-
Zeitschrift Fur Gerontologie Und... Oct 2022Older individuals experience various noninflammatory and autoimmune inflammatory rheumatic diseases. Given the increased incidence of rheumatic conditions in older... (Review)
Review
Older individuals experience various noninflammatory and autoimmune inflammatory rheumatic diseases. Given the increased incidence of rheumatic conditions in older adults, it is of great importance for healthcare providers to be aware of the potential benefits and risks of antirheumatic drugs. The present article aims to provide a comprehensive review regarding antirheumatic drug use in older patients, particularly by focusing on safety issues and polypharmacy. Antirheumatic medications include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids and disease-modifying antirheumatic drugs (DMARDs), which comprise conventional synthetic DMARDs, targeted synthetic DMARDs and biological DMARDs. Due to the alteration in drug pharmacokinetics and pharmacodynamics in old people, antirheumatic drug efficiency and safety may be different than in the younger population. Polypharmacy and multimorbidity are other potential challenges to be faced during the treatment of older patients with rheumatic diseases. The current review also discusses the strategies to minimize adverse reactions due to antirheumatic drugs.
Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Antirheumatic Agents; Humans; Polypharmacy; Rheumatic Diseases
PubMed: 34114088
DOI: 10.1007/s00391-021-01907-6 -
Arthritis & Rheumatology (Hoboken, N.J.) Jul 2022
Topics: Antirheumatic Agents; Arthritis; Humans; Rheumatology
PubMed: 35358367
DOI: 10.1002/art.42131 -
Best Practice & Research. Clinical... Apr 2020There is lack of research on the safety of medications used to treat rheumatic diseases in men wishing to conceive. When evaluating medication safety for potential... (Review)
Review
There is lack of research on the safety of medications used to treat rheumatic diseases in men wishing to conceive. When evaluating medication safety for potential fathers, two major reproductive issues are to be considered: first, whether a drug induces infertility, and second, whether a drug can cause adverse pregnancy outcomes. Cyclophosphamide is the only medication used in rheumatic disease management that causes irreversible infertility. All men prescribed cyclophosphamide should be counseled on fertility preservation including sperm banking. Sulfasalazine can cause reversible azoospermia; when conception is delayed, this medication should be held for three months and semen analysis should be performed. There are limited data on the teratogenic risk of paternal exposure to medications. Men wanting to conceive should avoid cyclophosphamide and thalidomide. Methotrexate; NSAIDs; glucocorticoids; sulfasalazine; the immunosuppressive agents azathioprine, 6-mercaptopurine, cyclosporine, tacrolimus, and mycophenolate mofetil; colchicine; TNF-alpha blockers; hydroxychloroquine; IVIG; rituximab; abatacept; and anakinra are compatible with paternal exposure. There are insufficient data to conclude the safety of other biologics and small molecules in men seeking to father a child.
Topics: Antirheumatic Agents; Child; Fathers; Female; Humans; Infertility, Male; Male; Paternal Exposure; Pregnancy; Pregnancy Outcome; Prenatal Exposure Delayed Effects; Rheumatic Diseases
PubMed: 31727565
DOI: 10.1016/j.bpobgyn.2019.09.004 -
Annals of the Rheumatic Diseases Dec 2022
Topics: Humans; Synovitis; Arthritis, Rheumatoid; Antirheumatic Agents
PubMed: 36241362
DOI: 10.1136/ard-2022-223330 -
The Journal of Rheumatology Feb 2023
Topics: Humans; Arthritis, Psoriatic; Antirheumatic Agents; Sex Factors
PubMed: 36243407
DOI: 10.3899/jrheum.220948 -
The Korean Journal of Internal Medicine Jan 2022
Topics: Antirheumatic Agents; Humans; Hydroxychloroquine; Osteoarthritis, Knee
PubMed: 35000374
DOI: 10.3904/kjim.2021.524 -
Inflammopharmacology Oct 2021An appreciation of the contribution of Professor Gary Graham to anti-inflammatory and antirheumatic pharmacology and clinical pharmacology.
An appreciation of the contribution of Professor Gary Graham to anti-inflammatory and antirheumatic pharmacology and clinical pharmacology.
Topics: Anti-Inflammatory Agents; Antirheumatic Agents; History, 20th Century; History, 21st Century; Humans; Pharmacology, Clinical
PubMed: 34533655
DOI: 10.1007/s10787-021-00872-1 -
Annals of the Rheumatic Diseases Jun 2023
Topics: Humans; Arthritis, Rheumatoid; Antirheumatic Agents
PubMed: 37169389
DOI: 10.1136/ard-2022-223361 -
Annals of the Rheumatic Diseases Mar 2023
Topics: Humans; Arthritis, Rheumatoid; Severity of Illness Index; Antirheumatic Agents
PubMed: 36764817
DOI: 10.1136/ard-2022-223360 -
The Journal of Rheumatology Aug 2023Rheumatoid arthritis (RA) is a systemic musculoskeletal disease where immune dysregulation and subsequent autoimmunity induce significant synovial joint inflammation and... (Review)
Review
Rheumatoid arthritis (RA) is a systemic musculoskeletal disease where immune dysregulation and subsequent autoimmunity induce significant synovial joint inflammation and damage, causing pain and disability. RA disease onset is promoted through multifaceted interactions between genetic and environmental risk factors. However, the mechanisms of disease onset are not completely understood and disease-specific treatments are yet to be developed. Current RA treatments include nonspecific disease-modifying antirheumatic drugs (DMARDs) that suppress destructive immune responses and prevent damage. However, DMARDs are not curative, and relapses are common, necessitating lifelong therapy in most patients. Additionally, DMARD-induced systemic immunosuppression increases the risk of serious infections and malignancies. Herein, we review the current understanding of RA disease pathogenesis, with a focus on T and B cell immune tolerance breakdown, and discuss the development of antigen-specific RA therapeutics that aim to restore a state of immune tolerance, with the potential for disease prevention and reduction of treatment-associated adverse effects.
Topics: Humans; Arthritis, Rheumatoid; Antirheumatic Agents; Inflammation; Autoimmunity; Immune Tolerance
PubMed: 36725060
DOI: 10.3899/jrheum.220881