Chris Deighton
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1. New and improved treatments are available for inflammatory arthritis including rheumatoid arthritis. 2. It is important to identify and treat active rheumatoid arthritis aggressively as soon as possible, ideally within 3 months of onset, in order to slow disease progression and damage. 3. Combining disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate with glucocorticoids is the recommended first-line treatment approach.
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The document discusses definitions, types, epidemiology, causes, and management of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). It defines MDR-TB as resistance to at least isoniazid and rifampicin, and XDR-TB as MDR-TB plus resistance to a fluoroquinolone and one second-line injectable drug. It notes that MDR-TB prevalence is highest in previously treated patients and discusses the role of laboratory testing in designing effective treatment regimens. It provides guidelines for managing MDR/XDR-TB, including using a combination of effective drugs and directly observed therapy.
Rheumatoid arthritis treatment
Rheumatoid arthritis is an inflammatory disease characterized by inflammation in the synovium that can lead to joint damage. The goals of treatment are to control inflammation and prevent further injury. Early diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs) is important to achieve remission and prevent long-term disability. Treatment involves DMARDs, glucocorticoids, exercise and lifestyle changes. Methotrexate is generally first-line for moderate-severe RA while hydroxychloroquine or sulfasalazine may be used for mild RA. Biologics that target cytokines like TNF may be added if initial treatment is ineffective. Prognosis is best when diagnosis and treatment occur early in the
3 evaluation and management of rheumatoid arthritis
This document discusses the management of rheumatoid arthritis (RA). It provides details on:
- Key features of RA including symptoms, joint involvement, rheumatoid factor levels, and erosions.
- The typical clinical course, with most patients experiencing progressive joint damage over time.
- Treatment principles including early intervention, balancing efficacy and safety, and monitoring.
- Specific treatment options including NSAIDs, DMARDs, immunosuppressants, corticosteroids, and newer biologics.
- Potential complications of long-term RA and its treatment, including NSAID-induced gastropathy. Selective COX-2 inhibitors are presented as a potential solution to reduce gastrointestinal risks.
Rheumatoid arthritis Part 1 Basics & guideline application on real life cases...
Rheumatoid arthritis Part 1 Basics & guideline application on real life cases Ahmed Yehia Ismaeel, Beni-Suef University
مبادرة ياللا نذاكر روماتولوجي
رابط شرح المحاضرة على يوتيوب
https://youtu.be/VP_-0_GqhOI?si=uZNYIyUBkMRXjpuH
Alternative combinations 2021( f )
1) Combination DMARD therapy is superior to monotherapy in treating rheumatoid arthritis, with methotrexate as the cornerstone. Studies show combinations of traditional DMARDs can be as effective as combinations including biologics.
2) The COBRA trial demonstrated the benefits of initial intensive combination therapy including prednisolone, methotrexate, and sulfasalazine, followed by tapering medications. Benefits were seen even after medications were withdrawn.
3) Triple therapy with methotrexate, hydroxychloroquine and sulfasalazine is effective and durable for rheumatoid arthritis, shown in trials to be superior to double therapies and monotherapy.
Dr moorthy arthritis awareness clash ppt 2011 2
- Rheumatoid arthritis (RA) is an autoimmune disease that causes joint inflammation and affects around 0.5-1% of the UK population.
- There are often long delays between symptom onset and seeking medical help or receiving a specialist referral, resulting in worse long-term outcomes and higher economic costs.
- Early diagnosis and treatment, including tight control of symptoms, can help achieve remission and prevent disability, making public awareness and education critical for improving RA management.
12 aaom reeves workshop apr 19 research summary
The document summarizes research on prolotherapy, which involves injections to repair soft tissues like ligaments and tendons. It discusses definitions of prolotherapy and focuses on dextrose prolotherapy. It provides evidence that prolotherapy is not experimental, as it is taught in postgraduate medical programs and supported by published studies. Several studies on specific conditions like Achilles tendinosis, knee osteoarthritis, and low back pain are summarized, demonstrating safety and efficacy of prolotherapy though some need further research.
Rheumatoid arthritis
This document discusses rheumatoid arthritis (RA), a chronic inflammatory disease characterized by joint inflammation and damage. The clinical presentation of RA involves symmetric joint pain, swelling, and morning stiffness. The pathogenesis involves an immune response involving T cells, B cells, and cytokines like TNF-alpha that promote inflammation. Disease activity is the main driver of joint damage and disability in RA. Treatment involves conventional disease-modifying antirheumatic drugs (DMARDs) and biologic agents to reduce inflammation, prevent further joint destruction, and improve function.
