Disease-Modifying Drugs for Rheumatoid Arthritis. When, How and Which One to Use
Abstract
Rheumatoid arthritis is the most common rheumatological disease worldwide, with many articular and extra-articular complications associated with comorbidities and mortality. Cardiac and pulmonary complications contribute the most towards morbidity, mortality and pose great difficulty in RA management. Recently there have been many updates in the pharmacological options available for rheumatoid arthritis, including biological and targeted biological disease-modifying drugs. This review article focuses on the pros and cons of the main therapeutic options currently used to manage rheumatoid arthritis according to the updated guidelines by EULAR. The report also encompasses a summary of the recent guidelines by EULAR.
How to Cite This Article
Hussain A, Avais2 1J. Disease-Modifying Drugs for Rheumatoid Arthritis. When, How and Which One to Use. J Pak Soc Intern Med. 2021;2(3):195–204. doi:10.70302/jpsim.v2i3.2146
Conflict of Interest
All authors declare no competing interests.
Funding
No specific funding was received for this research.
Funder information follows the Crossref Funder Registry standard.
References
- Aletaha D, Smolen JS. Diagnosis and management of RA: A Review. JAMA. 2018:320(13);1360-72.
- Smolen JA, Breedveld FC, Burmester GR, Vivian B, Maxime D, Paul E, et al. Treating RA to target: 2014 updates of the recommendations of an international task force. Ann. Rheum Dis. 2016:75(1);3-15
- Hoes JN, Jacotis JW, Boers M, Boumpas D, F Buttgereit F, Caeyerset N, al. EULAR evidence-based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis. 2007:66(12);1560-7.
- Fiehn C, Holle J, Iking-Konert C, Leipe J 6, Weseloh C, Frerixet M, et al. S2e guideline: treatment of rheumatoid arthritis with disease-modifying drugs. Z Rheumatol. 2018:77(2);35-53.
- Smolen JS, Landewe R, Breedveld FC, Maya B, Gerd B, Maxime D, et al. EULAR recommendations for managing RA with synthetic and biological DMARD: 2013 Updates. Ann Rheum Dis. 2014:73(3);492-509
- Birgit M, Janine G, Dorothee K, Hanns-Martin L. Current therapeutic options in the treatment of RA. J Clin Med. 2019:8(7);938.
- Chatzidionysiou K, Lie E, Nasonov E, Galina L, Merete LH, Ulrik T, et al. Highest clinical effectiveness of Rituximab in autoantibody-positive patients with RA and in those for whom no more than one previous TNF antagonists has failed: pooled data from 10 European registries. Ann Rheum Dis. 2011:70(9);1575-80.
- Brown PM, Pratt AG, Isaacs JD. Mechanism of action of MTX in RA, and the search for biomarkers. Nat Rev Rheumatol. 2016:12(12);731-42.
- Gonzalez-Ibarra F, Eivaz MS, Surapaneni S, Alssadi H, Syed AK, Badin S, et al. Methotrexate induced pancytopenia. Case Rep Rheumatol (2014):2014;679580.
- Strang A, Pullar T. Methotrexate toxicity induced by acute renal failure. J The Royal Soc Med. 2004:97;536-7.
- Kho LK, Kemode AG. Leflunomide induced peripheral neuropathy. J Clin Neurosci. 2007;14(2);179-181.
- Kruger K, Albrecht K, Rehart S, Scholz R, Kommission PDGRh. Recommendations of the German Society for Rheumatology on the perioperative approach under therapy with DMARD and biologics in inflammatory rheumatic diseases. Z Rheumatol.2014;73(1):77-84.
- Osuga T, Ikura Y, Kadota C, Hirano S, Iwai Y, Hayakumo T. Significance of liver biopsy for evaluation of Methotrexate induced liver damage in patients with RA. Int J Clin Pathol. 2015; 8(2):1961-6.
- Shea B, Swindon MV, Tanjong GE, Zulma O, Wanruchada K, Tamara R, et al. Folic acid and colonic acid for reducing the side effects in patients receiving MTX for RA. Cochrane Database Systemic Review. 2013:5-CD000951.
- Kruger K, Bolten W. Treatment with Leflunomide in RA. Z Rheumatol. 2015:64(2);96-101.
- Osterisen M, Khamashta M, Lockshin M, Ann Parke, Antonio B, Howard C, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006;8(3):209.
- Curtis JR, Beukelman T, Onoferi A, S Cassell, J D Greenberg, A Kavanaugh, et al. Elevated liver enzyme tests among patients with RA or psoriatic arthritis treated with Methotrexate and Leflunomide. Ann Rheum Dis. 2010;69(1):43-47.
- Chikura B, Lane S, Dawson JK. Clinical expression of Leflunomide-induced pneumonitis. Rheumatology Oxford. 2009;48(9):1065-106.
