Antirheumatic Therapy: Actions and Outcomes
Richard O. Day, Daniel E. Furst, Piet L.C.M. van Riel, Barry Bresnihan
Springer Science & Business Media, May 30, 2010 - Medical - 343 pages
Our goal for this book is to examine the contemporary therapy of rheumatoid arthritis (RA) from the increasingly important perspective of impact upon quality of life, costs and long-term health outcomes. For too long the focus has been on short term, symptomatic, and surrogate indicator outcomes. Yet RA is a life-long disor der with the majority of impact on an individual patient many years following onset. Further, even in the short-term, researchers and rheumatologists have tended to emphasize measurements of disease activity such as joint counts, ESR and physi cian's opinion as to the amount of disease activity present. It is only relatively recently that measures of structural damage, quality of life and impact on broad domains of health have been given increasing emphasis. Also, the significance of early treatment of RA in order to optimise long-term outcomes has a relatively short history . We have been focussed on the disease processes as surrogates for long term outcomes. Until the short-term process measures are validated as surrogates of long-term effects we should also turn our attention to outcomes of disease and the impact of our management on those outcomes [2). Inour view, this book is especially timely. We are at the dawn of a revolution in the management of RA and other complex immunological inflammatory disorders because their molecular, genetic and environmental mechanisms are being unrav elled. Inthe process, we are revealing a substantial number of novel and significant targets for pharmacotherapy.
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acid adalimumab adverse events agents anakinra analysis Ann Rheum antimalarials antirheumatic drugs arthri Arthritis Rheum 46 assessment auranofin autoimmune azathioprine baseline Breedveld FC cell chloroquine Clin clinical trials combination therapy compared controlled trials corticosteroids costs cyclosporin cytokine disease activity DMARD double-blind early RA early rheumatoid arthritis efficacy enzymes erosions etanercept evaluated Furst glucocorticoids gold treatment HSCT hydroxychloroquine improvement increased infection inflammatory infliximab inhibition inhibitors joint leflunomide long-term low dose mesalazine metabolite methotrexate methylprednisolone mg/day mg/kg/day minocycline monotherapy months necrosis factor NF-kB outcomes p38 MAPK parenteral gold patients receiving patients treated patients with early patients with RA patients with rheumatoid penicillamine pharmacokinetics placebo prednisolone progression protein RA patients radiographic radiological randomised randomized receptor reduced remission renal response rheumatoid arthritis Rheumatol Rheumatology score side effects significant significantly sulfasalazine synovial tetracyclines therapeutic tion TNF-o toxicity transplantation treatment of rheumatoid versus