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https://www.readbyqxmd.com/read/27917631/-15-years-experience-with-biological-therapy-of-inflammatory-rheumatic-diseases-in-czech-national-register-attra
#1
Karel Pavelka, Liliana Šedová, Karel Hejduk, Ladislav Dušek
The publication is summarizing application of biological DMARDs in autoimmune inflammatory rheumatic diseases.Up to now conventional therapy, which for example in rheumatoid arthritis was application of methotrexate (MTx) in combination with glucocorticoids, was effective, but the remission as a target was achieved in small proportion of patients and also there was little effect on structural progression of diseases. Biological therapy was great advance because response was achieved in ¾ patients who failed MTx...
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27910962/baricitinib-jak-inhibition-for-rheumatoid-arthritis
#2
J Gras
Rheumatoid arthritis (RA), a chronic autoimmune inflammatory disease characterized by inflammation and joint destruction, is associated with pain, progressive disability, systemic comorbidities and early death. Conventional disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs (bDMARDs) have been able to achieve remission or a very low disease activity status for RA. Nevertheless, since many patients do not reach a sufficient response with DMARDs or present with unacceptable side effects, new therapies are needed...
October 2016: Drugs of Today
https://www.readbyqxmd.com/read/27894399/effect-of-iguratimod-and-methotrexate-on-rankl-and-opg-expression-in-serum-and-il-1%C3%AE-induced-fibroblast-like-synoviocytes-from-patients-with-rheumatoid-arthritis
#3
X T Wang, P Li, T S Xu, R Ding, X Zhang, L Q Bi
The receptor activator of nuclear factor κB ligand (RANKL)/receptor activator of nuclear factor κB (RANK)/osteoprotegerin (OPG) system plays a key role in rheumatoid arthritis (RA)-associated bone erosion. The upregulation of the RANKL/OPG ratio promotes bone erosion. The objective of this study is to explore the effects of iguratimod, a small-molecule disease-modifying antirheumatic drug (DMARD), alone or in combination with methotrexate (MTX), on RANKL and OPG expression in RA. We performed an enzyme-linked immunosorbent assay (ELISA) to investigate the modulatory effects of iguratimod, MTX, or their combination on serum RANKL and OPG levels of patients with RA before and after treatment for 12 and 24 weeks...
October 31, 2016: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/27886796/adult-onset-still-s-disease-advances-in-the-treatment
#4
REVIEW
Santos Castañeda, Ricardo Blanco, Miguel A González-Gay
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder mainly characterized by persistent high spiking fevers, evanescent rash, and joint involvement. The pathogenesis of AOSD is only partially known, but pro-inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, IL-6, IL-18, and IFN-γ seem to play a major role in this disorder. AOSD is at the crossroad of auto-inflammatory syndromes and autoimmune diseases. It is diagnosed by exclusion to determine the presence of high serum ferritin levels, which is usually >1000 μg/L...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27882832/geographic-variation-in-the-quality-and-cost-of-care-for-patients-with-rheumatoid-arthritis
#5
Jason Shafrin, Arijit Ganguli, Yuri Sanchez Gonzalez, Jin Joo Shim, Seth A Seabury
BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best treated with comparatively expensive treatments, such as rheumatoid arthritis (RA), there could be tension between these aims. In this study, we measured geographic variation in quality, access, and cost for patients with RA, a disease with effective but costly specialty treatments. OBJECTIVE: To assess the geographic differences in the quality, access, and cost of care for patients with RA...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27878345/low-vaccination-rates-among-patients-with-rheumatoid-arthritis-in-a-german-outpatient-clinic
#6
Marco Krasselt, Jean-Philipp Ivanov, Christoph Baerwald, Olga Seifert
Patients with rheumatoid arthritis (RA) are at an increased risk of acquiring infections due to two reasons: the disease itself and the immunosuppressive therapy. Vaccinations against preventable diseases are therefore of utmost importance for these group of patients. To estimate vaccination frequencies among patients with rheumatoid arthritis, we studied patients in a survey and calculated vaccination rates based on their vaccination documents. Patients have been recruited from our outpatient clinic during one of their routine visits...
