biological-dmard-use
#13
Nobunori Takahashi, Takayoshi Fujibayashi, Daihei Kida, Yuji Hirano, Takefumi Kato, Daizo Kato, Kiwamu Saito, Atsushi Kaneko, Yuichiro Yabe, Hideki Takagi, Takeshi Oguchi, Hiroyuki Miyake, Tsuyoshi Watanabe, Masatoshi Hayashi, Yasuhide Kanayama, Koji Funahashi, Masahiro Hanabayashi, Shinya Hirabara, Shuji Asai, Toki Takemoto, Kenya Terabe, Nobuyuki Asai, Yutaka Yoshioka, Naoki Ishiguro, Toshihisa Kojima
This observational retrospective study examined whether abatacept efficacy could be augmented with concomitant methotrexate (MTX) or tacrolimus (TAC) in patients with rheumatoid arthritis (RA) who experienced failure with prior biological disease-modifying antirheumatic drugs (DMARDs) and in whom favorable therapeutic efficacy is difficult to achieve. All patients with a prior biological DMARD history who were treated with abatacept for 52 weeks and registered in a Japanese multicentre registry were included...
October 2015: Rheumatology International
https://www.readbyqxmd.com/read/25805514/-how-do-register-data-support-clinical-decision-making
#14
A Strangfeld, A Richter
BACKGROUND: Patients in daily rheumatological care differ in their individual risk profiles from participants in randomized controlled trials (RCT), e.g. due to comorbidities and age. Transferring results from RCTs into routine daily practice is therefore limited. OBJECTIVE: The aim of this study was to evaluate the contribution of observational studies for decision-making in routine rheumatology practice. MATERIAL AND METHODS: We used data from the German biologics register RABBIT which includes patients with rheumatoid arthritis (RA) when starting synthetic (s) or biologic (b) disease-modifying antirheumatic drugs (DMARD)...
March 2015: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/25773655/patterns-of-use-and-dosing-of-tocilizumab-in-the-treatment-of-patients-with-rheumatoid-arthritis-in-routine-clinical-practice-the-act-life-study
#15
Alejandro Balsa, Juan Víctor Tovar Beltrán, Rafael Cáliz Cáliz, Isabel Mateo Bernardo, Rosario García-Vicuña, Manuel Rodríguez-Gómez, Miguel Angel Belmonte Serrano, Carlos Marras, Eduardo Loza Cortina, Eva Pérez-Pampin, Vicente Vila
The aim of the study was to identify and describe the patterns of use of tocilizumab in clinical practice to ensure safety and optimal management of rheumatoid arthritis (RA). This is a 12-month prospective observational study in patients with moderate or severe RA of ≥6 months' duration who have started tocilizumab after failure of at least one previous disease-modifying antirheumatic drug (DMARD) including TNF inhibitors. For some analyses, patients were categorized by the use of tocilizumab as monotherapy or in combination, and by previous use of biological therapy...
September 2015: Rheumatology International
https://www.readbyqxmd.com/read/25758228/staphylococcus-aureus-sepsis-in-rheumatoid-arthritis
#16
Michael Sams, Margaret A Olsen, Reeti Joshi, Prabha Ranganathan
Patients with rheumatoid arthritis (RA) are at increased risk of infection. In this study, we determined the risk of and risk factors for Staphyococcus aureus (S. aureus) sepsis in RA. We assembled a retrospective nested case-control subset of RA patients with S. aureus sepsis from the Barnes-Jewish Hospital Medical Informatics database, confirmed the diagnoses, and collected data electronically and by chart review. We used multivariate logistic regression to identify independent risk factors for S. aureus sepsis, with risk expressed as odds ratios (ORs)...
September 2015: Rheumatology International
https://www.readbyqxmd.com/read/25603545/rituximab-for-rheumatoid-arthritis
#17
REVIEW
Maria Angeles Lopez-Olivo, Matxalen Amezaga Urruela, Lynda McGahan, Eduardo N Pollono, Maria E Suarez-Almazor
BACKGROUND: Rituximab is a selective, B-cell depleting, biologic agent for treating refractory rheumatoid arthritis (RA). It is a chimeric monoclonal antibody targeted against CD 20 that is promoted as therapy for patients who fail to respond to other biologics. There is evidence to suggest that rituximab is effective and well tolerated when used in combination with methotrexate for RA. OBJECTIVES: To evaluate the benefits and harms of rituximab for the treatment of RA...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25381973/ten-year-drug-survival-of-anti-tnf-agents-in-the-treatment-of-inflammatory-arthritides
#18
Martina Biggioggero, Ennio Giulio Favalli
Tumor necrosis factor (TNF) inhibitor therapies (anti-TNFs) are used routinely as first-line biotherapy for the treatment of rheumatoid arthritis (RA) and spondyloarthritis (SpA: psoriatic arthritis [PsA] and ankylosing spondylitis [AS]) in patients who have failed traditional non-biologic disease-modifying anti-rheumatic drugs (DMARDs). However, about 30% of patients experience failure of first-line anti-TNF agent because of inefficacy or adverse events. This study analyzed long-term anti-TNFα drug survival in a clinical practice setting...
November 2014: Drug Development Research
https://www.readbyqxmd.com/read/25274892/failure-in-longterm-treatment-is-rare-in-actively-treated-patients-with-rheumatoid-arthritis-but-may-be-predicted-by-high-health-assessment-score-at-baseline-and-by-residual-disease-activity-at-3-and-6-months-the-5-year-followup-results-of-the-randomized-clinical
#19
RANDOMIZED CONTROLLED TRIAL
Vappu Rantalaiho, Hannu Kautiainen, Salme Järvenpää, Markku Korpela, Timo Malmi, Pekka Hannonen, Oili Kaipiainen-Seppänen, Timo Yli-Kerttula, Timo Möttönen, Anu Mustila, Anna Karjalainen, Leena Paimela, Toini Uutela, Marjatta Leirisalo-Repo
OBJECTIVE: With modern initial aggressive combination treatments with synthetic disease-modifying antirheumatic drugs (sDMARD), most patients with rheumatoid arthritis (RA) achieve remission, have marginal radiographic progression, and sustain normal function. Here we aim to identify the patients failing these targets even after aggressive treatment. METHODS: Ninety-nine patients with early, active RA were treated with a combination of 3 sDMARD and prednisolone (PRD), and either infliximab or placebo infusions during the first 6 months, aiming at strict remission...
December 2014: Journal of Rheumatology
https://www.readbyqxmd.com/read/25220243/small-molecule-inhibitors-for-autoimmune-arthritis-success-failure-and-the-future
#20
REVIEW
Ling-Jun Ho, Jenn-Haung Lai
Treatment of patients with aggressive autoimmune arthritis, such as rheumatoid arthritis (RA), is a considerable challenge for physicians, particularly rheumatologists. Because of the nature of autoimmune arthritis, effective and complete suppression of disease activity has been the primary therapeutic goal. Although currently available disease-modifying antirheumatic drugs (DMARDs) can successfully control the disease progression in a large proportion of patients, the benefit/risk ratio is not very much satisfied...
January 15, 2015: European Journal of Pharmacology
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