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Topic: DMARD

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	News - Short Term, Beneficial Effects of Early DMARD Treatment in Rheumatoid Arthritis
		DMARD regimens consisted of intramuscular gold (aurothioglucose, 50 mg/week; second choice D-penicillamine, 500 to 750 mg/day), hydroxychloroquine (400 mg/day; second choice auranofin, 6 to 9 mg/day), or oral methotrexate (7.5 to 15 mg/week; second choice sulfasalazine 2,000 to 3,000 mg/day), depending upon patient response after first year.
		While patients receiving early DMARD treatment showed favourable results at early follow-up evaluations as compared to those on the pyramid approach, the clinical advantage was not apparent at later evaluations.
		Furthermore, the percentage of patients showing clinically relevant individual improvement was significantly higher in the early DMARD group than in the pyramid group starting at 3 months (48% versus 25%) and up to 21 months (70% versus 55%).
	www.docguide.com /news/content.nsf/news/8525697700573E1885256D6C005C4865 (645 words)

	Getting Established on DMARD Therapy - NRAS
		Remember that DMARDs are designed to attack inflammation, they are not painkillers and it is therefore important that you should also be taking painkillers whilst you have pain.
		Occasionally the side effects which the DMARD is causing may be treated by using another medication for that side effect, for example if the problem is nausea and sickness then it may be possible to successfully continue taking a drug with an anti-sickness pill to help you.
		All DMARD therapies are capable of harm as well as good and it is important to know whether they are causing harm.
	www.rheumatoid.org.uk /article.php?article_id=171 (3920 words)

	Tumor necrosis factor blockers may not cause cancer after all
		Each subject was followed after beginning use of either a biologic DMARD or MTX, with attention to diagnosis of cancer followed by any course or combination of palliative care, biopsy, radiation, chemotherapy, or surgery.
		From their rigorous definition of cancer, researchers identified a total of 11 cancers of the blood and lymphatic systems and 46 cancerous tumors during 2,940 person-years of biologic DMARD use, and 58 cancers of the blood and lymphatic systems and 558 tumors during 30,300 person-years of MTX use.
		Comparing biologic DMARD users with MTX users, the hazard ratio was 1.37 for blood-related cancers and 0.91 for solid tumors.
	www.eurekalert.org /pub_releases/2006-08/jws-tnf082406.php (567 words)

	DMARD senken das kardiovaskuläre Risiko -- MEDICA Messe
		Die Studienautoren spekulieren über den physiologischen Mechanismus, der den kardioprotektiven Effekt der DMARD ausmachen könnte.
		Demnach soll die antiinflammatorische Wirkung der DMARD dafür verantwortlich sein.
		Auch eine indirekte Wirksamkeit ist denkbar, indem DMARD zum Beispiel positiv auf Risikofaktoren eines Myokardinfarkts einwirken.
	www.medica.de /cgi-bin/md_medica/custom/pub/content.cgi?lang=1&ticket=g_u_e_s_t&oid=20510 (279 words)

	Arthritis: New Treatments - Combination DMARDS for Rheumatoid Arthritis
		Most of the clinical trials using more than one DMARD were confined to patients whose RA had already failed to respond to one or more of these drugs used as single agents.
		One of the goals of early combination DMARD therapy has been to make remission of the RA happen, so that all anti-rheumatic therapy could be gradually withdrawn (step-down therapy), but this goal has clearly not been achieved in the trials reported to date.
		While early combination DMARD therapy is NOT a major breakthrough in the treatment of RA, I believe that it is worth trying in some RA patients.
	www.thedoctorwillseeyounow.com /articles/arthritis/dmards_3 (601 words)

	Hinduja Hospital:P.D.Hinduja National Hospital & Medical Research Centre
		Therefore, for maximum benefit, DMARD therapy should ideally be initiated between 3 – 6 months of disease onset.
		The important question is – “Is uncontrolled disease with almost certain dysfunction and disability a better choice than DMARD that has 70 – 80% chance of controlling the disease process and 10% or so chances of side-effects ?”.
		If a DMARD singly or in combination is effective and well tolerated there is no need to change the same.
	www.hindujahospital.com /Rheu_in3.html (564 words)

