Evidence Needed for Efficacy of Antidepressant Medications Among Patients With Rheumatoid Arthritis

Annals of Pharmacotherapy ◽

10.1177/10600280211062271 ◽

2022 ◽

pp. 106002802110622

Author(s):

Armando Silva Almodóvar ◽

Dung Nguyen ◽

Milap C. Nahata

Keyword(s):

Rheumatoid Arthritis ◽

Tricyclic Antidepressants ◽

Joint Destruction ◽

Future Research ◽

Efficacy And Safety ◽

Comorbid Conditions ◽

Antidepressant Medications ◽

Norepinephrine Reuptake ◽

Experience Pain

Patients with rheumatoid arthritis (RA) experience pain from inflammation, joint destruction, and neuropathy. Antidepressants may play a role among patients with RA and depression, fibromyalgia, or neuropathy to achieve desired outcomes. This commentary evaluated evidence for medications individually and identified important variables for future research. While we await the results of well-designed studies, a trial of duloxetine or milnacipran may be considered for patients with remnant pain and RA remission. Research is needed to evaluate the efficacy and safety of serotonin–norepinephrine reuptake inhibitors and tricyclic antidepressants in patients with RA and associated comorbid conditions.

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Etanercept therapy in rheumatoid arthritis: Efficacy and safety

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1308495i ◽

2013 ◽

Vol 141 (7-8) ◽

pp. 495-502

Author(s):

Tatjana Ilic ◽

Biljana Milic ◽

Dejan Celic ◽

Biljana Vuckovic ◽

Igor Mitic

Keyword(s):

Rheumatoid Arthritis ◽

Joint Destruction ◽

Life Quality ◽

Activity Level ◽

Inadequate Response ◽

Efficacy And Safety ◽

Etanercept Therapy ◽

Acr20 Response ◽

Clinically Significant ◽

High Level

Introduction. Etanercept, tumor necrosis factor (TNF?) antagonist, lowers the disease activity level in patients with rheumatoid arthritis (RA), reduces joint destruction saving physical functions and improving life quality. Objective. The aim of this study was to establish efficacy and safety of etanercept in combination with disease modifying antirheumatic drugs (DMARDs) in the treatment of RA. Methods. To patients with active RA, who were on therapy with DMARD, etanercept was introduced in weekly doses of 50 mg, with continuation of DMARD. Efficacy of this form of treatment was evaluated in the 12th week. Maintenance of the effect of treatment was also evaluated during 24, 48 and 96 weeks. Long term evaluation of etanercept safety was assessed by registering all unwanted events during a two year period. Results. After 12 weeks of treatment with etanercept, 80% of patients had ACR20 response, while 85% showed clinically significant decrease of DAS28 index. We achieved remission in five patients (12.5%) and low activity of RA in 17 patients (42.5%). During a 96week of followup period, achieved therapy effects were maintained. In four patients (10%) etanercept therapy was interrupted after 24 weeks because of inadequate response. In one of them (2.5%) we recorded a cardiovascular incident. Acute infections were registered in 47 cases. Four of those were severe infections. Neither cases of malignancy development were noted, nor were there any lethal disease outcomes. Conclusion. Etanercept in combination with DMARD shows a high level of efficacy in the treatment of RA. The safety profile of the drug is satisfactory.

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Management of Rheumatoid Arthritis: An Overview

Cells ◽

10.3390/cells10112857 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2857

Author(s):

Andrei-Flavius Radu ◽

Simona Gabriela Bungau

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Status ◽

Future Research ◽

Unknown Etiology ◽

Pathophysiological Mechanism ◽

Efficacy And Safety ◽

Systemic Complications ◽

Synthetic Drugs ◽

Research Perspectives ◽

Medical Advances

Rheumatoid arthritis (RA) is a multifactorial autoimmune disease of unknown etiology, primarily affecting the joints, then extra-articular manifestations can occur. Due to its complexity, which is based on an incompletely elucidated pathophysiological mechanism, good RA management requires a multidisciplinary approach. The clinical status of RA patients has improved in recent years due to medical advances in diagnosis and treatment, that have made it possible to reduce disease activity and prevent systemic complications. The most promising results were obtained by developing disease-modifying anti-rheumatic drugs (DMARDs), the class to which conventional synthetic, biologic, and targeted synthetic drugs belong. Furthermore, ongoing drug development has led to obtaining molecules with improved efficacy and safety profiles, but further research is needed until RA turns into a curable pathology. In the present work, we offer a comprehensive perspective on the management of RA, by centralizing the existing data provided by significant literature, emphasizing the importance of an early and accurate diagnosis associated with optimal personalized treatment in order to achieve better outcomes for RA patients. In addition, this study suggests future research perspectives in the treatment of RA that could lead to higher efficacy and safety profiles and lower financial costs.

