Therapeutic Aspects of Rheumatoid Arthritis

Question 1

What are the possible treatment routes in inflammatory arthritis?

Answer 1

Medicines
Injections
Therapies
Surgery

Question 2

What are the drug categories that can be used in rheumatoid arthritis?

Answer 2

NSAIDs
Disease modifying anti-rheumatic drugs (DMARDs)
Biologics
Corticosteroids

Question 3

What are the options in DMARD therapy, which is first line and why?

Answer 3

Methotrexate (first line)
Sulfasalazine
Hydroxychloroquine
Leflunomide
Methotrexate first line as it is effective, well-tolerated and cheap

Question 4

What are the benefits of effective inflammatory suppression?

Answer 4

Improve symptoms
Decrease joint damage
Decrease disability

Question 5

What are the options for biologic therapy of rheumatoid arthritis?

Answer 5

TNFa inhibitors (x5)
IL-1 inhibitors (Anakinra)
Anti B Cell therapies (CD20, Rituximab)
Anti T Cell therapies (Abatacept)
IL-6 inhibitors (Tocilizumab)

Question 6

What are the disadvantages of biologic therapy in rheumatoid arthritis?

Answer 6

Possible causes of infection

May be chance of increased risk of malignancy

Question 7

Describe the use of corticosteroids in management of rheumatoid arthritis

Answer 7

Can be used orally, IV, IM or IA injection
Give a short term benefit but can cause long term toxicity
Rarely appropriate as single drug therapy