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El. knyga: Inflammatory Arthritis in Clinical Practice

James B. Galloway, David L. Scott, Ian C. Scott

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Išleidimo metai: 07-Feb-2015
Leidėjas: Springer London Ltd
Kalba: eng
ISBN-13: 9781447166481

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Formatas: PDF+DRM
Išleidimo metai: 07-Feb-2015
Leidėjas: Springer London Ltd
Kalba: eng
ISBN-13: 9781447166481

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Understanding the key components of the diagnosis, assessment and management of inflammatory arthritis patients is essential to improving patient care. This book aims to cover these areas. It places inflammatory arthritis into a historical context; deals with the epidemiology, pathology, clinical assessment and investigation of inflammatory arthritis patients and provides a comprehensive overview of currently available treatment options. It provides insight into stratified medicine, an area of emerging importance in the management of heterogeneous diseases like RA. Finally, it provides an overview of what treatments strategies are in development.

1 An Overview of Inflammatory Arthritis

(12)

Introduction

(1)

What Are the Inflammatory Arthropathies?

(1)

Historical Perspectives

(1)

Diagnosis

(1)

The Concept of Classification Criteria

(1)

Rheumatoid Arthritis

(1)

Ankylosing Spondylitis

(4)

Psoriatic Arthritis

(1)

Other Spondyloarthropathies

(1)

References

(2)

2 Epidemiology and Pathology

(10)

Epidemiology of Rheumatoid Arthritis

(1)

Epidemiology of Seronegative Arthritis

(2)

Aetiology of Inflammatory Arthritis

(1)

Rheumatoid Arthritis

(1)

Seronegative Spondyloarthropathies

(1)

Pathology of Inflammatory Arthritis

(1)

Histology

(1)

Lymphocytes

(1)

Cytokines

(1)

Chemokines

(1)

Metalloproteinases

(1)

Adhesion Molecules, Angiogenesis and Other Mediators

(1)

References

(3)

3 Clinical Features

(16)

Synovitis of Peripheral Joints

(1)

Symptoms

(1)

Joint Swelling and Tenderness

(1)

Peripheral Joints Involved

(1)

Rheumatoid Arthritis

(3)

Psoriatic Arthritis

(1)

Other Forms of Spondyloarthropathies

(1)

Enthesitis

(1)

Spinal Disease

(1)

Ankylosing Spondylitis

(1)

Other Types of Spondyloarthritis

(1)

Rheumatoid Arthritis

(1)

Systemic Features

(1)

Clinical Course

(1)

Onset of Rheumatoid Arthritis

(1)

Established Rheumatoid Arthritis

(1)

Other Inflammatory Arthropathies

(1)

Undifferentiated Early Arthritis

(1)

Extra-articular Disease

(1)

Rheumatoid Arthritis

(2)

Other Inflammatory Arthropathies

(1)

References

(2)

4 Clinical and Laboratory Assessments

(28)

Role of Assessments

(1)

Clinical Assessments

(1)

Joint Counts

(3)

Global Assessments

(2)

Pain Scores

(1)

Functional Assessments

(1)

Generic Health Status Measures

(1)

SF-36

(1)

EuroQol

(1)

Laboratory Assessments

(1)

Acute Phase Response

(2)

Multi-biomarker Disease Activity (MBDA) Tests

(1)

Rheumatoid Factor

(1)

Antibodies to Citrullinated Protein Antigens

(1)

Imaging

(1)

X-Rays in Rheumatoid Arthritis

(2)

Ultrasound in Rheumatoid Arthritis

(1)

Magnetic Resonance Imaging in Rheumatoid Arthritis

(1)

Imaging in Psoriatic Arthritis

(1)

Imaging in Ankylosing Spondylitis and Reactive Arthritis

(1)

Combined Measures

(1)

Core Data Set in Rheumatoid Arthritis

(1)

Composite Disease Activity Indices: Disease Activity Score

(1)

Simplified Indices

(1)

American College of Rheumatology (ACR) Response Criteria

(1)

Other Forms of Arthritis

(1)

Outcomes

(1)

Rheumatoid Arthritis

(2)

Psoriatic Arthritis

(1)

Ankylosing Spondylitis

(1)