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Efficacy and safety of sarilumab in combination with methotrexate in patients with active rheumatoid arthritis and inadequate effect of methotrexate monotherapy (results of phase III MOBILITY study)

Rheumatology Science and Practice ◽

10.14412/1995-4484-2019-142-148 ◽

2019 ◽

Vol 57 (2) ◽

pp. 142-148 ◽

Cited By ~ 4

Author(s):

E. L. Nasonov ◽

M. L. Stanislav ◽

T. A. Raskina ◽

G. V. Kuropatkin ◽

I. V. Shirinsky ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Joint Destruction ◽

Phase Iii ◽

Efficacy And Safety ◽

Acr20 Response ◽

Radiographic Outcomes ◽

Primary Endpoints ◽

Average Change ◽

Modified Total Sharp Score ◽

Mobility Study

Objective: to study the efficacy and safety of rheumatoid arthritis (RA) treatment with monoclonal antibodies to interleukin 6 receptors (IL6R) – sarilumab (SAR) in combination with methotrexate (MT).Subjects and methods. The study included adult patients with moderate or severe RA and inadequate effect of MT monotherapy. Patients were randomized in a 1:1:1 ratio to subgroups receiving SAR (at doses of 150 or 200 mg) or placebo (PL) every 2 weeks in combination with a weekly intake of MT for 52 weeks. The primary endpoints of the study included the achievement of ACR20 after 24 weeks, the change of HAQ-DI after 16 weeks and assessment of radiological progression of joint destruction (modified total Sharp score mTSS) after 52 weeks.Results and discussion. In general, the initial characteristics of patients were similar in all groups. A statistically significant improvement of all three primary endpoints was found in the groups of patients treated with SAR 150 and 200 mg compared to the group of PL. ACR20 response after 24 weeks was achieved in 53.6% (p<0.0005), 65.9 and 19.6% of patients respectively (p<0.0001), the average change in HAQ-DI after 16 weeks was 20.53; 20.55 and 20.29 respectively (p<0.0001); the average change in mTSS after 52 weeks was 0.49; 0.11 and 2.30, respectively (p<0.0001).Conclusion. Both doses of SAR (150 and 200 mg every 2 weeks) in combination with MT demonstrated sustained clinical efficacy in patients with RA, which was confirmed by a significant improvement in symptomatic, functional and radiographic outcomes. SAR therapy was generally well tolerated. The adverse events observed in this study were consistent with the effects of the IL6 blockade.

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Mapping Knowledge Structure and Themes Trends of Osteoporosis in Rheumatoid Arthritis: A Bibliometric Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.787228 ◽

2021 ◽

Vol 8 ◽

Author(s):

Haiyang Wu ◽

Kunming Cheng ◽

Qiang Guo ◽

Weiguang Yang ◽

Linjian Tong ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Western Europe ◽

Joint Destruction ◽

Knowledge Structure ◽

The United States ◽

Cartilage Destruction ◽

Future Research ◽

Comprehensive Overview ◽

Bibliometric Method ◽

Research Issues

Background: Rheumatoid arthritis is a chronic disabling disease characterized by chronic inflammation, articular cartilage destruction, and reduced bone mass. Multiple studies have revealed that the development of osteoporosis in rheumatoid arthritis (RA; ORA) patients could be led to a reduced quality of life and increased healthcare costs. Nevertheless, no attempt has been made to analyze the field of ORA research with the bibliometric method. This study aimed to provide a comprehensive overview of the knowledge structure and theme trends in the field of ORA research from a bibliometric perspective.Methods: Articles and reviews regarding ORA from 1998 to 2021 were identified from the Web of Science database. An online bibliometric platform, CiteSpace, and VOSviewer software were used to generate visualization knowledge maps including co-authorship, co-citation, and co-occurrence analysis. SPSS, R, and Microsoft Excel software were used to conduct curve fitting and correlation analysis, and to analyze quantitative indicators, such as publication and citation counts, h-index, and journal citation reports.Results: A total of 1,081 papers with 28,473 citations were identified. Publications were mainly concentrated in North America, Western Europe, and Eastern Asia. Economic strength is an important factor affecting scientific output. The United States contributed the most publications (213) with the highest h-index value (46) as of September 14, 2021. Diakonhjemmet Hospital and professor Haugeberg G were the most prolific institution and influential authors, respectively. Journal of Rheumatology was the most productive journal concerning ORA research. According to the burst references, “anti-citrullinated protein antibodies” and “preventing joint destruction” have been recognized as the hot research issues in the domain. The keywords co-occurrence analysis identified “teriparatide,” “interleukin-6,” “Wnt,” and “vertebral fractures” as the important future research directions.Conclusion: This was the first bibliometric study comprehensively summarizing the trends and development of ORA research. Our findings could offer practical sources for scholars to understand the key information in this field, and identify the potential research frontiers and hot directions in the near future.

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