Treatment of Severe Rheumatoid Arthritis
|
|
- Horace Singleton
- 8 years ago
- Views:
Transcription
1 Treatment of Severe Rheumatoid Arthritis Zhanguo Li Department of Rheumatology and Immunology, People s Hospital Beijing University Medical School, China
2 Contents Background Challenges Treatment strategies Recommendations
3 Contents Background Challenges Treatment strategies Recommendations
4 Background RA is a chronic, systemic autoimmune disease that affects 0.28%-1% of the population Polyarticular synovial inflammation causes swelling, tenderness and stiffness Leads to cartilage damage and bone erosion causing long-term disability Increased comorbidities
5 Background
6 Prevalence of RA in the world Prevalence (/1000) USA UK Greece Sweden China Italy France Agentina Rheumatology (Oxford). 2002;41: Rheumatology (Oxford). 2002;41: Ann Rheum Dis. 1998;57:315-8.
7 Prevalence of RA in China Rheumatology (Oxford) Apr;51(4):721-9.
8 Composition of Disabled Diseases 2nd Nationwide Survey on the Disabled (China, 2006) Cerebrovascular diseases RA 79.4% M 男 % F 女 Cerebral palsy,2. Dysplasia,3. Dwarfism,4. Congenital disorders,5. Poliomyelitis,6. Cerebrovascular diseases,7. Peripheral angiopathy,8. Neoplasia,9. Arthritis,10.Endemic diseases,11. Spinal cord diseases, 12. Industrial injury,13. Traffic accidents,14. Spinal cord injury,15. Cerebral trauma, 16. other trauma, 17. Tuberculosis,18. Purulent infection,19. Poisoning,20. Others,21. Unknown cause 16 provinces, 734 nationwide counties (cities) 2.6 million people, 2 of the national population
9 Economic Burden Associated with RA is Higher than Hypertension and Diabetes Yuan / Year Hypertension Diabetes RA State Development and Reform Commission (SDRC) (2003) Yang XH, et al. Chin Journal of Generalist. 2005; 4(9): 528.
10 Contents Background Challenges Treatment strategies Recommendations
11 Challenges Arthr Res Ther 2012,14:R68
12 Challenges Arthr Res Ther 2012,14:R68
13 Challenges Arthritis Rheum Sep;58(9):
14 Challenges The overall remission rate is low! Arthritis Rheum Sep;58(9):
15 Challenges Rheumatology Jun;46(6):975-9.
16 Challenges Journal of Peking University (2):260-3.
17 Challenges Journal of Peking University (2):260-3.
18 However
19
20
21 Contents Background Challenges Treatment strategies Recommendations
22 Treatment strategies Remission CR improvement of QOL RA traditional DMARDs biological DMARDs Approaches others: NSAIDs GC herbs immunoabsorption Strategies early individualized intensive recommendations & suggestions
23 Early treatment & prognosis Natural course Delayed treatment Early treatment Bone erosion and joint deformity 3m Ideal course Synovial destruction Onset
24 Combination therapy Study N Duration Treatments Outcomes Haagsma et al 105 <1yr SSZ or MTX SSZ+MTX Boers et al (COBRA) 155 <2yrs SSZ SSZ+Pred+MTX Mottonen et al 199 <2yrs SSZ±pred MTX+SSZ+HCQ+pred Calguneri et al yrs HCQ, SSZ or MTX Goekoop- Ruiterman et al 508 <2yrs MTX+HCQ or MTX+SSZ MTX+SSZ+HCQ Hetland et al 160 <6m MTX MTX+CsA St Clair et al ( ASPIRE) <3yrs MTX MTX, add SSZ, add HCQ MTX+SSZ+pred MTX+inf MTX MTX+infliximab Breedveld et al 799 <3yrs Adalimumab MTX MTX+adalimumab 52w DAS change: P< yr vdh-s: P< yrs ACR remission:p= yrs modified Paulus criteria: P<0.001 Median increse in vdh- S: P=0.003 p< w % ACR-N: P< yr ACR50: p<0.001 Semin Arthritis Rheum Apr; 40(5):
25
26 Combination therapy N=143 articles Including: RCTs: 42 others:101 Conclusion: 1. DMARDs combination therapy is superior 2. biologics+mtx > single drugs Ann Intern Med. 2008; 148(2):
27 Combination therapy 48 weeks, double-blind trial 353 active RA patients MTX+HCQ+SASP (triple therapy) MTX+etanercept primary outcome: DAS28 NEJM. Jul 25;369(4):
28 Combination therapy NEJM. Jul 25;369(4):
29 NEJM. Jul 25;369(4):
30 Intensive treatment Intensive treatment vs. routine care (18-month assessment) 100% 82% 95% 91% 84% Remission rate(%) 80% 60% 40% 20% 44% 14% 64% 40% 71% 18% intensive routine 0% EULAR response EULAR remission ACR 20 ACR 50 ACR 70 Lancet 2004;364:263-69
31 High remission and low relapse of RA with prolonged intensive DMARD therapy (a prospective multicenter study) DAS>5.1 RA patients(n=400) LEF 10mg qd HCQ0.2 bid + MTX 7.5mg/w Dr. Ru Li and colleagues MTX mg/w mg/w, LEF 20mg qd Adjustment by physicians Unpublished data
32 High remission and low relapse of RA with prolonged intensive DMARD therapy (a prospective multicenter study) Unpublished data
33 High remission and low relapse of RA with prolonged intensive DMARD therapy (a prospective multicenter study) Unpublished data
34 High remission and low relapse of RA with prolonged intensive DMARD therapy (a prospective multicenter study) Unpublished data
35 High remission and low relapse of RA with prolonged intensive DMARD therapy (a prospective multicenter study) Unpublished data
36 Comprehensive therapy Intraarticular GC injection Physical exercise Comprehensive/ NSAIDs Topical medication individualized Immunoabsorption surgery
37 Contents Background Challenges Treatment strategies Recommendations
38 Recommendations-ACR 2012 Figure ACR recommendations update for the treatment of early RA, defined as a disease duration <6 months.