References

(4)

5 Symptomatic Drug Treatment

(20)

Introduction

(1)

Simple Analgesics

(1)

Paracetamol

(1)

Opioids

(1)

Tramadol

(1)

Buprenorphine

(1)

Codeine and Dihydrocodeine

(1)

Compound Analgesics

(1)

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

(1)

Mechanism of Action and Cox I/Cox II Effects

(1)

Classification of NSAIDs

(1)

Conventional NSAIDs

(1)

Cox-2 Drugs (COXIBs)

(3)

Adverse Reactions to NSAIDs

(1)

Gastrointestinal Adverse Effects

(2)

Cardiovascular Adverse Effects

(1)

Use in Specific Forms of Arthritis

(1)

Rheumatoid Arthritis

(1)

Psoriatic Arthritis and Seronegative Spondyloarthritis

(1)

Ankylosing Spondylitis

(1)

References

(3)

6 Disease-Modifying Anti-Rheumatic Drugs

(24)

Background

(1)

Currently Used Conventional DMARDs

(1)

Starting DMARDs

(1)

Monitoring DMARDs

(1)

Stopping DMARDs

(1)

Early and Late Disease

(1)

Intensive Treatment

(1)

Treat to Target

(1)

Seronegative Arthritis

(1)

Changes in Clinical Trials

(1)

Reduction in Joint Counts and Acute Phase Proteins

(1)

American College of Rheumatology Responses (ACR)

(1)

Improved Disability

(1)

Radiological Damage

(1)

Methotrexate

(1)

Background

(1)

Clinical Use and Efficacy

(2)

Adverse Reactions

(1)

Leflunomide

100

(1)

Background

100

(1)

Clinical Use and Efficacy

101

(1)

Adverse Events

101

(1)

Sulfasalazine

102

(1)

Other DMARDs

103

(1)

Injectable Gold

103

(1)

Hydroxychloroquine

104

(1)

Ciclosporin

105

(1)

Azathioprine

105

(1)

Minor DMARDs

105

(1)

Combining DMARDs

106

(1)

Rationale

106

(1)

Effective Combinations

106

(1)

Ineffective Combinations

107

(1)

Intensive Treatments in Early Disease

107

(1)

Overall Effectiveness of Combinations

108

(1)

Seronegative Spondyloarthritis

108

(1)

References

109

(2)

7 Biologies -- An Overview

111

(8)

Introduction

112

(2)

Biologic Treatment Pathways

114

(1)

Rheumatoid Arthritis

114

(1)

Early Rheumatoid Arthritis

115

(1)

Psoriatic Arthritis

116

(1)

Ankylosing Spondylitis

116

(1)

Health Economic Case for Using Biologies

117

(1)

References

118

(1)

8 Anti-Tumour Necrosis Factor-Alpha (TNF-α) Treatment

119

(18)

Background

120

(2)

Etanercept

122

(1)

Infliximab

122

(1)

Adalimumab

123

(1)

Certolizumab

123

(1)

Golimumab

123

(1)

Indications

124

(1)

Rheumatoid Arthritis

124

(1)

Psoriatic Arthritis

124

(1)

Ankylosing Spondylitis

124

(1)

Clinical Effects

125

(1)

Rheumatoid Arthritis

125

(2)

Psoriatic Arthritis

127

(1)

Ankylosing Spondylitis

127

(1)

Safety and Adverse Effects

127

(1)

Biologies Registries

127

(1)

Local Injection Site Reactions

128

(1)

Hypersensitivity Responses

128

(1)

Infections

128

(2)

Demyelinating-like Disorders

130

(1)

Haematological Disorders

130

(1)

Heart Failure

130

(1)

Malignancy

131

(1)

Auto-immune Disorders

131

(1)

Interstitial Lung Disease

131

(1)

Psoriasis

132

(1)

Immune Responses to TNF-α Inhibitors

132

(1)

Switching Anti-TNF Agents in Cases of Primary or Secondary Failure

132

(1)

References

133

(4)

9 B-Cell Inhibition and Other Biologies

137

(18)

Introduction

137

(1)

Rituximab

138

(1)

Background

138

(1)

B Cells in RA

138

(1)

