Psoriasis-Arthritis und Spondyloarthritiden: Treat-to-target, Tight control und neue Therapien

2017 ◽  
Vol 142 (03) ◽  
pp. 201-204 ◽  
Author(s):  
Martin Rudwaleit
Keyword(s):  
Treat To Target ◽  
Tight Control ◽  
Psoriasis Arthritis

scholarly journals Serum biomarkers confirming stable remission in inflammatory bowel disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christoph Kessel ◽  
Miha Lavric ◽  
Toni Weinhage ◽  
Markus Brueckner ◽  
Sytze de Roock ◽  
...  
Keyword(s):  
Disease Control ◽  
Serum Biomarkers ◽  
Treat To Target ◽  
Optimal Management ◽  
Tight Control ◽  
Follow Up Study ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel

AbstractCrohn's disease (CD) and ulcerative colitis (UC) have a chronic-remittent course. Optimal management of inflammatory bowel diseases (IBD) relies on early intervention, treat-to-target strategies and a tight disease control. However, it is challenging to assess the risk of relapses in individual patients. We investigated blood-based biomarkers for the confirmation of disease remission in patients with IBD. We retrospectively analyzed samples of 40 IBD patients (30 UC, 10 CD) enrolled in a tight-control follow-up study. Half of the patients had a flare during follow up. Serum was analyzed for S100A12 as well as S100A8/A9 and for 50 further biomarkers in a bead-based multiplex assay. The concentrations of 9 cytokines/chemokines and S100A8/A9 significantly differed in IBD patients with unstable remission (before flares) when compared to IBD patients with stable remission. Although the number of patients was small, ROC curve analyses revealed a number of biomarkers (IL-1β, IL-1RA, IL-8, IL13, IL-15, IL-21, IL-25, IFN-β, CXCL9, CXCL10, CXCL11, Galectin-1, G-CSF and S100A8/A9) that were elevated in patients with later occurring relapses. While earlier studies on peripheral biomarkers in IBD are limited to only few analytes, our study using a broad screening approach identified serum biomarkers with the potential to indicate unstable disease control in IBD, which may help to steer individual therapies to maintain remission.

scholarly journals Efficacy of glucocorticoids, conventional and targeted synthetic disease-modifying antirheumatic drugs: a systematic literature review informing the 2016 update of the EULAR recommendations for the management of rheumatoid arthritis

2017 ◽  
Vol 76 (6) ◽  
pp. 1102-1107 ◽  
Author(s):  
Katerina Chatzidionysiou ◽  
Sharzad Emamikia ◽  
Jackie Nam ◽  
Sofia Ramiro ◽  
Josef Smolen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Treat To Target ◽  
Tight Control ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Eular Recommendations ◽  
Synthetic Dmards ◽  
Disease Modifying

ObjectivesTo perform a systematic literature review (SLR) informing the 2016 update of the recommendations for the management of rheumatoid arthritis (RA).MethodsAn SLR for the period between 2013 and 2016 was undertaken to assess the efficacy of glucocorticoids (GCs), conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and targeted synthetic DMARDs (tsDMARDs) (tofacitinib and baricitinib) in randomised clinical trials.ResultsFor GCs, four studies were included in the SLR. Patients without poor prognostic factors experienced benefit when GCs were added to methotrexate (MTX). Lower doses of GCs were similar to higher doses. For csDMARDs, two new studies comparing MTX monotherapy with combination csDMARD were included in the SLR. In the tREACH trial at the end of 12 months no difference between the groups in disease activity, functional ability and radiographic progression was seen, using principles of tight control (treat-to-target). In the CareRA trial, combination therapy with csDMARDs was not superior to MTX monotherapy and monotherapy was better tolerated.For tsDMARDs, tofacitinib and baricitinib were shown to be more effective than placebo (MTX) in different patient populations.ConclusionsAddition of GCs to csDMARD therapy may be beneficial but the benefits should be balanced against the risk of toxicity. Under tight control conditions MTX monotherapy is not less effective than combination csDMARDs, but better tolerated. Tofacitinib and baricitinib are efficacious in patients with RA, including those with refractory disease.

scholarly journals Evolving therapeutic goals in Crohn's disease management

2019 ◽  
Vol 8 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Thomas Chateau ◽  
Laurent Peyrin-Biroulet
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Treat To Target ◽  
Close Monitoring ◽  
Tight Control ◽  
Early Disease ◽  
Therapeutic Goals ◽  
Full Remission ◽  
Endoscopic Remission

Summary The main objectives in Crohn's disease are to avoid disease complications and preserve the patient's quality of life. Early disease control and close monitoring with specific targets to reach might be the only way to change the disease course. In two decades, we have moved from clinical response to full remission (clinical and endoscopic remission) requiring a tight monitoring of both symptoms and objective signs of inflammation. This review summarizes the concepts of tight control and treat-to-target and their potential for disease modification.

Spondyloarthritis

2019 ◽  
Vol 44 (05) ◽  
pp. 285-285
Author(s):  
Martin Rudwaleit
Keyword(s):  
Treat To Target ◽  
Psoriasis Arthritis

Die letzten beiden Dekaden bedeuteten für die Gruppe der Spondyloarthritiden einschließlich der Psoriasis-Arthritis einen Durchbruch in allen Bereichen dieser Erkrankungsgruppe: im Verständnis genetischer und pathophysiologischer Vorgänge, des klinischen Verlaufs, der Diagnostik und Klassifikation, der Bildgebung und neuer und effektiver Therapiemöglichkeiten bis hin zu einem Treat-to-Target Konzept. Auf diese neuen Erkenntnisse wird im vorliegenden Themenband durch namhafte Autoren umfassend und aktuell eingegangen.

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