39 Recommendations-ACR 2012 Figure ACR recommendations update for the treatment of established RA, defined as a disease duration >6 months or meeting the 1987 ACR classification criteria. Depending on a patient s current medication regimen
40 1. Treatment with DMARDs should be initiated as soon as diagnosis is made, with the aim of reaching a target of remission or LDA. 2. As first-line treatment, MTX or combination therapy of MTX with other conventional synthetic DMARDs should be suggested. 3. Low-dose GCs should be considered in combination with DMARDs for up to 6 months and be tapered as soon as clinically feasible. 4. In patients failing to respond within 6 months and when poor prognostic factors are present, biological DMARDs (TNFinhibitors, abatacept or tocilizumab or under certain circumstances rituximab) should be administered in combination with MTX.
41 5. Patients failed to respond to an initial biologic DMARD should receive another biologic DMARD. 6. Patients failed to respond to an initial TNFi may receive another TNFi, or an alternative biologic. If biologic treatment has failed, tofacitinib may be considered. 7. In patients achieving persistent remission and after having tapered GCs, clinicians should consider tapering the biological DMARD, particularly if the treatment is in combination with a conventional synthetic DMARD. In cases of sustained longterm remission, cautious dose-reduction of conventional synthetic DMARDs should be considered.
42 Conclusions 1 2 Remission is not as common in daily practice as in clinical trials, drug-free remission can be achieved in RA patients. Early, combined, intensive, and individualized strategies should be adopted in the treatment of RA. 3 RA management recommendation should be followed in daily practice.
43 Future of RA patients 43
44
45
46
47
48
49
50 Challenges Most stringent Least stringent Journal of Peking University (2):260-3.
51 Early diagnosis 1. stiffness 30min E-RA criteria 2. polyarthritis: 3 in 14 areas 3. Arthritis of hand joints: 1 area in wrist, MCP, or PIP joint 4. Positive RF 5 抗 CCP 抗 体 阳 性 * 14 areas:bilateral PIP, MCP, wrist, elbow, knee, ankle, and MTP joints * 3 points RA diagnosis Sensitivity 84% Specificity 87%
52 Sensitivity (%) Specificity (%) E-RA criteria ACR/Eular criteria ACR criteria
Dr Sarah Levy Consultant Rheumatology Croydon University Hospital
Dr Sarah Levy Consultant Rheumatology Croydon University Hospital Contents Definition/ epidemiology Diagnosis Importance of early diagnosis/ treatment Guidelines Evidence based treatment protocol Current
More informationDAS28 criteria for initiation of biologics in early RA: a clinician s view. Dr Patrick Kiely St George s Healthcare NHS Trust, London
DAS28 criteria for initiation of biologics in early RA: a clinician s view Dr Patrick Kiely St George s Healthcare NHS Trust, London History: NICE (E&W) guidelines for starting anti-tnf agents April 2001
More informationCurrent Rheumatoid Arthritis Treatment Options: Update for Managed Care and Specialty Pharmacists
Current Rheumatoid Arthritis Treatment Options: Update for Managed Care and Specialty Pharmacists 1. Which of the following matches of biologic targets that contribute to rheumatoid arthritis (RA) and
More informationRheumatoid Arthritis:
Rheumatoid Arthritis Update 2014 Mark Hulsey, MD FACR Rheumatoid Arthritis Key Features Symptoms >6 weeks duration Often lasts the remainder of the patient s life Inflammatory synovitis Palpable synovial
More informationEarly identification and treatment - the Norwegian perspective. Till Uhlig Dept of Rheumatology Diakonhjemmet Hospital Oslo, Norway
Early identification and treatment - the Norwegian perspective Till Uhlig Dept of Rheumatology Diakonhjemmet Hospital Oslo, Norway Oslo Rheumatoid Arthritis Registry (ORAR) Very early Arthritis Clinic
More informationMethotrexate (Rheumatoid Arthritis) - Forecast and Market Analysis to 2023
Brochure More information from http://www.researchandmarkets.com/reports/3128342/ Methotrexate (Rheumatoid Arthritis) - Forecast and Market Analysis to 2023 Description: Methotrexate (Rheumatoid Arthritis)
More informationDISEASE COURSE IN EARLY RHEUMATOID ARTHRITIS: AN OBSERVATIONAL STUDY
ORIGINAL ARTICLES DISEASE COURSE IN EARLY RHEUMATOID ARTHRITIS: AN OBSERVATIONAL STUDY Teodora Serban 1,2, Iulia Satulu 2, Oana Vutcanu 2, Mihaela Milicescu 1,2, Carina Mihai 1,2, Mihai Bojinca 1,2, Victor