- Kasitanon N, Fine DM, Hass M, Magder LS, Petri M. Hydroxychloroquine use predicts complete renal remission within 12 months among patients treated with Mycophenolate therapy for SLE Nephritis. Lupus. 2006:15(6):366-70.
- Akhavan PS, Su J, Lou W, Gladman DD, Urowitz MB, Fortin PR. The early protective effect of Hydroxychloroquine on the risk of cumulative damage in patients with SLE. J Rheumatol. 2013;40(6):831-41.
- Penn SK, Kao AH, Schott LL, Elliott JR, Toledo FG, Kuller L, et al. Hydroxychloroquine and glycemia in women with RA & SLE. J Rheumatol. 2010:37(6);1136-42.
- Box SA, Pullar T. Sulfasalazine in the treatment of RA. Br J Rheumatol. 1997;36(3):382-6.
- Emery P. Infliximab: a new treatment for RA. Hosp Med. 2001;62(3):150-2.
- Mikuls TR, Moreland LW. TNF blockade in the treatment of RA: Infliximab versus Etanercept. Expert Opin Pharmacother. 2001;2(1):75-84.
- Rau R. Adalimumab (a fully human anti-TNF Alpha monoclonal antibody) in treating active RA: the initial results of five trials. Ann Rheum Dis. 2002;61(s2):70-3.
- Kay J, Matteson EL, Dasgupta B, Peter N, Patrick D, Stephen H, et al. Golimumab in patients with active RA despite treatment with MTX: a randomized, double-blind, placebo-controlled, dose-ranging study. Arthritis Rheum. 2008;58(4):964-75.
- Fleischmann R, Vencovsky J, van Vollenhoven RF, Borenstein D, Box J, G Coteur, Goel N, et al. efficacy and safety of certolizumab pegol monotherapy in patients with RA failing previous DMARDs: the FAST4WARD study. Ann Rheum Dis. 2009;68(6):805-11.
- Maxwell L, Singh JA. Abatacept for Rheumatoid Arthritis. Cochrane database syst Rev. 2009; doi: 10.1002/14651858.CD007277.pub2. doi:10.1002/14651858.CD007277.pub2
- Harrold LR, John A, Best J, Zlotnick S, Karki C, Li F, et al. Impact of RTX on patients reported outcomes in patients with RA rim the US company registry. Clin Rheumatol 2017;36(9):2135-40.
- Migita K, Izumi Y, Torigoshi K, Izumi M, Nishino Y, Jiuchi Y, Nakamura M, et al. Inhibition of Janus Kinase/Signal Transducer and activator of Transcription (JAK/STAT) signaling pathway in RA synovial fibroblasts using small molecule compounds. Clin Exp Immunol. 2013;174(3);356-63.
- Dhillon S. Tofacitinib: a review in Rheumatoid Arthritis. Drugs. 2017;77(18):1987-2001.
- Keystone EC, Schiff M, Kemer JM, Kafka S, Levy M, DeVries T, et al. Once-weekly administration of 50mg etanercept in patients with active RA: results of a multicentre randomized, double-blind placebo-controlled trial. Arhritis Rheum. 2004;50(2):353-63.
- Emery P, Kosinski M, Li T, Martin M, Williams GR, Becker JC, et al. Treatment of RA patients with Abatacept and Methotrexate significantly improved health-related quality of life. J Rheumatol. 2006;33(4):681-9
- Van Vollenhoven R, Harju A, Brannemark S. Treatment with Infliximab when etanercept has failed or vice versa: data from the STURE registry showing that switching TNF blockers can make sense. Ann Rheum Dis. (2003):62(12);1195-1198.
- Genovese MC, Becker JC, Schiff M, Luggen M, Sherrer Y, Kremer J. Abatacept for RA refractory to TNF inhibition. N Eng J Med. 2005;353(11):1114-23.
- Boers M. Cost-effectiveness of biologics as first-line treatment of RA. Case closed? Ann Intern Med. 2009;151:668-69.
- Cohen SB, Emery P, Greenwald MW, Dougados M, Furie RA, Genovese MC, et al. Rituximab for RA refractory to anti-TNF therapy: results of a multicentre randomized, double-blind placebo-controlled phase III trial evaluating primary efficacy and safety at twenty-four weeks. Arthritis Rheum. 2006;54(9):2793-2806.
- Genovese MC, Rubbert-Roth A, Smolen JS, Kremer J, Khraishi M, Gómez-Reino J, et al. long-term safety and Efficacy of Tocilizumab in patients with RA: a cumulative analysis of up to 4.6 years of exposure. J Rheumatol. 2013;40(6):768-80.
- Lee YH, Bae SC, Song GG. The Efficacy and safety of Rituximab for the treatment of active RA: a systematic review and meta-analysis of randomized controlled trials. Rheumatol Int. 2011;31(11):1493-9.
- 40 Yamaoka K. Benefit and risk of Tofacitinib in the treatment of RA: A focus on Herpes Zoster. Drug safe. 2016);39(9);823-40.
Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.