Arthritis treatments
In any case DMARDs have an effect upon rheumatoid arthritis that is different and more delayed in onset than either NSAIDs or corticosteroids. arthritis treatments Arthritis + diet. Once persistent disease activity (chronic synovitis) is established, a DMARD agent should be considered. The development of erosions or joint space narrowing on x-rays of the involved joints is a clear indication for DMARD therapy, however one should not wait for x-ray changes to occur. The currently available drugs include: leflunomide soluble interleukin-1 (IL-1) receptor therapy tumor necrosis factor inhibitors methotrexate hydroxychloroquine and sulfasalazine intramuscular gold cytotoxic agents (cyclosporine A, azathioprine, and cyclophosphamide) Leflunomide (AravaT) Leflunomide was approved by the FDA and became available as a new DMARD agent for rheumatoid arthritis in October 1998. arthritis treatments Ultracet-pain-medication. In clinical trials, its efficacy was similar to that of methotrexate and will represent a viable alternative to patients who have failed or were intolerant to methotrexate. The most recent clinical trial data were presented at the 1999 American College of Rheumatology meetings(see ACR Highlights). In a yearlong study, leflunomide was superior to methotrexate in preventing x-ray joint erosions, but this finding will need to be confirmed with additional studies. arthritis treatments Gold shots for rheumatoid arthritis. Additional data have supported that leflunomide is well tolerated and effective over 24 months. Mechanism: The mechanism of action is not fully understood but may be related to its ability to inhibit tyrosine kinase activity and inhibit de novo pyrimidine biosynthesis through the inhibition of the enzyme dihydroorotate dehydrogenase. In vitro studies have demonstrated the inhibition of mitogen and IL-2 stimulated T cells. Dosage: The half-life of the active metabolite of leflunomide is 15 days. Leflunomide and its active metabolite are extensively protein bound and undergo further metabolism before excretion in the urine and in the feces (direct biliary excretion). To achieve steady state, it is recommended to start with a loading dose of 100mg daily for three days and then 20 mg daily. The dose may be reduced to 10mg daily if not tolerated or in patients having difficulty metabolizing or excreting the drug. Usual time to maximal effect: Onset of action 4-8 weeks, with some evidence that onset of action may be sooner than methotrexate. Side Effects: In clinical trials, leflunomide has been associated with a 2-4% incidence of liver transaminase elevations 3 times the upper limit of normal that reversed with cessation of the drug.
Arthritis treatments
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