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Disease-modifying antirheumatic drugs

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https://www.readbyqxmd.com/read/28102443/-new-options-for-the-practice-update-s1-s2-guidelines-on-rheumatoid-arthritis
#1
REVIEW
M Schneider
Guidelines are important tools for evidence-based pharmacological treatment of patients suffering from rheumatoid arthritis. Recommendations assist physicians in identifying the best form of treatment but ultimately, the final decision is based on joint participation by the patient and physician. Nowadays, general concepts, such as treat to target seem to be more important in rheumatoid arthritis than differencies between various drugs or drug classes. The universal recommendation to use methotrexate as the initial disease-modifying antirheumatic drug (DMARD) is driven more by economic reasons than by scientific data, which is not completely wrong but should be disclosed...
January 19, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28097393/comparative-efficacy-and-safety-of-baricitinib-2%C3%A2-mg-and-4%C3%A2-mg-in-patients-with-active-rheumatoid-arthritis-a%C3%A2-bayesian-network-meta-analysis-of-randomized-controlled-trials
#2
Y H Lee, S-C Bae
OBJECTIVE: This study aimed to assess the relative efficacy and safety of once-daily baricitinib 2 mg and 4 mg administration in patients with active rheumatoid arthritis (RA). METHODS: In this network meta-analysis, randomized controlled trials (RCTs) examining the efficacy and safety of baricitinib in patients with active RA were included. A Bayesian network meta-analysis was conducted to combine the direct and indirect evidence from the RCTs. RESULTS: Seven RCTs involving 3461 patients met the inclusion criteria...
January 17, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28089976/disease-characteristics-and-rheumatoid-arthritis-development-in-patients-with-early-undifferentiated-arthritis-a-2-year-followup-study
#3
Gina H Brinkmann, Ellen S Norli, Tore K Kvien, Anne J Haugen, Lars Grøvle, Halvor Nygaard, Olav Bjørneboe, Cathrine Thunem, Maria D Mjaavatten, Elisabeth Lie
OBJECTIVE: To examine the 2-year disease course in patients with undifferentiated arthritis (UA) focusing on fulfillment of the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) rheumatoid arthritis (RA) classification criteria. METHODS: Data were provided by the Norwegian Very Early Arthritis Clinic study, which included patients presenting with ≥ 1 swollen joint of ≤ 16 weeks' duration. UA was defined as patients not fulfilling the 2010 ACR/EULAR RA criteria and who did not have a clinical diagnosis other than RA at baseline...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28089501/effectiveness-of-conventional-disease-modifying-antirheumatic-drugs-in-psoriatic-arthritis-a-systematic-review
#4
Jesús Maese, Petra Díaz Del Campo, Daniel Seoane-Mato, Mercedes Guerra, Juan D Cañete
BACKGROUND: Due to the clinical heterogeneity of psoriatic arthritis (PsA), recommendations have been developed by international groups to guide therapeutic decisions of the rheumatologist. The objective of the current systematic review (RS) was to evaluate the evidence of efficacy of disease-modifying antirheumatic drugs (DMARDs) in PsA. METHODS: Literature search in Medline, EMBASE, Cochrane Library, from 2008 to 2014. We included RS, randomized clinical trials and observational studies, in patients with PsA and an evaluation of efficiency of conventional DMARDs (methotrexate, sulfasalazine, leflunomide), according to the following outcomes: peripheral and axial symptoms; peripheral radiological damage; enthesitis according to power Doppler ultrasound or magnetic resonance imaging (enthesitis count before and after therapy); dactylitis; uveitis...
January 12, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28087505/2016-update-of-the-asas-eular-management-recommendations-for-axial-spondyloarthritis
#5
Désirée van der Heijde, Sofia Ramiro, Robert Landewé, Xenofon Baraliakos, Filip Van den Bosch, Alexandre Sepriano, Andrea Regel, Adrian Ciurea, Hanne Dagfinrud, Maxime Dougados, Floris van Gaalen, Pál Géher, Irene van der Horst-Bruinsma, Robert D Inman, Merryn Jongkees, Uta Kiltz, Tore K Kvien, Pedro M Machado, Helena Marzo-Ortega, Anna Molto, Victoria Navarro-Compàn, Salih Ozgocmen, Fernando M Pimentel-Santos, John Reveille, Martin Rudwaleit, Jochen Sieper, Percival Sampaio-Barros, Dieter Wiek, Jürgen Braun
To update and integrate the recommendations for ankylosing spondylitis and the recommendations for the use of tumour necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA) into one set applicable to the full spectrum of patients with axSpA. Following the latest version of the European League Against Rheumatism (EULAR) Standardised Operating Procedures, two systematic literature reviews first collected the evidence regarding all treatment options (pharmacological and non-pharmacological) that were published since 2009...
