Synthetic DMARDs may be used as monotherapy or in combination, and can be co-prescribed with low-dose corticosteroids if necessary. (samj.org.za)
In recent years, treatment with biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs), either as monotherapy or in combination with other drugs, have become the standard of treatment. (researchgate.net)
Biologic4
Biologic DMARD therapy should be considered for patients who have failed a 6-month trial of at least 3 synthetic DMARDs. (samj.org.za)
and ( iii ) the emergence of biologic disease-modifying anti-rheumatic drugs (DMARDs). (samj.org.za)
Additional disease-modifying antirheumatic drugs or biologic agents should be added if disease activity persists. (aafp.org)
Patients who are in remission from rheumatoid arthritis for more than six months and on stable medication regimens are candidates for tapering or discontinuing disease-modifying antirheumatic drug or biologic treatment. (aafp.org)
Rheumatoid9
Updated treatment recommendations for the therapy of rheumatoid arthritis (RA) in South Africa advocate early diagnosis, prompt initiation of disease-modifying anti-rheumatic drugs (DMARDs), and an intense treatment strategy where disease activity is assessed with a composite score such as the Simplified Disease Activity Index (SDAI). (samj.org.za)
A handout on this topic is available at http://familydoctor.org/familydoctor/en/diseases-conditions/rheumatoid-arthritis.html . (aafp.org)
Rapid diagnosis of rheumatoid arthritis allows for earlier treatment with disease-modifying antirheumatic drugs, which is associated with better outcomes. (aafp.org)
Although rheumatoid arthritis is often a chronic disease, some patients can taper and discontinue medications and remain in long-term remission. (aafp.org)
Methotrexate should be the first-line disease-modifying antirheumatic drug in patients with rheumatoid arthritis unless there are contraindications. (aafp.org)
Patients with rheumatoid arthritis should be treated as early as possible to have the best chance of remission. (aafp.org)
Patients should be screened for chronic infections, including latent tuberculosis, hepatitis B virus, and hepatitis C virus, before starting rheumatoid arthritis treatment. (aafp.org)
Do not prescribe biologics for rheumatoid arthritis before a trial of methotrexate (or other conventional nonbiologic disease-modifying antirheumatic drugs). (aafp.org)
What are the recommendations for the screening and treatment of latent tuberculosis in patients with rheumatoid arthritis under management with biodmards and jak inhibitors? (reumatologiaclinica.org)
Patients4
These recommendations provide practical suggestions for the screening and management of TB and other comorbidities, and offer an approach to monitoring of RA patients. (samj.org.za)
In a randomized trial of patients who were on stable disease-modifying antirheumatic drug (DMARD) regimens and in clinical remission for at least six months, 84% of patients who continued full DMARD treatment remained in remission after 12 months, compared with 61% who tapered DMARDs by 50%, and with 48% of those who stopped all DMARDs. (aafp.org)
Screen all patients for HBV infection before treatment initiation, and monitor patients during and after treatment with Rituxan. (rituxan-hcp.com)
Hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death, can occur in patients treated with drugs classified as CD20-directed cytolytic antibodies, including Rituxan. (rituxan-hcp.com)
Treatment3
The goal of therapy is to initiate early medical treatment to achieve disease remission or the lowest disease activity possible. (aafp.org)
Most uveitis seen in Western countries is noninfectious and appears to be autoimmune or autoinflammatory in nature, requiring treatment with immunosuppressive and/or anti-inflammatory drugs. (dovepress.com)
When should treatment with csdmards be started to achieve remission, low disease activity and arrest of radiographic damage? (reumatologiaclinica.org)
Disease activity1
Frequent assessments and escalation of therapy are necessary until low disease activity (LDA) (SDAI ≤11) or ideally remission (SDAI ≤3.3) is achieved. (samj.org.za)
Months1
Spontaneous remission is uncommon, especially after the first 3-6 months. (medscape.com)