Rheumatoid arthritis (Part 3): biological therapy

Rheumatoid arthritis is a serious condition that affects work capacity. Visceral lesions are responsible for shortening the average life of 5 to 10 years. Major consequence of this disease is disability. The loss of work ability is the most costly consequence of early rheumatoid arthritis.

Try to treat early rheumatoid arthritis. Despite major advances in the field of therapy, so far there is no known cure for rheumatoid arthritis, as neither prophylactic methods. Optimal treatment of disease require early diagnosis and timely use (ie early enough), to reduce the probability of irreversible joint injuries. It is very important to treat a patient early, when symptoms do not evolve more.

Progress in recent years in understanding the pathogenic mechanisms of disease led to major developments necessarily to treat rheumatoid arthritis. Recognizing the central role of cytokines in particular TNF-alpha in rheumatoid synovium of hypothesis testing led to the control of rheumatoid arthritis by blocking TNF-alpha.

Biological therapy (anti-TNF agents)

Clinical studies in recent years have demonstrated that the TNF alpha blockers cause a rapid and significant improvement of the clinical disease (pain and inflammation), creating thereby a substantial improvement of life quality of patients treated, but also a unique effect of stopping the progression of radiological (joint structural damage) characteristic of the disease.

TNF blockers are indicated in patients with rheumatoid arthritis, despite a complete and correct therapy. TNF blockers slow or even stop disease progression, if is used early (before the onset of osteoarticular lesions).

TNF blockers can be administered only under the supervision of an experienced physicians in the diagnosis and treatment of rheumatoid arthritis, including evaluation:
* Disease evolution
* Efficiency and tolerance of immunomodulatory therapies.

Before initiation by setting specific goals for each patient. Your doctor will do a complete examination, including a Rg. chest to exclude any contraindications.

Contraindications. Use of TNF blockers is contraindicated in cases of acute or chronic infections (including tuberculosis) or recent cancer. Their appearance during treatment. require discontinuation, which will be resumed only after complete cure.

For monitoring the effectiveness of therapy:
* Assessing the number of swollen and painful joints;
* Determination of acute phase reactants (ESR and CRP);
* Global assessment of disease evolution by the physician and the patient (visual analogue scale or a scale with five degrees);
* Assessment of joint pain (visual analogue scale 100 mm);
* A functional assessment (such as Haq).

Based on understanding the molecular mechanism of disease, anti-TNF therapy opens a new era in the treatment of rheumatoid arthritis.