More informationRheumatoid Arthritis. Outline. Treatment Goal 4/10/2013. Clinical evaluation New treatment options Future research Discussion
Rheumatoid Arthritis Robert L. Talbert, Pharm.D., FCCP, BCPS University of Texas at Austin College of Pharmacy University of Texas Health Science Center at San Antonio Outline Clinical evaluation New treatment
More informationRecommendations for Early RA Patients
SUPPLEMENTARY APPENDIX 5: Executive summary of recommendations for patients with early RA, established RA, and high-risk comorbidities Recommendations for Early RA Patients We strongly recommend using
More informationABOUT RHEUMATOID ARTHRITIS
MEDIA BACKGROUNDER ABOUT RHEUMATOID ARTHRITIS Rheumatoid arthritis (RA) is a type of arthritis (chronic inflammatory polyarthritis) that typically affects hands and feet, although any joint in the body
More informationRheumatoid Arthritis: Constantly Evolving Treatment Approaches
Rheumatoid Arthritis: Constantly Evolving Treatment Approaches Jody Garry, Pharm.D. Primary Care Pharmacy Resident VA Medical Center - Iowa City Presentation Overview Pathophysiology & epidemiology Diagnostic
More informationCan Rheumatoid Arthritis treatment ever be stopped?
Can Rheumatoid Arthritis treatment ever be stopped? Robert L. DiGiovanni, DO, FACOI Program Director Largo Medical Center Rheumatology Fellowship robdsimc@tampabay.rr.com Do not pour strange medicines
More informationRheumatoid Arthritis. Disease RA Final.indd 2 15. 6. 10. 11:23
Rheumatoid Arthritis Disease RA Final.indd 2 15. 6. 10. 11:23 Understanding what to expect can help you prepare for your transition into treatment. Rheumatoid Arthritis What You Need To Know About Rheumatoid
More informationPage 1 of 15 Origination Date: 09/14 Revision Date(s): 10/2015, 02/2016 Developed By: Medical Criteria Committee 10/28/2015
Moda Health Plan, Inc. Medical Necessity Criteria Subject: Actemra (tocilizumab) Page 1 of 15 Origination Date: 09/14 Revision Date(s): 10/2015, 02/2016 Developed By: Medical Criteria Committee 10/28/2015
More informationBEDFORDSHIRE AND LUTON JOINT PRESCRIBING COMMITTEE (JPC)
BEDFORDSHIRE AND LUTON JOINT PRESCRIBING COMMITTEE (JPC) September 2014 Review date: September 2017 Bulletin 203: Tocilizumab (subcutaneous) in combination with methotrexate or as monotherapy for the treatment
More informationImprovement in Quality of Life of Rheumatoid Arthritis Patients on Biologic Therapy
Improvement in Quality of Life of Rheumatoid Arthritis Patients on Biologic Therapy R Adams 1, Ct Ng 2, A Gibbs 2, L Tilson 1, D Veale 2, B Bresnihan 2, O FitzGerald 2, M Barry 1 1. National Centre for
More information(THE CHANGING LANDSCAPE)
Updating the therapeutic strategy in RA What is effective, what is changing in daily practice regarding the use of DMARDs and biological agents in the Balkan countries The Greek experience (THE CHANGING
More informationImaging of Hand in Rheumatoid Arthritis with CR, US and MRI. Azar Bahrami, PGY4 Radiology Rounds Jan, 31, 2007
Imaging of Hand in Rheumatoid Arthritis with CR, US and MRI Azar Bahrami, PGY4 Radiology Rounds Jan, 31, 2007 Introduction RA most common type of inflammatory Arthritis with prevalence of 1% Accurate and
More informationUnderstanding Rheumatoid Arthritis
Understanding Rheumatoid Arthritis Understanding Rheumatoid Arthritis What Is Rheumatoid Arthritis? 1,2 Rheumatoid arthritis (RA) is a chronic autoimmune disease. It causes joints to swell and can result
More informationA Survey of Barriers to Treatment Access in Rheumatoid Arthritis. Country Annex Report: UK
A Survey of Barriers to Treatment Access in Rheumatoid Arthritis Country Annex Report: UK October 2009 1 Interviews In the UK, five rheumatologists and one patient representative were interviewed. The
More informationEvidence-based Management of Rheumatoid Arthritis (2009)
CPLD reviews its distance learning programmes every twelve months to ensure currency. This update has been produced by an expert and should be read in conjunction with the Evidencebased Management of distance
More informationTreat to Target Approach in Rheumatoid Arthritis: UK perspective. Dr Deirdre Shawe, North Hampshire Hospital, Basingstoke, UK
Treat to Target Approach in Rheumatoid Arthritis: UK perspective Dr Deirdre Shawe, North Hampshire Hospital, Basingstoke, UK What is the target? To achieve remission or low disease activity in Rheumatoid
More informationRheumatoid Arthritis. Nicole Klett,, M.D.