January 13, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28079510/a-comparison-of-discontinuation-rates-of-tofacitinib-and-biologic-disease-modifying-antirheumatic-drugs-in-rheumatoid-arthritis-a-systematic-review-and-bayesian-network-meta-analysis
#6
Sun-Kyeong Park, Min-Young Lee, Eun-Jin Jang, Hye-Lin Kim, Dong-Mun Ha, Eui-Kyung Lee
OBJECTIVES: The purpose of this study was to compare the discontinuation rates of tofacitinib and biologics (tumour necrosis factor inhibitors (TNFi), abatacept, rituximab, and tocilizumab) in rheumatoid arthritis (RA) patients considering inadequate responses (IRs) to previous treatment(s). METHODS: Randomised controlled trials of tofacitinib and biologics - reporting at least one total discontinuation, discontinuation due to lack of efficacy (LOE), and discontinuation due to adverse events (AEs) - were identified through systematic review...
January 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28073800/relationship-between-exposure-to-tumour-necrosis-factor-inhibitor-therapy-and-incidence-and-severity-of-myocardial-infarction-in-patients-with-rheumatoid-arthritis
#7
Audrey S L Low, Deborah P M Symmons, Mark Lunt, Louise K Mercer, Chris P Gale, Kath D Watson, William G Dixon, Kimme L Hyrich
OBJECTIVES: Patients with rheumatoid arthritis (RA) are at increased risk of myocardial infarction (MI) compared with subjects without RA, with the increased risk driven potentially by inflammation. Tumour necrosis factor inhibitors (TNFi) may modulate the risk and severity of MI. We compared the risk and severity of MI in patients treated with TNFi with that in those receiving synthetic disease-modifying antirheumatic drugs (sDMARDs). METHODS: This analysis included patients with RA recruited from 2001 to 2009 to the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis starting TNFi (etanercept/infliximab/adalimumab) and a biologic-naïve comparator cohort receiving sDMARD...
January 10, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28067080/-recent-advances-in-the-treatment-of-large-vessel-vasculitides
#8
Melinda Zsuzsanna Szabó, Emese Kiss
Giant cell arteritis and Takayasu arteritis classified to large vessel vasculitides have similar histopathology in the vascular wall proposing that these entities can be different phenotypes on a spectrum of a single disorder. Glucocorticoids are the mainstay of therapy combined with cyclophosphamide, azatioprine and mycofenolate mofetil, when it is required. However, a significant proportion of patients are glucocorticoid-dependent despite of the conventional disease-modifying antirheumatic drugs and suffer from serious side effects of the steroids, therefore alternate options for more effective disease management are needed...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28065486/biologic-disease-modifying-antirheumatic-drug-attributes-in-the-first-lines-of-treatment-of-rheumatoid-arthritis-2015-acordar-project
#9
Santiago Muñoz-Fernández, María Sagrario Bustabad Reyes, Jaime Calvo Alén, Manuel Castaño Sánchez, Eugenio Chamizo Carmona, Héctor Corominas, Nagore Fernández-Llanio Comella, María Cristina Hidalgo Calleja, José Javier Pérez Venegas, José Manuel Rodríguez Heredia, Susana María Romero Yuste, Virginia Ruiz-Esquide Torino
OBJECTIVE: To date, between 17% and 35% of patients with rheumatoid arthritis (RA) do not respond as expected to the initial biological therapy. The objective of this project is to recognize and weigh the attributes of biologic DMARD (bDMARD) to identify the most appropriate for each case, in the first lines of treatment of RA (after inadequate response to at least one synthetic DMARD or previous bDMARD). METHODS: To recognize the possible attributes that could define the bDMARD, we performed a systematic search of the literature that recognized the possible attributes involving general aspects, pharmacology, efficacy, safety, management, and cost...
January 3, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28058499/-rheumatoid-arthritis
#10
REVIEW
D Aletaha, A Kerschbaumer
Therapy reduction in rheumatoid arthritis (RA) is still a challenge for physicians as well as for patients. Effective therapy with subsequent achievement of low disease activity or even remission is achievable for numerous patients using currently available treatment options. Therapy discontinuation has therefore become a hot topic and the risk of exacerbation of well-controlled RA must be weighed against the medical and economic benefits of reducing or even discontinuing therapy. This article gives a review of data regarding tapering of therapy in RA, focusing on conventional disease-modifying antirheumatic drug (DMARD) monotherapy, reduction of conventional therapy under continuing therapy with biologics and discontinuation of biologics...
