Pharmacotherapy of rheumatoid arthritis: an overview
Identifieur interne : 002264 ( Main/Exploration ); précédent : 002263; suivant : 002265Pharmacotherapy of rheumatoid arthritis: an overview
Auteurs : Ehab S. El Desoky [Égypte]Source :
- Current Therapeutic Research [ 0011-393X ] ; 2001.
English descriptors
- Teeft :
- Acute pain, Adverse effects, American college, Antirheumatic drugs, Arthritis, Arthritis rheum, Autoimmune disease, Autoimmune diseases, Autologous blood, Best pratt, Biologic, Biologic agents, Body weight, Bone erosion, Bone marrow transplantation, Cause elevation, Celecoxib, Cell transplantation, Class study, Clin, Clin pharmacol, Clin rheumatol, Clinical efficacy, Clinical response, Clinical trials, Combination therapy, Complete blood count, Concomitant administration, Conventional nsaids, Corticosteroid, Current therapeuticresearch, Cyclosporine, Cytokine, Desoky, Diclofenac sodium, Disease progression, Diseased joints, Dmard, Dmard therapy, Dmards, Dos, Dosage, Dosage regimen, Early treatment, Etanercept, Further studies, Fusion protein, Gastrointestinal, Gene expression, Gene therapy, Gold salts, Gold sodium thiomalate, Healthy subjects, High doses, High risk, Hormone replacement therapy, Hydroxychloroquine, Inflammation, Inflammatory, Inflammatory activity, Inflammatory response, Infliximab, Inhibitor, Injectable gold, Intestinal absorption, Lancet, Leflunomide, Liver enzymes, Loading dosage, Loading dose, Maintenance dosage, Methotrexate, Minocycline, Monoclonal antibody, Monotherapy, Morning stiffness, Nonsteroidal, Nonsteroidal drugs, Nsaid, Nsalds, Osteoporosis, Other coadministered drugs, Other side effects, Penicillamine, Pharmacokinetic studies, Placebo, Plasma concentration, Platelet count, Preliminary results, Prostaglandin synthesis, Prothrombin time, Pyrimidine synthesis, Randomised comparison, Randomized, Receptor, Receptor antagonist, Refractory, Renal, Renal toxicity, Rheum, Rheumatic diseases, Rheumatoid, Rheumatoid arthritis, Rheumatoid arthritis patients, Rheumatol, Rheumatology, Rofecoxib, Selective inhibition, Selective inhibitors, Several months, Side effects, Small doses, Suboptimal response, Symptomatic ulcers, Synovial, Synovial fluid, Therapy, Toxicity, Traditional nsaids, Transcription factor, Transplantation, Treatment options, Triple therapy, Tumor necrosis factor, Ulcer complications, Uninjected joints, Weight gain.
Abstract
Abstract: Objective: The aim of this article was to provide an overview of the pharmacotherapy of rheumatoid arthritis (RA), including traditional drugs and the newer agents. Methods: Primary literature on the pharmacotherapy of RA was identified through a comprehensive MEDLINE® English-language search from January 1985 to September 2000. Additional studies were identified from a review of the references within these sources. Results: Treatment options for RA are expanding as research has provided a more explicit understanding of the pathophysiology of the disease. For the relief of the signs and symptoms of RA, the new selective cyclooxygenase-2 (COX-2) inhibitors (celecoxib and rofecoxib) are joining the available nonsteroidal anti-inflammatory drugs (NSAIDs). COX-2 inhibitors have fewer associated upper gastrointestinal side effects than traditional NSAIDs. Use of disease-modifying antirheumatic drugs (DMARDs) is now recommended early in the disease. Triple therapy with methotrexate (MTX), sulfasalazine, and hydroxychloroquine is one of the successful combination approaches with DMARDs. Leflunomide, a new second-line DMARD, reduces pyrimidine synthesis and decreases rheumatoid inflammation. Leflunomide is as effective as MTX, but unlike MTX, does not cause bone marrow toxicity. The biologic agents etanercept and infliximab have shown benefit alone and in combination with MTX. They have minimal toxicity, except for injection-site reactions. However, they should be reserved for patients who fail to respond to MTX alone or another DMARD.
