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Titolo:
New drugs for the treatment of rheumatoid arthritis
Autore:
Schuna, AA; Megeff, C;
Indirizzi:
Univ Wisconsin, Sch Pharm, Madison, WI 53706 USA Univ Wisconsin Madison WI USA 53706 sin, Sch Pharm, Madison, WI 53706 USA St Louis Univ, Coll Pharm, St Louis, MO 63103 USA St Louis Univ St Louis MO USA 63103 v, Coll Pharm, St Louis, MO 63103 USA St Louis Univ, Dept Community & Family Med, St Louis, MO 63103 USA St Louis Univ St Louis MO USA 63103 & Family Med, St Louis, MO 63103 USA
Titolo Testata:
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY
fascicolo: 3, volume: 57, anno: 2000,
pagine: 225 - 234
SICI:
1079-2082(20000201)57:3<225:NDFTTO>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
COX-2 INHIBITION; FUSION PROTEIN; DOUBLE-BLIND; LEFLUNOMIDE; PLACEBO; EFFICACY; METHOTREXATE; COMPLICATIONS; IMPROVEMENT; MELOXICAM;
Keywords:
anakinra; anti-inflammatory agents; arthritis; celecoxib; CGP-28238; drugs; etanercept; infliximab; leflunomide; mechanism of action; meroxicam; nimesulide; rofecoxib; toxicity;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Schuna, AA William S Middleton Mem Vet Adm Med Ctr, 2500 Overlook Terrace,Madison, WI 53705 USA William S Middleton Mem Vet Adm Med Ctr 2500 Overlook Terrace Madison WI USA 53705
Citazione:
A.A. Schuna e C. Megeff, "New drugs for the treatment of rheumatoid arthritis", AM J HEAL S, 57(3), 2000, pp. 225-234

Abstract

New pharmacologic treatment options for rheumatoid arthritis (RA) are describedNonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for RAbut are limited by the risk of adverse effects, especially gastrointestinal and renal toxicity. The therapeutic effects of these agents are mediated primarily through inhibition of cyclooxygenase (COX) and prevention of subsequent formation of prostaglandins and related inflammatory mediators. Nonspecific COX inhibition appears to be responsible for much of the toxicity of NSAIDs. Agents have been developed that can selectively inhibit the COX-2isoforms, while sparing COX-1. Celecoxib and other COX-2 inhibitors appearto be no more efficacious than conventional NSAIDs, but offer superior safety. COX-2 inhibitors should be considered for patients who are candidates for NSAID therapy but at risk for GI bleeding. Unlike disease-modifying antirheumatic drugs (DMARDs), these agents do not alter underlying disease progression. Leflunomide is a newer DMARD that reduces pyrimidine synthesis, thus decreasing rheumatoid inflammation. Leflunomide appears to be as effective as methotrexate but, unlike that drug, does not necessitate monitoring for bone marrow toxicity. Etanercept, the first biological agent with FDA-approved labeling for use in RA, has shown efficacy and minimal toxicity, except for injection-site reactions. Other biologicals that have been investigated for use in RA include infliximab and interleukin-1-receptor antagonist. COX-2 inhibitors, leflunomide, and etanercept are promising new drugs available for treating RA. Other agents are underdevelopment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 03:04:27