Lecture 29 - Treatment of RA Flashcards
Phase I trials are to evalutate ____
safetly
Phase II is to determine _____
efficacy
phase III is to compare to the…
existing therapy, large trials3
Phase IV is
post marketing surveillance
Optimal clinical design includes:
Ethical Randomisation Placebo/control Blinding (maskking) Adequate Power (sample size)
What is the therapeutic ‘window of opportunity’
first 3 months after symptom onset
If treated here, good chance of reducing disease severity
The aim for remission or low disease activity can be tested by..
DAS28-CRP criteria (<2.6)
The _____ is more important than the agent in RA
The Approach is more important than the agent in RA
If you treat people very intensively (reviewed at monthy intervals), treatment was escalated accordingly - this approach showed
Less radiographic joints erosions
No increase in adverse events
Disease modifying antirheumatic drugs (DMARDs) include:
Methotroxate
sulfasalazine
Antimalarial drugs
Leflunomide
DMARDs should be started…
As early as possible
Methotrexate is an antifolate agent meaning it blocks ____ synthesis
purine synthesis
mechanism of action not known
It is the anchor DMARD drug
triple therapy
The ____ _____ study showed (MTZ/SSZ/HCQ) is superior to dual or mono therapy
triple therapy study
The biological disease modifying antirheumatic drugs (bDMARDs) are reserved for patients that…
failt o respond to convential DMARDs
There are 5 classes of bDMARDs, they are:
TNF inhibitors
IL-1 antagonists
IL-6 antagonists
CTLA4 ligand
B-cell depleting agents (anti-CD20)
