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Dmard therapy

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https://www.readbyqxmd.com/read/28176966/efficacy-and-safety-of-non-pharmacological-and-non-biological-pharmacological-treatment-a-systematic-literature-review-informing-the-2016-update-of-the-asas-eular-recommendations-for-the-management-of-axial-spondyloarthritis
#1
COMMENT
Andrea Regel, Alexandre Sepriano, Xenofon Baraliakos, Désirée van der Heijde, Jürgen Braun, Robert Landewé, Filip Van den Bosch, Louise Falzon, Sofia Ramiro
To assess the efficacy and safety of non-biological therapies in patients with axial spondyloarthritis (axSpA) to inform the update of the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of axSpA. A systematic literature review (2009-2016) of all non-pharmacological treatments, non-biological drugs (except targeted synthetic disease-modifying antirheumatic drugs (DMARDs)) and surgical therapies was performed. Randomised controlled trials (RCTs) and clinical controlled trials were assessed for efficacy and safety, while observational studies with a comparator were assessed for safety...
2017: RMD Open
https://www.readbyqxmd.com/read/28166785/a-comparison-of-three-treatment-strategies-in-recent-onset-non-systemic-juvenile-idiopathic-arthritis-initial-3-months-results-of-the-best-for-kids-study
#2
P C E Hissink Muller, D M C Brinkman, D Schonenberg, Y Koopman-Keemink, I C J Brederije, W P Bekkering, T W Kuijpers, M A J van Rossum, L W A van Suijlekom-Smit, J M van den Berg, C F Allaart, R Ten Cate
BACKGROUND: Combination therapy with prednisone or etanercept may induce earlier and/or more improvement in disease activity in Disease Modifying Anti Rheumatic Drug (DMARD) naïve non-systemic Juvenile Idiopathic Arthritis (JIA) patients. Here we present three months clinical outcome of initial treatments of the BeSt-for-Kids study. METHODS: Included patients were randomized to either: 1. initial DMARD-monotherapy (sulfasalazine (SSZ) or methotrexate (MTX)), 2...
February 6, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28160071/adherence-to-combination-dmard-therapy-and-treatment-outcomes-in-rheumatoid-arthritis-a-longitudinal-study-of-new-and-existing-dmard-users
#3
Nasir Wabe, Anita Lee, Mihir Wechalekar, Leah McWilliams, Susanna Proudman, Michael Wiese
Medication adherence is believed to be a major contributor to treatment outcomes yet studies quantifying this relationship as rare in rheumatoid arthritis (RA). To determine the association of adherence to DMARD therapy with treatment outcomes among new and existing DMARD users over 2 years. Relevant clinical parameters were obtained from a longitudinal cohort of RA patients, most of who were treated with combination therapy. Patients were classified as adherent if the proportion of days covered for each DMARD was ≥80%...
February 3, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28151971/eq-5d-utility-response-and-drug-survival-in-rheumatoid-arthritis-patients-on-biologic-monotherapy-a-prospective-observational-study-of-patients-registered-in-the-south-swedish-ssatg-registry
#4
Tanja Schjødt Jørgensen, Carl Turesson, Meliha Kapetanovic, Martin Englund, Aleksandra Turkiewicz, Robin Christensen, Henning Bliddal, Pierre Geborek, Lars Erik Kristensen
OBJECTIVES: Biologic agents have dramatically changed treatment of rheumatoid arthritis (RA). To date only scarce head-to-head data exist especially when the biological therapies are given as monotherapy without concomitant disease modifying drugs (DMARDs). Thus the objective of the current study is to evaluate treatment response of all available biological therapies with special focus on utility (EQ-5D-3L) and drug survival of biologic DMARDs (bDMARDs) prescribed as monotherapy in RA patients in southern Sweden...
2017: PloS One
https://www.readbyqxmd.com/read/28151539/non-pharmacological-and-pharmacological-interventions-in-patients-with-early-arthritis-a-systematic-literature-review-informing-the-2016-update-of-eular-recommendations-for-the-management-of-early-arthritis
#5
Claire Immediato Daien, Charlotte Hua, Bernard Combe, Robert Landewe
OBJECTIVE: To perform a systematic literature review (SLR) on pharmacological and non-pharmacological treatments, in order to inform the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis (EA). METHODS: The expert committee defined research questions concerning non-pharmacological interventions, patient information and education, non-steroidal anti-inflammatory drug, glucocorticoid (GC) and disease-modifying antirheumatic drugs (DMARDs) use, as well as on disease monitoring...
