Disease-modifying activity

In this case rec, the recovery parameter, is defined as an exponential function. However because the model that is being tested involves a disease modifying activity, the effect needs to be added to the TVKPROG. 

Corticosteroids can be used in various ways. They are valuable in controlling symptoms before the onset of action of DMARDs. A burst of corticosteroids can be used in acute flares. Continuous low doses may be adjuncts when DMARDs do not provide adequate disease control. Corticosteroids may be injected into joints and soft tissues to control local inflammation. Steroids seldom should be used as monotherapy. There are data to suggest they have disease-modifying activity however, it is preferable to avoid chronic use when possible to avoid long-term complications. NSAlDs and DMARDs have steroid-sparing properties that permit reductions of steroid doses. 

Infliximab (Remicade) is a chimeric monoclonal antibody against tumor necrosis factor (TNF)-alpha that has shown efficacy in Crohn s disease and rheumatoid arthritis with a disease-modifying activity and rapid onset of action [237]. It is administered intravenously, generally in a schedule with initial infusions at 0, 2, and 6 weeks, followed by administration once every 8 weeks. Infliximab is effective in the treatment of patients with moderately to severely active Crohn s disease with an inadequate response to other treatment options or those with fistulizing disease. In combination with methotrexate, infliximab reduced signs and symptoms and... 

Goldberg, V.M., Buckwalter, J.A. (2005) Hyaluronans in the treatment of osteoarthritis of the knee evidence for disease-modifying activity. Osteoarthritis Cartilage, 13 (3), 216-224. 

The first-line agents in the treatment of rheumatoid arthritis are non-steroidal anti-inflammatory drugs such as diclofenac. Diclofenac and indometacin, another NSAID, tend to have similar activity hov/ever, indometacin has a higher incidence of side-effects and therefore diclofenac is more appropriate for initial treatment. Sodium aurothiomalate is classified as a disease-modifying antirheumatic drug and is used as a second-line treatment in rheumatoid arthritis, but has been superseded by methotrexate, administered v/eekly. Paracetamol is often indicated in the management of osteoarthritis. Local intra-articular injections of dexamethasone may be administered for the relief of soft-tissue inflammatory conditions. 

Polyarticular-course juvenile rheumatoid arthritis (JRA) For reducing signs and symptoms of moderately to severely active polyarticular-course JRA in patients who have had an inadequate response to at least 1 disease-modifying antirheumatic drug (DMARD). 

B. Indications and use Kineret is indicated for the reduction in signs and symptoms of moderately to severely active rheumatoid arthritis in patients 18 years of age or older who have failed one or more disease-modifying antirheumatic drugs (DMARDs). Kineret can be used alone or in combination with DMARDs other than tumor necrosis factor (TNF) blocking agents. 

New indication Reducing the signs and symptoms and delaying structural damage in patients with moderately to severely active rheumatoid arthritis, including those who have not previously failed treatment with disease-modifying drugs... 

Addyman R, Beyeler C, Astbury C, Bird HA. Urinary glucaric acid excretion in rheumatoid arthritis influence of disease activity and disease modifying drugs. Ann Rheum Dis 1996 55(7) 478-81. 

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