RA in Women: Current Approach/Overview | Arthritis Information

 

Rheumatoid Arthritis in Women: Current Approach and Overview of Recent Guidelines

Jean H. Tayar, MD; Maria Suarez-Almazor, MD, PhD

Rheumatoid arthritis is a chronic disease requiring long-term drug therapy, conferring a variety of risks from both the condition and its treatment—especially in pregnant women. New recommendations address many of these issues, but management remains largely an art.

Rheumatoid arthritis (RA) is the most common chronic autoimmune inflammatory polyarthritis, with a prevalence among adults of approximately 1%.1 The condition is twice as likely to develop in women as in men. Although several genetic and environmental risk factors have been linked to RA, the etiology remains unknown.

http://www.femalepatient.com/html/arc/fea/articles/034_09_016.aspThis looks very interesting- will have to open it up again at home. Too much to read when I'm supposed to be working.

The American College of Rheumatology (ACR) revised its recommendations for managing RA in 2008 based on a systematic review of the literature. These guidelines cover most of the nonbiologic DMARDs (azathioprine, hydroxychloroquine, leflunomide, MTX, minocycline, organic gold compounds, sulfasalazine) and 6 biologic agents (etanercept, infliximab, adalimumab, anakinra, abatacept, rituximab).6 Glucocorticosteroids, NSAIDs, and other analgesics were not part of this review.

The authors defined 3 important clinical features for guiding therapeutic decisions:

• Disease duration (ie, short [<6 months], intermediate [6 to 24 months], or long [>24 months])
• Disease activity based on various indices (ie, low, moderate, high)
• Presence of 1 or more predefined poor prognostic markers (ie, functional limitation, extra-articular disease, presence of RF or anti-CCP antibodies, bony erosions on radiography).

In general, sulfasalazine and hydroxychloroquine are recommended for cases with low disease activity and no poor prognostic factors, whereas MTX and leflunomide can be used in almost any RA scenario. Combination therapy is reserved for more complicated cases with high disease activity.

The use of an anti-TNFα agent in combination with MTX is recommended for early RA with high activity and 1 poor prognostic feature. Otherwise, the anti-TNFα agents are reserved for patients who fail to respond to MTX monotherapy and have high disease activity, or those with a poor prognostic factor and moderate disease activity. Abatacept and rituximab are recommended only when other nonbiologic and/or biologic DMARDs are ineffective in a patient with poor prognostic features and moderate to high disease activity. To establish risk surveillance, health care professionals should be familiar with the toxicities and contraindications associated with RA therapy (Table 1).[/quote]

I'm changing my name to " ART "   lol [QUOTE=6t5frlane]I'm changing my name to " ART "   lol[/QUOTE]

Heeelllllooooo, ART!

My sense of and attributes for being art are very much under construction. So...I will change my name to Artiste, and aim to improve my performance each day.
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