Lecture 29 - Treatment of RA Flashcards

1
Q

Phase I trials are to evalutate ____

A

safetly

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2
Q

Phase II is to determine _____

A

efficacy

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3
Q

phase III is to compare to the…

A

existing therapy, large trials3

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4
Q

Phase IV is

A

post marketing surveillance

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5
Q

Optimal clinical design includes:

A
Ethical
Randomisation
Placebo/control
Blinding (maskking)
Adequate Power (sample size)
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6
Q

What is the therapeutic ‘window of opportunity’

A

first 3 months after symptom onset

If treated here, good chance of reducing disease severity

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7
Q

The aim for remission or low disease activity can be tested by..

A

DAS28-CRP criteria (<2.6)

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8
Q

The _____ is more important than the agent in RA

A

The Approach is more important than the agent in RA

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9
Q

If you treat people very intensively (reviewed at monthy intervals), treatment was escalated accordingly - this approach showed

A

Less radiographic joints erosions

No increase in adverse events

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10
Q

Disease modifying antirheumatic drugs (DMARDs) include:

A

Methotroxate

sulfasalazine

Antimalarial drugs

Leflunomide

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11
Q

DMARDs should be started…

A

As early as possible

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12
Q

Methotrexate is an antifolate agent meaning it blocks ____ synthesis

A

purine synthesis

mechanism of action not known

It is the anchor DMARD drug

triple therapy

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13
Q

The ____ _____ study showed (MTZ/SSZ/HCQ) is superior to dual or mono therapy

A

triple therapy study

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14
Q

The biological disease modifying antirheumatic drugs (bDMARDs) are reserved for patients that…

A

failt o respond to convential DMARDs

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15
Q

There are 5 classes of bDMARDs, they are:

A

TNF inhibitors

IL-1 antagonists

IL-6 antagonists

CTLA4 ligand

B-cell depleting agents (anti-CD20)

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16
Q

What are the current PBS criteria for bDMARDs?

A

1) Failes 6 monts intensive eligibility in RA
2) Erythrocyte sedimentation rate >25mm/hr - has active disease

3) Active joint count >20 active joints (swollen)
>4 major joints

17
Q

What is the first line bDMARD?

A

TNF inhibitors

18
Q

only ______ can manage many deformities from previous damage - another reason early treatment is crucial

A

surgery