By Richard O. Day, Daniel E. Furst, Piet L.C.M. van Riel, Barry Bresnihan
This ebook provides a complete evaluation of disease-modifying antirheumatic medications (DMARDs). The introductory common chapters care for the chemistry of DMARDs, their use in treatment, pharmacoeconomics, and a survey of opinion leaders within the box; the subsequent particular chapters represent every one agent in regards to mechanism of motion, remedy, pharmacology, efficacy, toxicity, and tracking. for every agent a few heritage is given, fresh advancements and impact of the remedy on sufferers` caliber of existence and long term results are offered.
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Extra info for Antirheumatic Therapy: Actions and Outcomes (Progress in Inflammation Research)
External scientific evidence provides clinicians with an understanding of efficacy and effectiveness in groups of patients considered together, but the final benefit-eost ratio must be individually assessed for each patient. External evidence Hierarchy of scientific rigor The most scientifically rigorous evidence for therapeutic efficacy is obtained from comprehensive systematic reviews of randomised clinical trials (RCTs), with or without meta-analysis (Fig. 1) [3-6]. Systematic reviews methodically and critically synthesize evidence from all available sources, using a systematic, unbiased approach.
In the group treated with minocycline, no differences were observed in radiological progression between DR4 positive and negative patients. However, in the placebo group, a gradient was observed, with increased radiological damage according to the allele dose (none, heterozygous, and homozygous) . In a trial comparing the combination of methotrexate, sulfasalazine, and hydroxychloroquine with methotrexate alone , a differential response was also observed. Patients with the shared epitope had a better response to combination therapy compared to methotrexate alone, which accounted for most of the positive results of the trial, while negative patients has similar responses to either treatment.
Similar criteria for improvement have been developed by the European League against Rheumatism (EULAR) . An additional measure that helps make trial results more understandable for practicing clinicians and their patients, and can be helpful in daily clinical practice 28 Targeting DMARD therapy decision-making, is the number needed to treat (NNT). The NNT is the estimated number of patients that have to be treated with an intervention in order to prevent one additional bad outcome, or to gain one additional good outcome.
Antirheumatic Therapy: Actions and Outcomes (Progress in Inflammation Research) by Richard O. Day, Daniel E. Furst, Piet L.C.M. van Riel, Barry Bresnihan