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Author: Paul Emery
Publisher:
ISBN: 9781416027676
Category : Rheumatoid arthritis
Languages : en
Pages : 0
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Book Description
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.
Author: Paul Emery
Publisher:
ISBN: 9781416027676
Category : Rheumatoid arthritis
Languages : en
Pages : 0
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Book Description
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.
Author: Sarah Wood
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Author: John J. Cush
Publisher:
ISBN: 1932610286
Category : Medical
Languages : en
Pages : 368
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Book Description
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.
Author: John D. Isaacs
Publisher: Karger Medical and Scientific Publishers
ISBN: 1905832915
Category : Medical
Languages : en
Pages : 118
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Book Description
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
Author: Louise Grech
Publisher: Springer
ISBN: 9811014213
Category : Medical
Languages : en
Pages : 100
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Book Description
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.
Author: Katrina E. Donahue
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
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.
Author: John H. Stone
Publisher: Springer Science & Business Media
ISBN: 1848009348
Category : Medical
Languages : en
Pages : 489
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Book Description
Important strides have been made in understanding the pathophysiologic basis of many inflammatory conditions in recent years, but rheumatology remains a discipline in which diagnosis is rooted in the medical history skillfully extracted from the patient, the careful physical examination, and the discriminating use of laboratory tests and imaging. Moreover, selection of the most appropriate therapy for patients with rheumatic diseases also remains heavily reliant upon clinical experience. Medical disciplines such as rheumatology that depend significantly upon clinical wisdom are prone to the development of systems of ‘Pearls’ and ‘Myths,’ related to the diseases they call their own, a ‘Pearl’ being a nugget of truth about the diagnosis or treatment of a particular disease that has been gained by dint of clinical experience and a ‘Myth’ being a commonly held belief that influences the practice of many clinicians – but is false. This book will pool together the clinical wisdom of seasoned, expert rheumatologists who participate in the care of patients with autoimmune diseases, systemic inflammatory disorders, and all other rheumatic conditions.
Author: Ian R. Mackay
Publisher:
ISBN: 9781461492092
Category : Clinical immunology
Languages : en
Pages :
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Book Description
Offering a broad appeal to microbiologists, immunologists, and infectious disease specialists, this four volume encyclopedia covers all autoimmune, tropical, and infectious diseases. Emphasis will also be placed on genetics, physiology, metabolism, pathogenesis and applied microbiology. Under the leadership of some of the most world renowned names in the field, the encyclopedia will bring together an outstanding collection of contributions by top scientists in a variety of fields. Volumes 1-3: Diseases will be divided by the 11 main sections of the body, namely Integumentary, Skeletal, Respiratory, Digestive, Urinary, and Reproductive. For some of the autoimmune disease, more then one system will be involved but the delineation serves to broadly break down the diseases into systems. Volume 4 will cover the vaccines for said diseases and future prospects will be offered by leaders in industry and academia. Volume 4 will also be broken down into all the body systems, as in the other two volumes. For each vaccine, for each disease, and in each system the following will be included: • A list of the vaccines currently available along with a list of the companies that manufacture them • Molecular Immunology of the Vaccine • Type of Immunity involved in protection • Mode of Vaccination for each vaccine; repeated boosters and length of immunological memory • Commercial production of vaccines • Storage of vaccines • Standardization and Control of Vaccines • WHO programs and World-Wide Disease Eradication Programs based upon Vaccines.
Author: Ruben Tavares
Publisher:
ISBN: 9780494403518
Category :
Languages : en
Pages : 512
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Book Description
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.
Author:
Publisher: Birkhäuser
ISBN: 9783764385309
Category : Medical
Languages : en
Pages : 0
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Book Description
Inflammation has become one of the most exciting and rewarding areas of medical research. Recent years have seen a revolution in our understanding of how blood and tissue cells interact and of the intracellular mechanisms controlling their activation. This has revealed the underlying inflammatory pathology of many diseases and provided multiple new targets for anti-inflammatory and immunomodulatory therapy. The Encyclopedia of Inflammatory Diseases will cover the following areas: Inflammatory Processes and Cells Inflammatory Diseases Mediators of Inflammation Pharmacology of Inflammation Since inflammatory diseases and their therapy cover a broad range of scientific and medical fields, the encyclopedia will be co-edited by four international experts, a clinician and three researchers from the disciplines of immunology, biochemistry, and pharmacology, in this way providing students, basic and clinical scientists and practitioners in academia, hospitals and industry with valuable interlinked information. This living project will serve as a reliable and comprehensive data pool for everybody working in inflammation research. Owing to its dynamic nature, it will grow with time and future editions, becoming an indispensible source of information for academia, clinical practitioners and industry.