Rheumatoid Arthritis Nicole Klett,, M.D. Rheumatoid Arthritis Systemic Chronic Inflammatory Primarily targets the synovium of diarthrodial joints Etiology likely combination genetic and environmental Diarthrodial
More informationDeveloping a National Audit for Rheumatoid and Early Inflammatory Arthritis Ian Rowe
Developing a National Audit for Rheumatoid and Early Inflammatory Arthritis Ian Rowe Chair Clinical Affairs Committee, BSR Outline The British Society for Rheumatology Challenges in improving patient outcomes
More informationGuidelines for the Pharmaceutical Management of Rheumatoid Arthritis Swedish Society of Rheumatology, April 14, 2011
Guidelines for the Pharmaceutical Management of Rheumatoid Arthritis Swedish Society of Rheumatology, April 14, 2011 Working party: Eva Baecklund, Helena Forsblad d Elia, Carl Turesson Background Our purpose
More informationDISEASE-MODIFYING ANTIRHEUMATIC DRUG THERAPY FOR RHEUMATOID ARTHRITIS
DISEASE-MODIFYING ANTIRHEUMATIC DRUG THERAPY FOR RHEUMATOID ARTHRITIS APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE NCQA APPROVED CODES HEDIS
More informationRheumatoid Arthritis Information
Rheumatoid Arthritis Information Definition Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs. Alternative
More informationTREG EULAR Conference Analysis. Rome, Italy June 16-19, 2010
TREG EULAR Conference Analysis Rome, Italy June 16-19, 21 Rheumatoid Arthritis: Management and Current Therapies Arthur Kavanaugh, MD Martin Bergman, MD John J Cush, MD Orrin Troum, MD Alvin Wells MD,
More information2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis
2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis Published in the September 2010 Issues of A&Rand ARD Phases of the Project Phase 1 Data analysis Phase 2 Consensus process Predictors of
More informationEarly Diagnosis of Rheumatoid Arthritis & Axial Spondyloarthritis
Early Diagnosis of Rheumatoid Arthritis & Axial Spondyloarthritis 奇 美 醫 院 過 敏 免 疫 風 濕 科 陳 宏 安 Rheumatoid arthritis Most common chronic inflammatory joint disease Multisystem autoimmune disease of unknown
More informationSymptoms ongoing for 6/12, initially intermittent in nature.
Rheumatoid Arthritis Case Study INTRODUCTION Each student will have watched the relevant MDT member carrying out their initial assessment on the same newly diagnosed Rheumatoid Arthritis patient. Videos
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Health Technology Appraisal
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Health Technology Appraisal Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure
More information1991 :super specialties perceptions
Ved Chaturvedi, MD, DM Research & Referral Hospital New Delhi President Indian Rheumatology Association MSK Ultrasound..A decade experience of bedside MSK US by a clinician. Was it worth it.? 1991 :super
More informationRheumatoid Arthritis
Rheumatoid Arthritis Carole Callaghan Principal Pharmacist NHS Lothian Aim To update pharmacists on the current management of rheumatoid arthritis and explore ways to implement pharmaceutical care for
More informationStandard of care for RA in SA 2013
Standard of care for RA in SA 2013 Background Rheumatoid arthritis (RA) is a chronic inflammatory disease, which if treated inadequately leads to irreversible joint damage, resulting in deformities, disability
More informationRheumatoid Arthritis. GP workshop 15 January 2011
Rheumatoid Arthritis GP workshop 15 January 2011 Case 1 A 72 year old Malay woman with RA comes for routine follow up. She feels generally unwell in the last 5 days. Appetite is fair. Her joints are fine.
