scholarly journals Rheumatoid arthritis: a joint venture

2020 ◽  
pp. 193-195
Author(s):  
E Potgieter
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Venture ◽  
Functional Disability ◽  
Joint Destruction ◽  
Developed Countries ◽  
Western World ◽  
Inflammatory Disorder ◽  
Full Time ◽  
Industrialised Countries ◽  
Full Time Employment

Rheumatoid arthritis (RA) is a chronic auto-immune inflammatory disorder, usually affecting the joints. Its prevalence is estimated at 0.3–1% in industrialised countries and areas of urban living. RA leads to functional disability, significant pain and joint destruction, and subsequent loss of income: in developed countries half of people diagnosed with RA are unable to sustain full-time employment ten years after diagnosis. It also carries substantial cardiovascular risk if inadequately treated. RA is possibly the largest cause of treatable disability in the Western World. The exact prevalence of RA in South Africa is currently not known, but its significant impact is compounded by frequent late diagnoses and a scarcity of treating specialists.

scholarly journals Outcomes in rheumatoid arthritis patients treated with abatacept: a UK multi-centre observational study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ernest Choy ◽  
Lara Groves ◽  
Daniel Sugrue ◽  
Michael Hurst ◽  
John Houghton ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Observational Study ◽  
Medical Records ◽  
Functional Disability ◽  
Joint Destruction ◽  
Treatment Patterns ◽  
Chronic Synovitis ◽  
Line Of Therapy ◽  
The Uk ◽  
Inflammatory Autoimmune Disease

Abstract Background Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes chronic synovitis, resulting in progressive joint destruction and functional disability and affects approximately 400,000 people in the UK. This real-world study aimed to describe the characteristics, treatment patterns and clinical outcomes of patients who received abatacept in UK clinical practice. Methods This was a multi-centre, retrospective, observational study of patients with RA treated with abatacept at four UK centres between 01 January 2013 and 31 December 2017. Data were collected from medical records of each patient from the index date (date of first bDMARD initiation) until the most recent visit, death or end of study (31 December 2017). Results In total, 213 patients were included in the study. Patients received up to eight lines of therapy (LOTs). Treatment with abatacept, or any other bDMARD, was associated with reductions in DAS28-ESR and DAS28-CRP scores at 6 and 12 months. The distribution of EULAR responses (good/moderate/no response) tended to be more favourable for patients when receiving abatacept than when receiving other bDMARDs (22.8%/41.3%/35.9% versus 16.6%/41.4%/42.1% at 6 months, and 27.9%/36.1%/36.1% versus 21.2%/34.5%/44.2% at 12 months). Patients receiving abatacept at LOT1 (n = 68) spent significantly longer on treatment compared with patients receiving other bDMARDs (53.4 vs. 17.4 months; p< 0.01); a similar trend was observed for LOT2. Among patients who discontinued after 6 months, a greater proportion experienced infection requiring antibiotics when receiving other bDMARDs compared to those receiving abatacept. Conclusions RA patients who received bDMARDs, including abatacept, experienced reduced disease activity. When receiving abatacept as first or second line of therapy, patients persisted with treatment significantly longer than those receiving other bDMARDs.

scholarly journals Smart Drug-Delivery Systems in the Treatment of Rheumatoid Arthritis: Current, Future Perspectives

2021 ◽  
Author(s):  
Largee Biswas ◽  
Vikas Shukla ◽  
Vijay Kumar ◽  
Anita Kamra Verma
Keyword(s):  
Rheumatoid Arthritis ◽  
Drug Delivery ◽  
Drug Delivery Systems ◽  
Folate Receptor ◽  
Joint Destruction ◽  
Delivery Systems ◽  
Inflammatory Disorder ◽  
Emerging Trends ◽  
Smart Drug ◽  
Smart Drug Delivery

Rheumatoid arthritis (RA) is a progressive autoimmune inflammatory disorder characterized by cellular infiltration in synovium causing joint destruction and bone erosion. The heterogeneous nature of the disease manifests in different clinical forms, hence treatment of RA still remains obscure. Treatments are limited owing to systemic toxicity by dose-escalation and lack of selectivity. To overcome these limitations, Smart drug delivery systems (SDDS) are under investigation to exploit the arthritic microenvironment either by passive targeting or active targeting to the inflamed joints via folate receptor, CD44, angiogenesis, integrins. This review comprehensively deliberates upon understanding the pathophysiology of RA and role of SDDSs, highlighting the emerging trends for RA nanotherapeutics.

