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Drug Therapy for Rheumatoid Arthritis in Adults
Authors: John I. Gomez, MD
Other Findings: Influence of Patient Characteristics on Outcomes of DMARD Treatment
The strength of evidence for each of the following findings is low:
- Patients with moderate rheumatoid arthritis (RA) had better overall improvement and better functional status than patients with severe RA. However, patients with severe RA had the greatest degree of improvement from baseline.
- In treatment with methotrexate (MTX), as the age of patients increased, the likelihood of major clinical improvement decreased slightly; however, overall age did not affect efficacy or risk of adverse effects.
- Biologics showed no apparent influence on the risk of cardiovascular events in the elderly (≥65 years of age).
- Toxicity of MTX was more likely in patients with greater renal impairment.
- High-risk comorbidities (cardiovascular disease, diabetes, malignancies, and renal impairment) did not increase the risk of serious adverse events or infections in patients treated with anakinra.
- Concomitant antidiabetic, antihypertensive, or statin medications given to patients treated with anakinra did not increase the risk of adverse events.
Keywords: adverse effects | anakinra | anti-rheumatic | antirheumatic | biologic DMARD | cardiovascular event | comorbidities | disease-modifying | DMARDs | methotrexate | methotrexate | oral DMARD | RA | renal impairment | rheumatoid arthritis
- Donahue KE, Jonas D, Hansen RA, et al. Drug Therapy for Rheumatoid Arthritis in Adults: An Update. Comparative Effectiveness Review No. 55 (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I). Rockville, MD: Agency for Healthcare Research and Quality; April 2012. AHRQ Publication No. 12-EHC025-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsra.cfm.
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