	DMARDs: Rheumatoid Arthritis Medications
		DMARDs are intended to reduce or prevent joint damage, preserve joint function, and maintain patient mobility.
		DMARDs are relatively slow acting, with a delay of one to six months before they begin to show results.
		Discontinuing a DMARD may reactivate disease or cause a “rebound flare,” with no assurance that disease control will be reestablished upon resumption of the medication, according to Arthritis and Rheumatism.
	www.allaboutarthritis.com /AllAboutArthritis/layoutTemplates/html/en/contentdisplay/document/condition/arthritis/generalArticle/DMARDS_prescription_meds.htm (638 words)

	Disease Modifying Anti-rheumatic Drugs (Agents with Delayed Onset of Action)
		DMARDs have an effect upon rheumatoid arthritis that is different and more delayed in onset than either NSAIDs or corticosteroids.
		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.
		Methotrexate is the only conventional DMARD agent in which the majority of patients continue on therapy after 5 years.
	www.angelfire.com /amiga2/boofy/DMARDS.htm (893 words)

	(4) Rheumatoid arthritis: management with DMARDs
		DMARDs are the most important agents used to treat rheumatoid arthritis as they suppress symptoms, delay joint damage and potentially delay deformity.
		In the meantime, patients with a suspected diagnosis of rheumatoid arthritis should be referred promptly to a specialist centre where their diagnosis can be confirmed and appropriate treatment started without delay, based on a careful evaluation of efficacy and potential toxicity in the individual patient.
		Finally, patients with very active disease and poor predictive outcomes, such as high inflammatory markers, large joint involvement and strong seropositivity, may be treated with combination therapy from the outset, for example, parenteral pulse methylprednisolone, oral weekly methotrexate, and daily cyclosporin as well as intra-articular steroid injections to all their inflamed large joints.
	www.pharmj.com /Editorial/19990731/education/dmards.html (5855 words)

	Arthritis Foundation of Malaysia
		This booklet is intended to be a general guide to the DMARDs commonly used to treat rheumatoid arthritis.
		Each DMARD may be given on its own, but if it does not control your arthritis, a second one may be added.
		DMARDs tend to have a greater effect on arthritis than NSAIDs and there are some side effects, which are associated with taking this type of medication.
	www.afm.org.my /info/medications_for_ra.php (1702 words)

	Disease Modifying Anti-Rheumatic Drugs (DMARDs) \| Caremark Health Resources
		Most DMARDs were originally developed to treat other diseases and were only accidentally found to be effective for RA.
		DMARDs are also called slow-acting antirheumatic drugs (SAARDs) because it generally takes between one and six months before their effect is evident.
		Patients respond differently to the various DMARDs and sometimes several drugs must be tried before one is found to be effective.
	healthresources.caremark.com /topic/dmards (1033 words)

	DMARD - Legemiddelsiden
		DMARDs omfatter flere legemidler som er ulike mht.virkninger og bivirkninger.
		Ciklosporin, azatioprin, penicillamin og klorambucil/cyklofosfamid brukes vanligvis kun i tilfeller hvor andre DMARD har gitt bivirkninger eller ikke har hatt tilstrekkelig effekt.
		Visse kombinasjoner av forskjellige typer DMARD gir Ã¸kt effekt, uten Ã¸kt risiko for bivirkninger (f.eks.
	www.legemiddelsiden.no /default.aspx?PageID=696 (580 words)

	Arthritis Today - Fitness
		People newly diagnosed with an inflammatory form of arthritis, such as RA, may be prescribed a DMARD upon their diagnosis.
		Another reason DMARDs should be started early is that, although they are generally effective, they take a long time to show results.
		DMARDs are most commonly used for RA, but some are also used for juvenile RA, ankylosing spondylitis, psoriatic arthritis and lupus.
	www.arthritis.org /conditions/drugguide/about_dmards.asp (331 words)

	Arthritis Research & Therapy \| Full text \| Aspects of early arthritis. Traditional DMARD therapy: is it sufficient?
		Meta-analyses and retrospective analyses of large patient cohorts have revealed that responses to DMARDs or their retention rates are better in the early stages of the disease [10,11].
		However, the patients without DMARD treatment or with delayed treatment had milder disease at baseline, as indicated by several parameters such as age at onset, delay to presentation, sex, maximal early morning stiffness, rheumatoid factor titre, Health Assessment Questionnaire (HAQ), C-reactive protein, and number of swollen and tender joints.
		The study conducted by Proudman and coworkers [30] employed both a potent DMARD (methotrexate) and a steroid in all patients in the 'aggressive' arm, whereas in the comparator group only 66% of patients received steroids at all, with a cumulative dose of about one-third that in the aggressive treatment group.
	arthritis-research.com /content/8/3/211 (4861 words)