2017: RMD Open
https://www.readbyqxmd.com/read/28149009/serum-lipid-alterations-in-early-rheumatoid-arthritis-patients-on-disease-modifying-anti-rheumatoid-therapy
#6
Sana Parveen, Rachel Jacob, Liza Rajasekhar, C Srinivasa, Iyyapu Krishna Mohan
Dyslipidaemia is a major CVD risk factor in the general population. Current evidence suggests that lipid metabolism is altered in RA due to inflammation, and that use of anti-inflammatory therapy may reverse some of these changes. The objective of our study is to compare the effect of treatment with DMARD on lipid fractions after 6 months of therapy. Forty patients who met the American College of Rheumatology, ACR/EULAR criteria for rheumatoid arthritis, with disease duration of less than 1 year and no prior treatment were included in the study...
March 2017: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/28117616/biologics-induced-interstitial-lung-diseases-in-rheumatic-patients-facts-and-controversies
#7
Juan Chen, Shuhong Chi, Feng Li, Jiali Yang, William C Cho, Xiaoming Liu
Interstitial lung disease (ILD) is a common, devastating pulmonary complication. An increased number of reports suggesting that biological disease modifying antirheumatic drugs (DMARDs) induced or exacerbated ILDs in rheumatoid arthritis (RA) patients has garnered increased attention. Areas covered: This article discusses ILDs induced by or exacerbated during biological therapy in RA patients. The article summarizes the efficacy and safety of a variety of licensed and off-label biologics clinically used for rheumatic diseases, focusing on the onset or exacerbation of RA-associated ILDs (RA-ILDs) in RA patients treated with biologics targeting tumor necrosis factor, CD20, interleukin 1 (IL-1) and IL-6 receptors...
February 2, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28089501/effectiveness-of-conventional-disease-modifying-antirheumatic-drugs-in-psoriatic-arthritis-a-systematic-review
#8
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 13, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28079512/long-term-treatment-response-in-rheumatoid-arthritis-patients-starting-adalimumab-or-etanercept-with-or-without-concomitant-methotrexate
#9
Merel J l'Ami, Eva L Kneepkens, Michael T Nurmohamed, Charlotte L M Krieckaert, Ingrid M Visman, Gert-Jan Wolbink
OBJECTIVES: To observe long-term clinical response and drug survival in a prospective two-year cohort study in rheumatoid arthritis (RA) patients starting adalimumab or etanercept treatment, with or without methotrexate (MTX), after failure of conventional DMARD therapy, including MTX. METHODS: Disease activity score of 28 joints (DAS28) and Health Assessment Questionnaire (HAQ) were collected of 873 consecutive RA patients, treated with adalimumab or etanercept, prospectively at baseline, 4, 16, 28, 40, 52, 78 and 104 weeks of biological therapy...
January 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28065486/biologic-disease-modifying-antirheumatic-drug-attributes-in-the-first-lines-of-treatment-of-rheumatoid-arthritis-2015-acordar-project
#10
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
#11
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...
February 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28053390/effectiveness-of-arthroscopic-elbow-synovectomy-in-rheumatoid-arthritis-patients-long-term-follow-up-of-clinical-and-functional-outcomes
#12
Vivek Shankar, Pankaj Sharma, Ravi Mittal, Samarth Mittal, Uma Kumar, Shivanand Gamanagatti
OBJECTIVE: To determine the long-term clinical and functional results of arthroscopic elbow synovectomy in rheumatoid arthritis patients with refractory elbow synovitis in terms of improvement in pain, function, and active range of motion (AROM) or arc of motion. METHOD: Fifteen rheumatoid elbows in 13 patients, not responding to DMARD therapy and with radiological changes not more than Larsen grade 3 were taken, who underwent arthroscopic elbow synovectomy. The main outcome measured in forms of Mayo Elbow Performance Scale (MEPS) score, measurement of pain using a Visual Analogue Scale (VAS), radiological angles of elbow, disease activity score (DAS-28), arc of motions (AOM) and complications, which were assessed at follow-up periods of 6 months, 24 months, and 30 months...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28028155/abatacept-reduces-disease-activity-and-ultrasound-power-doppler-in-acpa-negative-undifferentiated-arthritis-a-proof-of-concept-clinical-and-imaging-study
#13
Maya H Buch, Elizabeth M A Hensor, Chadi Rakieh, Jane E Freeston, Edward Middleton, Sarah Horton, Sudipto Das, Charles Peterfy, Ai Lyn Tan, Richard J Wakefield, Paul Emery
OBJECTIVES: No proven treatment exists for ACPA-negative undifferentiated arthritis (UA). The aim of this study was to evaluate whether abatacept is effective in treating poor prognosis, ACPA-negative UA, including its effect on power Doppler on US (PDUS). METHODS: A proof-of-concept, open-label, prospective study of 20 patients with DMARD-naïve, ACPA-negative UA (⩾2 joint synovitis) and PDUS ⩾ 1 with clinical and 20-joint US (grey scale/PDUS) assessments at baseline, 6, 12, 18 and 24 months...