More information1. Title 2. Background
1. Title EARLY PsA Effectiveness of early Adalimumab therapy in psoriatic arthritis patients from Reuma.pt, the Rheumatic Diseases Portuguese Register, Portuguese RheumatoLogy SocietY (SPR) 2. Background
More informationRoche s RoACTEMRA improved rheumatoid arthritis signs and symptoms significantly more than adalimumab as single-agent therapy
Media Release Basel, 6 June 2012 Roche s RoACTEMRA improved rheumatoid arthritis signs and symptoms significantly more than adalimumab as single-agent therapy Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced
More informationRheumatoid Arthritis: Key Features
Rheumatoid Arthritis: Key Features Symptoms >6 weeks duration Often lasts the remainder of the patient s life Inflammatory synovitis Palpable synovial swelling Morning stiffness >1 hour, fatigue Symmetrical
More informationUnderstanding and improving communications between people with rheumatoid arthritis and their healthcare professionals. RCUKCOMM00116w February 2014
Understanding and improving communications between people with rheumatoid arthritis and their healthcare professionals RCUKCOMM00116w February 2014 This project has been funded by Roche Products Ltd &
More informationRheumatoid Arthritis
Rheumatoid Arthritis While rheumatoid arthritis (RA) has long been feared as one of the most disabling types of arthritis, the outlook has dramatically improved for many newly diagnosed patients. Certainly
More informationIn the last decade, there have been major changes in the
233 Promising New Treatments for Rheumatoid Arthritis The Kinase Inhibitors Yusuf Yazici, M.D., and Alexandra L. Regens, B.A. Abstract Three major advances over the last decade have impacted the way we
More informationRheumatoid arthritis: diagnosis, treatment and prognosis. Dr David D Cruz MD FRCP Consultant Rheumatologist
Rheumatoid arthritis: diagnosis, treatment and prognosis Dr David D Cruz MD FRCP Consultant Rheumatologist The Louise Coote Lupus Unit St Thomas Hospital London AMUS meeting London 7 th March 2012 Disclosures
More informationWeek 12 study results
Week 12 study results 15 April 2015 Copyright 2015 Galapagos NV Disclaimer This document may contain certain statements, including forward-looking statements, such as statements concerning the safety and
More informationArthritis in Children: Juvenile Rheumatoid Arthritis By Kerry V. Cooke
Reading Comprehension Read the following essay on juvenile rheumatoid arthritis. Then use the information in the text to answer the questions that follow. Arthritis in Children: Juvenile Rheumatoid Arthritis
More informationImmune modulation in rheumatology. Geoff McColl University of Melbourne/Australian Rheumatology Association
Immune modulation in rheumatology Geoff McColl University of Melbourne/Australian Rheumatology Association A traditional start to a presentation on biological agents in rheumatic disease is Plasma cell
More informationPractical Aspects of Ultrasonography Assessment in Rheumatoid Arthritis
Practical Aspects of Ultrasonography Assessment in Rheumatoid Arthritis Dr. Andrew K. Brown Senior Lecturer & Consultant Rheumatologist Content Practical RA Assessment Advantages of ultrasonography Potential
More informationTreating Rheumatoid Arthritis to Target : the patient version of the international recommendations
Treating Rheumatoid Arthritis to Target : the patient version of the international recommendations Data presented from the publication: M. de Wit, et al. Ann Rheum Dis. 2011;70:891-5. Epub Apr 7, 2011.
More informationSpeaking Plainly. Biologic treatment options for rheumatoid arthritis
in association with Plain English Campaign Speaking Plainly Biologic treatment options for rheumatoid arthritis A guide to help healthcare professionals talking to patients with rheumatoid arthritis Foreword
More informationREFERENCE CODE GDHC503DFR PUBLICAT ION DATE DECEMBER 2014 METHOTREXATE (RHEUMATOID ARTHRITIS) - FORECAST AND MARKET ANALYSIS TO 2023
REFERENCE CODE GDHC503DFR PUBLICAT ION DATE DECEMBER 2014 METHOTREXATE (RHEUMATOID ARTHRITIS) - Executive Summary The table below provides the key metrics for Methotrexate in the 10MM (US, France, Germany,
More informationRheumatoid Arthritis www.arthritis.org.nz
Rheumatoid Arthritis www.arthritis.org.nz Did you know? RA is the second most common form of arthritis Approximately 40,000 New Zealanders have RA RA can occur at any age, but most often appears between
More informationIssue date: August 2010
Issue date: August 2010 Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor Part review of NICE technology appraisal
More informationHow will we prevent rheumatoid arthritis? Kevin Deane, MD/PhD Division of Rheumatology University of Colorado
How will we prevent rheumatoid arthritis? Kevin Deane, MD/PhD Division of Rheumatology University of Colorado Outline 1) Brief overview of natural history of RA and how current understanding of disease
More informationA patientwithsystemicsclerosis andjointpain. Christian Beyer University Erlangen-Nuremberg(GER)
A patientwithsystemicsclerosis andjointpain Christian Beyer University Erlangen-Nuremberg(GER) Whatisimportanttoyou? lungs GI tract fatigue heart skin muscles Raynaud s joints Whatisimportanttopatients?
