Diretrizes para o tratamento da artrite reumatoide

Mota, Lícia Maria Henrique da; Cruz, Bóris Afonso; Brenol, Claiton Viegas; Pereira, Ivânio Alves; Rezende-Fronza, Lucila Stange; Bértolo, Manoel Barros; Freitas, Marcos Rabelo de; Silva, Nílzio Antônio da; Louzada‐Júnior, Paulo; Giorgio, Rina Dalva Neubarth; Lima, Rodrigo Aires Corrêa; Bernardo, Wanderley Marques; Pinheiro, Geraldo da Rocha Castelar

doi:10.1590/s0482-50042013000200004

Cited by 24 publications

(16 citation statements)

References 173 publications

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“…In Brazil, the public health system provides free access to any patient with an RA diagnosis that failed non-biologic DMARDS; these patients are usually treated in public institutions linked to tertiary rheumatologic training services. This represents over 50% of the Ministry of Health’s budget for free medications for chronic diseases [ 6 , 7 ]. However, a survey conducted among 212 rheumatologists working in LA showed that biologic DMARDS are guaranteed to less than 10% of RA patients, with a major negative socioeconomic impact [ 5 ].…”

Section: Medications and Health Facilitiesmentioning

confidence: 99%

Latin-American challenges and opportunities in rheumatology

Rocha

2017

Arthritis Res Ther

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The importance of diseases to mankind is very similar worldwide. However, social and environmental issues, not to mention political and individual aspects, affect the prevalence and management of diseases and their outcomes. I present a brief and tentative comment to illustrate that the Latin-American rheumatology community, despite relevant gains in recent years, has some challenges to face in order to improve patient care in our region.

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Section: Medications and Health Facilitiesmentioning

confidence: 99%

Latin-American challenges and opportunities in rheumatology

Rocha

2017

Arthritis Res Ther

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“…Specifically with regard to therapeutic regimens, a possible limitation for this study is that even though all patients were recruited from the same service, the drugs used in each case were not strictly the same. Nevertheless, all regimens followed the same standardized protocol [ 21 , 22 ]. No association between phagocytic functions and type of therapy used (synthetic vs. biologic DMARDs) was found in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Patients received the recommended standard treatment regimen, including traditional disease modifying anti-rheumatic drugs (DMARDs) or biological therapy as needed. RA treatment followed the Brazilian Society of Rheumatology instructions [ 21 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

Enhanced neutrophil phagocytic capacity in rheumatoid arthritis related to the autoantibodies rheumatoid factor and anti-cyclic citrullinated peptides

Siqueira

Mota

Couto

et al. 2015

BMC Musculoskelet Disord

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BackgroundThere is no consensus on the mechanisms by which anti-cyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) influence the pathogenesis of rheumatoid arthritis (RA). The current study verified if the presence of RF or anti-CCP is associated with phagocytic capacity and reactive oxygen species (ROS) production by phagocytes in RA patients to better clarify the role played by these antibodies in pathogenesis of the disease.MethodsA cohort of 30 RA patients followed from early stages of the disease were characterized by positivity for RF or anti-CCP, disease activity score (DAS-28), health assessment questionnaire (HAQ), use of synthetic or biologic therapy, lifestyle, comorbidities and radiographic erosions. Phagocytic capacity against Saccharomyces cerevisiae and superoxide anion production were assessed in RA patients and compared with 20 healthy controls. Phagocytic capacity and superoxide anion production were also compared between RF- and anti-CCP-positive and -negative RA patients.ResultsAnti-CCP- and RF-positive RA patients had higher neutrophil phagocytic capacity than anti-CCP- (p = 0.005) and RF (p = 0.005)-negative individuals through pattern-recognition receptors. As assessed via pattern recognition or opsonin receptors, neutrophils and monocytes from RA patients presented overall higher phagocytic capacity than neutrophils and monocytes from healthy controls (p < 0.05). Furthermore, RA patients also showed a higher capacity for producing cytotoxic oxygen radicals (p = 0.0026). Phagocytosis and superoxide anion production did not correlate with any of the clinical variables analyzed in this study.ConclusionsThis study showed increased phagocytosis by neutrophils in RA patients who were positive for anti-CCP and RF autoantibodies. Furthermore, there was an overall hyperactivation of the phagocytes in RA patients. Our data suggest that anti-CCP and RF may indirectly enhance the inflammation cascade involving neutrophils and may indirectly sustain tissue damage in RA. Targeting the production of these autoantibodies may be a promising strategy in the management of RA.

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“…Currently, the commonly used treatment ways in RA are surgery, medicine, and psychotherapy. Drugs used to treat RA are classified into nonsteroidal compounds (NSAIDS), disease-modifying antirheumatic drugs (DMAKDS), and glucocorticoids [3].…”

Section: Introductionmentioning

confidence: 99%

A Network Pharmacology Study on the Active Ingredients and Potential Targets ofTripterygium wilfordiiHook for Treatment of Rheumatoid Arthritis

Wei

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Traditional Chinese medicine has specific effect on some chronic diseases in clinic, especially in rheumatic diseases. Tripterygium wilfordii Hook (TWH) is a traditional Chinese medicine commonly used in the treatment of rheumatoid arthritis (RA); the unique therapeutic effect has been confirmed by a large number of research papers. TWH has many compounds that lead to its active compounds. However, the potential targets and pharmacological and molecular mechanism of its action treatment of rheumatic diseases are not entirely clear. Therefore, the network pharmacology approach is needed to further study and explore its treatment mechanism. We have successfully set up 10 networks, including four major networks and other networks. Four major networks include rheumatoid arthritis disease network, compound-compound target network of TWH, TWH compound target-rheumatoid arthritis disease network, and TWH-rheumatoid arthritis disease-mechanism network. Other networks consist of RA disease and TWH related targets clusters, biological processes, and pathways network. Our study successfully predicted, explained, and confirmed the TWH of RA disease molecular synergy and found the potential of RA related targets, cluster, biological process, and pathways. This study not only provides prompts to the researcher who explores pharmacological and biological molecular mechanism of TWH applying to RA disease, but also proves a feasible method for discovering potential activated compounds from Chinese herbs.

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Diretrizes para o tratamento da artrite reumatoide

Cited by 24 publications

References 173 publications

Latin-American challenges and opportunities in rheumatology

Latin-American challenges and opportunities in rheumatology

Enhanced neutrophil phagocytic capacity in rheumatoid arthritis related to the autoantibodies rheumatoid factor and anti-cyclic citrullinated peptides

A Network Pharmacology Study on the Active Ingredients and Potential Targets ofTripterygium wilfordiiHook for Treatment of Rheumatoid Arthritis

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