	Johns Hopkins Arthritis ACR 2004 Highlights on Rheumatoid Arthritis Clinical Aspects
		Data on DMARD exposure (methotrexate, leflunomide, sulfasalazine, azathioprine, cyclosporine, and cyclophosphamide) and exposure to corticosteroids were obtained from centralized pharmacy records.
		While this investigation looked at several DMARDs as a group, there are important differences in the individual DMARDs in terms of their immunosuppressive capabilities (with cyclophosphamide and azathioprine more likely than methotrexate or leflunomide to be associated with serious infections) that would merit sub-analyses of each DMARD alone (or when DMARDs are used in combination).
		Demographic characteristics, clinical parameters, use of non-biologic DMARDs, type of orthopedic procedure performed, and measures of disease activity and severity were balanced between the TNF inhibitor treated and untreated groups.
	www.hopkins-arthritis.org /edu/acr2004/ra-clinical.html (2027 words)

	Disease-modifying Anti-rheumatic Drugs (DMARDs) for Rheumatoid Arthritis: Benefits and Risks
		While rheumatologists initiate DMARD therapy, general practitioners need to be aware of potential adverse reactions and to share the responsibility of monitoring patients.
		The value of a DMARD is measured by its ability to suppress inflammatory activity over a long time-frame thus improving day to day function, and on the ability to prevent, lessen or delay destructive changes which may result in permanent loss of function.
		The value of a DMARD cannot, therefore, be adequately assessed with trials which do not have placebo or alternative treatment controls.
	www.medsafe.govt.nz /Profs/PUarticles/dmards.htm (2767 words)

	Arthritis Research Campaign \| Prescribing and Monitoring of Disease Modifying Anti-Rheumatic Drugs (DMARDS) for ... (Site not responding. Last check: )
		DMARDs are now usually given as soon as the diagnosis of rheumatoid has been made, that is within a few months of the disease onset.
		As most DMARD changes are likely to be made by the attending rheumatologist, he/she will bear the main responsibility for assessing response to treatment, although it is important for GPs to understand the process.
		As the range of DMARDs is relatively small the decision to stop an individual agent should be taken with care, and every effort should be made to maintain patients on such therapies if they are effective.
	www.arc.org.uk /about_arth/med_reports/series4/ip/6508/6508.htm (5722 words)

	RA DMARD - DMARD Therapy is a recommended RA Treatment
		Early DMARD therapy is recommended for all patients with aggressive RA who have ongoing joint pain, significant morning stiffness, or fatigue despite NSAID treatment.
		For these reasons, early DMARD therapy is recommended for all patients with aggressive RA who have ongoing joint pain, significant morning stiffness, or fatigue despite NSAID treatment.
		In addition, treatment with a single DMARD is not always successful; therefore, the ACR guidelines suggest that some patients may benefit from use of more than one DMARD.
	www.ra.com /ra/rastore/cgi-bin/ProdSubEV_Cat_200754_SubCat_200754_NavRoot_300.htm (467 words)

	Arthritis Week -- Your Online Arthritis Newsletter
		Depending on the type of arthritis, a person may be given a disease-modifying antirheumatic drug (DMARD) -- a strong medicine that seeks to slow or prevent joint damage by interfering with or suppressing the immune system.
		Although DMARDs are usually quite effective, some of them take up to several months to show results.
		For that reason, you may need to take another drug, such as an NSAID or perhaps a corticosteroid, to help control inflammation while the DMARD is starting to work.
	www.arthritisweek.org /members/Treatments/DMARDs.htm (222 words)

	CIAOMed: Combination DMARD Therapy Leads to Sustained Remission in RA
		In the study, patients were randomized to receive either a combination of DMARDS (n = 97) or a single DMARD (n = 98).
		In the combination group, the initial DMARD was sulfasalazine (SSZ) 500 mg twice daily, methotrexate (MTX) at 7.5 mg/week, and hydroxychloroquine (HCQ) at 300 mg/day.
		In 169 RA patients for whom complete data were available, 14% of patients who received a combination of DMARDs plus prednisolone and 3% who received a single DMARD with or without prednisolone had remissions according to modified ACR criteria (fatigue excluded) at 2 years.
	www.ciaomed.org /articles.cfm?articleID=1132 (589 words)

