Clinical Aspects of Rheumatoid Arthritis Flashcards
1
Q
What are the different treatment options for RA?
A
- Medicines
- Injections
- Therapies
- Surgery
2
Q
What are the different therapeutic categories for treatment of RA?
A
- NSAIDs
- Disease modifying anti rheumatic drugs (DMARD)
- Biologics
- Corticosteroids (oral, I-m, I-a)
3
Q
What does DMARD stand for?
A
Disease modifying anti-rheumatic drugs
4
Q
What are disease modifying anti rheumatic drugs (DMARD)?
A
- Group of structurally unrelated drugs that slow onset effect of disease activity and retard disease progression
5
Q
What are examples of DMARDs?
A
- Examples
-
Methotrexate
- Effective and well tolerated (gold standard)
- Cornerstone treatment of combination treatment (with DMARD and biologics)
- Sulfasalazine
- Hydroxychloroquine
- Leflunomide
-
Methotrexate
6
Q
What drug is the main treatment for RA?
A
- Methotrexate (a DMARD)
7
Q
How does the speed of action of biologics compare to DMARDs?
A
- In contrast to DMARDs they work quickly
8
Q
What are examples of different biologics?
A
- TNF-alpha inhibitors
- IL-1 inhibitors (anakinra)
- Anti B cell therapies (CS20, Rituximab)
- Anti T cell therapies (abatacept)
- IL-6 inhibitors (tocilizumab, Darilumab)
- Oral kinase inhibitors
9
Q
What are some issues of biologics?
A
- Issues with toxicity such as injection
- Expensive
10
Q
How do biologics work?
A
- Targets key aspects of inflammatory cascade
11
Q
Should corticosteroids be used long term for RA?
A
Never (Balance of short term benefit vs long term toxicity)
12
Q
Summarise the approach to management of RA?
A
- Early and aggressive intervention key to obtaining optimal outcomes
- Effective suppression of inflammation improves symptoms and prevents joint damage and disability
- Usually use combination of therapies
- Step up, step down and parallel
13
Q
What is successful therapeutics?
A
- Adalimumab (TNF-alpha)
