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Báo cáo y học: "Are biologics more effective than classical disease-modifying antirheumatic drugs"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Are biologics more effective than classical disease-modifying antirheumatic drugs? | Available online http arthritis-research.eom content 10 5 118 Commentary Are biologics more effective than classical disease-modifying antirheumatic drugs Michael T Nurmohamed1 2 and Ben AC Dijkmans1 2 1 Department of Rheumatology VU University Medical Centre De Boelelaan 1117 1081 HV Amsterdam The Netherlands 2Department of Rheumatology Jan van Breemen Institute Dr Jan van Breemenstraat 2 1056 AB Amsterdam The Netherlands Corresponding author Michael T Nurmohamed mt.nurmohamed@vumc.nl Published 19 September 2008 This article is online at http arthritis-research.com content 10 5 118 2008 BioMed Central Ltd Arthritis Research Therapy 2008 10 118 doi 10.1186 ar2491 Abstract Major achievements have been reached in the treatment of rheumatoid arthritis during past decades due to the recognition of methotrexate as an anchor drug for treatment of rheumatoid arthritis due to the notion of a treatment window of opportunity in patients with recent-onset rheumatoid arthritis necessitating early aggressive therapy due to the development of biologics and due to remission as a treatment target. Most biologics have a much faster onset of action than synthetic disease-modifying antirheumatic drugs but presently there is no convincing evidence that biologic drugs have a superior clinical efficacy in comparison with the synthetic drugs. Biologics are however accompanied by less radiological deterioration. Rheumatoid arthritis RA and other inflammatory arthritis diseases are systemic inflammatory diseases of unknown aetiology which untreated may lead to joint destruction and dysfunction to disability and to a decreased life expectancy. The treatment goal is therefore to control the underlying inflammatory process in order to slow or even prevent joint damage. Until the mid-1980s pharmacological treatment was performed according to the pyramid approach. The sequence was to start with a nonsteroidal anti-inflammatory drug with or without corticosteroids and then to add a .