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Updated Guidelines for RA Treatment

In 2008, the American College of Rheumatology (ACR) issued guidelines for the use of non-biologic and biologic treatments in rheumatoid arthritis (RA). Much has changed in the years since the last recommendations, with the availability of new drugs and increased experience with the older agents. The ACR guideline update, which was published in the May 2012 issue of Arthritis Care & Research, focuses on early treatment, special considerations for high-risk patients, and screening for tuberculosis. “The 2012 update re-emphasizes the importance of more aggressive treatment in early RA.” The ACR update re-emphasizes the importance of aggressive treatment in early RA. In addition to better outcomes, early intensive treatment can help patients maintain physical function and quality of life. Prevention is critical because joint damage resulting from RA is permanent once it occurs. It should be noted that the updated recommendations focus on common clinical scenarios. They should be used as a guide for clinicians with the clear understanding that the best treatment decisions can only be made by having collaborative dialogue with patients. For each patient, physicians must consider: The risks and benefits of treatment. Comorbidities and concomitant medications. Patient preferences. Practical economic considerations. Rheumatoid Arthritis Treatment Recommendations The goal of early RA treatment is for remission or at least low disease activity. For patients who have been symptomatic for 6 months or less, the usual approach should be disease-modifying antirheumatic drug (DMARD) monotherapy. If disease activity is moderate or high and patients have poor prognosis, combination DMARD therapy can be tried. If disease activity is high in early RA and the prognosis is poor, an anti-tumor necrosis factor...

Conference Highlights: ACR 2010 Annual Scientific Sessions

The 2010 Scientific Sessions of the American College of Rheumatology, or ACR, was held from November 7 to 11 in Atlanta. The features below highlight just some of the studies that emerged from the meeting. » Promising Results for Experimental RA Drug » Comparing Therapies for ANCA-Positive Vasculitis » Abatacept Well-Tolerated in Patients With RA Promising Results for Experimental RA Drug The Particulars: Tasocitinib is an investigational oral JAK inhibitor that may be beneficial for patients suffering from rheumatoid arthritis (RA). It is thought to block cytokine production. A phase III trial involving 611 patients with RA was conducted to assess the effect of tasocitinib on reducing symptoms, disability, and remission. Data Breakdown: In the study, responses at the ACR20 symptom level after 3 months were seen in 65.7% of patients receiving tasocitinib at 10 mg twice daily and in 59.8% of those taking a 5 mg dose, compared with 26.7% of those taking placebo. ACR50 and ACR70 symptom responses were seen in 36.8% and 20.3%, respectively, of the 10-mg tasocitinib patients at 3 months, compared with 12.5% and 5.8% of the placebo group. Similar results were seen in responses assessed with the Health Assessment Questionnaire-Disability Index. An analysis of remission (according to the Disease Activity Scale-28) at 3 months found that tasocitinib did not offer a significant advantage at either dosage relative to placebo. However, remission was seen in 6.0% of the 5-mg group (relative to placebo). Take Home Pearl: Tasocitinib appears to offer some benefits for RA patients, but more studies are needed to assess efficacy and safety. Comparing Therapies for ANCA-Positive Vasculitis [back to top] The...
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