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Modern Rheumatology Sep 2020Rheumatoid arthritis (RA) is a chronic inflammatory disease primarily affecting the joints and is associated with significant levels of disability and reduced quality of... (Review)
Review
Rheumatoid arthritis (RA) is a chronic inflammatory disease primarily affecting the joints and is associated with significant levels of disability and reduced quality of life. Janus kinase (JAK) inhibitors are a relatively new class of small molecule oral treatments and offer an alternative for patients with RA who do not respond to conventional or biologic therapy. Upadacitinib is a JAK inhibitor engineered to be selective for JAK1, and has recently been approved for use in patients with moderate-to-severe RA. The purpose of this article is to provide a comprehensive review of upadacitinib, including preclinical development and characterization, phase I and II studies, and the phase III SELECT program. Ongoing trials of upadacitinib in additional indications, including spondyloarthritis, inflammatory bowel disease, and atopic dermatitis, are also discussed.
Topics: Administration, Oral; Antirheumatic Agents; Arthritis, Rheumatoid; Clinical Trials as Topic; Heterocyclic Compounds, 3-Ring; Humans; Janus Kinase Inhibitors
PubMed: 32530345
DOI: 10.1080/14397595.2020.1782049 -
Calcified Tissue International Nov 2022The therapeutic armamentarium for rheumatoid arthritis has increased substantially over the last 20 years. Historically antirheumatic treatment was started late in the... (Review)
Review
The therapeutic armamentarium for rheumatoid arthritis has increased substantially over the last 20 years. Historically antirheumatic treatment was started late in the disease course and frequently included prolonged high-dose glucocorticoid treatment which was associated with accelerated generalised bone loss and increased vertebral and non-vertebral fracture risk. Newer biologic and targeted synthetic treatments and a combination of conventional synthetic DMARDs prevent accelerated systemic bone loss and may even allow repair of cortical bone erosions. Emerging data also gives new insight on the impact of long-term conventional synthetic DMARDs on bone health and fracture risk and highlights the need for ongoing studies for better understanding of "established therapeutics". An interesting new antirheumatic treatment effect is the potential of erosion repair with the use of biologic DMARDs and janus kinase inhibitors. Although several newer anti-rheumatic drugs seem to have favorable effects on bone mineral density in RA patients, these effects are modest and do not seem to influence the fracture risk thus far. We summarize recent developments and findings of the impact of anti-rheumatic treatments on localized and systemic bone integrity and health.
Topics: Antirheumatic Agents; Biological Products; Bone Diseases, Metabolic; Bone and Bones; Glucocorticoids; Humans; Janus Kinase Inhibitors
PubMed: 35771255
DOI: 10.1007/s00223-022-01001-y -
Autoimmunity Reviews Dec 2019Biological drugs have revolutionised the treatment of rheumatic diseases, and the recent expiry of the patents for many biological agents has generated considerable... (Review)
Review
Biological drugs have revolutionised the treatment of rheumatic diseases, and the recent expiry of the patents for many biological agents has generated considerable interest among pharmaceutical companies and regulatory agencies, and led to the marketing of highly similar, low-cost versions known as biosimilars. The increasing trend of switching patients from effective but expensive drugs to their biosimilar counterparts will have a considerable economic impact in the coming years. However, although this will greatly extend patient access the latest treatments, clinicians, scientific societies and the patients themselves have expressed a number of concerns about their long-term efficacy and safety, as well as the consequences of potentially multiple switches being dictated by economic pressure rather than medical needs. Thee aim of this review is to evaluate the pros and cons of choosing biosimilars, and whether and when they can really be considered clinically equivalent to the original drugs.
Topics: Antirheumatic Agents; Biosimilar Pharmaceuticals; Humans; Rheumatic Diseases
PubMed: 31639517
DOI: 10.1016/j.autrev.2019.102404 -
Rheumatology (Oxford, England) Mar 2022
Topics: Antirheumatic Agents; Humans; Travel; Travel-Related Illness
PubMed: 34505900
DOI: 10.1093/rheumatology/keab686 -
Journal of Biomedical Materials... Apr 2021Osteoarthritis (OA) is a joint degenerative disease that has become one of the leading causes of disability in the world. It is estimated that OA affects 50 million... (Review)
Review
Osteoarthritis (OA) is a joint degenerative disease that has become one of the leading causes of disability in the world. It is estimated that OA affects 50 million adults in the United States. Currently, there are no FDA-approved treatments that slow OA progression and its treatment is limited to pain management strategies and life style changes. Despite the discovery of several disease-modifying OA drugs (DMOADs) and promising results in preclinical studies, their clinical translation has been significantly limited because of poor intra-articular (IA) bioavailability and challenges in delivering these compounds to tissues of interest within the joint. Here, we review current OA treatments and their effectiveness at reducing joint pain, as well as novel targets for OA treatment and the challenges related to their clinical translation. Moreover, we discuss intra-articular (IA) drug delivery as a promising route of administration, describe its inherent challenges, and review recent advances in biomaterial-based IA drug delivery for OA treatment. Finally, we highlight the potential of tissue targeting in the development of effective IA drug delivery systems.
