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Disease-modifying antirheumatic drugs

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https://www.readbyqxmd.com/read/29770511/liver-enzyme-abnormalities-of-inpatients-with-rheumatic-diseases-a-10-year-retrospective-study-in-a-korean-medicine-hospital
#1
Hyeonhoon Lee, Seunghoon Lee, Jung Won Kang, Jae-Dong Lee
Herbal medicines have been used as a treatment option for rheumatic disease (RD), but they often produce liver enzyme abnormality. This study examines the incidence of herb-induced liver injury (HILI) and the relationship between risk factors and liver enzyme abnormality (LEA) in inpatients with RD. HILI was analyzed using the Roussel Uclaf causality assessment method liver injury criteria and causality assessment. Multivariable analysis was performed to assess the relationship between patient characteristics and LEA in RD...
May 16, 2018: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/29765703/effects-of-baricitinib-on-radiographic-progression-of-structural-joint-damage-at-1-year-in-patients-with-rheumatoid-arthritis-and-an-inadequate-response-to-conventional-synthetic-disease-modifying-antirheumatic-drugs
#2
Desirée van der Heijde, Maxime Dougados, Ying-Chou Chen, Maria Greenwald, Edit Drescher, Rena Klar, Li Xie, Inmaculada de la Torre, Terence P Rooney, Sarah L Witt, Douglas E Schlichting, Stephanie de Bono, Paul Emery
Background: Baricitinib was efficacious in a 24-week phase III study in patients with rheumatoid arthritis (RA) and an inadequate response to conventional synthetic disease-modifying anti rheumatic drugs (DMARDs) (csDMARDs) (RA-BUILD). Objectives: To evaluate radiographic progression of structural joint damage in RA-BUILD patients over 48 weeks of baricitinib treatment in the long-term extension study, RA-BEYOND. Methods: In RA-BUILD, patients were randomised to placebo, baricitinib 2 mg or 4 mg once daily, with rescue possible from week 16...
2018: RMD Open
https://www.readbyqxmd.com/read/29765444/sequentiality-of-treatment-in-the-rheumatoid-arthritis-drug-programme-in-the-years-2009-2014
#3
Małgorzata Tłustochowicz, Andrzej M Śliwczyński, Melania Brzozowska, Zbigniew Teter, Michał Marczak
Approximately 1% of the population suffers from rheumatoid arthritis (RA) worldwide (0.45% in Poland). The therapy consists of the use of disease-modifying antirheumatic drugs (DMARDs). Biologics are used in the form of the drug programme. Analysis of the NHF database demonstrated the sequence of conversion between drugs and time spent in a single treatment. In 2009, the patients would start the following treatments: adalimumab 5.8%; etanercept 14.4%; infliximab 23.1%; leflunomide 53.6%; rituximab 3%. After the first year 16% of patients changed therapy or abstained, and in the second year this situation affected 65% of patients...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29764965/effect-of-treat-to-target-strategies-aiming-at-remission-of-arterial-stiffness-in-early-rheumatoid-arthritis-a-randomized-controlled-study
#4
Lydia Ho-Pui Tam, Qing Shang, Edmund Kwok-Ming Li, Priscilla Ching-Han Wong, Kitty Yan Kwok, Emily Wai-Lin Kun, Isaac Cheuk-Wan Yim, Violet Ka-Lai Lee, Ronald Man-Lung Yip, Steve Hin-Ting Pang, Virginia Weng-Nga Lao, Queenie Wah-Yan Mak, Isaac Tsz-Ho Cheng, Xerox Sze-Lok Lau, Tena Ka-Yan Li, Tracy Yaner Zhu, Alex Pui-Wai Lee, Lai-Shan Tam
OBJECTIVE: To determine the efficacy of 2 tight control treatment strategies aiming at Simplified Disease Activity Score (SDAI) remission (SDAI ≤ 3.3) compared to 28-joint count Disease Activity Score (DAS28) remission (DAS28 < 2.6) in the prevention of arterial stiffness in patients with early rheumatoid arthritis (RA). METHODS: This was an open-label study in which 120 patients with early RA were randomized to receive 1 year of tight control treatment. Group 1 (n = 60) aimed to achieve SDAI ≤ 3...
