Phytochemicals and Novel Nanotherapeutic Approaches in the Management of Rheumatic Diseases

2022 ◽  
pp. 249-266
Author(s):  
Ashfaq Ahmad Shah ◽  
Amit Gupta
Keyword(s):  
Tumor Necrosis ◽  
Joint Stiffness ◽  
Parenteral Route ◽  
Rheumatoid Arthritis Joint ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
Disease Modifying Agents ◽  
Almost All ◽  
Therapeutic Compounds ◽  
Necrosis Factor

Over 100 types of arthritis have been recognized in which the dominating forms are osteoarthritis and rheumatoid arthritis. Joint stiffness, pain, swelling, lowered range of motion of joints affected, redness around joints are the main complications of almost all types of arthritis. Medications like non-steroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, and immunosuppressants are only used to control the symptoms of the disease but are not able to alleviate them properly. However, with the incorporation of disease-modifying antirheumatic drugs (DMARDs) as well as tumor necrosis factor inhibitors (TNFi) in treatment, there are now promising therapeutic options to select from for the management of rheumatoid diseases. Nanotherapeutic approach has enabled us to deliver the disease-modifying agents directly to the inflammation site, thus eschewing off-target and unwanted systemic effects. Therefore, it provides an opportunity to reconsider the therapeutic compounds that were considered too toxic to be administrated via oral or parenteral route.

scholarly journals Current Therapy of Rheumatoid Arthritis (part 2)

2018 ◽  
Vol 1 (2) ◽  
pp. 90
Author(s):  
Hendrata Erry Andisari
Keyword(s):  
Tumor Necrosis ◽  
Biological Agents ◽  
Current Therapy ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Conventional Dmards ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
And Control ◽  
Necrosis Factor

<p><em>Therapy in RA has undergone many advances today and in line with knowledge of the pathogenesis of RA, the current therapeutic goal is to alter the journey and control the activity of RA disease. Several groups of drugs have been used in RA therapy including non-steroidal anti-inflammatory drugs (NSAIDs), conventional disease-modifying antirheumatic drugs (DMARDs) as well as biological agents (bDMARD), glucocorticoids and anti-pain medicines. In recent years, the development of biological agents that have specific targets for inflammatory mediators such as interleukin (IL) -1, IL-6 and Tumor Necrosis Factor (TNF) suggests a potent therapeutic effect on RA. In this article will be presented the latest biological agents as the latest therapy on RA.</em></p><p> </p><strong><em>Keyword</em></strong><em>s : conventional DMARDs, biological agents</em>

scholarly journals Recent Therapeutics Policies of Arthritis Rheumatoid (part I)

2018 ◽  
Vol 1 (1) ◽  
pp. 12
Author(s):  
Hendrata Erry Andisari
Keyword(s):  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Biological Agents ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
And Control ◽  
Necrosis Factor ◽  
Arthritis Rheumatoid

<p>Therapy in RA has undergone many advances today and in line with knowledge of the pathogenesis of RA, the current therapeutic goal is to alter the journey and control the activity of RA disease. Several groups of drugs have been used in RA therapy including non-steroidal anti-inflammatory drugs (NSAIDs), conventional disease-modifying antirheumatic drugs (DMARDs) as well as biological agents (bDMARD), glucocorticoids and anti-pain medicines. In recent years, the development of biological agents that have specific targets for inflammatory mediators such as interleukin (IL) -1, IL-6 and Tumor Necrosis Factor (TNF) suggests a potent therapeutic effect on RA. In this article will be presented the latest biological agents as the latest therapy on RA.</p>

Effectiveness of a second biologic after failure of a non-tumor necrosis factor inhibitor as first biologic in rheumatoid arthritis

2021 ◽  
pp. jrheum.201467
Author(s):  
Katerina Chatzidionysiou ◽  
Merete Lund Hetland ◽  
Thomas Frisell ◽  
Daniela Di Giuseppe ◽  
Karin Hellgren ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Disease Activity ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Inhibitor ◽  
Primary Response ◽  
Low Disease Activity ◽  
Factor Inhibitor ◽  
Disease Modifying ◽  
Necrosis Factor

