Maintien à 3 ans de la stratégie de décroissance des anti-TNF dans la polyarthrite rhumatoïde : suivi de l’étude randomisée et contrôlée STRASS (Spacing of TNF-blocker injections in Rheumatoid ArthritiS Study)

2016 ◽  
Vol 83 ◽  
pp. A68
Author(s):  
J. Sigaux ◽  
F. Bailly ◽  
F. Tubach ◽  
X. Mariette ◽  
J. Morel ◽  
...  
2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1147.1-1147
Author(s):  
A. Haddouche ◽  
K. Ait Bellabas ◽  
W. F. Hamrani ◽  
S. Sahraoui ◽  
R. Fatma ◽  
...  

Background:The management of rheumatoid arthritis refractory to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) is currently well codified and includes different types of biologics and even targeted sDMARDs. A rotation of biologic therapies is recommended in order to better control the disease.Methods:We report the case of a 20-year-old patient followed in our hospital for the management of a deforming and erosive seropositive rheumatoid arthritis (FR +, ACPA +) with a juvenile onset at the age of 8 years. The diagnosis of an immunopositive polyarticular form of JIA was retained in 2010 (9 years old); the patient was treated with methotrexate (MTX) at a dose of 10 mg per week and methylprednisolone at doses varying between 4 and 10 mg per day. Following the failure of MTX, etanercept was introduced for 6 months without success, followed by tocilizumab in 2012 at a dose of 8mg/kg/month for a year, without good response. In 2014, a course of rituximab (RTX) at a dose of 2 shots of 500mg, 2 weeks apart was prescribed followed 9 months later by etanercept at a dose of 50 mg a week for 3 years then by adalimumab (40mg/ week) because of the multiple treatment failures.In 2018, the repetition of RTX at a dose of 1g, renewed 15 days later, improved the patient for only 3 months. Then, a combination of two biologics, namely RTX (2 x 1g, 15 days apart) and adalimumab 1 month later (40mg / week) was received by the patient with a good response at 3 months. The latter was maintained for 7 months even after stopping the adalimumab following confinement for COVID-19. In September 2020, flares occurred and the adalimumab (ADA) has been delivered but without success during 3 months, stopped later for a benign form of COVID-19 (15 months after RTX). In January 2021, the association RTX + ADA was given again and we hope that it will be as effective as the first prescription.Results:The clinical and biological severity of our patient’s rheumatoid arthritis led us to give a combination of two biological treatments. Indeed, we do not have other therapeutic classes to deliver to her, that encouraged us to rotate between all the available biological therapies in our country. The combination of a CD20 inhibitor (RTX) with a TNF blocker (ADA) was safe and made possible, for the first time, the achievement of clinical and biological remission during 7 months, even after stopping the TNF blocker. Greenwald et al. reported the safety of the combination of RTX + TNF inhibitors in a randomized clinical trial in 51 patients. Its efficacy, a secondary goal of the study, was suggested at 24 weeks by the percentage of ACR 20 and ACR 50 responses that was greater than in the RTX placebo group.Conclusion:The combination of RTX with a TNF blocker can be a real alternative therapy in rheumatoid arthritis with failure to a biological monotherapy.Disclosure of Interests:None declared


2011 ◽  
Vol 18 (3) ◽  
pp. 161 ◽  
Author(s):  
Soo-Kyung Cho ◽  
Yoon-Kyoung Sung ◽  
Chan-Bum Choi ◽  
Wan-Sik Uhm ◽  
Tae-Hwan Kim ◽  
...  

2019 ◽  
Author(s):  
PRISCILA LUANA CORREIA GÜNTZEL ◽  
SAMANTA GERHARDT ◽  
EDUARDA ROVERE GRILL ◽  
VIVIANE TIMM ◽  
JEFFERSON BECKER ◽  
...  

2018 ◽  
Vol 6 (9) ◽  
pp. 616-619
Author(s):  
Hasna Jabri ◽  
◽  
Hajar Arfaoui ◽  
Wiam Elkhattabi ◽  
Hicham Afif ◽  
...  

2021 ◽  
Vol 8 (2) ◽  
pp. 162-164
Author(s):  
Fadia Rahal ◽  
◽  
Amina Mezari ◽  
Fella Hanni ◽  

La parodontite est la pathologie chronique inflammatoire caractérisée par une perte des tissus de soutien des dents. Plusieurs dizaines de pathologies systémiques dont la polyarthrite rhumatoïde (PR) sont possiblement associées à la parodontite. En effet, les caractéristiques cliniques et la physiopathogénie de la PR possèdent de grandes similarités avec celles de la parodontite. PR et parodontite partagent des facteurs de risque communs tels que des susceptibilités génétiques et des facteurs environnementaux. Bien que l’impact du traitement de la PR sur la parodontite et vis-versa reste à établir, une bonne hygiène bucco-dentaire fait partie intégrante de la prise en charge de la PR et les praticiens doivent inciter leurs patients à y veiller pour leur propre santé.


2020 ◽  
Vol 87 (3) ◽  
pp. 226-228
Author(s):  
Khai-Jing Ng ◽  
Kuang-Yung Huang ◽  
Chien-Hsueh Tung ◽  
Bao-Bao Hsu ◽  
Cheng-Han Wu ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document