SARS‐CoV‐2 infection in an advanced rheumatoid arthritis patient
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Hydroxychloroquine
Tocilizumab
myalgia
Sore throat
Sulfasalazine
This study was conducted to evaluate the extent to which disease-modifying antirheumatic medications (DMARDs) used as part of a triple therapy for the treatment of rheumatoid arthritis (RA) including methotrexate, sulfasalazine, and hydroxychloroquine are associated with fractures in postmenopausal women with RA. Incident fractures following use of methotrexate, sulfasalazine, and/or hydroxychloroquine in postmenopausal women with RA in the Women's Health Initiative were estimated by Cox proportional hazards using hazard ratios (HRs) and 95% CIs after consideration of potential confounders. There were 1201 women with RA enrolled in the Women's Health Initiative included in these analyses, of which 74% were white, 17% were black, and 9% were of other or unknown race/ethnicity. Of the women with RA, 421 (35%) had not used methotrexate, sulfasalazine, or hydroxychloroquine, whereas 519 (43%) women had used methotrexate, 83 (7%) sulfasalazine, and 363 (30%) hydroxychloroquine alone or in combination at some time during study follow-up. Over a median length of 6.46 years of follow-up, in multivariable adjusted models, no statistically significant association was found between methotrexate (HR, 1.1; 95% CI, 0.8-1.6), sulfasalazine (HR, 0.6; 95% CI, 0.2-1.5), or hydroxychloroquine (HR, 1.0; 95% CI, 0.7-1.5) use and incident fractures or between combination therapy with methotrexate and sulfasalazine or methotrexate and hydroxychloroquine use (HR, 0.9; 95% CI, 0.5-1.6) and incident fractures. In conclusion, postmenopausal women with RA receiving any component of triple therapy should not be expected to have any substantial reduction in fracture risk from use of these DMARDs. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Rheumatoid arthritis is a common disease that causes substantial morbidity and mortality. The responses of patients with rheumatoid arthritis to treatment with a single so-called disease-modifying drug, such as methotrexate, are often suboptimal. Despite limited data, many patients are treated with combinations of these drugs.We enrolled 102 patients with rheumatoid arthritis and poor responses to at least one disease-modifying drug in a two-year, double-blind, randomized study of treatment with methotrexate alone (7.5 to 17.5 mg per week), the combination of sulfasalazine (500 mg twice daily) and hydroxychloroquine (200 mg twice daily), or all three drugs. The dose of methotrexate was adjusted in an attempt to achieve remission in all patients. The primary and point of the study was the successful completion of two years of treatment with 50 percent improvement in composite symptoms of arthritis and no evidence of drug toxicity.Fifty of the 102 patients had 50 percent improvement at nine months and maintained at least that degree of improvement for two years without evidence of major drug toxicity. Among them were 24 of 31 patients treated with all three drugs (77 percent), 12 of 36 patients treated with methotrexate alone (33 percent, P < 0.001 for the comparison with the three-drug group), and 14 of 35 patients treated with sulfasalazine and hydroxychloroquine (40 percent), P = 0.003 for the comparison with the three-drug group). Seven patients in the methotrexate group and three patients in each of the other two groups discontinued treatment because of drug toxicity.In patients with rheumatoid arthritis, combination therapy with methotrexate, sulfasalazine, and hydroxychloroquine is more effective than either methotrexate alone or a combination of sulfasalazine, and hydroxychloroquine.
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Hydroxychloroquine
Association (psychology)
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Система комплексной поддержки и сопровождения научного журнала Elpub позволяет запустить двуязычный сайт журнала со встроенной системой электронной редакции в соответствии с лучшими издательскими практиками, а так же предусматривает техническую и методическую поддержку со стороны специалистов НЭИКОН.
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Hydroxychloroquine
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Rheumatoid arthritis (RA) is a systemic disease leading to joint destruction.The therapy of RA is mainly based on disease modifying anti-rheumatic drugs (DMARDs) and biological drugs.The response to treatment is different among patients.Therefore, we have searched for factors that may predict the efficacy and toxicity during therapy in individual patients.This review presents the role of genetic polymorphisms as predictors of the efficacy and toxicity during the therapy of rheumatoid arthritis patients with disease modifying anti-rheumatic drugs (methotrexate, leflunomide, sulfasalazine) and biological drugs (anti-TNF-alpha antagonists, Tocilizumab, Rituximab) .We are still far from applying pharmacogenetic tests in routine clinical practice that can predict the outcome of treatment, but genetic background will be the most important factor in personalizing therapy.
Key words:
Polymorphis; Rheumatoid arthritis; Therapy; Biological drugs; Methotrexate
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Tocilizumab
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OBJECTIVETo Compare the Efficacy of combination therapy of Methotrexate (MTX) and Hydroxychloroquine (HCQ) with MTX and Sulfasalazine (SSZ) in Rheumatoid Arthritis (RA) patients of Kumaon region. METHODSRA patients of age group in between 18-60 years, a definite rheumatoid arthritis patients based on 2010 ACR/EULAR CRITERIA, presenting to the medicine OPD with Disease Activity Score 28 (DAS 28) Score >3.2 were included in the study, and patients receiving treatment combinations were divided into study groups.In the OPD, HCQ was given at a dosage of 200 mg twice a day, whereas dosage of MTX was 10 to 20 mg/week.The dosage of SSZ was 500 mg to 1000 mg twice a day.The primary end point of the study was based on EULAR DAS 28 response criteria at the end of study period. RESULTSThe mean values of DAS 28 score show statistical significant decline within the group in every follow-up and during 2 nd and 3 rd follow-ups DAS 28 score between 2 groups shows statistical significant difference.At the end of study period (6 months), the difference between 2 study groups was not statistically significant.According to EULAR RESPONSE CRITERIA, good response was seen in 26 patients from group 1 st and 27 patients from group 2 nd . CONCLUSIONThe efficacy of drug combinations, i.e.MTX plus SSZ and MTX plus HCQ, in treating Rheumatoid Arthritis patients are comparable.Combination of MTX plus SSZ, however, shows rapid decrease in disease activity as compared to combination of MTX plus HCQ.
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