May 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29760159/inadequate-response-to-treat-to-target-methotrexate-therapy-in-patients-with-new-onset-rheumatoid-arthritis-development-and-validation-of-clinical-predictors
#5
Xavier M Teitsma, Johannes W G Jacobs, Paco M J Welsing, Pascal H P de Jong, Johanna M W Hazes, Angelique E A M Weel, Attila Pethö-Schramm, Michelle E A Borm, Jacob M van Laar, Floris P J G Lafeber, Johannes W J Bijlsma
OBJECTIVE: To identify and validate clinical baseline predictors associated with inadequate response (IR) to methotrexate (MTX) therapy in newly diagnosed patients with rheumatoid arthritis (RA). METHODS: In U-Act-Early, 108 disease-modifying antirheumatic drug (DMARD)-naive patients with RA were randomised to initiate MTX therapy and treated to target until sustained remission (disease activity score assessing 28 joints (DAS28) <2.6 with four or less swollen joints for ≥24 weeks) was achieved...
May 14, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29745893/cell-therapies-for-refractory-rheumatoid-arthritis
#6
REVIEW
Rui Liu, Pengfei Zhao, Wenfeng Tan, Miaojia Zhang
Rheumatoid arthritis (RA), an autoimmune disease, is characterised by a persistent synovitis in the joints and systemic inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids and disease-modifying antirheumatic drugs (DMARDs) are widely used to treat RA patients. However, a portion of patients still have inadequate response to traditional medications. Recently, cell-based therapies have become the focus, attracting more attention due to their potential for remission induction. Several immune-regulatory cell types, such as haematopoietic stem cells, mesenchymal stem cells and regulatory T cells have been defined as novel targets...
May 8, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29739026/-cataracts-in-uveitis
#7
Arnd Heiligenhaus, Karoline Walscheid, Uwe Pleyer
Cataracts are a frequent complication of uveitis, and their management can be challenging. Operation planning requires knowledge of the cause (e.g., infectious versus noninfectious) and course of uveitis, including any intraocular comorbidities (e.g., macular edema). Preoperative patient selection is particularly important in uveitis patients to achieve good surgical results. Steroid-sparing disease-modifying antirheumatic drugs (DMARDs) can reduce the rate of postoperative complications and can improve visual acuity...
May 2018: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29739025/-conventional-synthetic-disease-modifying-antirheumatic-drugs-dmards-for-the-treatment-of-non-infectious-uveitis
#8
Christoph Tappeiner, Thomas Rath, Arnd Heiligenhaus
The first-line therapy of uveitis normally consists of topical and/or systemic corticosteroid use. To achieve long-term ocular quiescence, to prevent uveitic secondary complications, to allow corticosteroid sparing and to avoid corticosteroid-related adverse effects, the application of immunosuppressive drugs (disease modifying antirheumatic drugs; DMARDs) is often necessary during the course of the disease. This article presents a structural overview of the most important conventional synthetic DMARDs, their indication, adverse events and interdisciplinary monitoring...
May 2018: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29737909/abatacept-in-the-treatment-of-psoriatic-arthritis-biological-and-clinical-profiles-of-the-responders
#9
Gaetano Zizzo, Elisa Gremese, Gianfranco Ferraccioli
Abatacept (CTLA4Ig), a selective T-cell costimulation modulator, has been approved for the treatment of psoriatic arthritis patients with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs, but not for those with uncontrolled skin lesions, nor with axial involvement. In this review, we will try to interpret such a differential efficacy of abatacept on the psoriatic arthritis clinical domains, on the basis of its differential effectiveness on the diverse T-cell subsets at different sites...
May 8, 2018: Immunotherapy
https://www.readbyqxmd.com/read/29730637/comparative-effectiveness-of-tocilizumab-versus-tnf-inhibitors-as-monotherapy-or-in-combination-with-conventional-synthetic-disease-modifying-antirheumatic-drugs-in-patients-with-rheumatoid-arthritis-after-the-use-of-at-least-one-biologic-disease-modifying
#10
Kim Lauper, Dan C Nordström, Karel Pavelka, Maria Victoria Hernández, Tore K Kvien, Eirik Klami Kristianslund, Maria Jose Santos, Žiga Rotar, Florenzo Iannone, Catalin Codreanu, Galina Lukina, Sara L Gale, Khaled Sarsour, Yves Luder, Delphine Sophie Courvoisier, Cem Gabay
OBJECTIVE: To compare the effectiveness of tocilizumab (TCZ) and tumour necrosis factor (TNF) inhibitors (TNFi) as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) after the use of at least one biologic DMARD (bDMARD). METHODS: We included patients with RA having used at least one bDMARD from 10 European registries. We compared drug retention using Kaplan-Meier and Cox models and Clinical Disease Activity Index (CDAI) change over time with mixed-effects models for longitudinal data...
