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Therapeutic progress I: Current treatment of rheumatoid arthritis

Identifieur interne : 002C60 ( Main/Exploration ); précédent : 002C59; suivant : 002C61

Therapeutic progress I: Current treatment of rheumatoid arthritis

Auteurs : N. J. L. Gittoes [Royaume-Uni]

Source :

RBID : ISTEX:A4B34F557CC65B368EC5A1A6A506E1FAA86FD18F

English descriptors

Abstract

Over recent years the pharmacological treatment strategy for rheumatoid arthritis (RA) has changed. An early, aggressive approach has been adopted with a view to maintaining functional capacity. The changing role of nonsteroidal antiinflammatory agents is discussed in the light of the potential toxicity of this class of drugs. The current use of second‐line agents is dealt with in depth and includes guidelines to patient monitoring. Particular attention has been paid to the growing use of cyclosporin A in the treatment of RA as this drug represents the newest, most potent, nonexperimental form of treatment. The questions of when to introduce second‐line agents, who should receive treatment and how many drugs should be prescribed are all addressed in this review. The relative efficacy and toxicity of these agents is discussed and a treatment protocol is proposed.

Url:
DOI: 10.1111/j.1365-2710.1994.tb00668.x


Affiliations:


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Le document en format XML

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<term>Antiinflammatory drugs</term>
<term>Antirheumatic drugs</term>
<term>Arthritis</term>
<term>Azathioprine</term>
<term>Baseline</term>
<term>Baseline value</term>
<term>Blood dyscrasias</term>
<term>Blood levels</term>
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<term>Bone marrow suppression</term>
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<term>Creatinine</term>
<term>Current treatment</term>
<term>Cytotoxic drug</term>
<term>Disease activity</term>
<term>Disease activity index</term>
<term>Disease course</term>
<term>Disease process</term>
<term>Disease severity</term>
<term>Dmard</term>
<term>Dmards</term>
<term>Dos</term>
<term>Drug interactions</term>
<term>Early arthritis</term>
<term>Effective treatment</term>
<term>Efficacy</term>
<term>Erythrocyte sedimentation rate</term>
<term>Fluid retention</term>
<term>Full blood count</term>
<term>Functional capacity</term>
<term>Hydroxychloroquine</term>
<term>Individual patient characteristics</term>
<term>Inflammatory</term>
<term>Inflammatory process</term>
<term>Initial dose</term>
<term>Intramuscular administration</term>
<term>Little effect</term>
<term>Liver function tests</term>
<term>Maintenance dose</term>
<term>Methotrexate</term>
<term>Methylprednisolone acetate</term>
<term>Nonsteroidal</term>
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<term>Occular toxicity</term>
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<term>Parenteral gold</term>
<term>Peptic ulceration</term>
<term>Pincus</term>
<term>Potential role</term>
<term>Progressive disease</term>
<term>Pulmonary hypersensitivity</term>
<term>Radiographic evidence</term>
<term>Radiological progression</term>
<term>Rash</term>
<term>Relative toxicity</term>
<term>Renal</term>
<term>Renal failure</term>
<term>Renal function</term>
<term>Renal impairment</term>
<term>Resistant disease</term>
<term>Rheumatic</term>
<term>Rheumatic diseases</term>
<term>Rheumatic diseuses</term>
<term>Rheumatoid</term>
<term>Rheumatoid arthritis</term>
<term>Rheumatoid factor</term>
<term>Rheumatology</term>
<term>Second line drugs</term>
<term>Short term</term>
<term>Significant improvement</term>
<term>Steroid</term>
<term>Symptomatic relief</term>
<term>Therapeutic approach</term>
<term>Toxic</term>
<term>Toxic drugs</term>
<term>Toxicity</term>
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<term>Treatment duration</term>
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<div type="abstract" xml:lang="en">Over recent years the pharmacological treatment strategy for rheumatoid arthritis (RA) has changed. An early, aggressive approach has been adopted with a view to maintaining functional capacity. The changing role of nonsteroidal antiinflammatory agents is discussed in the light of the potential toxicity of this class of drugs. The current use of second‐line agents is dealt with in depth and includes guidelines to patient monitoring. Particular attention has been paid to the growing use of cyclosporin A in the treatment of RA as this drug represents the newest, most potent, nonexperimental form of treatment. The questions of when to introduce second‐line agents, who should receive treatment and how many drugs should be prescribed are all addressed in this review. The relative efficacy and toxicity of these agents is discussed and a treatment protocol is proposed.</div>
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