Clinical Features and Treatment of Rheumatoid Arthritis: A Review

• Published in: Research journal of pharmacy and technology 2018-12, Vol.11 (12), p.5701-5706
• Main Authors: Nandgude, Tanaji D., Hasabe, Priyajit S., Kolsure, Anuja K.
• Format: Article
• Language: English
• Subjects: Autoimmune diseases; Circadian rhythm; Cytokines; Drug dosages; Immune system; Inflammation; Melatonin; Pathogenesis; Rheumatic diseases; Rheumatoid arthritis; Rheumatology; Tumor necrosis factor-TNF
• ISSN: 0974-3618; 0974-360X; 0974-306X
• DOI: 10.5958/0974-360X.2018.01032.6

[...]exogenous glucocorticoids treatment is recommended in RA at low doses in cetimay partially act like a 'replacement therapy'. Interestingly, despite a considerably higher cost than conventional prednisone, chronotherapy with night time release prednisone was recognised as a cost effective option for patients with RA not on glucocorticoids who are eligible for therapy with biological disease modifying antirheumatic drug (DMARDs). [...]since different cell populations involved in the inflammatory process are particularly activated during the night, other therapeutically approaches used in RA, for example, conventional DMARDs and non-steroidal anti-inflammatory drugs (NSAIDs), should follow the same concepts of glucocorticoids chronotherapy. The circadian clock and RA9-11: In all individuals, a circadian clock drives daily rhythms in physiology necessary to synchronize the human functions with the 24 h environment. [...]physiological functions under circadian control include the sleep-wake cycle, heart rate, blood pressure, body temperature, as well as endocrine gland regulation (i.e., gonadal and adrenal steroid genesis) and immune response. Imaging studies have shown that joint capsules and ten synovial tissues can also be affected by inflammation in PSA. [...]in clinical assessment, it is important to focus on other sites of inflammation and not just concentrate on how many tender or swollen joints the patient has.Proinflammatory cytokines such as TNF-a are present in psoriatic plaques and synovial fluid in large amounts.1 TNF-a is also found in many other arthropathies and biologic drugs which are aimed at blocking TNF-a have been effective therapies for such conditions.