Objective In Rheumatoid Arthritis (RA), evidence regarding the effectiveness of a second biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) in patients whose first ever bDMARD was a non-tumor-necrosis-factor-inhibitor (TNFi) bDMARD is limited. The objective of this study was therefore to assess the outcome of the second bDMARD (non-TNFi [rituximab, abatacept or tocilizumab, separately] and TNFi) after failure of a non-TNFi bDMARD as first bDMARD. Methods We identified RA patients from the five Nordic biologics registers started treatment with a non-TNFi as first ever bDMARD but switched to a second bDMARD. For the second bDMARD, we assessed survival-on-drug (at 6 and 12 months), and primary response (at 6 months). Results We included 620 patients starting a second bDMARD (ABA 86, RTX 40, TCZ 67 and TNFi 427) following failure of a first non-TNFI bDMARD. At 6 and 12 months after start of their second bDMARD, around 70% and 50%, respectively, remained on treatment, and at 6 months less than one third of patients were still on their second bDMARD and had reached low disease activity or remission according to DAS28. For those patients whose second bMDARD was a TNFI, the corresponding proportion was slightly higher (40%). Conclusion The survival-on-drug and primary response of a second bDMARD in RA patients switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD.

scholarly journals Clinical evaluation of DMARDs and NSAIDs in cases of Rheumatoid arthritis in Chhattisgarh

2018 ◽  
Vol 9 (1) ◽  
pp. 61-64
Author(s):  
Basant Kumar Maheshwari ◽  
Prafulla Kumar Khodiar ◽  
Debapriya Rath
Keyword(s):  
Rheumatoid Arthritis ◽  
Medical Sciences ◽  
Rheumatoid Disease ◽  
Disease Modifying Drugs ◽  
Serological Examination ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
Disease Modifying Agents ◽  
Systemic Symptoms ◽  
Group 1

Background: Rheumatoid arthritis (RA) is an autoimmune disease characterized by polyarticular inflammation with systemic symptoms like malaise, fatigue and fever. Various groups of drugs have been used along with supportive therapies (physical and occupational) for the treatment of rheumatoid arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) and disease modifying agents in rheumatoid disease (DMARDs) are the two major classes among them. However, none of these medications have proved to be successful enough to be accepted universally as the standard therapy for RA.Aims and Objective: To compare the clinical efficacy of nimesulide as a standalone therapy with combination therapy of nimesulide plus methotrexate and nimesulide plus hydroxychloroquine.Materials and Methods: The study comprised of three groups of rheumatoid arthritis patients. Each group consists of 32 study subjects. Group 1, 2 and 3 consisted of patients taking nimesulide alone, nimesulide plus hydroxycholoroquine and nimesulide plus methotrexate respectively for the disease. The cases were followed up to a period of six months and based upon subjective & objective (Radiological and serological examination) criteria, results have been evaluated.Results: Observations have revealed that nimesulide plus hydroxycholoroquine combination produced significant improvement in the patients in mild, moderate and severe cases of rheumatoid arthritis as compared to nimesulide plus methotrexate. The improvement observed was least in the patients who received nimesulide as standalone therapy. No significant adverse drug reaction was seen in any of the study groups.Conclusion: The study concludes that nimesulide plus hydroxychloroquine combination can be used in cases of rheumatoid arthritis as disease modifying drugs without noticeable toxicity in doses used in this study in patients who have no renal and hepatic insufficiency.Asian Journal of Medical Sciences Vol.9(1) 2018 61-64

scholarly journals Tumor necrosis factor (TNF) receptor associated periodic syndrome (TRAPS): a rare cause of recurrent fever

2018 ◽  
Vol 6 (7) ◽  
pp. 2537
Author(s):  
Sachin Gitte ◽  
Pradhan G. ◽  
Santoshi M.
Keyword(s):  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Periodic Fever ◽  
Recurrent Fever ◽  
Periodic Syndrome ◽  
Novel Variant ◽  
One Year ◽  
Almost All ◽  
Conclusive Diagnosis ◽  
Necrosis Factor

The one year old male child presented with fever on and off, associated with periorbital swelling and arthritis. Infectious, rheumatological and oncological diagnoses were ruled out. Further follow-up over 4-5 years revealed that, the child continued to have similar episodes every month and investigated for almost all possible causes but no conclusive diagnosis was made. Hence evaluation for rare causes of periodic fever was considered. Genetic testing revealed mutation in a novel variant of TNFRSF1A gene, thus confirming Tumor necrosis factor receptor­associated periodic syndrome (TRAPS). Tumor necrosis factor receptor­associated periodic syndrome (TRAPS) is an autosomal dominant inherited condition of periodic fever and joint pain. Here we are presenting a case of this rare syndrome.

