Journal ArticleDOI
Diagnosis and Management of Rheumatoid Arthritis: A Review.
Daniel Aletaha,Josef S Smolen +1 more
TLDR
A treat-to-target strategy aimed at reducing disease activity by at least 50% within 3 months and achieving remission or low disease activity within 6 months, with sequential drug treatment if needed, can prevent RA-related disability.Abstract:
Importance Rheumatoid arthritis (RA) occurs in about 5 per 1000 people and can lead to severe joint damage and disability. Significant progress has been made over the past 2 decades regarding understanding of disease pathophysiology, optimal outcome measures, and effective treatment strategies, including the recognition of the importance of diagnosing and treating RA early. Observations Early diagnosis and treatment of RA can avert or substantially slow progression of joint damage in up to 90% of patients, thereby preventing irreversible disability. The development of novel instruments to measure disease activity and identify the presence or absence of remission have facilitated new treatment strategies to arrest RA before joints are damaged irreversibly. Outcomes have been improved by recognizing the benefits of early diagnosis and early therapy with disease-modifying antirheumatic drugs (DMARDs). The treatment target is remission or a state of at least low disease activity, which should be attained within 6 months. Methotrexate is first-line therapy and should be prescribed at an optimal dose of 25 mg weekly and in combination with glucocorticoids; 40% to 50% of patients reach remission or at least low disease activity with this regimen. If this treatment fails, sequential application of targeted therapies, such as biologic agents (eg, tumor necrosis factor [TNF] inhibitors) or Janus kinase inhibitors in combination with methotrexate, have allowed up to 75% of these patients to reach the treatment target over time. New therapies have been developed in response to new pathogenetic findings. The costs of some therapies are considerable, but these costs are decreasing with the advent of biosimilar drugs (drugs essentially identical to the original biologic drugs but usually available at lower cost). Conclusions and relevance Scientific advances have improved therapies that prevent progression of irreversible joint damage in up to 90% of patients with RA. Early treatment with methotrexate plus glucocorticoids and subsequently with other DMARDs, such as inhibitors of TNF, IL-6, or Janus kinases, improves outcomes and prevents RA-related disability. A treat-to-target strategy aimed at reducing disease activity by at least 50% within 3 months and achieving remission or low disease activity within 6 months, with sequential drug treatment if needed, can prevent RA-related disability.read more
Citations
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Journal ArticleDOI
Global, regional and national burden of osteoarthritis 1990-2017: A systematic analysis of the Global Burden of Disease Study 2017
Saeid Safiri,Ali-Asghar Kolahi,Damian G Hoy,Emma Smith,Deepti Bettampadi,Mohammad Ali Mansournia,Amir Almasi-Hashiani,Ahad Ashrafi-Asgarabad,Maziar Moradi-Lakeh,Mostafa Qorbani,Gary S. Collins,Anthony D. Woolf,Lyn March,Marita Cross +13 more
TL;DR: The global prevalence was higher in women and increased with age, peaking at the >95 age group among women and men in 2017, and a positive association was found between the age-standardised YLD rate and SDI at the regional and national levels.
Journal ArticleDOI
Scavenger receptor-A is a biomarker and effector of rheumatoid arthritis: A large-scale multicenter study.
Fanlei Hu,Jiang Xiang,Chunqing Guo,Yingni Li,Shixian Chen,Wei Zhang,Yan Du,Ping Wang,Xi Zheng,Fang Xiangyu,Xin Li,Jing Song,Yang Xie,Fei Huang,Jimeng Xue,Mingxin Bai,Yuan Jia,Xu Liu,Limin Ren,Xiaoying Zhang,Jianping Guo,Hudan Pan,Yin Su,Huanfa Yi,Huanfa Yi,Hua Ye,Daming Zuo,Daming Zuo,Juan Li,Huaxiang Wu,Yongfu Wang,Ru Li,Liang Liu,Xiang-Yang Wang,Zhanguo Li +34 more
TL;DR: It is shown that serum levels of soluble scavenger receptor-A (sSR-A) are increased in patients with RA and correlate positively with clinical and immunological features of the disease, and modulating SR-A levels can alter progression of collagen-induced arthritis in mice.
Journal ArticleDOI
Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis.
TL;DR: This review summarizes the current understanding of the underlying pathomechanism, diagnosis of RA, as well as the mode of action, clinical benefits, and side-effects of the currently available DMARDs.
Treating rheumatoid arthritis to the target―関節リウマチの治療戦略をここまで変えたものは何か―
TL;DR: Helen is a 45-year old woman diagnosed with rheumatoid arthritis (RA) 2 months ago; on physical exam she has 9/28 swollen joints and 12 /28 tender joints; she also complains of pain in her feet with evidence of synovitis in 5 MTP joints.