Definition of remission of ra
The document discusses definitions of remission for rheumatoid arthritis (RA) and the goals of treating RA. It provides context on the history of RA treatment goals moving from symptom relief to preventing joint damage and achieving remission. The key points are:
1) Definitions of remission have evolved from the original ACR criteria to the 2011 ACR-EULAR definition, which includes boolean and index-based definitions for use in clinical trials.
2) Achieving early remission through aggressive treatment is associated with better long-term outcomes for RA patients.
3) The 2011 definition was developed for clinical trials but needs validation for use in practice to guide treatment and measure remission.
Mdr tuberculosis
This document provides an overview of multidrug-resistant tuberculosis (MDR TB). It defines the different types of drug-resistant TB and discusses the epidemiology and mechanisms of drug resistance. It emphasizes the importance of proper diagnosis and treatment for managing drug-resistant TB. The key points are that improper or incomplete treatment can cause drug resistance to develop, MDR TB requires testing to identify resistance and an individualized treatment regimen using second-line drugs, and treatment must be closely monitored for at least 18-24 months.
2018 Q4 Rheumatoid Arthritis Management.pptx
This document provides information on rheumatoid arthritis (RA) including its definition, epidemiology, risk factors, pathogenesis, clinical presentation, diagnostic criteria, disease activity, and treatment algorithms. It discusses the treatment of RA through pharmacologic interventions like disease-modifying antirheumatic drugs (DMARDs), biologics, synthetic small molecules, and nonpharmacologic therapies. Guidelines for diagnosing and managing RA are outlined based on sources like the American College of Rheumatology.
Nejm journal watch practice changing articles 2014
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Rheumatoid Arthritis Medical Treatment ( Prof. Fathy EL-Belasy) Strategy & Drugs
Approach to Medical treatment of Rheumatoid Arthritis.
pharmacological treatment
by Prof. Fathy EL-Belasy
Rheumatoid Arthritis in Family Medicine
This document discusses the importance of early diagnosis and treatment of rheumatoid arthritis (RA) by family physicians. It notes that untreated RA leads to joint damage and disability. The goals of treatment are to suppress inflammation early and achieve remission to prevent joint damage. Joint damage can occur within weeks or months of symptoms starting. Studies show treatment is most effective when started within 12 weeks of symptoms. The 2010 ACR/EULAR classification criteria emphasize early diagnosis and are more sensitive for early RA compared to older criteria. Family physicians can play a key role by identifying patients with possible inflammatory arthritis and referring them promptly for rheumatology assessment to facilitate early treatment and improve long-term outcomes.
Advances in depression treatment
Via Christi Women's Connection presentation on advance in depression treatment by Matthew Macaluso, DO, medical director of Via Christi Psychiatric Clinic.
Marineo + smith jan 2012 scrambler therapy better than drugs marineo 2012
Marineo + smith jan 2012 scrambler therapy better than drugs marineo 2012Calmar Pain Relief Therapy, LLC
Scrambler Therapy May Relieve Chronic Neuropathic Pain More Effectively Than Guideline-Based Drug Management: Results of a Pilot, Randomized, Controlled TrialRheumatoid Arthritis: Early Diagnosis and Treatment
Dr. Swamy Venuturupalli talks about Rheumatoid Arthritis, Early Diagnosis and Treatment at the James R. Klinenberg symposium on Rheumatic diseases in Pasadena, CA.
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Rheumatoid arthritis Part 1, case based approach with application of the late...
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3 evaluation and management of rheumatoid arthritis
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Nejm journal watch practice changing articles 2014
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Rheumatoid Arthritis Medical Treatment ( Prof. Fathy EL-Belasy) Strategy & Drugs
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Marineo + smith jan 2012 scrambler therapy better than drugs marineo 2012
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Rheumatoid Arthritis: Early Diagnosis and Treatment
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This document discusses decision making for arthritis treatment and medication. It notes that while treatment decisions can be complex, patients are generally good at making informed choices when engaged in shared decision making with clinicians. The document outlines some common arthritis medications like NSAIDs and topical preparations, noting their risks and benefits. It also discusses factors that influence patients' preferences, like their perception of risk versus pain relief. Overall, it advocates for shared decision making between patients and clinicians to find the right balance of risks and benefits based on the best available information and individual patient values and circumstances.
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- 1. New treatments: expert response Dr Chris Deighton Department of Rheumatology Derbyshire Royal Infirmary
- 4. Severity (Arbitrary Units) 0 Duration of Disease (years) 5 10 15 20 25 30 What components of the disease are we trying to modify? Early RA Intermediate Late Graph: Adapted from: Kirwan JR. J Rheumatol. 2001;28:881-886. Inflammation Disability Radiographs
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- 12. Why steroids?