scholarly journals Rheumatoid Arthritis Management for General Internists

2016 ◽  
Vol 8 ◽  
Author(s):  
Mitchell Uh MD FRCPC ◽  
David Collins MD FRCPC ABIM
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Joint Destruction ◽  
Morbidity And Mortality ◽  
Inflammatory Disorder ◽  
General Internists ◽  
Canadian Population ◽  
Increased Risk ◽  
Significant Disability

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that causes progressive joint destruction, deformity, and significant disability. In addition to arthritis, RA is associated with numerous extra-articular features with attendant morbidity and mortality. These include but are not limited to ocular inflammation, interstitial lung disease, pleuropericardial disease, vasculitis, accelerated atherosclerosis, and increased risk of lymphoma. The prevalence of RA in the Canadian population is approximately 1%.

scholarly journals Probiotic Supplementation for Rheumatoid Arthritis: A Promising Adjuvant Therapy in the Gut Microbiome Era

2021 ◽  
Vol 12 ◽  
Author(s):  
Margarida Ferro ◽  
Sofia Charneca ◽  
Eduardo Dourado ◽  
Catarina Sousa Guerreiro ◽  
João Eurico Fonseca
Keyword(s):  
Rheumatoid Arthritis ◽  
Adjuvant Therapy ◽  
Functional Disability ◽  
Current Knowledge ◽  
Joint Destruction ◽  
Current Evidence ◽  
Fermented Foods ◽  
Probiotic Supplementation ◽  
Chronic Inflammatory Response

Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease that ultimately leads to joint destruction and functional disability. Although the exact etiology of RA is not fully understood, it is well established that gut microbiota (GM) plays a vital role in the pathogenesis of RA, with accumulating evidence suggesting that gut dysbiosis induces a chronic inflammatory response that may be linked to disease development. Of interest, patients with RA have significant changes in the intestinal microbiota compared to healthy controls, and several studies have suggested the use of probiotics as a possible adjuvant therapy for RA. Benefits of probiotic supplementation were reported in animal models of arthritis and human studies, but the current evidence regarding the effect of probiotic supplementation in the management of RA remains insufficient to make definite recommendations. Several different strains of Lactobacillus and Bifidobacteria, as single species or in mixed culture, have been investigated, and some have demonstrated beneficial effects on disease activity in RA human subjects. As of now, L.casei probiotic bacteria seems to be the strongest candidate for application as adjuvant therapy for RA patients. In this review, we highlight the role of GM in the development and progression of RA and summarize the current knowledge on the use of probiotics as a potential adjuvant therapy for RA. We also review the proposed mechanisms whereby probiotics regulate inflammation. Finally, the role of fermented foods is discussed as a possible alternative to probiotic supplements since they have also been reported to have health benefits.

scholarly journals Comprehensive Review on Ayurvedic Formulations and Herbal Medicines for Treatment of Rheumatoid Arthritis

2021 ◽  
Vol 23 (07) ◽  
pp. 772-790
Author(s):  
Farha Sultana ◽  
◽  
Bhavika Arora ◽  
Sandeep Arora ◽  
Rakesh K. Sindhu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Destruction ◽  
Herbal Medicines ◽  
Inflammatory Disorder ◽  
Infectious Agents ◽  
Genetic Changes ◽  
First Choice ◽  
Environmental Agents ◽  
Herbal Therapies ◽  
Cartilage Erosion

Rheumatoid arthritis, an autoimmune inflammatory disorder is characterized by progressive cartilage erosion leading to joint destruction, pain, stiffness, and swelling. Although the etiology of the disease is unknown, genetic changes due to factors such as environmental agents, immune response towards infectious agents influence rheumatoid arthritis. Earlier NSAIDs were the first choice of drugs for the treatment of disease but due to having certain side effects and limitations, herbal therapies which possess higher efficacy and safety are now in demand. There are hundreds of plants that have phytoconstituents that exhibit anti-inflammatory activity. A combination of plants is used to make polyherbal formulations that act synergistically to give anti-arthritic activity. The review is about the botanicals and traditional formulations which have been clinically tested for the treatment of Rheumatoid arthritis.

