Antirheumatic Therapy: Actions and Outcomes (Progress in by Richard O. Day, Daniel E. Furst, Piet L.C.M. van Riel, Barry

By Richard O. Day, Daniel E. Furst, Piet L.C.M. van Riel, Barry Bresnihan

This e-book supplies a accomplished review of disease-modifying antirheumatic medicines (DMARDs). The introductory normal chapters care for the chemistry of DMARDs, their use in remedy, pharmacoeconomics, and a survey of opinion leaders within the box; the subsequent particular chapters signify each one agent with reference to mechanism of motion, treatment, pharmacology, efficacy, toxicity, and tracking. for every agent a few historical past is given, contemporary advancements and impression of the remedy on sufferers` caliber of lifestyles and long term results are awarded.

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Additional info for Antirheumatic Therapy: Actions and Outcomes (Progress in Inflammation Research)

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Patient preferences and shared decision-making Patient preferences and individual tolerance of risk are crucial components in the choice of DMARD therapy. Increasingly, patients want to be active participants in decision-making processes about their health. Shared decision-making requires that patients become informed, gain an understanding of potential harms and benefits, and ultimately make choices consistent with their personal values. A study in 36 Targeting DMARD therapy patients with RA showed that 89% of them wanted full disclosure about therapeutic options and potential risks, but the study did not specifically examine preferences for shared decisions [70].

Only biologic agents appear to offer some advantages over other drugs in short-term studies . These benefits seem more pronounced in patients with longer disease duration who have failed other therapies. For DMARD-naoive patients, although some significant differences have been observed in the rate of radiological progression when comparing traditional DMARDs with biologic agents, other clinical difference s are small [29,30]. Table 2 shows NNTs for selected RCTs of DMARDs and biologic agents [25, 31].

Improvement measures are only valid if they are adjusted to the background placebo effects. For instance, 60% of patients on either drug A or B can achieve ACR20 responses in a trial; however, the efficacy of the drug will be quite different if the ACR20 placebo response for drug A is 40%, and for drug B 20%. NNTs and NNHs take background placebo effects into account and are more appropriate for clinicians to comparing drugs tested in different trials, than just evaluating ACR improvement responses.

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