Approaches to rheumatoid arthritis in 2000

Current Opinion in Rheumatology
F A Wollheim

Abstract

The year 2000 was characterized by euphoria among clinicians based on the continued and consolidated success of tumor necrosis factor (TNF) inhibition but also by problems caused by the high cost of this therapy. Looking at the risks and adverse effects has only begun, and there is so far a remarkable lack of publications dealing with this topic. Leflunomide also emerges as an established disease-modifying antirheumatic drug (DMARD). Other therapies include the cyclooxygenase-2 (Cox-2) inhibitors, which are tolerated better by the gastrointestinal system but raise concerns regarding thromboembolism in patients at risk. The enthusiasm regarding Cox-2 inhibitors is somewhat tempered by recent reports of thromboembolic complications, although those have been rare. The advances in research regarding mechanisms of inflammation and pathogenesis continue to generate new therapeutic approaches, which, however, remain mostly experimental. The complexity of genetics has been emphasized by reports on susceptibility and severity relation to TNF, mannose-binding lectin, and gamma-interferon polymorphism. Epidemiologic studies focusing on prevalence, incidence and outcome continue to deliver conflicting messages. One major worry relates to c...Continue Reading

References

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Citations

Feb 1, 2006·Rheumatology International·Péter RassZoltán Szekanecz
Oct 30, 2009·Clinical Rheumatology·Siobhan O'DonnellTheodora P M Vliet Vlieland
Nov 16, 2002·Prostaglandins & Other Lipid Mediators·Ikuo Morita
Nov 14, 2013·TheScientificWorldJournal·Qingguo ZhangShang-You Yang
Apr 9, 2005·Arthritis and Rheumatism·Diane LacailleJohn M Esdaile
Apr 4, 2007·The Journal of Immunology : Official Journal of the American Association of Immunologists·Ben WielockxClaude Libert
Sep 20, 2008·The Journal of Immunology : Official Journal of the American Association of Immunologists·Virginia Vila-del SolManuel Fresno

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