Url:
DOI: 10.1016/S0011-393X(01)80020-5
Affiliations:
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El Desoky</name><affiliation wicri:level="1"><country xml:lang="fr">Égypte</country><wicri:regionArea>Pharmacology Department, Faculty of Medicine, Assiut University, Assiut</wicri:regionArea><wicri:noRegion>Assiut</wicri:noRegion></affiliation><affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Current Therapeutic Research</title><title level="j" type="abbrev">CUTHRE</title><idno type="ISSN">0011-393X</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001">2001</date><biblScope unit="volume">62</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="92">92</biblScope><biblScope unit="page" to="112">112</biblScope></imprint><idno type="ISSN">0011-393X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0011-393X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Acute pain</term><term>Adverse effects</term><term>American college</term><term>Antirheumatic drugs</term><term>Arthritis</term><term>Arthritis rheum</term><term>Autoimmune disease</term><term>Autoimmune diseases</term><term>Autologous blood</term><term>Best pratt</term><term>Biologic</term><term>Biologic agents</term><term>Body weight</term><term>Bone erosion</term><term>Bone marrow transplantation</term><term>Cause elevation</term><term>Celecoxib</term><term>Cell transplantation</term><term>Class study</term><term>Clin</term><term>Clin pharmacol</term><term>Clin rheumatol</term><term>Clinical efficacy</term><term>Clinical response</term><term>Clinical trials</term><term>Combination therapy</term><term>Complete blood count</term><term>Concomitant administration</term><term>Conventional nsaids</term><term>Corticosteroid</term><term>Current therapeuticresearch</term><term>Cyclosporine</term><term>Cytokine</term><term>Desoky</term><term>Diclofenac sodium</term><term>Disease progression</term><term>Diseased joints</term><term>Dmard</term><term>Dmard therapy</term><term>Dmards</term><term>Dos</term><term>Dosage</term><term>Dosage regimen</term><term>Early treatment</term><term>Etanercept</term><term>Further studies</term><term>Fusion protein</term><term>Gastrointestinal</term><term>Gene expression</term><term>Gene therapy</term><term>Gold salts</term><term>Gold sodium thiomalate</term><term>Healthy subjects</term><term>High doses</term><term>High risk</term><term>Hormone replacement therapy</term><term>Hydroxychloroquine</term><term>Inflammation</term><term>Inflammatory</term><term>Inflammatory activity</term><term>Inflammatory response</term><term>Infliximab</term><term>Inhibitor</term><term>Injectable gold</term><term>Intestinal absorption</term><term>Lancet</term><term>Leflunomide</term><term>Liver enzymes</term><term>Loading dosage</term><term>Loading dose</term><term>Maintenance dosage</term><term>Methotrexate</term><term>Minocycline</term><term>Monoclonal antibody</term><term>Monotherapy</term><term>Morning stiffness</term><term>Nonsteroidal</term><term>Nonsteroidal drugs</term><term>Nsaid</term><term>Nsalds</term><term>Osteoporosis</term><term>Other coadministered drugs</term><term>Other side effects</term><term>Penicillamine</term><term>Pharmacokinetic studies</term><term>Placebo</term><term>Plasma concentration</term><term>Platelet count</term><term>Preliminary results</term><term>Prostaglandin synthesis</term><term>Prothrombin time</term><term>Pyrimidine synthesis</term><term>Randomised comparison</term><term>Randomized</term><term>Receptor</term><term>Receptor antagonist</term><term>Refractory</term><term>Renal</term><term>Renal toxicity</term><term>Rheum</term><term>Rheumatic diseases</term><term>Rheumatoid</term><term>Rheumatoid arthritis</term><term>Rheumatoid arthritis patients</term><term>Rheumatol</term><term>Rheumatology</term><term>Rofecoxib</term><term>Selective inhibition</term><term>Selective inhibitors</term><term>Several months</term><term>Side effects</term><term>Small doses</term><term>Suboptimal response</term><term>Symptomatic ulcers</term><term>Synovial</term><term>Synovial fluid</term><term>Therapy</term><term>Toxicity</term><term>Traditional nsaids</term><term>Transcription factor</term><term>Transplantation</term><term>Treatment options</term><term>Triple therapy</term><term>Tumor necrosis factor</term><term>Ulcer complications</term><term>Uninjected joints</term><term>Weight gain</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Objective: The aim of this article was to provide an overview of the pharmacotherapy of rheumatoid arthritis (RA), including traditional drugs and the newer agents. Methods: Primary literature on the pharmacotherapy of RA was identified through a comprehensive MEDLINE® English-language search from January 1985 to September 2000. Additional studies were identified from a review of the references within these sources. Results: Treatment options for RA are expanding as research has provided a more explicit understanding of the pathophysiology of the disease. For the relief of the signs and symptoms of RA, the new selective cyclooxygenase-2 (COX-2) inhibitors (celecoxib and rofecoxib) are joining the available nonsteroidal anti-inflammatory drugs (NSAIDs). COX-2 inhibitors have fewer associated upper gastrointestinal side effects than traditional NSAIDs. Use of disease-modifying antirheumatic drugs (DMARDs) is now recommended early in the disease. Triple therapy with methotrexate (MTX), sulfasalazine, and hydroxychloroquine is one of the successful combination approaches with DMARDs. Leflunomide, a new second-line DMARD, reduces pyrimidine synthesis and decreases rheumatoid inflammation. Leflunomide is as effective as MTX, but unlike MTX, does not cause bone marrow toxicity. The biologic agents etanercept and infliximab have shown benefit alone and in combination with MTX. They have minimal toxicity, except for injection-site reactions. However, they should be reserved for patients who fail to respond to MTX alone or another DMARD.</div></front></TEI><affiliations><list><country><li>Égypte</li></country></list><tree><country name="Égypte"><noRegion><name sortKey="El Desoky, Ehab S" sort="El Desoky, Ehab S" uniqKey="El Desoky E" first="Ehab S." last="El Desoky">Ehab S. El Desoky</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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