Medical therapy: Where are we now?

Resman-Targoff, Beth H.

doi:10.2146/ajhp060363

Cited by 3 publications

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MTX is also the most common choice for initial monotherapy in patients with active RA or with indicators of poor prognosis [3]. The decision to initiate MTX in patients with UA is a complex one for many clinicians.…”

Section: Resultsmentioning

confidence: 99%

Clinical trials report

Crawford¹,

Moreland²

2007

Curr Rheumatol Rep

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Clinical trials report

Crawford¹,

Moreland²

2007

Curr Rheumatol Rep

View full text Add to dashboard Cite

Effects of Intra-articular Botulinum Toxin Type A in an Equine Model of Acute Synovitis

Depuy

Howard

Keegan

et al. 2007

American Journal of Physical Medicine &Amp; Rehabilitation

View full text Add to dashboard Cite

show abstract

Evolution of Clinical Pharmacy in the Practice of Rheumatology

et al. 2007

View full text Add to dashboard Cite

P harmacists are valuable members of multidisciplinary teams caring for patients with rheumatic diseases, serving as clinicians, educators, and researchers. As pharmacotherapy specialists, pharmacists are essential in providing evidence-based clinical care and drug information and serving as patient care advocates to ensure safe and cost-effective drug therapy.The need for clinical pharmacy services in the practice of rheumatology has expanded over the past 40 years and continues to evolve as new therapeutic targets are identified and novel technologies and pharmacologic approaches become available. Prior to this time, nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, antimalarial drugs, corticosteroids, penicillamine, and sulfasalazine were available for clinical use. 1-3 In 1971, Nobel Prize winner John R Vane demonstrated that the mechanism of acetylsalicylic acid effects was inhibition of cyclooxygenase (COX)-mediated production of prostaglandins and thromboxanes. This research subsequently led to the development of additional NSAIDs, including selective COX-2 inhibitors, 4 with wide variability in therapeutic 5 and toxic 6 responses associated with these agents. However, since NSAIDs provided only symptomatic relief, there was a need for the use of disease-modifying antirheumatic drugs (DMARDs) that could affect the progression of disabling diseases such as rheumatoid arthritis.By 1987, the effectiveness of methotrexate in the management of rheumatoid arthritis was so impressive that the Health and Public Policy Committee of the American College of Physicians developed guidelines for its use prior to Food and Drug Administration (FDA) approval for this indication. 7 Oral gold, azathioprine, cyclosporine, cyclophosphamide, leflunomide, mycophenolate, and biological response modifiers (tumor necrosis factor [TNF] blockers, and interleukin-1 [IL-1] receptor antagonists) were also being used to manage an array of rheumatologic conditions during the 1980s into the 21st century. 1,8 During that time, it was recognized that combination therapy with several of those DMARDs achieved an additive or synergistic response, 9 and that early and aggressive intervention in patients with newly diagnosed rheumatoid arthritis could slow radiographic progression of joint damage, limit disability, increase the likelihood of remission, and decrease mortality. 10-12 Most recently, a recombinant form of urate oxidase (rasburicase) 13,14 and agents that inhibit T-cell activation (abatacept)12 or deplete B lymphocytes (rituximab) 12 are being used in rheumatology.As we look toward the future, new biologic therapies that deplete or inhibit the activation of other inflammatory cells, proinflammatory/regulatory cytokines, chemokineinduced migration of inflammatory cells into the synovi-

show abstract

Medical therapy: Where are we now?

Abstract: Studies have demonstrated that early treatment of RA and rapid suppression of inflammation are extremely important as they provide long-term benefits and improve the overall prognosis for patients with the disease.

Cited by 3 publications

References 17 publications

Clinical trials report

Clinical trials report

Effects of Intra-articular Botulinum Toxin Type A in an Equine Model of Acute Synovitis

Evolution of Clinical Pharmacy in the Practice of Rheumatology

Contact Info

Product

Resources

About