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Current Opinion in Rheumatology May 2024Postinfectious inflammatory arthritis can result from various pathogens, including bacteria, viruses, fungi, and parasites. Prompt identification and treatment of acute... (Review)
Review
PURPOSE OF REVIEW
Postinfectious inflammatory arthritis can result from various pathogens, including bacteria, viruses, fungi, and parasites. Prompt identification and treatment of acute infection is vital, but some cases progress to chronic arthritis despite successful treatment of infection. Postinfectious inflammatory arthritis varies from mild, self-limited arthralgia to severe, refractory arthritis, necessitating ongoing disease-modifying treatment. This review explores the spectrum of postinfectious inflammatory arthritis to provide insights into effective management.
RECENT FINDINGS
Research continues regarding the benefit of antimicrobial therapy, beyond treatment of the acute infection, to diminish the severity of postinfectious inflammatory arthritis. Following treatment of acute infection, most cases are self-limited so treatment is symptomatic. However, a difficult-to-predict fraction of cases develop chronic postinfectious inflammatory arthritis that can be challenging to manage. Recently, as more biologic, and targeted synthetic DMARDs have become available, treatment options have expanded.
SUMMARY
In this article, we use the term 'postinfectious inflammatory arthritis' rather than 'reactive arthritis' because it describes a broader spectrum of diseases and emphasizes the common pathogenesis of a postinfectious inflammatory process. We summarize the conventional therapies and recent management developments for the most frequently encountered postinfectious inflammatory arthritides.
Topics: Humans; Arthritis; Inflammation; Antirheumatic Agents; Infections
PubMed: 38411201
DOI: 10.1097/BOR.0000000000001009 -
The Journal of Rheumatology Apr 2022
Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Humans; Rheumatology
PubMed: 35034005
DOI: 10.3899/jrheum.211233 -
Endocrine Regulations Apr 2022Rheumatoid arthritis is a common chronic inflammatory disease with substantial economic, social, and personal costs. Its pathogenesis is multifactorial and complex. The...
Rheumatoid arthritis is a common chronic inflammatory disease with substantial economic, social, and personal costs. Its pathogenesis is multifactorial and complex. The ultimate goal of rheumatoid arthritis treatment is stopping or slowing down the disease progression. In the past two decades, invention of new medicines, especially biologic agents, revolutionized the management of this disease. These agents have been associated with an improved prognosis and clinical remission, especially in patients who did not respond to traditional disease-modifying anti-rheumatic drugs (DMARDs). Improvement in the understanding of the rheumatoid arthritis pathogenesis leads to the development of novel biologic therapeutic approaches. In the present paper, we summarized the current therapeutics, especially biologic agents, available for the treatment of rheumatoid arthritis.
Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Biological Factors; Disease Progression; Humans; Prognosis
PubMed: 35489053
DOI: 10.2478/enr-2022-0016 -
The Medical Letter on Drugs and... Dec 2019
Review
Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Antirheumatic Agents; Arthritis, Psoriatic; Biological Products; Drug Costs; Drug Interactions; Humans; Phosphodiesterase 4 Inhibitors
PubMed: 31999665
DOI: No ID Found -
Current Opinion in Pharmacology Jun 2022Recent development of new medications has changed the juvenile idiopathic arthritis (JIA) treatment goal to inactive disease. With numerous options, how does a clinician... (Review)
Review
Recent development of new medications has changed the juvenile idiopathic arthritis (JIA) treatment goal to inactive disease. With numerous options, how does a clinician choose which medication to use? Treatment options may depend on the clinical classification and a new paradigm considers the JIA subtypes in reference to categories of adult inflammatory arthritis; poligo JIA, spondyloarthritis JIA, and systemic JIA that can help guide a clinician in determining treatment options. Treatment strategies such as consensus treatment plans can provide guidance on treatment escalation. However, a treat-to-target strategy using frequent standardized disease activity measurements, shared decision making with the patient, and treatment escalation to achieve the disease activity target can provide a personalized approach to managing JIA.
