New guidelines for treating rheumatoid arthritis

July 22, 2008

Proven combinations of medicines and the introduction of new anti-arthritis drugs have significantly improved the treatment of rheumatoid arthritis (RA), according to guidelines issued by the American College of Rheumatology and co-authored by physicians at the University of Alabama at Birmingham (UAB).

Lead author Kenneth Saag, M.D., M.Sc., a professor in the UAB Division of Clinical Immunology and Rheumatology, said the new guidelines update strategies for treating RA with the goal of preventing joint damage and disability.

The new recommendations do not strive to replace individualized medical decisions, Saag said. Instead, they are meant to guide rheumatologists and other health care workers toward the most updated recommendations. The last set of American College of Rheumatology RA treatment guidelines was published in 2002.

"The recommendations developed are not intended to be used in a 'cookbook' or prescriptive manner, or to limit a physician's clinical judgment," Saag said. "They provide guidance based on clinical evidence and expert panel input."

The recommendations focus on several classes of anti-arthritic drugs, including a potent group of agents called disease-modifying anti-rheumatic drugs (DMARDs). Newer genetically engineered DMARDs called biologics often work in combination with earlier therapies. Many anti-arthritic drugs are designed to stop damaging inflammation, and biologics work to interrupt the chain of events that leads to inflammation.

Newer biologics called anti-TNF agents – adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade) – prevent the production of an immunity protein that plays a role in inflammation.

Some of the key recommendations include:

-- Methotrexate or leflunomide therapy is recommended for most RA patients.
-- Anti-TNF agents etanercept, infliximab, or adalimumab along with methotrexate can be used in new or early RA cases with worsening and severe symptoms.
-- Doctors should not initiate or resume treatment with methotrexate, leflunomide, or biologics if RA patients have active bacterial infection, shingles (herpes-zoster), hepatitis B, hepatitis C and active or latent tuberculosis.
-- Doctors should not prescribe anti-TNF agents to patients with a history of heart failure, lymphoma or multiple sclerosis.

Source: University of Alabama at Birmingham

Explore further: Study finds links between physicians setting cancer care guidelines and drug industry

Related Stories

Children should eat less than 25 grams of added sugars daily

August 22, 2016

Children ages 2 to 18 should eat or drink less than six teaspoons of added sugars daily, according to the scientific statement recommending a specific limit on added sugars for children, published in the American Heart Association ...

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Cow embryos reveal new type of chromosome chimera

May 27, 2016

I've often wondered what happens between the time an egg is fertilized and the time the ball of cells that it becomes nestles into the uterine lining. It's a period that we know very little about, a black box of developmental ...

Shaving time to test antidotes for nerve agents

February 29, 2016

Imagine you wanted to know how much energy it took to bike up a mountain, but couldn't finish the ride to the peak yourself. So, to get the total energy required, you and a team of friends strap energy meters to your bikes ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.