Failure of anti-TNF treatment in patients with rheumatoid arthritis: The pros and cons of the early use of alternative biological agents

Publication date: Available online 19 October 2019Source: Autoimmunity ReviewsAuthor(s): Andrea Rubbert-Roth, Melinda Zsuzsanna Szabó, Melinda Kedves, György Nagy, Fabiola Atzeni, Piercarlo Sarzi-PuttiniAbstractThe five TNF inhibitors currently approved for the treatment of RA are characterised by differences in their molecular structures, half-lives, administration routes, dosing intervals, immunogenicity, and use in women who wish to become pregnant. TNF inhibitors still represent the first biologic after conventional synthetic DMARD (csDMARD) in the majority of patients according to registry data. This was possibly because they were historically the first biological agents available (biological DMARDS with a different mechanism of action or targeted synthetic DMARDs did not become available until 2006s), and so switching from one to another was frequent in the case of an inadequate response and/or side effects. TNF inhibitors are also efficacious for other inflammatory joint and spine diseases, and have been approved for inflammatory bowel disease, uveitis and psoriasis. In addition, national registries have provided long-term safety data and demonstrated their beneficial effect on cardiovascular morbidity and mortality. However, approximately 30–40% of patients discontinue anti-TNF treatment because of primary failure, secondary loss of response, or intolerance. The options for managing anti-TNF treatment failures include switching to an alternative anti...
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research

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A 56-year-old automobile mechanic was referred to our rheumatology service by his orthopedist to evaluate left posterior knee pain and swelling that had been present for three months. The patient had undergone bilateral total knee arthroplasties (TKAs) for sports-related osteo­arthritis three years before. In addition to the knee pain, the patient described several years of... [Read More]
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(Natural News) Lyme disease and rheumatoid arthritis are two different diseases that share many symptoms. A patient will benefit from knowing how to tell them apart. The diseases have different origins. Lyme disease is a bacterial disease caused by the bacteria Borrelia burgdorferi, which infect humans via tick bites. Meanwhile, rheumatoid arthritis stems from a mixture of...
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Source: Pharmacoepidemiology and Drug Safety - Category: Drugs & Pharmacology Authors: Tags: ORIGINAL REPORT Source Type: research
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