scholarly journals Persistence on biologic DMARD monotherapy after achieving rheumatoid arthritis disease control on combination therapy: retrospective analysis of corrona registry data

2020 ◽  
Author(s):  
Dimitrios A. Pappas ◽  
Heather J. Litman ◽  
Tamara Lesperance ◽  
Greg Kricorian ◽  
Elaine Karis ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Disease Control ◽  
Retrospective Analysis ◽  
Registry Data ◽  
Rheumatoid Arthritis Disease ◽  
Biologic Dmard

scholarly journals A Review on Comparison of Effectiveness and Safety of Disease Modifying Anti-Rheumatoid Drugs Used in Patients with Rheumatoid Arthritis

2020 ◽  
Vol 10 (6) ◽  
pp. 207-212
Author(s):  
P.P. Muhamed Faris ◽  
K. Sreejith ◽  
B. Athulnadh ◽  
K.V. Musaina Thasneem ◽  
Cherakkulath C Neena ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
English Language ◽  
Cochrane Library ◽  
Triple Combination Therapy ◽  
Biological Dmards ◽  
Rheumatoid Arthritis Disease ◽  
Synthetic Agents ◽  
Synthetic Dmards ◽  
Disease Modifying

Objective: To compare the safety and effectiveness of monotherapy as well as combination therapy with disease modifying anti rheumatoid drugs (DMARDs) in rheumatoid arthritis patients. Data sources: Study works limited to the English language and more concentrated to adults by using Google Scholar, PubMed and The Cochrane library. Summary: Some head to head trial works, retrospective studies and prospective cohort studies were used to compare the safety and effectiveness of the therapy. Here we go through the comparison in between each disease modifying anti rheumatoid drug (DMARD) monotherapy, combination with monotherapy and also combination with combination therapy. Conclusion: Among the synthetic DMARDs monotherapy, methotrexate would be the preferred DMARD. Biological DMARDs have more efficacy than synthetic agents and have comparable safety profile. Rituximab would be the preferred agent among the bDMARDs. Since synthetic agents are more economical as compared to biologicals, hence these are preferred over biological agents. Combinations of biological DMARDs with methotrexate have improved efficacy and safety than methotrexate monotherapy. Combination of biological DMARDs have no advantage over biological monotherapy, there was an increased safety risk and no therapeutic benefit. Combination of biological DMARDs with methotrexate have better efficacy than monotherapy with either bDMARDs or methotrexate alone. A triple combination therapy of synthetic DMARDs (methotrexate, sulfasalazine and hydroxychloroquine) had better safety, effectiveness and high tolerability than double combination therapy or monotherapy. Keywords: Rheumatoid arthritis, disease modifying antirheumatoid drugs

scholarly journals Molecular remission at T cell level in patients with rheumatoid arthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jun Inamo ◽  
Katsuya Suzuki ◽  
Masaru Takeshita ◽  
Yasushi Kondo ◽  
Yuumi Okuzono ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
T Cells ◽  
T Cell ◽  
Disease Control ◽  
Expression Profiling ◽  
Molecular Mechanisms ◽  
Principal Component ◽  
Cell Level ◽  
Molecular Remission ◽  
Signature Genes

AbstractWhile numerous disease-modifying anti-rheumatic drugs (DMARDs) have brought about a dramatic paradigm shift in the management of rheumatoid arthritis (RA), unmet needs remain, such as the small proportion of patients who achieve drug-free status. The aim of this study was to explore key molecules for remission at the T cell level, which are known to be deeply involved in RA pathogenesis, and investigate the disease course of patients who achieved molecular remission (MR). We enrolled a total of 46 patients with RA and 10 healthy controls (HCs). We performed gene expression profiling and selected remission signature genes in CD4+ T cells and CD8+ T cells from patients with RA using machine learning methods. In addition, we investigated the benefits of achieving MR on disease control. We identified 9 and 23 genes that were associated with clinical remission in CD4+ and CD8+ T cells, respectively. Principal component analysis (PCA) demonstrated that their expression profiling was similar to those in HCs. For the remission signature genes in CD4+ T cells, the PCA result was reproduced using a validation cohort, indicating the robustness of these genes. A trend toward better disease control was observed during 12 months of follow-up in patients treated with tocilizumab in deep MR compared with those in non-deep MR, although the difference was not significant. The current study will promote our understanding of the molecular mechanisms necessary to achieve deep remission during the management of RA.

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