January 5, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28033292/bortezomib-followed-by-autologous-stem-cell-transplantation-in-a-patient-with-rheumatoid-arthritis-a-case-report-and-review-of-the-literature
#11
Junru Liu, Juan Li, Meilan Chen, Lifen Kuang
RATIONALE AND PATIENTS CONCERNS: Despite the introduction of varied disease-modifying antirheumatic drugs and biological agents, a substantial proportion of patients remain untreatable. We report a 56-year-old Chinese female patient with a case of refractory rheumatoid arthritis (RA) complicated with multiple myeloma (MM) who was treated successfully with Bortezomib followed by autologous stem cell transplantation (ASCT). DIAGNOSIS AND INTERVENTIONS: We report a 56-year-old Chinese female patient who was diagnosed as RA complicating with MM...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28011918/hepatitis-b-virus-reactivation-in-rheumatoid-arthritis-patients-undergoing-biologics-treatment
#12
Ming-Han Chen, Ming-Huang Chen, Chun-Yu Liu, Chang-Youh Tsai, De-Feng Huang, Hsiao-Yi Lin, Mei-Hsuan Lee, Yi-Hsiang Huang
BACKGROUND: Immunosuppressants can induce hepatitis B virus(HBV) reactivation, however, informative data regarding the risk of different immunosuppressive regimens including biologics on HBV reactivation(HBVr) among patients with rheumatoid arthritis(RA) is unsettled. METHODS: Among 2334 RA patients who had available HBsAg data, 123 patients positive for hepatitis B surface antigen(HBsAg) without receiving anti-HBV prophylaxis were enrolled. These patients undergoing varied mono- or combination immunosuppressive therapy, including 36 receiving biological disease-modifying antirheumatic drugs(bDMARDs)...
December 23, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28010149/outcomes-of-tumor-necrosis-factor-inhibitor-cycling-versus-switching-to-a-disease-modifying-anti-rheumatic-drug-with-a-new-mechanism-of-action-among-patients-with-rheumatoid-arthritis
#13
Benjamin Chastek, Laura K Becker, Chieh-I Chen, Puneet Mahajan, Jeffrey R Curtis
OBJECTIVES: To examine treatment patterns, treatment effectiveness, and treatment costs for 1 year after patients with rheumatoid arthritis switched from a tumor necrosis factor inhibitor (TNFi) (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab), either cycling to another TNFi ("TNFi cyclers") or switching to a new mechanism of action (abatacept, tocilizumab, or tofacitinib) ("new MOA switchers"). METHODS: This retrospective cohort study used administrative claims data for a national insurer...
January 4, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28007755/low-immunogenicity-of-tocilizumab-in-patients-with-rheumatoid-arthritis
#14
Gerd R Burmester, Ernest Choy, Alan Kivitz, Atsushi Ogata, Min Bao, Akira Nomura, Stuart Lacey, Jinglan Pei, William Reiss, Attila Pethoe-Schramm, Navita L Mallalieu, Thomas Wallace, Margaret Michalska, Herbert Birnboeck, Kay Stubenrauch, Mark C Genovese
OBJECTIVE: Subcutaneous (SC) and intravenous formulations of tocilizumab (TCZ) are available for the treatment of patients with rheumatoid arthritis (RA), based on the efficacy and safety observed in clinical trials. Anti-TCZ antibody development and its impact on safety and efficacy were evaluated in adult patients with RA treated with intravenous TCZ (TCZ-IV) or TCZ-SC as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). METHODS: Data from 5 TCZ-SC and 8 TCZ-IV phase III clinical trials and 1 TCZ-IV clinical pharmacology safety study (>50 000 samples) were pooled to assess the immunogenicity profile of TCZ-SC and TCZ-IV (8974 total patients)...
December 22, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28002163/a-quality-improvement-approach-to-rheumatoid-arthritis-management-with-biologic-disease-modifying-antirheumatic-drugs-assessing-variability-in-a-treatment-pathway
#15
Amish J Dave, Heather O Tory, J Adebukola Awosogba, Jonathan S Coblyn, Bonnie Bermas, Daniel H Solomon, Sonali P Desai
No abstract text is available yet for this article.
