Rheumatoid Arthritis and Treatment

Therapies/Treatments That Can Be Done to Help the Immune System of a Patient 18-55 Diagnosed With Rheumatoid Arthritis

THERAPIES/TREATMENTS TO HELP THE IMMUNE SYSTEM OF An 18-55 PATIENT DIAGNOSED WITH RHEUMATOID ARTHRITIS

Therapies/treatments that can be done to help the immune system of a patient 18-55 diagnosed with Rheumatoid Arthritis (RA)

Annotated Bibliography

Cem Gabay, A, et al. (2013). Tocilizumab Monotherapy vs. Adalimumab Monotherapy for the Treatment Of Rheumatoid Arthritis (ADACTA): A Randomized, Double-Blind, Controlled Phase 4 Trial.

Using a randomized population involving double-blind, Phase 4 superiority and parallel-group, the study used 76 centers found in different countries including the U.S. The patients used were above 18 years and suffering from Rheumatoid Arthritis for the last six months and above. The patients were supposed to have shown intolerance to methotrexate or were not appropriate for a continuation of the treatment using this method. With the random assignment of 1:1, the patients have introduced to tocilizumab 8 mg per body weight for every four weeks together with placebo every four weeks for the nest 24 weeks (Cem et al., 2013). From the results, it was noted that tocilizumab monotherapy became more functional to the adalimumab immunotherapy in the reduction of the signs and symptoms of RA, and hence posed as one of the ways of offering immune management of patients suffering from RA. The findings had adverse event profiles belonging to tocilizumab together with adalimumab.

Katherine S. Upchurch and Jonathan Kay (2012). Evolution of Treatment for Rheumatoid Arthritis

Taking a randomized selection of 18 and above year's patients with RA, the study administers variances of different medical therapies in a bid to establish the best in offering immunity to patients with RA. The study uses a controlled experiment, introducing a combination of MTX+TNF-α inhibitor therapy to the patients (Katherine and Jonathan, 2012). The controlled experiment, involving over 23 patients, takes place over a period of 24 weeks, incorporating 4-week introduction of the subjects to the MTX+TNF-α inhibitors, separately and together as a combination. From the results, patients failed to the single treatment of the MTX+TNF-α inhibitors. Other possible alternatives were tried, as reported by the study, including treatment with biologics that have different antibodies to certain ILs, inflammatory mediators, and cytokines. The study concludes that the best way and a way that the immune of the RA patients can be boosted is through medical therapy. This therapy has to comprise of different combinations.

Michael E. Weinblatt et al. (2013). Safety of Abatacept Administered Intravenously in Treatment of Rheumatoid Arthritis: Integrated Analyses of up to 8 Years of Treatment from the Abatacept Clinical Trial Program.

The study intends to carry out an assessment of the safety of the events of Intravenous (IV) abatacept treatment for patients with rheumatoid arthritis. Using data obtained from eight different clinical trials of IV abatacept in RA were pooled, the assessment was done over 12 months, and with incidence, and rates for every 100 patients were calculated. With standardized incidence ratios for infections in hospitalized cases, comparisons were made using external RA groups in the U.S. general population (Michael et al., 2013). The results indicated that there was a long-term safety of the abatacept just like the short-term and the long-term periods characterized by reduced incidences and no infections for patients diagnosed with RA. This method stands as a safe therapeutic activity that can be used to offer treatment and boost the immune systems of patients diagnosed with RA and aged between 18 and 55 years.

Curtis, Yang et al., (2014). The risk of Hospitalized Bacterial Infections Associated With Biologic Treatment among U.S. Veterans with Rheumatoid Arthritis.

The study intends to make a comparison of the risk for hospitalized infections for no-antiTNF and anti-TNF biological agents among U.S. veterans who are suffering from RA. The study uses data collected from the U.S. veteran health administration. The study takes after patients with anti-TNF, abatacept, and rituximab initiations. Injections were supplied using infusions. Using the data for treatments, the analysis was based on a few cases that could be susceptible to the problem at hand (Curtis et al., 2014). From the results, it was obtained that for male veterans with RA; the risk that was associated with rituximab also called abatacept was like that involved with etanercept. This happened for patients who were older, indicating that for those who are between the ages of 18 and 55; this might be one of the possible ways of offering treatment and hence boost the immune system.

Mark C. Genovese et al. (2013). Efficacy and safety of secukinumab in patients with rheumatoid arthritis: a phase II, dose-finding, double- blind, randomized, placebo-controlled study.

The study seeks to assess the efficacy and safety involving the use of secukinumab in patients with RA. Using a population sample of 237 patients who had an adequate response to methotrexate, they were introduced to monthly subcutaneous injections of the drug-bearing 25 mg, 75 mg, 150 mg, and 300 mg or placebo (Mark et al., 2013). From the results, the study made comments that ACR20 response rates had differences between all the dosages administered. Nonetheless, there was no achievement of the primary end. There were increasing levels of DAS28 as seen with 75, 150 and 300 mg secukinumab than placebo. There occurred no unexpected safety incidences. Moreover, there were no specific organ-related toxicities. Other trials that were done indicated that it was safe and good to offer immune strength to patients with RA using secukinumab. This treatment offers a safe, non-reactive, and easy way of administration to patients with RA and in need of boosted immune systems.

Michael Schiff, Et Al., (2013). Head-To-Head Comparison of Subcutaneous Abatacept vs. Adalimumab for Rheumatoid Arthritis: Two-Year Efficacy and Safety Findings from AMPLE Trial.

The study endeavors to carry out a two-year comparison of the efficacy, safety and radiographic outcomes involving subcutaneous abatacept against adalimumab, when combined with methotrexate (MTX), in patients suffering from RA and in need of a treatment. An AMPLE study was done involving a phase 3b, two-year, randomized study with randomization and with a one-year primary endpoint (Michael et al., 2013). Patients with biologic naivety and had active RA together with an inadequate response to MTX were subjected to randomization and introduced to 125 mg abatacept every week or 40 mg adalimumab after every two weeks all with stability in a dose of MTX. The results indicated that based on clinical, radiographic and functional outcomes, subcutaneous abatacept together with adalimumab had similar levels of efficacies. In the overall perception, the frequency of AE had similarities in both groups but showed less discontinuity because of AEs, serious infections, SAEs, and fewer local ISRs including abatacept. This means that this is one of the portable ways of offering treatment to patients with RA and hence boosting their immunity.

Dixon, W. D., et al. (2009). The drug- specific risk of tuberculosis in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society for Rheumatology Biologics Register (BSRBR).

The study offers more insights on the effect of anti-TNF therapy used on patients when TB-predisposing drugs are used. The study made comparisons directly between different drugs, explore on the event to time, ethnicity and the site of infection. The study uses data from the British Society. The study takes a national perspective and compares 10,712 anti-FTN-treated patients and another 3,232 patients who had active RA and got treatment from antirheumatic drugs to modify the disease. The study found out that the rate of growth of TB in patients with RA and treated with anti-TNF was higher than the other group. This is the ultimate effect of the therapy on the patients' immune system, which appears to be compromised. Limited by the regulations to protect on the sample, the study managed to yield equitable results for further study. Further clarification on the study indicates success with the application of the results of the study.

Scott, D. L. (2012). Biologics-Based Therapy for the Treatment of Rheumatoid arthritis.