January 2017: Rheumatology
https://www.readbyqxmd.com/read/28013211/effect-of-anti-tnf-and-conventional-synthetic-disease-modifying-anti-rheumatic-drug-treatment-on-work-disability-and-clinical-outcome-in-a-multicentre-observational-cohort-study-of-psoriatic-arthritis
#14
William Tillett, Gavin Shaddick, Amelia Jobling, Ayman Askari, Annie Cooper, Paul Creamer, Gavin Clunie, Philip S Helliwell, Jana James, Lesley Kay, Eleanor Korendowych, Suzanne Lane, Jonathon Packham, Ragai Shaban, Matthew L Thomas, Lyn Williamson, Neil McHugh
OBJECTIVE: To determine the effect of medical treatment on work disability in patients with active PsA in a real-world setting. METHODS: Four hundred patients with active PsA commencing or switching to anti-TNF or conventional synthetic DMARD (csDMARD) were recruited to a multicentre UK prospective observational cohort study. Work disability was measured using the work productivity and activity-specific health problem instrument and peripheral joint activity was measured with the disease activity in PsA composite measure...
December 24, 2016: Rheumatology
https://www.readbyqxmd.com/read/28011918/hepatitis-b-virus-reactivation-in-rheumatoid-arthritis-patients-undergoing-biologics-treatment
#15
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/27992958/impaired-akt-phosphorylation-in-monocytes-of-patients-with-rheumatoid-arthritis
#16
Krista Kuuliala, Antti Kuuliala, Mari Hämäläinen, Riitta Koivuniemi, Hannu Kautiainen, Eeva Moilanen, Heikki Repo, Marjatta Leirisalo-Repo
It has been proposed that the Akt kinase pathway provides a regulatory mechanism to limit the inflammatory response. We examined the activation of Akt upon LPS challenge in monocytes of patients with rheumatoid arthritis (RA), and correlated it with disease activity. Twelve subjects with recent-onset, DMARD-naïve RA, thirteen patients with chronic, DMARD therapy -nonresponding RA and 27 healthy volunteers provided whole blood samples for phosphospecific flow cytometric measurement of unstimulated and LPS-stimulated Akt phosphorylation at serine 473 in monocytes, determined in relative fluorescence units (RFU)...
December 19, 2016: Scandinavian Journal of Immunology
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
#17
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/27974098/use-of-biologic-agents-in-idiopathic-inflammatory-myopathies-in-sweden-a-descriptive-study-of-real-life-treatment
#18
John Svensson, Marie Holmqvist, Anna Tjärnlund, Maryam Dastmalchi, Balsam Hanna, Sara Magnusson Bucher, Ingrid E Lundberg
OBJECTIVES: Biologic treatment has revolutionised treatment in rheumatology in the last decades. Patients with idiopathic inflammatory myopathies (IIM) have so far only been treated with biologics off-label, with little published follow-up on those who are treated and how they are treated. We therefore set out to characterise the Swedish IIM patients who have been treated with biologics. METHODS: By linking Swedish registers we identified 95 patients with IIM who were treated with biologics between 2000 and 2011...
December 9, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27943573/circulating-cell-free-dna-a-marker-to-predict-the-therapeutic-response-for-biological-dmards-in-rheumatoid-arthritis
#19
Teppei Hashimoto, Kohsuke Yoshida, Naonori Hashimoto, Ayako Nakai, Kenta Kaneshiro, Kohjin Suzuki, Yoshiko Kawasaki, Nao Shibanuma, Akira Hashiramoto
AIM: To evaluate the correlation between circulating cell-free DNA (ccfDNA) in plasma and clinical disease activities in patients with rheumatoid arthritis (RA). METHOD: The study group included 30 patients with RA who started biological disease-modifying anti-rheumatic drugs (DMARDs) therapy. The concentration of ccfDNA in plasma was measured by quantitative real-time polymerase chain reaction at baseline to 24 weeks in every 4-week period from 30 patients and 21 healthy individuals...
December 10, 2016: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/27917631/-15-years-experience-with-biological-therapy-of-inflammatory-rheumatic-diseases-in-czech-national-register-attra
#20
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
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