Mechanism of Action

139

(1)

Clinical Indications

139

(1)

Clinical Efficacy

139

(2)

Initial and Repeat Courses

141

(1)

Adverse Reactions

141

(1)

Infection

142

(1)

Anti-biologic Antibodies

143

(1)

Tocilizumab

143

(1)

Background

143

(1)

Clinical Use

143

(1)

Dosing

144

(1)

Clinical Efficacy

144

(1)

Adverse Events

144

(2)

Anti-biologic Antibodies

146

(1)

Abatacept

147

(1)

Background

147

(1)

Clinical Use

147

(1)

Dosing

147

(1)

Clinical Efficacy

148

(1)

Adverse Reactions

149

(1)

Ustekinumab

149

(1)

Background

149

(1)

Clinical Use

149

(1)

Adverse Events

150

(1)

Anakinra

150

(1)

Background

150

(1)

Clinical Use

150

(1)

Side-Effects

151

(1)

References

151

(4)

10 Steroids

155

(8)

Background

155

(1)

Pharmacological Effects

156

(1)

Effects on Joint Inflammation

157

(1)

Erosive Progression

157

(1)

Early Rheumatoid Arthritis

158

(1)

Treating Flares with Systemic Steroids

159

(1)

Psoriatic Arthritis and Ankylosing Spondylitis

159

(1)

Side-Effects

159

(1)

Local Steroids

160

(1)

References

161

(2)

11 Non-drug Treatments

163

(10)

Background

163

(1)

Multidisciplinary Teams

164

(1)

Education and Support

165

(1)

Promoting Coping

165

(1)

Promoting Mobility, Function and Participation

165

(1)

Physiotherapy

166

(2)

Occupational Therapy

168

(2)

Podiatry

170

(1)

Orthopaedic Surgery

170

(1)

References

171

(2)

12 Stopping Treatments

173

(10)

Introduction

173

(1)

Conventional Disease Modifying Drugs (DMARDs)

174

(1)

Can Patients Stay on DMARDs?

174

(1)

Withdrawing DMARDs in Responders

174

(1)

Step-Down DMARD Therapy

175

(1)

Observational Studies of DMARD Withdrawal

175

(1)

Predicting Flares After DMARD Withdrawal

176

(1)

Recommendations in Guidelines

176

(1)

Biological Treatments

176

(1)

Stopping and Tapering

176

(1)

Studies in Rheumatoid Arthritis

177

(1)

Studies in Psoriatic Arthritis

178

(1)

Studies in Ankylosing Spondylitis

178

(1)

Steroids

178

(1)

Conclusions

179

(1)

References

180

(3)

13 Emerging Therapies in Rheumatoid Arthritis

183

(8)

Introduction

184

(1)

Biosimilars

184

(1)

Interchangeability of Biosimilars with Existing Agents

185

(1)

Drugs in Development

186

(1)

JAK Inhibitors

186

(2)

Other Kinase Inhibitors

188

(1)

PDE4 Inhibitors

188

(1)

Future Targets

189

(1)

References

189

(2)

14 Stratified Medicine in Inflammatory Arthritis

191

(12)

What Is Stratified Medicine?

191

(1)

Why Stratified Medicine Is Needed in Inflammatory Arthritis Patients

192

(1)

Existing Research in Stratified Medicine in Inflammatory Arthritis Patients

193

(1)

Predictors of Disease Course in RA

193

(1)

Serology

193

(1)

Smoking

193

(1)

Alcohol

194

(1)

Social Deprivation

194

(1)

Gender

194

(1)

Genetics

195

(1)

Predicting RA Severity

195

(1)

Predictors of Treatment Responses in RA

196

(1)

Gender

196

(1)

Smoking

196

(1)

Serology

197

(1)

Disease Duration

198

(1)

Genetics

199

(1)

Prediction Models for Treatment Responses in RA

199

(1)

Stratified Medicine in Non-RA Inflammatory Arthropathies

200

(1)

Psoriatic Arthritis

200

(1)

Ankylosing Spondylitis

201

(1)

Current Use of Stratified Medicine in Inflammatory Arthritis Patients

201

(2)

Conclusion

203

(1)

References

203

(4)

Index

207

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