Combined anti-tumor necrosis factor-alpha therapy and DMARD
therapy in rheumatoid arthritis patients reduces inflammatory gene expression in whole blood compared to DMARD
NSAIDs are used for controlling pain while DMARDs
retard the destructive erosive process2.
(In years) Rheumatoid factor Total 50%, (25) 56%, (28) positive, % (Number Male 12%, (6) 12%, (6) of patients) Female 38%, (19) 44%, (22) C-Reactive Protein, Total 42%, (21) 42%, (21) positive, % (Number Male 6%, (3) 8%, (4) of patients) Female 36%, (18) 34%, (17) Table 4: Comparing the Disease Activity Score (DAS28) of 2 Groups Group I Group II P value (MEAN [+ or -] SD) (MEAN [+ or -] SD) Baseline 5.
3-11) Nevertheless, early treatment is unrealistic for most RA patients in the absence of adequate educational, triaging, and referral systems as studies analyzing the time from symptom onset to delivery of DMARDs
have reported significant delays.
The family physician plays several important roles in the management of patients with RA by early diagnosis of RA, with initiation of synthetic DMARD
therapy, and in long-term follow-up to minimize complications of DMARD
therapy and its impact on patient comorbidities.
70] Hepatitis B vaccination should ideally be offered to non-immune patients before commencing DMARD
A retrospective cohort study of 20,357 RA patients in the Veterans Affairs health care system found that patients on adalimumab had an adjusted 47% lower risk of zoster, and those on etanercept had a 38% reduction in risk, compared with patients on conventional DMARDs
Systemic corticosteroids can be used in addition to DMARDs
, generally in a temporary fashion, and intra-articular corticosteroid injections should be considered for local symptomatic inflammation.
As an antiangiogenic agent, 2ME2 may represent a novel, non-immunologic, oral-delivery DMARD
approach to treating rheumatoid arthritis.
Establishing a diagnosis as early as possible and then starting the patient on combination DMARD
therapy is the foundation of treatment of patients with PA (O'Dell, 2004).
Surveyed RA patients most frequently are taking a conventional disease-modifying antirheumatic drug (DMARD
) + a TNF-alpha inhibitor, and conventional DMARD
The most common, and oldest, DMARD
is methotrexate, which is deemed effective, safe and inexpensive, though it carries some side effects, as do the other DMARDs
, such as hydroxychloroquine (Plaquenil), sulfasalazine (Azulfidine), and leflunomide (Arava).