November 22, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27866179/tripterygium-glycosides-for-treating-late-onset-rheumatoid-arthritis-a-systematic-review-and-meta-analysis
#7
Xiao Xu, Quan Jin Li, Sha Xia, Miao Miao Wang, Wei Ji
Context • Older- or late-onset rheumatoid arthritis (LORA) is defined as rheumatoid arthritis (RA) with an onset of symptoms at age 60 y or older, which includes a specific clinical course and features. To date, a specific therapeutic treatment for LORA is still a dilemma in modern medicine. Objective • The study aimed to assess the effectiveness and safety of Tripterygium glycosides for treating LORA. Design • Seven databases were searched from their inceptions until June 2015. The research team included randomized, controlled trials (RCTs) in which Tripterygium glycosides were employed, either alone or as an adjuvant treatment with disease-modifying antirheumatic drugs (DMARDs), in patients with LORA...
November 2016: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/27856658/new-targets-in-psoriatic-arthritis
#8
REVIEW
Juergen Braun
PsA is an immune-mediated chronic inflammatory disease that affects both skin and joints; it is a heterogeneous disease characterized by synovitis, enthesitis, dactylitis and spondylitis. The impact on patients and the burden of disease are substantial. For assessment of the disease, patient-reported outcomes are increasingly important. Conventional therapy consists of NSAIDs, local and systemic CSs, and synthetic and biological DMARDs. While MTX, LEF, SSZ and CYC are the synthetic drugs mainly used, TNF-α blocking agents have represented the majority of biologics used in the last decade (infliximab, etanercept, adalimumab, certolizumab and golimumab)...
December 2016: Rheumatology
https://www.readbyqxmd.com/read/27853889/efficacy-and-safety-of-adalimumab-in-beh%C3%A3-et-s-disease-related-uveitis-a-multicenter-retrospective-observational-study
#9
Claudia Fabiani, Antonio Vitale, Giacomo Emmi, Lorenzo Vannozzi, Giuseppe Lopalco, Silvana Guerriero, Ida Orlando, Rossella Franceschini, Daniela Bacherini, Luca Cimino, Alessandra Soriano, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Carlo Salvarani, Luca Cantarini
The study aim was to evaluate the efficacy of adalimumab (ADA) in a large series of Behçet's disease (BD)-related uveitis. We performed a multicenter retrospective observational study including 40 selected patients (66 eyes) receiving ADA. Clinical data were retrospectively analyzed at baseline, at 3 and 12 months of treatment. Primary end point was reduction of ocular inflammatory flares. Secondary end points were improvement of best corrected visual acuity (BCVA), reduction of macular thickness measured by optical coherence tomography (OCT), reduction in the occurrence of vasculitis assessed by fluorescein angiography (FA), and evaluation of statistically significant differences between patients treated with ADA monotherapy and those undergoing ADA plus DMARDs and in patients firstly treated with ADA compared to patients previously administered with other biologics; ADA steroid sparing effect was also evaluated...
November 16, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27843301/examining-patient-preferences-in-the-treatment-of-rheumatoid-arthritis-using-a-discrete-choice-approach
#10
Rieke Alten, Klaus Krüger, Julian Rellecke, Julia Schiffner-Rohe, Olaf Behmer, Guido Schiffhorst, Hans-Dieter Nolting
BACKGROUND: Biological disease-modifying antirheumatic drugs (bDMARDs) used in second-line treatment of rheumatoid arthritis (RA) are administered parenterally. However, so-called targeted synthetic DMARDs (tsDMARDs) - developed more recently - offer alternative (ie, oral) administration forms in second-line treatment. Since bDMARDs and tsDMARDs can be regarded as equal in terms of efficacy, the present study examines whether such characteristics as route of administration drive RA patients' treatment choice...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27836567/management-of-psoriatic-arthritis-early-diagnosis-monitoring-of-disease-severity-and-cutting-edge-therapies
#11
REVIEW
Siba P Raychaudhuri, Reason Wilken, Andrea C Sukhov, Smriti K Raychaudhuri, Emanual Maverakis
Psoriatic arthritis (PsA) is a heterogeneous disease that can involve a variety of distinct anatomical sites including a patient's peripheral and axial joints, entheses, skin and nails. Appropriate management of PsA requires early diagnosis, monitoring of disease activity, and utilization of cutting edge therapies. To accomplish the former there are a variety of PsA-specific tools available to screen, diagnose, and assess patients. This review will outline the recently developed PsA screening tools, including the Toronto Psoriatic Arthritis Screening Questionnaire (TOPAS), the Psoriasis Epidemiology Screening Tool (PEST), the Psoriatic Arthritis Screening and Evaluation (PASE), and the Psoriasis and Arthritis Screening Questionnaire (PASQ)...
