Management Of Early Rheumatoid Arthritis With Disease Modifying Anti Rheumatic Drugs
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Management Of Early Rheumatoid Arthritis With Disease Modifying Anti Rheumatic Drugs
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Author : Sarah Wood
language : en
Publisher:
Release Date : 2021
Management Of Early Rheumatoid Arthritis With Disease Modifying Anti Rheumatic Drugs written by Sarah Wood and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021 with categories.
Early Rheumatoid Arthritis
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Author : Paul Emery
language : en
Publisher:
Release Date : 2005
Early Rheumatoid Arthritis written by Paul Emery and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005 with Rheumatoid arthritis categories.
This issue covers the latest developments in the understanding of rheumatoid arthritis at the early stage. Treatments such as with newer biologic agents and conventional disease-modifying antirheumatic drugs are reviewed. Also included are articles on imaging modalities as a means of identifying those in the early stages and monitoring response to treatment.
Rheumatoid Arthritis
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Author : John J. Cush
language : en
Publisher:
Release Date : 2008-01-01
Rheumatoid Arthritis written by John J. Cush and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-01-01 with Medical categories.
Emphasizes the importance of early intervention in RA with focus on pharmacologic treatment of RA. Detailed information on the various medications employed in treatment, including corticosteroids, NSAIDs DMARDs, biologic agents, and combination therapy is reviewed, including evidence based data on efficacy, safety, side effects, and monitoring requirements. Clinical evaluation is presented, including lab findings, joint scoring, diagnostic criteria, and radiographic outcomes. Surgical options and the management of advanced RA are disussed.
Rheumatoid Arthritis
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Author : Larry W. Moreland
language : en
Publisher: Remedica Publishing
Release Date : 2008
Rheumatoid Arthritis written by Larry W. Moreland and has been published by Remedica Publishing this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Medical categories.
Since the first edition appeared, treatment options in RA have progressed rapidly; new strategies include the early initiation of therapy, combination treatments, and the introduction of targeted therapies. This comprehensive yet concise handbook contains expert opinion on treatment with disease-modifying anti-rheumatic drugs and targeted biologic therapies, plus a review of therapies on the horizon.
Drug Therapy For Early Rheumatoid Arthritis
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Author : Katrina E. Donahue
language : en
Publisher:
Release Date : 2018
Drug Therapy For Early Rheumatoid Arthritis written by Katrina E. Donahue and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018 with categories.
OBJECTIVES: Compare the benefits and harms of drug therapies for adults with early rheumatoid arthritis (RA) within 1 year of diagnosis, updating the findings on early RA from the 2012 review. DATA SOURCES: English-language articles identified through MEDLINE®, Cochrane Library, Embase®, International Pharmaceutical Abstracts, gray literature, the previous 2012 review, expert recommendations, reference lists of published literature, and supplemental evidence data requests from January 2011 to October 5, 2017. REVIEW METHODS: Literature was synthesized qualitatively in narrative form and summary tables within and between corticosteroids and classes of disease-modifying antirheumatic drugs (DMARDs). Additionally, combination treatment strategies were examined. We conducted network meta-analysis for five outcomes: American College of Rheumatology 50-percent improvement (ACR50), remission based on Disease Activity Score (DAS), radiographic joint damage, all discontinuations, and discontinuations due to adverse events. Eligibility for network meta-analyses required the following: (1) patients with early RA had not attempted prior treatment with methotrexate (MTX), (2) doses of treatments were within ranges approved by the Food and Drug Administration (FDA), (3) length of followup was similar, and (4) studies were double-blinded randomized controlled trials of low or medium risk of bias. RESULTS: We analyzed 49 studies: 41 RCTs and 8 observational studies reported in 124 published articles. All included studies enrolled patients with moderate to high disease activity at baseline as measured with mean or median DAS 28 scores. A combination of corticosteroids plus MTX achieved higher remission rates than with MTX monotherapy (low strength of evidence [SOE]). Combination therapy with TNF (tumor necrosis factor) or non-TNF biologics plus MTX improved disease control, remission, and functional capacity compared with monotherapy with either MTX or a biologic (low to moderate SOE). Network meta-analyses found higher ACR50 response for combination therapy of biologics plus MTX than for MTX monotherapy (range of relative risk, 1.20 [95% confidence interval (CI), 1.04 to 1.38] to 1.57 [95% CI, 1.30 to 1.88]). In available data, consisting mostly of clinical trials, no significant differences emerged between any DMARDs for rates of discontinuation attributable to adverse events or serious adverse events (low SOE for adalimumab, certolizumab pegol, etanercept, infliximab, or abatacept with MTX, and moderate SOE for rituximab or tocilizumab with MTX). Data about subgroups (based on disease activity, prior therapy, demographics, and the presence of other serious conditions) were insufficient. No difference in findings were noted in MTX naïve and resistant populations. We found no studies of biosimilars for patients with early RA. CONCLUSIONS: Qualitative synthesis and network meta-analyses suggest that the combination of MTX with TNF or non-TNF biologics improves disease activity and remission when compared with biologic monotherapy or a conventional synthetic DMARD (csDMARD) monotherapy in patients with moderate to high disease activity at baseline as measured with mean or median DAS 28 scores. Overall rates of adverse events and discontinuation were similar among patients given csDMARDs, TNF biologics, and non-TNF biologics. We did not find eligible studies of biosimilars.
