Biological agents rheumatoid arthritis

KUnkhoff A. Biological agents for rheumatoid arthritis. Drugs 2004 64 1267-83. 

Sulfasalazine also is indicated for use in rheumatoid arthritis and juvenile rheumatoid arthritis. Refer to the monograph in the Biologic and Immunologic Agents chapter. 

Moreland, W. et al. (1997). Biological agents for treating rheumatoid arthritis — concepts and progress. Arthritis Rheumatism 40(3), 397-409. 

A small-molecule inhibitor of tumor necrosis factor a, a protein involved in inflammatory diseases such as rheumatoid arthritis, has been identified <2005SCI1022>. Direct inhibition by the commercial biological agents Enbrel and Remicade has produced major advances in rheumatoid arthritis treatment and validated extracellular inhibition of this proinflammatory cytokine as an effective therapy. The new inhibitor 35 is composed of trifluoromethylphenyl indole and dimethylchromone moieties linked by a dimethylethylenediamine spacer. 

Disease-modifying antirheumatic drugs (DMARDs) or biological agents should be started within 3 months of the diagnosis of rheumatoid arthritis. 

For patients with rheumatoid arthritis, the order of DMARD or biological agent choice is not clearly defined. In addition, some advocate trials of combination DMARD therapy before courses of biological agents are tried. 

Therapeutic Agents Targeting TNF-oc. The Streptococcus pneumoniae host resistance model is also valuable for evaluating the importance of macrophage cytokines on bacterial host resistance. Human biological therapeutics targeting inhibition of TNF-a have been used to treat inflammatory autoimmune diseases such as rheumatoid arthritis. Decreased TNFa as a result of treatment with monoclonal antibodies (mAb) to TNF-a has an effect on several biomarkers of infection (Takashima et al, 1997 van der Poll et al, 1997 Benton et al., 1998 O Brien et al, 1999). These studies have reported that treatment of mice with a mAb to TNF-a results in altered levels of TNF-a in the lungs... 

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