Serum concentrations of piroxicam in patients with rheumatoid arthritis on long-term treatment with ampiroxicam.

Objective To evaluate safety and efficacy of long-term denosumab 60 mg every 6 (Q6M) or 3 months (Q3M) in rheumatoid arthritis (RA) patients. Methods This 12-month, randomised, double-blind, placebo-controlled, multicentre phase 3 trial with an open-label extension period from 12 to 36 months (DESIRABLE) enrolled Japanese RA patients treated with placebo for 12 months then denosumab Q6M (P/Q6M) or denosumab Q3M (P/Q3M); denosumab Q6M for 36 months (Q6M/Q6M); or denosumab Q3M for 36 months (Q3M/Q3M). Efficacy was assessed by van der Heijde modified total Sharp (mTSS), bone erosion (ES), and joint space narrowing (JSN) scores. Results Long-term treatment better maintained mTSS and ES suppression in the P/Q3M and Q3M/Q3M versus P/Q6M and Q6M/Q6M groups; changes from baseline in total mTSS at 36 months were 2.8 (standard error 0.4), 1.7 (0.3), 3.0 (0.4), and 2.4 (0.3), respectively; corresponding changes in ES were 1.3 (0.2), 0.4 (0.2), 1.4 (0.2), and 1.1 (0.2). No JSN effect was observed. Bone mineral density consistently increased in all groups after denosumab initiation, regardless of concomitant glucocorticoid administration. Serum C-telopeptide of type I collagen decreased rapidly at 1-month post-denosumab administration (both in the initial 12- month [Q3M, Q6M groups] and long-term treatment [P/Q3M, P/Q6M groups] phases). Adverse event incidence leading to study drug discontinuation was similar across treatment groups. Conclusion Denosumab treatment maintained inhibition of progression of joint destruction up to 36 months. Based on effects on ES progression, higher dosing frequency at an earlier treatment stage may be needed to optimise treatment. Denosumab was generally well tolerated.

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Long term treatment of rheumatoid arthritis with rituximab

Autoimmunity Reviews ◽

10.1016/j.autrev.2009.02.008 ◽

2009 ◽

Vol 8 (7) ◽

pp. 591-594 ◽

Cited By ~ 26

Author(s):

Roberto Caporali ◽

Marta Caprioli ◽

Francesca Bobbio-Pallavicini ◽

Serena Bugatti ◽

Carlomaurizio Montecucco

Keyword(s):

Rheumatoid Arthritis ◽

Term Treatment ◽

Long Term Treatment

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Slower Elimination of Tofacitinib in Acute Renal Failure Rat Models: Contribution of Hepatic Metabolism and Renal Excretion

Pharmaceutics ◽

10.3390/pharmaceutics12080714 ◽

2020 ◽

Vol 12 (8) ◽

pp. 714

Author(s):

Sung Hun Bae ◽

Sun-Young Chang ◽

So Hee Kim

Keyword(s):

Rheumatoid Arthritis ◽

Renal Failure ◽

Acute Renal Failure ◽

Hepatic Metabolism ◽

Term Treatment ◽

Concentration Time ◽

Long Term Treatment ◽

Total Body ◽

Body Clearance

Tofacitinib is a Jak inhibitor developed as a treatment for rheumatoid arthritis. Tofacitinib is metabolized mainly through hepatic CYP3A1/2, followed by CYP2C11. Rheumatoid arthritis tends to increase renal toxicity due to drugs used for long-term treatment. In this study, pharmacokinetic changes of tofacitinib were evaluated in rats with gentamicin (G-ARF) and cisplatin-induced acute renal failure (C-ARF). The time-averaged total body clearance (CL) of tofacitinib in G-ARF and C-ARF rats after 1-min intravenous infusion of 10 mg/kg was significantly decreased by 37.7 and 62.3%, respectively, compared to in control rats. This seems to be because the time-averaged renal clearance (CLR) was significantly lower by 69.5 and 98.6%, respectively, due to decreased creatinine clearance (CLCR). In addition, the time-averaged nonrenal clearance (CLNR) was also significantly lower by 33.2 and 57.4%, respectively, due to reduction in the hepatic CYP3A1/2 and CYP2C11 subfamily in G-ARF and C-ARF rats. After oral administration of tofacitinib (20 mg/kg) to G-ARF and C-ARF rats, both CLR and CLNR were also significantly decreased. In conclusion, an increase in area under plasma concentration-time curves from time zero to time infinity (AUC) of tofacitinib in G-ARF and C-ARF rats was due to the significantly slower elimination of tofacitinib contributed by slower hepatic metabolism and urinary excretion of the drug.

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89. Influence of Immunogenicity on the Efficacy of Long-Term Treatment of Rheumatoid Arthritis with Adalimumab: A UK-Based Prospective Study

Rheumatology ◽

10.1093/rheumatology/keu101.010 ◽

2014 ◽

Vol 53 (suppl_1) ◽

pp. i89-i90

Author(s):

Meghna Jani ◽

Hector Chinoy ◽

Richard B. Warren ◽

Christopher E. M. Griffiths ◽

Ann W. Morgan ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Prospective Study ◽

Term Treatment ◽

Long Term Treatment

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The Frequency of Coronary Heart Disease and Myocardial Infarction in Patients with Rheumatoid Arthritis

10.1055/s-0039-1689616 ◽

1975 ◽

Author(s):

S. Czaplicki ◽

J. Gietka ◽

K. Sulek

Keyword(s):

Rheumatoid Arthritis ◽

Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Normal Population ◽

Term Treatment ◽

Coronary Risk Factors ◽

Long Term Treatment ◽

Adhesion Of Platelets

The frequency of coronary heart disease and myocardial infarction in 500 persons with rheumatoidearthritis (116 men and 384 women) receiving salicylates during long period time were examined. Coronary heart disease in 2 cases (1 man and 1 woman) and myocardial infarction in 1 man were found.On the basis of the age and duration observations the authors discovered that the coefficient morbidity was statistically significant lower than in the same population but without rheumatoid arthritis. The coronary risk factors as hypertenia arterialis, hyper-cholestrolemia and diabetes was less frequent than in normal population too. The cigarettes smoking and obesity were found equally frequent.The authors suggested that long term treatment with acetylsalicylic acid effects inhibition adhesion of platelets and in this way protects before arterial thrombosis and may be artherosclerosis.

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