scholarly journals Comparison of the effects of rituximab, tumor necrosis factor alpha inhibitors and non-steroidal antiinflammatory drugs on ankylosing spondylitis clinical activity and sacroileitis intensity on magnetic resonance imaging

2013 ◽  
Vol 94 (6) ◽  
pp. 870-876
Author(s):  
M S Protopopov ◽  
Sh F Erdes ◽  
S A Lapshina ◽  
L I Myasoutova ◽  
R Kh Zakirov ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Tumor Necrosis Factor ◽  
Disease Activity ◽  
Tumor Necrosis Factor Alpha ◽  
Tumor Necrosis ◽  
Clinical Activity ◽  
Necrosis Factor Alpha ◽  
Factor Alpha ◽  
Inflammatory Drugs ◽  
Necrosis Factor

Aim. To investigate the effect of rituximab in ankylosing spondylitits on disease activity and on intensity of sacroileitis detected by magnetic resonance imagigng compared to tumor necrosis factor alpha inhibitors and non-steroidal anti-inflammatory drugs. Methods. The study included 91 patient [14 (15.4%) females, 77 (84.6%) males, mean age - 34.4±9.13 years, disease duration - 6.6±3.8 years] with established diagnosis of ankylosing spondylitits. The main group included 20 patients (17 males, mean age 36.9±9.9 years) who were treated with rituximab. The comparison group included 36 patients (30 males, mean age 34.3±8.6 years) treated with tumor necrosis factor alpha inhibitors. The control group consisted of 35 patients (30 males, mean age 33.4±9.3 years) treated with non-steroidal anti-inflammatory drugs and sulfasalazine. Disease activity was measured by BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDASESR (Ankylosing Spondylitis Disease Activity Score) scores before the treatment initiation, at the 2nd, 8th, 16th and 24th weeks of treatment. Magnetic resonance imaging of sacroiliac joints was performed before the treatment initiation and at the 24th week of treatment, T1 and STIR sequences were analyzed. Results were processed using the SPARCC (Spondyloarthritis Research Consortium of Canada) scoring methodology. Results. There was a significant reduction of the disease clinical activity measured by BASDAI score (from 6.19±1.48 to 3.70±0.91, p 0.01) and ASDASESR score (form 3.43±0.72 tо 2.11±0.46, p 0.01) in patients treated with rituximab at the week 24. Mean SPARCC score reduced from 15.9±7.2 to 4.6±8.2 (p 0.01). The influence of rituximab on clinical activity of the disease was superior over the effect of the standard treatment (BASDAI and SPARCC scores 5.22±1.14 and 7.8±7.1 accordingly at the week 24, p 0.05), but inferior over the effect of tumor necrosis factor alpha inhibitors (BASDAI and SPARCC scores 2.03±0.64 и 4.9±7.0 accordingly at the week 24, p 0.01). Conclusion. Anti B-cell therapy is effective in treating active ankylosing spondylitis and leads to the decrease of the clinical symptoms intensity and disease activity measured by BASDAI и ASDASESR scores. The effect of rituximab was superior over the effect of non-steroidal anti-inflammatory drugs and sulfasalazine and inferior over the effect of tumor necrosis factor alpha inhibitors.

scholarly journals The Effects of Tumor Necrosis Factor Inhibitors in a Particular Association of Psoriatic Arthritis and Behcet Disease

2019 ◽  
Vol 70 (3) ◽  
pp. 1067-1070
Author(s):  
Anca Emanuela Musetescu ◽  
Alesandra Florescu ◽  
Ana-Maria Bumbea ◽  
Lucian Mihai Florescu ◽  
Paulina Lucia Ciurea ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Tumor Necrosis ◽  
Behçet Disease ◽  
Complex Treatment ◽  
Behcet Disease ◽  
Current Case ◽  
Disease Modifying Drugs ◽  
Disease Modifying ◽  
Tuberculosis Therapy ◽  
Necrosis Factor

The current case report presents a patient diagnosed with Behcet disease in concurrence with psoriatic arthritis, leading to a complex treatment, difficult management and challenging approach of both rheumatic disorders. After treatment with synthetic disease-modifying drugs and three different TNF inhibitors, the patient developed pulmonary tuberculosis, followed by tuberculosis spondylodiscitis, even after proper anti-tuberculosis therapy.

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