THU0212 FIRST LINE TREATMENT WITH CONVENTIONAL SYNTHETIC DISEASE MODIFYING ANTIRHEUMATIC DRUGS IN RHEUMATOID ARTHRITIS: A MULTINATIONAL POPULATION-BASED COHORT FROM 14 REAL WORLD HEALTHCARE DATABASES AND 9 COUNTRIES - REALITY VERSUS GUIDELINES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 331.1-331
Author(s):  
A. G. Sena ◽  
D. Granados ◽  
N. Hughes ◽  
W. Fakhouri ◽  
A. Hottgenroth ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Real World ◽  
Common Data Model ◽  
Full Time ◽  
First Line ◽  
Research Support ◽  
First Line Therapy ◽  
Line Therapy ◽  
Deutschland Gmbh ◽  
Full Time Employment

Background:Treatment guidelines recommend early initiation of csDMARDs following diagnosis of rheumatoid arthritis (RA), with methotrexate (MTX) as first-line therapy. Scarce evidence exists on adherence to this guidanceObjectives:To characterize first-line csDMARD treatment during the first year following an RA diagnosis.Methods:14 real world databases (3 Primary care, 6 primary/secondary care records, 5 claims) from 9 countries were included, all mapped to the OMOP common data model.Patients were included on the earliest event of: 1st diagnosis of RA or 1st DMARD prescription with an RA diagnosis within 30 days. Patients were >18 years-old, required 1+ year pre-index data, and at least 1-year follow-up. Study period covered 2000-2018. Previous users of DMARDs or non-RA inflammatory arthritis history were excluded. Only MTX, Hydroxychloroquine (HCQ), Sulfasalazine (SSZ) and Leflunomide (LEF) were available in all databases.Results:We identified 323,547 eligible participants. Large variation was observed internationally (Figure 1). MTX as first-line monotherapy ranged from 33.3% to 74.5%, and in combination with HCQ from 2.1% to 6.7%. Three additional csDMARDs were used as first-line: HCQ in 10.1% to 30.2%, SSZ in 0.9% to 28.7%, and LEF in 1.8% to 15.2%.Figure 1.First line csDMARD treatment during 1yr from first observed RA diagnosisConclusion:We report wide heterogeneity of first-line csDMARDs regimens internationally. Despite recommendations for MTX to be first line therapy, data suggest that a large proportion of patients receive alternative csDMARD.Disclosure of Interests: :Anthony G Sena Shareholder of: J&J shares, Grant/research support from: Full-time employment salary from Janssen, Consultant of: Full-time employment salary from Janssen, Employee of: Janssen employee, Paid instructor for: Janssen employee, Speakers bureau: Janssen employee, Denis Granados: None declared, Nigel Hughes Shareholder of: J&J shares, Grant/research support from: Full-time employment salary from Janssen, Consultant of: Janssen employee, Employee of: Janssen employee, Paid instructor for: Janssen employee, Speakers bureau: Janssen employee, WALID FAKHOURI Shareholder of: E Lilly Shares, Employee of: Eli Lilly and Company, Antje Hottgenroth Shareholder of: Eli Lilly shares, Employee of: Lilly Deutschland GmbH, Raivo Kolde: None declared, Sulev Reisberg: None declared, Carmen Olga Torre: None declared, Talita Duarte-Salles: None declared, Yesika Díaz: None declared, Jose Felipe Golib-Dzib Grant/research support from: Full-time employment salary from Janssen, Employee of: Yes, Janssen employee, Paid instructor for: Janssen Employee, Speakers bureau: Janssen Employee, Emily S. Brouwer Shareholder of: J&J shares, Takeda shares, Grant/research support from: Full-time employment salary from Janssen, Consultant of: Janssen employee, Employee of: Janssen employee, Paid instructor for: Janssen Employee, Speakers bureau: Janssen Employee, Edward Burn: None declared, Jennifer Lane: None declared, David Vizcaya Employee of: Bayer, Sara Bruce Wirta Employee of: Janssen-Cilag Sweden AB, Marcel de Wilde: None declared, Katia Verhamme: None declared, Peter Rijnbeek: None declared, Elke Theander Employee of: Janssen-Cilag Sweden AB, Katerina Chatzidionysiou Consultant of: AbbVie, Pfizer, Lilly., Daniel Prieto-Alhambra Grant/research support from: Professor Prieto-Alhambra has received research Grants from AMGEN, UCB Biopharma and Les Laboratoires Servier, Consultant of: DPA’s department has received fees for consultancy services from UCB Biopharma, Speakers bureau: DPA’s department has received fees for speaker and advisory board membership services from Amgen, Patrick Ryan: None declared

Deciphering Role of Cytokines for Therapeutic Strategies Against Rheumatoid Arthritis