More informationElbow Injuries and Disorders
Elbow Injuries and Disorders Introduction Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. There are many injuries and disorders that
More informationPaediatric Rheumatology InterNational Trials Organization PRINTO
Paediatric Rheumatology InterNational Trials Organization PRINTO Nicola Ruperto, MD, MPH PRINTO Senior Scientist EULAR Centre of Excellence in Rheumatology 2008-2013 IRCCSG Istituto G. Gaslini, Genoa,
More informationCritical Issues in School Health Arthritis in the School Setting. Lawrence Zemel MD Tegan Willard RN Connecticut Children s
Critical Issues in School Health Arthritis in the School Setting Lawrence Zemel MD Tegan Willard RN Connecticut Children s Juvenile Rheumatoid Idiopathic Arthritis Definition of JRA (JIA) Persistent arthritis
More informationMedia Release. Basel, 11 June 2009. RA patients with enhanced response identified
Media Release Basel, 11 June 2009 New data demonstrate the ability of MabThera to reduce the progression of joint damage when used as a first-line biologic treatment in rheumatoid arthritis RA patients
More information(Intro to Arthritis with a. Arthritis) Manager of Education & Services for the Vancouver Island Region of The Arthritis Society
Arthritis 101 (Intro to Arthritis with a Focus on Rheumatoid Arthritis) by Cari Taylor by Cari Taylor Manager of Education & Services for the Vancouver Island Region of The Arthritis Society What You Will
More informationX-Plain Rheumatoid Arthritis Reference Summary
X-Plain Rheumatoid Arthritis Reference Summary Introduction Rheumatoid arthritis is a fairly common joint disease that affects up to 2 million Americans. Rheumatoid arthritis is one of the most debilitating
More informationOnce the immune system is triggered, cells migrate from the blood into the joints and produce substances that cause inflammation.
HealthExchange Points For Your Joints An Arthritis Talk Howard Epstein, MD Orthopaedic & Rheumatologic Institute Rheumatic & Immunologic Disease Cleveland Clinic Beachwood Family Health & Surgery Center
More information2012 Rheumatoid Arthritis Update
For your information Clinical Professor of Medicine, David Geffen School of Medicine at UCLA Private practice, Tustin CA 2012 Rheumatoid Arthritis Update Robin K. Dore, MD Clinical Professor of Medicine
More informationDIVISION OF RHEUMATOLOGY DEPARTMENT OF MEDICINE UNIVERSITY OF WESTERN ONTARIO POSTGRADUATE EDUCTION ORTHOPAEDIC OFF-SERVICE GOALS & OBJECTIVES
DIVISION OF RHEUMATOLOGY DEPARTMENT OF MEDICINE UNIVERSITY OF WESTERN ONTARIO POSTGRADUATE EDUCTION ORTHOPAEDIC OFF-SERVICE GOALS & OBJECTIVES GOAL #1 develop the ability to order and understand interpretation
More informationRheumatoid Arthritis - Evidence to Optimize Outcomes in Patients
Applying the Evidence to Optimize Outcomes in Patients With Rheumatoid Arthritis Presented by The University of Kentucky College of Medicine and developed through a strategic educational facilitation with
More informationRheumatoid Arthritis. What is rheumatoid arthritis? Understanding joints. What causes rheumatoid arthritis?
Page 1 of 6 Rheumatoid Arthritis Rheumatoid arthritis causes inflammation, pain, and swelling of joints. In time, affected joints typically become damaged. The severity can vary from mild to severe. Treatments
More informationRheumatoid Arthritis www.arthritis.org.nz
Rheumatoid Arthritis www.arthritis.org.nz Did you know? Rheumatoid arthritis (RA) is the third most common form of arthritis Approximately 40,000 New Zealanders have RA RA can occur at any age, but most
More informationTight control early rheumatoid arthritis clinic in Hong Kong: a pilot study
O R I G I N A L A R T I C L E Tight control early rheumatoid arthritis clinic in Hong Kong: a pilot study Kitty Y Kwok MH Leung 郭 殷 梁 滿 濠 Objective To evaluate disease activity in early rheumatoid arthritis
More informationMorgan Schultz 1, Stephanie Keeling 2, Steven Katz 2, Walter Maksymowych 2, Dean Eurich 3, Jill Hall 1 1
Morgan Schultz 1, Stephanie Keeling 2, Steven Katz 2, Walter Maksymowych 2, Dean Eurich 3, Jill Hall 1 1 Faculty of Pharmacy and Pharmaceutical Sciences, 2 Faciluty of Medicine and Dentistry, 3 School
More informationSystemic Juvenile Adiopathic Arthritis: Treatment Options 15. Alexei A. Grom, MD Cincinnati Children s Hospital Medical Center
Systemic Juvenile Adiopathic Arthritis: Treatment Options 15 Alexei A. Grom, MD Cincinnati Children s Hospital Medical Center Disclosures NIH grants AR059049, AR048929 Consulting fees Novartis, Roche,
More informationRheumatology ICD-10 documentation
Rheumatology documentation Seven key impacts to documentation 1. Disease or disorder site 2. Acuity and/or encounter status of treatment 3. Etiology, causative agent, or disease type and injury/ poisoning
More informationRheumatoid Arthritis
Rheumatoid Arthritis Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Autoimmune diseases are illnesses that occur when the body's tissues are mistakenly
More informationACT-RAY and MRI substudy
Tocilizumab as Monotherapy or in Combination With Methotrexate associated with Early Reductions in Tissue Inflammation: 12-Week Results From a Magnetic Resonance Imaging Substudy of a Randomized Controlled
More information11/8/2011. Administrative Definitions of Rheumatoid Arthritis: Rising Prevalence Regardless of Definition Used. No Disclosures. Background.
