Treatment of rheumatoid arthritis

Abstract

The management of the rheumatoid patient involves the considered use of pharmacologic agents as therapies to induce symptomatic relief and to reduce disease activity. Aspirin and nonsteroidal antiinflammatory drugs are used initially to lessen the degree of pain and swelling associated with the inflammatory disease process. The aggressive institution of second‐line therapy, previously known as disease‐modifying antiinflammatory rheumatic drugs, is advocated to modify the disease course itself. These second‐line treatments include antimalarials, gold salts, methotrexate, d‐penicillamine, and azathioprine. Randomized placebo controlled trials have demonstrated the efficacy of these compounds in this illness. Improvement in standard parameters of disease activity (number of painful and swollen joints, duration of morning stiffness, erythrocyte sedimentation rate) can be related to the therapeutic value of second‐line agents. Whether they modify radiographic progression is under rigorous study. Newer therapies under research investigation include sulfasalazine, cyclosporin A, and combination therapy.

Dispositional Optimism/Pessimism and Coping Strategies: Predictors of Psychosocial Adjustment of Rheumatoid and Osteoarthritis Patients1

“…RA is a chronic autoimmune disorder characterized by inflammation of joint tissues and a variety of nonspecific symptoms, such as fever, morning stiffness, and fatigue. The course of the illness is unpredictable, progressive, and is marked by acute painful episodes (Weinblatt & Maier, 1989). OA is a group of diseases characterized by the degeneration of the bone and cartilage of the joint, and pain is a common problem for patients (Dekker et al, 1992).…”

Efficacy and Rapid Response of Tocilizumab in Rheumatoid Arthritis Patients not Responder to Previous Biologic Therapy

“…Similarly to other chronic inflammatory clinical conditions, also in RA, HDL cholesterol and total cholesterol levels are often reduced; these changes are frequently in line with inflammatory marker elevations. In humans several inflammatory reactive cytokines are known to reduce both HDL cholesterol and LDL cholesterol levels; activation of the reticulo endothelial system is likely associated with such changes, but other mechanisms may be involved [29,31,32].…”

Formulation and Optimization of Celecoxib Nanoemulgel

“…In autoimmune disease class, rheumatoid arthritis (RA) is one of the devastating diseases where patients suffer acute joint swellings, serious pain, and stiffness [1,2]. During further advancement of this disease, the patient may witness weight loss, moderate fever, anemia, and extreme tiredness.…”