2020 ◽  
Vol 21 ◽  
Author(s):  
Gaurav Doshi ◽  
Ami Thakkar
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Destruction ◽  
Therapeutic Agents ◽  
Therapeutic Strategies ◽  
Inflammatory Disorder ◽  
Irreversible Damage ◽  
Pharmacological Agents ◽  
Symmetric Pattern ◽  
Novel Therapeutic Strategies

: Rheumatoid Arthritis (RA) is a systemic, chronic, autoimmune, inflammatory disorder which affects of the both large and small synovial joints in a symmetric pattern. RA initiates as painful inflammation of the joints leading to stiffness of joint, joint destruction and further worsens the condition causing permanent irreversible damage to the joints making them physically disabled. Across the globe, there are around 1.2 million cases of RA reported. Inspite of various available therapeutic and pharmacological agents against RA, none of the treatment assure complete cure. Understanding the in depthrole of cytokines and interleukins in disease pathogenesis of RA could help in exploiting them for developing novel therapeutic strategies against RA. This review provides insights into pathogenesis of RA and gives a brief overview of cytokines which play an important role in the progression of the disease. We have also discussed possible role of interleukins in context of RA which could help future researchers to explore them for identifying new therapeutic agents.

scholarly journals A cost-effective analysis of various disease modifying anti-rheumatic drugs for patients with Rheumatoid Arthritis

2018 ◽  
Vol 7 (6) ◽  
pp. 1153
Author(s):  
Soniya Krishnan ◽  
Balan C. S. ◽  
Seema P. Mohamedali
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Disability ◽  
Joint Destruction ◽  
Health Assessment ◽  
Cost Effective ◽  
Term Therapy ◽  
Significant Difference ◽  
Disease Modifying ◽  
Effective Analysis

Background: Rheumatoid Arthritis (RA) is a chronic disabling disorder that lowers quality of life in the affected patients. Early treatment with disease-modifying anti-rheumatic drugs (DMARDs, provides better control of disease and minimize joint destruction. Long term therapy imparts considerable economic burden to the patients. Cost effective analysis was performed among the patients treated with methotrexate (MTX) alone, hydroxychloroquine (HCQ) alone, and both (MTX+HCQ).Methods: A prospective, observational study for six months to analyze the cost-effectiveness in RA patients with DMARDs-MTX, HCQ and MTX+HCQ. A total of 91 patients were included for analysis; 43 patients in MTX and HCQ group; 37 patients in MTX group and 11 patients in HCQ group. To assess the functional disability,” Stanford Health Assessment Questionnaire - Disability Index” (HAQ-DI) was administered. The patients were followed up for four months. The HAQ-DI at the baseline was compared with that of final follow up. The change in HAQ-DI and the total costs were used to find out the average cost- effective ratio (ACER).Results: The least ACER was obtained for Hydroxychloroquine and highest was for Methotrexate. But there was no statistically significant difference in ACER between various treatment groups. There was no significant difference in the disease activity improvement between the three groups.Conclusions: MTX, HCQ and MTX+HCQ showed improvement in disease activity without any significant difference. MTX is superior considering direct cost but there is no difference in the total cost between three groups.

scholarly journals Treatment strategy for patients with rheumatoid arthritis

2020 ◽  
Vol 63 (7) ◽  
pp. 422-430
Author(s):  
Soo-Kyung Cho ◽  
Yoon-Kyoung Sung
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Targeted Therapies ◽  
Functional Disability ◽  
Joint Destruction ◽  
Joint Damage ◽  
Chronic Inflammatory Disease ◽  
Biologic Dmards

Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the joints, causing joint destruction, functional disability, and reduced quality of life in patients. The aim of RA treatment is to decrease the inflammation, prevent joint damage, and improve patientsʼ quality of life while minimizing progression of the disease. Both early detection and intervention with disease-modifying anti-rheumatic drugs (DMARDs) have been reported to improve therapeutic outcomes. Treatment with DMARDs should be started immediately after the diagnosis is established, with methotrexate as the best initial drug of choice. Disease activity should be regularly monitored. Targeted therapies can be considered in patients with persistent active disease despite methotrexate therapy. Remission or low disease activity is the preferred treatment target. There are two major classes of DMARDs: conventional synthetic DMARDs and the targeted therapies specific to pro-inflammatory cytokines including biologic DMARDs and small molecule inhibitors. Recently, the importance of shared decision making, in which patients and clinicians make decisions together, and education of the patient has been emphasized in the treatment strategies of RA. This review summarizes the effectiveness and safety of the DMARDs currently available for RA treatment. Recommendations for RA management would also be discussed in this article.

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