Management of Rheumatoid Arthritis: Special Consideration for Biologic Disease-Modifying Antirheumatic Drugs

Abstract

Rheumatoid arthritis (RA) is a progressive chronic inflammatory disease affecting 0.5–1.0% of the adult population worldwide. Due to the damages caused by this autoimmune disease, new biologic therapies, particularly the biologic disease-modifying antirheumatic drugs (bDMARDs), are now being the treatment of choice in the management of RA. However, special precaution and prescreening before the usage of bDMARDs are needed to ensure better clinical response and avoiding risk of adverse event during treatment with the selected bDMARDs. In this review paper, we will provide overview on the incidence and pathogenesis of the disease, available pharmacological treatment and emphasizing special consideration in need on initiation of bDMARDs among RA patients. A literature review was performed by searching for relevant articles in Medline database through PubMed using medical subject headings terms and keywords: RA, bDMARDs, special consideration, tumor necrosis factor inhibitor, and non-tumor necrosis factor inhibitor. All papers reviewed were from 1999 to 2017 and were written in English. In this article, use of conventional synthetic DMARDs (csDMARDs), bDMARDs and special consideration to be taken upon initiation of biologic therapies in RA will be reviewed.

Rheumatoid arthritis serotype and synthetic disease-modifying anti-rheumatic drugs in patients with periodontitis: A case-control study

“…This can also be explained by the pattern of prescription where methotrexate is prescribed to participants newly diagnosed with RA [ 41 , 42 ]. Participants with more advanced RA have usually first tried monotherapy unsuccessfully and will be on a combination of medications [ 43 ]. Hence, a higher PPD and CAL in participants on a combination of DMARDs suggests that participants with a more severe form of RA has a more severe form of periodontitis.…”

Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs

“…The therapeutic goals of IA are to achieve good control of the disease activity, to reduce the progression of permanent joint damage, and to improve patients' quality of life. Pharmacotherapy modalities in the management of IA include the use of the conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) followed by the targeted biologic disease-modifying antirheumatic drugs (bDMARDs) Razak et al, 2018). The DMARDs are the key agents recommended in the management for IA disease control, damage prevention, persevering affected joint function, increase in patients' quality of life, and increase in the possibilities to achieve complete remission of the disease (Wee et al, 2016).…”