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Thus treatment strategies vary and even amongst non-biologics dosing schedules coupled with patient's educational level and access to the rheumatology facility may determine the choice of disease-modifying anti-rheumatic drugs (DMARD) therapy.
Since their introduction in the late 1990s, biologic agents, such as tumor necrosis factor-[alpha] (TNF[alpha]) antagonists, have been an increasingly used modality for treating RA, especially RA that is recalcitrant to management with conventional disease modifying anti-rheumatic drugs (DMARDs).
Recently, biological DMARDs, including tumor necrosis factor (TNF) inhibitors, have been shown to be efficacious in the treatment of AS.
Rigel believes that there is a significant opportunity for an oral, safe DMARD that can be used earlier in course of the disease, preventing its progression prior to major bone and cartilage destruction.
We performed a crude Cox regression to determine the association between a variety of patient characteristics and the length of time using traditional multiple DMARD before adding a biologic agent.
Different Factors Are Important for RA Patients and Rheumatologists Regarding DMARD Escalation.
* For patients with predominantly axial disease that is active and insufficiently responsive to NSAID treatment, a biologic DMARD should be considered, specifically a TNF inhibitor.
As risk of infection and response to vaccination is of concern, it is advisable to update all vaccinations prior to the initiation of therapy and avoid live vaccinations during DMARD or biologic therapy.
Rheumatologists should consider including such injections in combination with aggressive DMARD treatment as part of a treat to target strategy in patients with early RA, they concluded.
During 22,215 person-years of follow-up, the crude rate of herpes zoster among RA patients who were first-time users of an anti-TNF agent was 12.1 cases per 1,000 person-years, not significantly different from the 12.8 per 1,000 rate during 7,165 person-years of follow-up in the control group, which comprised RA patients who were failing on methotrexate and adding another conventional DMARD, usually hydroxychloroquine (Plaquenil).
Biological therapy is recommended for axial involvement and for peripheral involvement with no response to DMARD. In the 1/3 to half of the patients, sacroiliitis develops over the years.
GSK today announced the start of a phase III clinical development programme with otilimab, an investigational antigranulocyte macrophage colony-stimulating factor (anti GM-CSF) monoclonal antibody, for patients with moderate to severe rheumatoid arthritis (RA) who have had an inadequate response to disease modifying antirheumatic drugs (DMARD) or targeted therapies.
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