Administrative Definitions of Rheumatoid Arthritis: Rising Prevalence Regardless of Definition Used Christine A. Peschken, Carol A. Hitchon, Hui Chen, Allan Garland, Hani S. El-Gabalawy, Charles N. Bernstein
More informationPhenotypes and Classification of Psoriasis
Rheumatology 2010 Birmingham 21 April 2010 Phenotypes and Classification of Psoriasis Christopher E.M. Griffiths Abbott Centocor Incyte Galderma Janssen-Cilag Leo Pharma Lynxx Novartis Pfizer Schering-Plough
More informationEffectiveness and Drug Adherence in Rheumatoid Arthritis Patients on Biologic Monotherapy: A prospective observational study in Southern Sweden
Effectiveness and Drug Adherence in Rheumatoid Arthritis Patients on Biologic Monotherapy: A prospective observational study in Southern Sweden Collaborators: Primary investigators Dr Lars Erik Kristensen,
More informationInformation on Rheumatoid Arthritis
Information on Rheumatoid Arthritis Table of Contents About Rheumatoid Arthritis 1 Definition 1 Signs and symptoms 1 Causes 1 Risk factors 1 Test and diagnosis 2 Treatment options 2 Lifestyle 3 References
More informationMedical Policy Anti-CCP Testing for Rheumatoid Arthritis
Medical Policy Anti-CCP Testing for Rheumatoid Arthritis Table of Contents Policy: Commercial Coding Information Information Pertaining to All Policies Policy: Medicare Description References Authorization
More informationMeasuring and Improving the Quality of Care for Patients With. Rheumatoid Arthritis
Measuring and Improving the Quality of Care for Patients With Rheumatoid Arthritis section 1 reporting Measuring and Improving the Quality of Care for Patients With Rheumatoid Arthritis An estimated 1.3
More informationHealth Care Needs Assessment of Services for Adults with Rheumatoid Arthritis
Health Care Needs Assessment of Services for Adults with Rheumatoid Arthritis PART D: Cost Implications for NHS Rheumatoid Arthritis Services in Scotland Scottish Public Health Network August 2013 1 Table
More informationRHEUMATOLOGY ICD-10 CROSSWALK
RHEUMATOLOGY ICD-10 CROSSWALK ICD is revised periodically and is currently in its tenth edition and will be implemented in the United States on October 1, 2015. There is an annual minor update and three-yearly
More informationto Part of Dossier: Name of Active Ingredient: Title of Study: Quality of life study with adalimumab in rheumatoid arthritis. ESCALAR.