May 5, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29728806/-new-antirheumatics-advances-for-patients-and-society
#11
REVIEW
S Throm, R Hömke
The current repertoire of conventional, biological and targeted synthetic disease-modifying antirheumatic drugs (DMARDs) presents wide-ranging options to help patients with inflammatory rheumatic diseases. These therapeutic possibilities have improved quality of life for many patients and also had a positive impact at the societal level. Among these positive effects are a reduction in short-term inability to work and early retirement; for paediatric patients they represent an opportunity for an almost normal school life including physical education...
May 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29713865/-getting-older-with-rheumatoid-arthritis-is-there-a-burnout-of-the-disease
#12
REVIEW
J Bauhammer, C Fiehn
Rheumatoid arthritis (RA) is a chronic inflammatory disease. Synovitis is the main pathology and can lead to a progressive destruction of the joints. It is often said that RA "burns out", implying that the inflammation decreases spontaneously in the long term, mostly severe course of RA and reaches a stage with a stable absence of joint inflammation, even without treatment. To test this concept we analyzed the published evidence. Data of historic long-term inception cohorts of patients who have never been treated with antirheumatic drugs and patients who received conventional disease-modifying antirheumatic drugs (DMARD), show that the disease stays active with sustained radiological progression in the majority of patients...
April 30, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29705743/-in-vivo-visualisation-of-different-modes-of-action-of-biological-dmards-inhibiting-osteoclastic-bone-resorption
#13
Yoshinobu Matsuura, Junichi Kikuta, Yuika Kishi, Tetsuo Hasegawa, Daisuke Okuzaki, Toru Hirano, Masafumi Minoshima, Kazuya Kikuchi, Atsushi Kumanogoh, Masaru Ishii
OBJECTIVES: Osteoclasts play critical roles in inflammatory bone destruction. Precursor cell migration, cell differentiation, and functional cell activation are all in play. Biological disease-modifying antirheumatic drugs (DMARDs) have been shown to significantly inhibit both bone erosion as well as synovitis, although how such agents reduce osteoclastic bone destruction in vivo has not been fully explained. Here, we used an intravital time-lapse imaging technique to directly visualise mature osteoclasts and their precursors, and explored how different biological DMARDs acted in vivo ...
April 28, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29702364/mechanisms-and-therapeutic-targets-for-bone-damage-in-rheumatoid-arthritis-in-particular-the-rank-rankl-system
#14
REVIEW
Yoshiya Tanaka, Takeshi Ohira
Rheumatoid arthritis (RA), a chronic inflammatory disorder, causes swelling, bone erosion, and joint deformity. Bone erosion in RA-affected joints arises from activation of osteoclasts by inflammatory processes. RA patients may also have primary, disease-related, or glucocorticoid-induced osteoporosis, caused by a disrupted balance between osteoclasts and osteoblasts. Disease-modifying antirheumatic drugs (DMARDs) interfere with the processes causing inflammation in the joint but do not sufficiently treat bone erosion and osteoporosis...
April 24, 2018: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29696196/remission-induction-by-raising-the-dose-of-remicade-in-ra-rrrr-study-rationale-and-study-protocol-for-a-randomized-controlled-trial-comparing-for-sustained-clinical-remission-after-discontinuation-of-infliximab-in-patients-with-rheumatoid-arthritis
#15
Koji Oba, Nao Horie, Norihiro Sato, Kazuyoshi Saito, Tsutomu Takeuchi, Tsuneyo Mimori, Nobuyuki Miyasaka, Takao Koike, Yoshiya Tanaka
Infliximab, an inhibitor of TNF-α, is one of the most widely used biological disease-modifying antirheumatic drugs. Recent studies indicated that baseline serum TNF-α could be considered as a key indicator for optimal dosing of infliximab for RA treatment to achieve the clinical response and its sustained remission. The Remission induction by Raising the dose of Remicade in RA (RRRR) study is an open-label, parallel group, multicenter randomized controlled trial to compare the proportions of clinical remission based on the simplified disease activity index (SDAI) after 1 year of treatment and its sustained remission rate after another 1 year between the investigational treatment strategy (for which the dose of infliximab was chosen based on the baseline serum TNF) and the standard strategy of 3 mg/kg per 8 weeks of infliximab administration in infliximab-naïve patients with RA showing an inadequate response to MTX...