Topics: Antirheumatic Agents; Arthritis, Juvenile; Humans
PubMed: 35461129
DOI: 10.1016/j.coph.2022.102226 -
Arthritis & Rheumatology (Hoboken, N.J.) May 2024
Topics: Humans; Arthritis, Psoriatic; Antirheumatic Agents
PubMed: 38108094
DOI: 10.1002/art.42780 -
Drugs May 2024Although several biological disease-modifying antirheumatic drugs (bDMARDs), including interleukin (IL)-17A inhibitors, are approved for psoriatic arthritis, the... (Review)
Review
Although several biological disease-modifying antirheumatic drugs (bDMARDs), including interleukin (IL)-17A inhibitors, are approved for psoriatic arthritis, the treatment of this disease remains suboptimal. Bimekizumab (Bimzelx), a dual IL-17A and IL-17F inhibitor, is approved in the EU, Great Britain and Japan for the treatment of psoriatic arthritis. In pivotal phase 3 clinical trials in patients who were bDMARD-naïve or previously had an inadequate response or intolerance to tumour necrosis factor (TNF) α inhibitors, bimekizumab improved the signs and symptoms of psoriatic arthritis across a range of joint, skin, radiographic and patient-reported outcomes compared with placebo, including the proportion of patients achieving a ≥ 50% response in the American College of Rheumatology criteria. Phase 2 clinical trial data have shown that responses are maintained up to 3 years. Bimekizumab was generally well tolerated in patients with psoriatic arthritis, with a safety profile consistent with that in other approved indications. The most common adverse events included nasopharyngitis, upper respiratory tract infection, oral candidiasis, headache and diarrhoea. In conclusion, bimekizumab extends the treatment options available to patients with psoriatic arthritis.
Topics: Humans; Arthritis, Psoriatic; Antibodies, Monoclonal, Humanized; Interleukin-17; Antirheumatic Agents
PubMed: 38703349
DOI: 10.1007/s40265-024-02026-3 -
Expert Opinion on Biological Therapy Feb 2023Spondyloarthritides (SpA) such as axial spondyloarthritis (axSpA) including ankylosing spondylitis (AS) and psoriatic arthritis (PsA) including psoriasis are chronic... (Review)
Review
INTRODUCTION
Spondyloarthritides (SpA) such as axial spondyloarthritis (axSpA) including ankylosing spondylitis (AS) and psoriatic arthritis (PsA) including psoriasis are chronic immune-mediated disorders with involvement of tumor necrosis factor (TNF), interleukin (IL)-17 cytokines, and janus kinases (JAK) in their pathogenesis, with IL-23 clearly also playing a role in psoriasis, PsA, and chronic inflammatory bowel diseases.
AREAS COVERED
In this narrative review, we focus on a biologic disease modifying anti-rheumatic drug (bDMARD), the bispecific IL-17A and IL-17 F inhibitor bimekizumab, and a targeted synthetic (ts) DMARD, the JAK inhibitor (i) filgotinib - emerging agents for the treatment of axSpA. Upadacitinib, another JAKi that has recently been reviewed intensively by us is already approved for axSpA and PsA in Europe.
EXPERT OPINION
In contrast to inhibition of IL-17, JAKi also work in rheumatoid arthritis (RA), while agents inhibiting IL-17 are not, even though some effect may be there. Indeed, 4 JAKi including filgotinib are approved for RA. There are several head-to-head trials with bimekizumab in plaque psoriasis. The last one showed that the bispecific inhibition of IL-17A and IL-17 F with bimekizumab may indeed be superior to inhibition of IL-17A alone with 300 mg secukinumab (usual dosage). Whether this is also the case for treatment of axSpA and PsA remains to be shown.
Topics: Humans; Interleukin-17; Arthritis, Psoriatic; Spondylarthritis; Spondylitis, Ankylosing; Psoriasis; Arthritis, Rheumatoid; Antirheumatic Agents
PubMed: 36511882
DOI: 10.1080/14712598.2022.2156283 -
The Journal of Rheumatology Jun 2021
Topics: Antirheumatic Agents; Humans; Hydroxychloroquine; Pharmaceutical Preparations
PubMed: 33722952
DOI: 10.3899/jrheum.201589 -
The Journal of Rheumatology Jul 2021
Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Humans
PubMed: 33722954
DOI: 10.3899/jrheum.201189