2.0 Synopsis Abbott Laboratories Name of Study Drug: Individual Study Table Referring to Part of Dossier: Adalimumab (HUMIRA) (For National Authority Use Only) Name of Active Ingredient: Adalimumab Title
More informationDisclosures. None. Seth Compton, MD Fellow of Rheumatology University of Mississippi Medical Center. Thank you for coming
Disclosures None Seth Compton, MD Fellow of Rheumatology University of Mississippi Medical Center Steroids Steroids Thank you for coming 1 Outline Osteoarthritis Rheumatoid Arthritis Monoarthritis Systemic
More informationHow To Treat Rheumatoid Arthritis
RHEUMATOLOGY Rheumatology 2012;51:v48 v54 doi:10.1093/rheumatology/kes122 Developing an effective treatment algorithm for rheumatoid arthritis Edward C. Keystone 1, Josef Smolen 2 and Piet van Riel 3 Abstract
More informationThe management of rheumatoid arthritis
Medical management of rheumatoid arthritis Peter Jones Correspondence to: peter.jones@qehealth.co.nz The management of rheumatoid arthritis has changed in the last 10 years. Back then, a patient who awoke
More informationRecognizing the Value of Innovation in the Treatment of Rheumatoid Arthritis
White Paper March 2013 Recognizing the Value of Innovation in the Treatment of Rheumatoid Arthritis Catherine Augustyn, Brigham Walker, and Thomas F. Goss, PharmD Boston Healthcare Associates, Inc., Boston,
More informationSECTION 3. Criteria for Special Authorization of Select Drug Products. Section 3 Criteria for Special Authorization of Select Drug Products
SECTION 3 Criteria for Special Authorization of Select Drug Products Section 3 Criteria for Special Authorization of Select Drug Products CRITERIA FOR SPECIAL AUTHORIZATION OF SELECT DRUG PRODUCTS The
More informationMaster Thesis in Medicine
RISK OF INFECTIONS IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH TOCILIZUMAB IN CLINICAL PRACTICE Master Thesis in Medicine Joyce Åkerlund Supervisor: Catharina Lindholm, MD, PhD, Associate Professor Department
More informationArthritis and Rheumatology Clinics of Kansas Patient Education. Reactive Arthritis (ReA) / Inflammatory Bowel Disease (IBD) Arthritis
Arthritis and Rheumatology Clinics of Kansas Patient Education Reactive Arthritis (ReA) / Inflammatory Bowel Disease (IBD) Arthritis Introduction: For as long as scientists have studied rheumatic disease,
More informationA Genetic Analysis of Rheumatoid Arthritis
A Genetic Analysis of Rheumatoid Arthritis Introduction to Rheumatoid Arthritis: Classification and Diagnosis Rheumatoid arthritis is a chronic inflammatory disorder that affects mainly synovial joints.
More informationArthritis Research UK Epidemiology Unit
Arthritis Research UK Epidemiology Unit Qualitative research proposal to explore factors influencing acceptable risk thresholds used to recommend particular treatment options for rheumatoid arthritis.
More informationPROVEN NON-INVASIVE TREATMENT FOR RHEUMATOID ARTHRITIS
PROVEN NON-INVASIVE TREATMENT FOR RHEUMATOID ARTHRITIS BIONICARE HAND SYSTEM Non-drug, non-invasive Adjunctive therapy For patients symptomatic despite current therapy For patients intolerant to drug
More informationRheumatology Labs for Primary Care Providers. Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine
Rheumatology Labs for Primary Care Providers Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine Objectives Review the Indications for and Interpretation of lab testing for the following diseases:
More informationVectra DA Blood Test for Rheumatoid Arthritis. Original Policy Date January /2014
MP 2.04.81 Vectra DA Blood Test for Rheumatoid Arthritis Medical Policy Section 2.0 Original Policy Date January /2014 Last Review Status/Date 1/2014 Disclaimer Our medical policies are designed for informational
More informationRheumatoid Arthritis. How are joints in the body designed?
Rheumatoid Arthritis How are joints in the body designed? There are more than 100 joints that connect the body s 206 bones. These joints allow us to move the way we do when we walk to work, throw a ball
More informationA LTCI Approach to Managing Rheumatoid Arthritis
A LTCI Approach to Managing Rheumatoid Arthritis A bit of Science, a bit of Art, a lot of Perseverance... Stephen K. Holland, MD Senior Vice President & Medical Director Long Term Care Group, Inc. Long
More informationGuideline on clinical investigation of medicinal products other than NSAIDs for treatment of rheumatoid arthritis
1 2 3 20 March 2015 CPMP/EWP/556/95 Rev. 2 Committee for Medicinal Products for Human Use (CHMP) 4 5 6 Guideline on clinical investigation of medicinal products other than NSAIDs for Draft 7 8 Draft Agreed
More informationRheumatoid Arthritis: Diagnosis, Management and Monitoring
Rheumatoid Arthritis: Diagnosis, Management and Monitoring Effective Date: September 30, 2012 Scope This guideline is intended to aid in early recognition, intervention and management of patients with
More informationNew Evidence reports on presentations given at EULAR 2012. Rituximab for the Treatment of Rheumatoid Arthritis
New Evidence reports on presentations given at EULAR 2012 Rituximab for the Treatment of Rheumatoid Arthritis Report on EULAR 2012 presentations Long-term safety of rituximab: 10-year follow-up in the
More informationTreating to Target: The Example of RA
Treating to Target: The Example of RA Presenter Neal S. Birnbaum, MD, FACP, MACR Clinical Professor of Medicine University of California, San Francisco Director, Division of Rheumatology California Pacific
More informationJuvenile idiopathic arthritis and its long term outcome
Focus Juvenile idiopathic arthritis and its long term outcome Sue Rudge is a paediatric rheumatologist at the Wellington Regional Rheumatology Unit and Starship Hospital, Auckland Introduction KEY POINTS
More information