November 8, 2016: Journal of Autoimmunity
https://www.readbyqxmd.com/read/27830969/plasmapheresis-therapy-in-combination-with-tnf-%C3%AE-inhibitor-and-dmards-a-multi-target-method-for-treatment-of-rheumatoid-arthritis
#12
Yongjing Cheng, Feng Yang, Cibo Huang, Jia Huang, Qian Wang, Yingjuan Chen, Yingjue Du, Like Zhao, Ming Gao, Fang Wang
OBJECTIVE: To evaluate the effects of a multi-target method involving plasmapheresis therapy combined with tumor necrosis factor (TNF)-α inhibitor and disease-modifying anti-rheumatic drugs (DMARDs) on disease activity parameters in the treatment of active rheumatoid arthritis (RA). METHODS: Sixty-five patients with active RA were divided into 2 groups according to treatment administered: the plasmapheresis combination therapy group (Plasmapheresis combination group; 38 cases), in which patients received plasmapheresis therapy along with a TNF-α inhibitor (recombinant human tumor necrosis factor-Fc; rhTNFR:Fc; Etanercept biosimilars) and DMARDs, and a TNF-α inhibitor therapy group (biological agent group; 27 cases), in which patients received a TNF-α inhibitor and DMARDs...
November 10, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27829672/management-of-psoriatic-arthritis-in-2016-a-comparison-of-eular-and-grappa-recommendations
#13
REVIEW
Laure Gossec, Laura C Coates, Maarten de Wit, Arthur Kavanaugh, Sofia Ramiro, Philip J Mease, Christopher T Ritchlin, Désirée van der Heijde, Josef S Smolen
Psoriatic arthritis (PsA) is a heterogeneous, potentially severe disease. Many therapeutic agents are now available for PsA, but treatment decisions are not always straightforward. To assist in this decision making, two sets of recommendations for the management of PsA were published in 2016 by international organizations - the European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). In both sets of recommendations, the heterogeneity of PsA is recognized and the place of various drugs in the therapeutic armamentarium is discussed...
November 10, 2016: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/27826996/treatment-of-psoriatic-arthritis-with-traditional-dmard-s-and-novel-therapies-approaches-and-recommendations
#14
Ajesh B Maharaj, Vinod Chandran
Recent advances in the therapeutics of psoriatic arthritis (PsA) have provided more options to clinicians managing PsA. The purpose of this review is to update the reader on treatment options for PsA using conventional synthetic disease modifying agents (csDMARDs) and novel therapies including tumour necrosis factor alpha inhibitors, interleukin 12/23 inhibitor (ustekinumab), the interleukin 17 antagonists including secukinumab, brodalumab, ixekizumab, and the phosphodiesterase-4 inhibitor, apremilast. Areas covered: We reviewed published articles on the treatment of PsA...
November 18, 2016: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/27824423/-glucocorticoid-therapy-in-rheumatoid-arthritis-pro
#15
Georg Pongratz
Glucocorticoids are invaluable in the therapy of chronic-inflammatory diseases, like rheumatoid arthritis (RA). They act fast and efficient to suppress inflammation and serve to bridge the gap until disease modifying drugs (DMARD) show effect. However, the value of glucocorticoids with regard to their cost / benefit ratio in long term RA therapy is still controvers. In this short review, the main aspects favoring glucocorticoids as DMARD in long term RA therapy will be discussed. It becomes apparent, that at low dosage (prednisolone ≤ 5 mg / d), careful selection and monitoring of patients, and osteoporosis prophylaxis according to guidelines, long term therapy with glucocorticoids is an option and, with a favorable cost / benefit ratio, contributes to inflammation control and prevention of structural damage...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27796445/biologic-therapies-and-bone-loss-in-rheumatoid-arthritis
#16
REVIEW
C A F Zerbini, P Clark, L Mendez-Sanchez, R M R Pereira, O D Messina, C R Uña, J D Adachi, W F Lems, C Cooper, N E Lane
INTRODUCTION: Rheumatoid arthritis (RA) is a common systemic autoimmune disease of unknown cause, characterized by a chronic, symmetric, and progressive inflammatory polyarthritis. One of the most deleterious effects induced by the chronic inflammation of RA is bone loss. During the last 15 years, the better knowledge of the cytokine network involved in RA allowed the development of potent inhibitors of the inflammatory process classified as biological DMARDs. These new drugs are very effective in the inhibition of inflammation, but there are only few studies regarding their role in bone protection...