	Carilion - Methotrexate for rheumatoid arthritis - [Medication]
		It is the most common DMARD used to treat rheumatoid arthritis.
		Methotrexate is often the first DMARD prescribed for rheumatoid arthritis and usually provides relatively rapid relief of at least some symptoms.
		In addition, methotrexate in combination with leflunomide, another DMARD, has been shown to be more effective than when methotrexate is given alone.
	www.carilion.com /kbase/htm/aa18/961/aa18961.htm (840 words)

	Effects of disease modifying agents and dietary intervention on insulin resistance and dyslipidemia in inflammatory ...
		DMARD therapy together with dietary intervention was associated with weight loss of 4 kg (0-6.5 kg), a decrease in CRP of 14% (6-36%; P < 0.006), and a reduction in insulin resistance of 36% (26-61%; P < 0.006).
		Disease-modifying antirheumatic drugs (DMARDs) may have an attenuating effect on CVD risk and death in RA In a more recent report [12], the use of methotrexate in RA was associated with a 70% (95% confidence interval 30-80) reduction in risk for cardiovascular death [12].
		The baseline clinical and biochemical features, and use of DMARDs and changes in cardiovascular risk factors in all 22 patients are presented in the second columns of Tables 1 and 2, respectively.
	bmc.ub.uni-potsdam.de /ar597/text.htm (3619 words)

	InteliHealth:
		DMARDs are slow-acting drugs that usually take weeks or months before the benefits become apparent.
		Do not become discouraged and stop taking a DMARD before it has had a chance to work (unless you have a side-effect or reaction; discuss any change in your medications with your doctor).
		Failure to respond to one DMARD does not mean you also will fail to respond to a different DMARD.
	www.intelihealth.com /IH/ihtIH/WSANP/31522/31535/348084.html?d=dmtContent (1169 words)

	The Arthritis File: Drug Therapies
		To evaluate the efficacy and safety of additive triple disease modifying anti-rheumatic drug (DMARD) combination therapy of a low dose of sulfhydryl compounds D-penicillamine, bucillamine or tiopronin, sulfasalazine (SSZ) and methotrexate (MTX) as a treatment for rheumatoid arthritis (RA) patients, we studied a total of 33 Japanese RA patients (6 males, 27 females).
		This suggests that additive triple DMARD combination therapy of a low dose of sulfhydryl compounds, SSZ and MTX could be a useful drug therapy for the treatment of RA patients, even those who are refractory.
		Estimates of the use of DMARD were based on the treatments reported on 502 visits by patients with RA in 1980-81, 339 visits by patients with RA in 1985, 386 visits by patients with RA in 1989-91, and 383 visits by patients with RA in 1993-95.
	ssl.adgrafix.com /users/lifestag/arthritis/drug.html (8214 words)

	Arthritis Insight-Featured Discussion: DMARDs
		Although it is very important to remember that every person reacts differently to different meds, personal experiences are important to many of us when deciding our treatment options.
		And the majority of you have stopped at least one DMARD due to side effects.
		Hard to know, really, if the DMARDs are working in general, as he's never been able to get off steroids.
	www.arthritisinsight.com /feature/dmards/index.html (1025 words)

	DMARDs - Page 1 (Site not responding. Last check: )
		Some DMARDs are used mainly to treat cancer or prevent rejection of an organ transplant.
		Exactly how DMARDs work is not completely understood, but they appear to help suppress the immune system.
		DMARDs do not provide immediate relief and may take months to be effective.
	pain.health.ivillage.com /arthritis/dmards.cfm (440 words)

	Rheumatoid Arthritis Cardiovascular Risk Remains High In DMARD Era
		The increased risk of cardiovascular disease and myocardial infarction associated with rheumatoid arthritis does not appear to have been changed by the introduction of DMARDs, according to a Swedish study.
		Dr Ulf Bergstrom and colleagues, University Hospital Malmo, compared cardiovascular morbidity and mortality in 1995-2002, and in an earlier patient cohort (1978-85).
		MySpa Clinics are a Cosmetic Surgery company based in the UK who offer Breast Enhancement, Liposuction and Breast surgery services.
	www.medicalnewstoday.com /medicalnews.php?newsid=56793 (178 words)

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