The optimal combination therapy for the treatment of early rheumatoid arthritis

Cock, Diederik De; Elst, Kristien Van der; Meyfroidt, Sabrina; Verschueren, Patrick; Westhovens, René

doi:10.1517/14656566.2015.1056735

Cited by 13 publications

(6 citation statements)

References 98 publications

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“…These studies advocate the ‘window of opportunity’ theory stating that intensive treatment early in the disease process and rapid control of disease activity results in better radiographic outcomes and preserved functionality later on 12. However, there are still problems with the implementation of such strategies in daily practice, partly because of questions regarding the optimal dosage and combination of drugs 13 14.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of methotrexate with step-down glucocorticoid remission induction (COBRA Slim) versus other intensive treatment strategies for early rheumatoid arthritis in a treat-to-target approach: 1-year results of CareRA, a randomised pragmatic open-label superiority trial

Verschueren¹,

Cock

Corluy³

et al. 2016

Ann Rheum Dis

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Section: Introductionmentioning

confidence: 99%

Effectiveness of methotrexate with step-down glucocorticoid remission induction (COBRA Slim) versus other intensive treatment strategies for early rheumatoid arthritis in a treat-to-target approach: 1-year results of CareRA, a randomised pragmatic open-label superiority trial

Verschueren¹,

Cock

Corluy³

et al. 2016

Ann Rheum Dis

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“…GCs combined with MTX [80,63]. There is however an important price difference between both strategies and until now it remains unclear if bDMARDs can be discontinued without loss of effect after being used temporarily as remission-inducing agents [81]. For these reasons, current guidelines do not recommend bDMARDs as first-line treatment for early RA except in special cases with an unfavorable prognostic profile.…”

Section: Different Treatment Regimens For Ramentioning

confidence: 99%

cDNA phage display for the discovery of theranostic autoantibodies in rheumatoid arthritis

et al. 2016

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Rheumatoid arthritis (RA) is the world's most common autoimmune disease mainly characterized by a chronic inflammation of multiple synovial joints. Rheumatologists now have a whole range of treatment options including glucocorticoids (GCs), classical synthetic and biological disease-modifying antirheumatic drugs (cs- and bDMARDS), resulting in a tremendous improvement in treatment outcomes for RA patients over the last two decades. Despite this progress, the choice of treatment regimen to achieve stable remission at the individual patient level still largely depends on trial and error. In this review, the need for novel theranostic markers that can predict a patient's response to methotrexate, the standard first-line csDMARD treatment, is discussed. Like in many autoimmune diseases, the majority of RA patients form a whole range of autoantibodies. We aim to find novel theranostic autoantibody markers using serological antigen selection, a high-throughput technique that uses cDNA phage display to identify novel antigen targets. We have constructed a barcoded cDNA phage display library from the synovial tissue of three RA patients by fusing cDNA products to the filamentous phage minor coat protein VI. This library contains a large proportion of full-length genes and gene fragments that are cloned in frame with the phage gene VI. By screening this library for antibody reactivity in serum samples of patients from the CareRA trial, which compared different intensive treatment strategies based on csDMARDs and a step-down GC schedule, our cDNA phage display library has great potential for the discovery of novel theranostic autoantibody biomarkers.

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“…The combination of therapeutic approaches has been successfully explored for other ailments such as autoimmune diseases and cancer . In the case of synucleinopathies, some combinations have been recently suggested, including lithium plus levodopa/carbidopa, rasagiline and levodopa, and creatine plus coenzyme Q10, that produce additive neuroprotective effects in models of PD .…”

Section: Combination Therapies: a Rational Approach For The Treatmentmentioning

confidence: 99%

Combination therapies: The next logical Step for the treatment of synucleinopathies?

Valera

Masliah

2015

Movement Disorders

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Currently there are no disease-modifying alternatives for the treatment of most neurodegenerative disorders. The available therapies for diseases such as Parkinson’s disease (PD), PD dementia (PDD), Dementia with Lewy bodies (DLB) and Multiple system atrophy (MSA), in which the protein alpha-synuclein (α-syn) accumulates within neurons and glial cells with toxic consequences, are focused on managing the disease symptoms. However, utilizing strategic drug combinations and/or multi-target drugs might increase the treatment efficiency when compared to monotherapies. Synucleinopathies are complex disorders that progress through several stages, and toxic α-syn aggregates exhibit prion-like behavior spreading from cell to cell. Therefore, it follows that these neurodegenerative disorders might require equally complex therapeutic approaches in order to obtain significant and long-lasting results. Hypothetically, therapies aimed at reducing α-syn accumulation and cell-to-cell transfer, such as immunotherapy against α-syn, could be combined with agents that reduce neuroinflammation with potential synergistic outcomes. Here we review the current evidence supporting this type of approach, suggesting that such rational therapy combinations, together with the use of multi-target drugs, may hold promise as the next logical step for the treatment of synucleinopathies.

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The optimal combination therapy for the treatment of early rheumatoid arthritis

Cited by 13 publications

References 98 publications

Effectiveness of methotrexate with step-down glucocorticoid remission induction (COBRA Slim) versus other intensive treatment strategies for early rheumatoid arthritis in a treat-to-target approach: 1-year results of CareRA, a randomised pragmatic open-label superiority trial

Effectiveness of methotrexate with step-down glucocorticoid remission induction (COBRA Slim) versus other intensive treatment strategies for early rheumatoid arthritis in a treat-to-target approach: 1-year results of CareRA, a randomised pragmatic open-label superiority trial

cDNA phage display for the discovery of theranostic autoantibodies in rheumatoid arthritis

Combination therapies: The next logical Step for the treatment of synucleinopathies?

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