Pharmaceutical Care Issues Of Patients With Rheumatoid Arthritis
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Author : Louise Grech
language : en
Publisher: Springer
Release Date : 2016-07-07
Pharmaceutical Care Issues Of Patients With Rheumatoid Arthritis written by Louise Grech and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-07-07 with Medical categories.
This book presents concise, comprehensive summaries of topics necessary to understand rheumatoid arthritis (RA) management, aligned with patient needs, as a reference suitable for practitioners and students of all levels. Special attention is paid to the innovative RhMAT (Rheumatoid Arthritis Medication Assessment Tool), in addition to descriptions of the pharmacological management of RA, pharmacoeconomic and pharmacovigilance considerations, the benefits of seamless care, and case presentations.Rheumatoid arthritis is one of the most common forms of inflammatory arthritis in the world, with a prevalence of 0.5 to 1%. While no cure has yet been established, modern biotechnology has enabled highly effective management, if treatment begins early. However, cost and side effects, such as immune suppression, continue to present barriers, and monitoring of patients is pivotal to safe and effective disease management. Both hospital and community pharmacists are involved in RA patient management, and have responsibilities to this patient population. Identifying pharmaceutical care issues and ensuring that the patients are managed in accordance to best evidence-based medicine are paramount. Best care is delivered when pharmacists effectively communicate with each other, the prescribers and the multidisciplinary team members involved in the care of the patient. This book aims to tackle the various aspects of the management of RA patients across all the settings.
Uncover
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Author : Ruben Tavares
language : en
Publisher:
Release Date : 2007
Uncover written by Ruben Tavares and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2007 with categories.
Rationale. Clinical guidelines for rheumatoid arthritis (RA) pharmacotherapy recommend initiating disease modifying anti-rheumatic drugs (DMARDs) within three months of established disease and three months of symptoms are required to establish a diagnosis with certainty. Unfortunately, data on delays to accessing DMARD therapy for early RA is lacking from Canada. These patients may not be receiving optimal treatment in a timely manner. Purpose. To determine the proportion of Canadian RA patients treated with DMARDs within six months of symptom onset; to determine the predictors and components of time to treatment; and, to characterize early pharmacotherapy and clinical management in usual care. Methods. A retrospective chart audit of 339 randomly selected adult patients, clinically diagnosed with RA between June 2001 and May 2003 from the practices of 18 rheumatology specialists. Time to DMARD treatment was determined using Kaplan-Meier analysis. Multivariable logistic regression (LR) and Cox modeling using Markov Chain Monte Carlo multiple imputed data was conducted to determine predictors of delay. Bootstrapping was used to validate LR models. Median component delays and frequency estimates of pharmacotherapies and clinical assessments utilized were determined. Results. Subjects were 50 +/- 14 years at symptom onset and 75.5% were female. At baseline, subjects had a median (interquartile range) of 10 (6,14) swollen and 13 (8,19) tender joints, an erythrocyte sedimentation rate (ESR) of 32 (20,46) mm/h, and C-reactive protein (CRP) of 29 (14,37) mg/L, 69.9% of subjects were rheumatoid factor positive (RF+), 40.4% had an arthritic comorbidity, 41.9% previously consulted another rheumatologist, and the majority (85.0%) were previously treated with non-steroidal anti-inflammatory drugs (NSAIDs). Within six months of symptom onset, 39.1% were treated with DMARDs. Multivariable predictors of increased time from symptom onset to treatment included the existence of an arthritic comorbidity, female gender, and younger age at symptom onset. Previously consulting another rheumatologist and seeing an academic investigator were associated with decreased time to treatment. The major delays occurred prior to rheumatology referral (78%), of which, 27% occurred prior to NSAID therapy. Therapy with DMARDs was initiated a median of 70 days prior diagnosis confirmation. The most common first DMARDs were hydroxychloroquine (HCQ, 55.5%) and methotrexate (MTX, 40.1%). At DMARD initiation, 47.2% were prescribed a combination therapy, including multiple DMARDs for 16.5% and DMARD-corticosteroid combinations for 30.7%. Laboratory assessments frequently accompanied referral letters (81.0%). Joint examination (40.7%), pain (50.2%), function (28.9%), and radiographs (49.7%) were infrequently included in referral letters. Except for radiography (55.5%), all other assessments noted above were conducted at a frequency of greater than 80% at baseline and follow-up by the investigator. Formal assessments of disease activity (DAS, 0.3%; DAS28, 8.6%), functional (HAQ, 34.6%; MHAQ, 16.0%), and pain (VAS, 43.6%) were infrequently collected over follow-up. Conclusions. Almost 40% of RA patients are treated with DMARDs within six months of symptom onset. The largest components of delays to treatment precede referral to rheumatologic care. On average, patients are treated with DMARDs prior to the confirmation of a diagnosis. Attention should be given to the development of RA symptoms in patients with arthritic comorbidities, lesser age, and females, as these variables predict increased time to treatment. Underlying characteristics of subjects who consult a single rheumatologist leading up to diagnosis and those referred to nonacademic specialists need to be explored as they also predict increased time to treatment. In light of patients being started on DMARDs in advance of a confirmed diagnosis, as well as the low proportion of patients with high disease activity early in the disease course, the initial DMARD care provided may be considered aggressive with nearly 50% receiving either multiple DMARDs or single-DMARD-corticosteroid combinations at this time point. The potential improvement in rheumatologic care achievable with tight monitoring of patients should be met with increased frequency of formal disease activity, function, pain and radiography assessments over the course of care.
Fast Facts Rheumatoid Arthritis
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Author : John D. Isaacs
language : en
Publisher: Karger Medical and Scientific Publishers
Release Date : 2011-05-01
Fast Facts Rheumatoid Arthritis written by John D. Isaacs and has been published by Karger Medical and Scientific Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-05-01 with Medical categories.
This thoroughly updated second edition of 'Fast Facts: Rheumatoid Arthritis' provides an easy-to-read overview of how the condition is thought to develop and how it is diagnosed, monitored and treated. Written by two leading UK and US rheumatologists, it covers the many recent developments in this field, including: • Recently published classification criteria • The emerging role of anti-CCP autoantibodies • The latest developments in ultrasound and MRI • The association between RA and cardiovascular disease and lung disease • New concepts of undifferentiated arthritis and treatment to remission • The importance of early referral and new biological therapies 'Fast Facts: Rheumatoid Arthritis' provides a well-referenced international perspective on this condition. It is a 'must read' for all healthcare professionals caring for patients with this debilitating inflammatory joint disease. Contents: • The normal joint • Etiology • Pathogenesis • Epidemiology • Clinical features • Investigation • Assessment • Management - traditional measures • Management - biological therapies • Therapeutic developments
Pocket Reference To Early Rheumatoid Arthritis
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Author : Paul Emery
language : en
Publisher: Springer Science & Business Media
Release Date : 2011-12-21
Pocket Reference To Early Rheumatoid Arthritis written by Paul Emery and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-12-21 with Medical categories.
Written by a world-renowned expert in rheumatology this book serves as a refresher for GPs and hospital doctors containing practical diagnostic and treatment advice. Reviews clinical developments and guidelines, and places them into everyday clinical practice Stresses the importance of early and aggressive treatment Concise but comprehensive whilst being loaded with illustrations including imaging examples all presented in pocket sized format Rheumatoid arthritis (RA) is the most common and serious inflammatory arthritis, resulting in joint destruction, functional impairment and increased mortality. The outcome of the disease, however, has improved considerably in recent years with the availability of effective therapies and the recognition that early intensive treatment strategies result in better outcomes. This book has been designed to increase physician awareness of the importance of early and intensive treatment – a key pharmaceutical strategy in rheumatoid arthritis.
Biologics For Early Rheumatoid Arhritis
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Author :
language : en
Publisher:
Release Date : 2010
Biologics For Early Rheumatoid Arhritis written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with categories.