October 31, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27779782/use-of-tumor-necrosis-factor-alpha-inhibitors-in-children-and-young-adults-with-juvenile-idiopathic-arthritis-or-rheumatoid-arthritis
#17
Wan-Ju Lee, Leslie Briars, Todd A Lee, Gregory S Calip, Katie J Suda, Glen T Schumock
OBJECTIVE: To characterize the use of tumor necrosis factor-alpha inhibitors (TNFI) in children with juvenile idiopathic arthritis (JIA) and young adults with rheumatoid arthritis (RA). METHODS: Patients with incident JIA or RA were identified using the Truven Health MarketScan Commercial Claims and Encounters database from 2009 to 2013. The incident diagnosis was defined as no prior claims with a JIA/RA code and no JIA/RA medications recorded during the previous 6 months...
October 25, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27769592/defining-the-optimal-biological-monotherapy-in-rheumatoid-arthritis-a-systematic-review-and-meta-analysis-of-randomised-trials
#18
Simon Tarp, Daniel E Furst, Anna Dossing, Mikkel Østergaard, Tove Lorenzen, Michael S Hansen, Jasvinder A Singh, Ernest H Choy, Maarten Boers, Maria E Suarez-Almazor, Lars E Kristensen, Henning Bliddal, Robin Christensen
OBJECTIVES: To summarize and compare the benefits and harms of biological agents used as monotherapy for rheumatoid arthritis (RA) in order to inform decisions for patients who are intolerant to conventional DMARD therapy. METHODS: We searched MEDLINE, EMBASE, CENTRAL, and other sources for randomised trials that compared biological monotherapy with methotrexate, placebo, or other biological monotherapies. Primary outcomes were ACR50 and the number of patients who discontinued due to adverse events...
September 14, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27769591/pegloticase-failure-and-a-possible-solution-immunosuppression-to-prevent-intolerance-and-inefficacy-in-patients-with-gout
#19
Adey A Berhanu, Svetlana Krasnokutsky, Robert T Keenan, Michael H Pillinger
INTRODUCTION: Pegloticase is a highly effective therapy for patients with refractory and/or tophaceous gout, but has a high discontinuation rate (30-50%) due to development of anti-drug antibodies causing loss of efficacy and risk of infusion reactions. OBJECTIVE: To describe the use of azathioprine or other immunosuppressive therapies as a pegloticase adjunct to prevent pegloticase immunogenicity when treating gout. METHODS: Case report of azathioprine use in a patient receiving pegloticase therapy for refractory tophaceous gout, and review of the literature for the impact of immunosuppressive agents on development of anti-drug antibodies...
September 20, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27749239/treatment-in-rheumatoid-arthritis-and-mortality-risk-in-clinical-practice-the-role-of-biologic-agents
#20
Luis Rodriguez-Rodriguez, Leticia Leon, Jose Ivorra-Cortes, Alejandro Gómez, Jose Ramon Lamas, Esperanza Pato, Juan Angel Jover, Lydia Abásolo
OBJECTIVES: To assess the mortality rate (MR) and the mortality risk of a rheumatoid arthritis (RA) inception cohort, with and without biologic agents (BAs). Other factors associated to mortality were also investigated. METHODS: Retrospective longitudinal study of RA patients, attending the rheumatology outpatient clinic of a tertiary Hospital (Madrid), collected over 5 years (2000-2004), and followed from the diagnosis of RA up to the patients' death, lost to follow-up or September 2013...
October 7, 2016: Clinical and Experimental Rheumatology
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