Journal ArticleDOI
ImmunoPET: Concept, Design, and Applications
TL;DR: The latest immuno PET imaging strategies and their preclinical and clinical applications are presented and current conjugation strategies that can be leveraged to develop next-generation immunoPET probes are emphasized.
References
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Journal ArticleDOI
2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.
Daniel Aletaha,Tuhina Neogi,Alan J. Silman,Julia Funovits,David T. Felson,Clifton O. Bingham,Neal S. Birnbaum,Gerd Burmester,Vivian P. Bykerk,Marc D. Cohen,Bernard Combe,Karen H. Costenbader,Maxime Dougados,Paul Emery,Gianfranco Ferraccioli,Johanna M. W. Hazes,Kathryn Hobbs,Tom W J Huizinga,Arthur Kavanaugh,Jonathan Kay,Tore K Kvien,Timothy J. Laing,Philip J. Mease,Henri A Ménard,Larry W. Moreland,Raymond L. Naden,Theodore Pincus,Josef S Smolen,Ewa Stanislawska-Biernat,Deborah P M Symmons,Paul P. Tak,Katherine S. Upchurch,Jiří Vencovský,Frederick Wolfe,Gillian A. Hawker +34 more
TL;DR: This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features.
Journal ArticleDOI
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update
Josef S Smolen,Robert Landewé,Ferdinand C. Breedveld,Maya H Buch,Maya H Buch,Gerd R Burmester,Maxime Dougados,Paul Emery,Paul Emery,Cécile Gaujoux-Viala,Laure Gossec,Jackie L Nam,Jackie L Nam,Sofia Ramiro,Kevin L. Winthrop,Maarten de Wit,Daniel Aletaha,Neil Betteridge,Johannes W. J. Bijlsma,Maarten Boers,Frank Buttgereit,Bernard Combe,Maurizio Cutolo,Nemanja Damjanov,Johanna M. W. Hazes,Marios Kouloumas,Tore K Kvien,Xavier Mariette,Karel Pavelka,Piet L. C. M. van Riel,Andrea Rubbert-Roth,Marieke Scholte-Voshaar,David Scott,T. Sokka-Isler,John B. Wong,Désirée van der Heijde +35 more
TL;DR: These recommendations intend informing rheumatologists, patients, national rheumology societies, hospital officials, social security agencies and regulators about EULAR's most recent consensus on the management of RA, aimed at attaining best outcomes with current therapies.
Journal ArticleDOI
The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis.
TL;DR: Relation entre risque de pemphigus et DW1eme et DRW6eme, et relation entre susceptibilite a la polyarthrite rhumatoide and un groupe d'epitopes trouves dans les sous-types non DW10 de DR4.
Journal ArticleDOI
2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis
Jasvinder A. Singh,Kenneth G. Saag,S. Louis Bridges,Elie A. Akl,Raveendhara R. Bannuru,Matthew C. Sullivan,Elizaveta E. Vaysbrot,Christine McNaughton,Mikala C. Osani,Robert H. Shmerling,Jeffrey R. Curtis,Daniel E. Furst,Deborah Parks,Arthur Kavanaugh,James R. O'Dell,Charles H. King,Amye Leong,Eric L. Matteson,John T. Schousboe,Barbara E. Drevlow,Seth Ginsberg,James Grober,E. William St. Clair,Elizabeth A. Tindall,Amy S. Miller,Timothy E. McAlindon +25 more
TL;DR: To develop a new evidence‐based, pharmacologic treatment guideline for rheumatoid arthritis (RA), a large number of patients with RA are referred to a single clinic for treatment with these medications.
Journal ArticleDOI
The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment
Ferdinand C. Breedveld,Michael H. Weisman,Arthur Kavanaugh,Stanley Cohen,Karel Pavelka,Ronald F van Vollenhoven,John T. Sharp,John L. Perez,George Spencer-Green +8 more
TL;DR: Combination therapy with adalimumab plus MTX was significantly superior to either MTX alone or ad alimumab alone in improving signs and symptoms of disease, inhibiting radiographic progression, and effecting clinical remission in patients with early, aggressive rheumatoid arthritis.
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2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis
Jasvinder A. Singh,Kenneth G. Saag,S. Louis Bridges,Elie A. Akl,Raveendhara R. Bannuru,Matthew C. Sullivan,Elizaveta E. Vaysbrot,Christine McNaughton,Mikala C. Osani,Robert H. Shmerling,Jeffrey R. Curtis,Daniel E. Furst,Deborah Parks,Arthur Kavanaugh,James R. O'Dell,Charles H. King,Amye Leong,Eric L. Matteson,John T. Schousboe,Barbara E. Drevlow,Seth Ginsberg,James Grober,E. William St. Clair,Elizabeth A. Tindall,Amy S. Miller,Timothy E. McAlindon +25 more
The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.
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