Treatment of inflammatory rheumatic diseases
From WikiLectures
Main groups of drugs for rheumatic diseases:
- Nonsterodial rheumatic drugs (non-steroidal anti-inflammatory drugs) – NSA
- Disease modifying drugs – DMARDs (Disease modifying antirevmatic drugs)
- Glucocorticoids
- Other
NSA[edit | edit source]
- relieve inflammation, swelling and pain, but they do not improve the prognosis in the long term – treat only symptoms
- e.g. : ibuprofen, diclofenac, naproxen, nimesulide, celecoxib
- side effects: gastrotoxicity (GIT – ulcers, NSA – gastropathy)
DMARDs[edit | edit source]
- in the long term they have a positive effect on the process of the disease, but they do not improve the X-ray prognosis, the onset of action lasts 6-12 weeks
- wide group of drugs:
- Hydroxychloroquine
- Leflunomide
- Ciclosporin
- Sulfasalazin
- Methotrexate
- Azathioprine
- Cyklofosfamid
- Biological treatment
Glucocorticoids[edit | edit source]
- anti-inflammatory and rapid effect, but in monotherapy it is not enough to induce remission
- to overcome the phase, before DMARDs starts working
- they have a positive effect on the X-ray progression of the disease
Biological treatment of rheumatic diseases[edit | edit source]
Mainly used for diseases:
- Rheumatoid arthritis
- Juvenile idiopathic arthritis (Still's disease)
- Psoriasis
- Bechterew's disease
- Systemic lupus erythematosus
- Systemic scleroderma
- Systemic vasculitis
- Polymyositis, dermatomyositis
Used drugs:
- TNF-α inhibitors: infliximab (REMICADE), etanercept (ENBREL) and adalimumab (HUMIRA)
- IL–6 inhibitors: tocilizumab (ROACTEMRA)
- IL–1 inhibitors: anakinra (KINERET)
Other drugs[edit | edit source]
- Antibiotics (reactive arthritis, to the side effects of immunosuppression)
- tars, calcitriol, retinoids... (psoriasis)
Links[edit | edit source]
References[edit | edit source]
- Péntek, M. and co. Sarcoidosis occuring during anti-TNF-α treatment for inflammatory rheumatic diseases: report of two cases. Clinical and Experimental Rheumatology 2008; 26: 471-475
- ČEŠKA, Richard, Vladimír TESAŘ, Petr DÍTĚ a Tomáš ŠTULC. Interna. Vyd. 1. Praha: Triton, 2010, xix, 855 s. ISBN 978-80-7387-423-0
- PAVELKA, Karel. Revmatologie. 2., přeprac. vyd. Praha: Galén, c2010, 177 s. ISBN 978-80-7262-688-5.
- PAVELKA, Karel. Revmatologie. 2., přeprac. vyd. Praha: Galén, c2010, 177 s. ISBN 978-80-7262-688-5.
- http://www.praktickelekarenstvi.cz/pdfs/lek/2009/02/06.pdf
- https://www.webmd.com/rheumatoid-arthritis/guide/dmard-rheumatoid-arthritis-treatment