January 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28002151/use-of-biologic-therapy-in-racial-minorities-with-rheumatoid-arthritis-from-2-us-health-care-systems
#16
Gail S Kerr, Christopher Swearingen, Ted R Mikuls, Yusuf Yazici
BACKGROUND: In the United States, there is racial/ethnic disparity in the care of rheumatoid arthritis (RA), yet there are limited data regarding the impact of varied health care systems on treatment outcomes. OBJECTIVE: The aim fo this study was to compare the frequencies of use of disease-modifying antirheumatic drugs and biologic agents in racial minorities with RA in a single-payer and variable-access health systems. METHODS: Rheumatoid arthritis disease status was examined in the Ethnic Minority Rheumatoid Arthritis Consortium (EMRAC) and Veterans Affairs Rheumatoid Arthritis Registry (VARA); frequencies of prednisone and disease-modifying antirheumatic drugs and biologic agent use at enrollment were documented...
January 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/27999943/long-term-use-of-biologic-agents-does-not-increase-the-risk-of-serious-infections-in-elderly-patients-with-rheumatoid-arthritis
#17
Hirotoshi Kawashima, Shin-Ichiro Kagami, Daisuke Kashiwakuma, Kentaro Takahashi, Masaya Yokota, Shunsuke Furuta, Itsuo Iwamoto
This study aimed to determine whether the long-term use of biologic agents increases serious infections in elderly patients with rheumatoid arthritis (RA) and to determine the risk factors of serious infections in biologics-treated elderly RA patients. We retrospectively analyzed the incidence rate of serious infections that required hospitalization between biologics-treated and non-biologic disease-modifying antirheumatic drug (DMARD)-treated elderly RA patients (aged over 65 years). We examined the risk factors for serious infections in biologics-treated elderly RA patients...
December 20, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27997219/real-world-cost-effectiveness-of-infliximab-for-moderate-to-severe-rheumatoid-arthritis-in-a-medium-sized-city-of-china
#18
Jingyang Li, Zhenhua Wen, Anlie Cai, Feng Tian, Liang Zhang, Youwen Luo, Li Deng, Jingyun He, Yicheng Yang, Wendong Chen
AIM: To assess the cost-effectiveness of infliximab-containing therapy (ICT) for moderate-to-severe rheumatoid arthritis (RA) in a medium-sized Chinese city. METHODS: A Chinese prospective cohort study comparing ICT (25 patients) versus conventional disease-modified antirheumatic drugs (24 patients) for RA was used to assess the cost-effectiveness of ICT. RESULTS: The cohort study observed significantly reduced disease activity score of 28 joints (coefficient -2...
December 20, 2016: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/27992656/meta-regression-of-a-dose-response-relationship-of-methotrexate-in-mono-and-combination-therapy-in-dmard-naive-early-rheumatoid-arthritis-patients
#19
S A Bergstra, C F Allaart, T Stijnen, Rbm Landewé
OBJECTIVE: To investigate a possible short term dose-response relationship of initial treatment with methotrexate in monotherapy and combination therapy in recent onset rheumatoid arthritis (RA) patients. METHODS: A systematic literature search was performed on trials and cohorts including early, Disease Modifying Antirheumatic Drugs (DMARD) naive RA patients, treated with methotrexate, with data on clinical results within 6 months from treatment start. Cohen's effect sizes were calculated for the HAQ, ESR/CRP and/or DAS/DAS28 in 4 treatment groups: methotrexate monotherapy, or methotrexate in combination with synthetic (cs)DMARDs, biologic (b)DMARDs or glucocorticoids...
December 19, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27991741/4%C3%AE-hydroxycholesterol-level-in-patients-with-rheumatoid-arthritis-before-vs-after-initiation-of-bdmards-and-correlation-with-inflammatory-state
#20
B M Wollmann, S W Syversen, E Lie, C Gjestad, L L Mehus, I C Olsen, E Molden
Systemic inflammation has been linked to suppressed CYP3A(4) activity. We determined 4β-hydroxycholesterol (4βOHC), an endogenous CYP3A4 metabolite, in patients with rheumatoid arthritis (RA) before and after treatment with biological disease-modifying antirheumatic drugs (bDMARDs). The 4βOHC was compared in 41 patients before and 2-5 months after initiating TNFα inhibitors (n = 31), IL-6 inhibitors (n = 5), or B-cell inhibitors (n = 5). Correlations between 4βOHC and inflammatory markers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) were also tested before and after bDMARDs...
November 5, 2016: Clinical and Translational Science
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