Topics: Animals; Antirheumatic Agents; Biocompatible Materials; Drug Carriers; Drug Delivery Systems; Humans; Injections, Intra-Articular; Osteoarthritis
PubMed: 32780515
DOI: 10.1002/jbm.a.37074 -
Rheumatology (Oxford, England) May 2024
Topics: Humans; Communication; Antirheumatic Agents; Patient Education as Topic; Physician-Patient Relations; Rheumatic Diseases
PubMed: 38145488
DOI: 10.1093/rheumatology/kead706 -
Revue Medicale Suisse Mar 2022Regular blood monitoring allows for treatment adjustments and early detection or even prevention of some side effects of antirheumatic dugs. Guidelines may vary between...
Regular blood monitoring allows for treatment adjustments and early detection or even prevention of some side effects of antirheumatic dugs. Guidelines may vary between national societies for rheumatology, but largely recommend baseline screening followed by regular blood tests depending on the specific drug and duration of treatment. In this article we discuss the monitoring of the major antirheumatic drugs and further develop on some significant and specific drug side effects.
Topics: Antirheumatic Agents; Humans; Mass Screening; Rheumatology
PubMed: 35306766
DOI: 10.53738/REVMED.2022.18.773.467 -
Expert Opinion on Emerging Drugs Sep 2019: Uveitis is a leading cause of visual impairment and a significant burden of blindness. Although corticosteroids and conventional immunosuppressive agents have been... (Review)
Review
: Uveitis is a leading cause of visual impairment and a significant burden of blindness. Although corticosteroids and conventional immunosuppressive agents have been successfully used, these are non-specific, and their long-term use may induce significant adverse effects. : This article discusses existing local and systemic applied treatments for ocular inflammation including corticosteroids, non-biologic, and biologic disease-modifying anti-rheumatic drugs (DMARD). Potential drugs being studied in clinical trials are introduced for both local and systemic use. : Treatment options for uveitis continue to expand. Still, more efforts and research are needed to better understand the mechanisms potentially leading to clinical trials.
Topics: Adrenal Cortex Hormones; Animals; Anti-Inflammatory Agents; Antirheumatic Agents; Drug Design; Humans; Immunosuppressive Agents; Inflammation; Uveitis
PubMed: 31498689
DOI: 10.1080/14728214.2019.1663823 -
International Journal of Rheumatic... May 2024
Topics: Humans; Methotrexate; Japan; Antirheumatic Agents; Drug Dosage Calculations; Treatment Outcome; Arthritis, Rheumatoid
PubMed: 38720411
DOI: 10.1111/1756-185X.15176 -
Drug Discovery Today Aug 2023Rheumatoid arthritis (RA) is an inflammatory, autoimmune and connective-tissue arthropathy. The methotrexate (MTX) and aceclofenac (ACL) combination drug regimen is... (Review)
Review
Rheumatoid arthritis (RA) is an inflammatory, autoimmune and connective-tissue arthropathy. The methotrexate (MTX) and aceclofenac (ACL) combination drug regimen is known to regulate the immunological pathways. Also, RA-elicited inflammation is decreased by the combination drug treatment. ACL and MTX combination treatment has been shown to regulate the signaling pathway controlled by NF-κB and FOXO1. The present manuscript reviews the importance of the combination drug regimen to treat and/or manage RA. The combination drug regimen could affect the Th1/Th17 axis to switch the balance toward the immunoregulatory (Th1) phenotype for establishing immune homeostasis. In conclusion, we propose the study of the immunological signaling pathways in experimental humanized RA mice.
Topics: Mice; Animals; Methotrexate; Antirheumatic Agents; Arthritis, Rheumatoid; Inflammation; Arthritis, Experimental; Drug Therapy, Combination
PubMed: 37330038
DOI: 10.1016/j.drudis.2023.103671