December 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29692623/nephritis-cerebritis-and-myositis-after-adalimumab-therapy-in-a-patient-with-rheumatoid-arthritis-a-case-report
#16
Narges E Omran, Abdulsalam A Noorwali
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that mainly affects the joints, therefore, may cause deformities and disability if untreated. The first line of treatment is disease-modifying antirheumatic drugs (DMARDs). When the patient fails to respond to DMARDs, mainly methotrexate, then second-line therapy is required. Tumor necrosis factor α (TNFα) plays an important role in the pathogenesis of RA; however, the treatment with anti-TNFα medications is challenging. It may trigger the autoimmune system and result in producing antibodies that induce symptoms and signs mimic to systemic lupus erythematosus (SLE), and in rare situations can affect vital organs with severe and life-threatening complications...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29692255/juvenile-scleroderma-what-has-changed-in-the-meantime
#17
Amra Adrovic, Sezgin Sahin, Kenan Barut, Ozgur Kasapcopur
BACKGROUND: Juvenile scleroderma is a rarely seen chronic connective tissue disorder characterized by stiffening of the skin. The frequency of the disease was reported as one per million. According to organ involvement, the disease is divided into two main forms: systemic and localized scleroderma. OBJECTIVES: Since it is uncommon in children, many aspects of the disease remain discussable. With this review, we aimed to revise recent findings and new developments in this rare condition...
April 22, 2018: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/29691687/-characteristics-of-pharmacotherapy-in-older-patients-with-rheumatism
#18
REVIEW
H-J Lakomek, Christian Schulz
Due to medical advances and the availability of efficient immunosuppressive therapies, the life-expectancy of people suffering from inflammatory rheumatic diseases is continuously increasing. In Germany, geriatric patients (definition: age older than 70 years combined with geriatric multimorbidity) affected, e. g. by rheumatoid arthritis (RA) frequently receive corticosteroids and less often biologic disease-modifying antirheumatic drugs (bDMARDs) and conventional DMARDs (cDMARDs), which is justified by additionally existing comorbidities and polypharmacy...
April 24, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29683364/inflammatory-biomarkers-in-saliva-and-serum-of-patients-with-rheumatoid-arthritis-with-respect-to-periodontal-status
#19
Leena Äyräväinen, Anna Maria Heikkinen, Antti Kuuliala, Kirsi Ahola, Riitta Koivuniemi, Leena Laasonen, Eeva Moilanen, Mari Hämäläinen, Taina Tervahartiala, Jukka H Meurman, Marjatta Leirisalo-Repo, Timo Sorsa
OBJECTIVE: To study prospectively the association of salivary and serum matrix metalloproteinase (MMP)-8, tissue inhibitor of MMPs (TIMP)-1 and interleukin (IL)-6 with periodontal and systemic inflammation in rheumatoid arthritis (RA). We hypothesized that biomarker concentrations reflect inflammation. METHODS: 53 early untreated RA (ERA) and 28 chronic RA (CRA) patients, underwent rheumatological and dental examinations at baseline and one year later after starting first conventional or biological disease modifying antirheumatic drug...
April 23, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29682324/certolizumab-pegol-in-a-heterogeneous-population-of-patients-with-moderate-to-severe-rheumatoid-arthritis
#20
Enrique R Soriano, Analia Dellepiane, Gabriela Salvatierra, Cristian Alejandro Benítez, Rodrigo Garcia Salinas, Carlos Baruzzo
Aim: To determine the efficacy and safety of certolizumab pegol for the treatment of rheumatoid arthritis in a real-world setting. Materials & methods: Patients with moderate-to-severe rheumatoid arthritis who initiated therapy with certolizumab were followed for 12 weeks. Response was assessed with Disease Activity Score of 28 joints, European Ligue Against Rheumatism criteria and Simplified Disease Activity Index. Predictors of response were analyzed with binary logistic regression models...
April 2018: Future Science OA
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