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Drugs for RA - Coggle Diagram
Drugs for RA
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bDMARDs
Biological
TNF inhibitors
Infliximab, Etanercept, Adalimumab, Golimumab, Certolizumab
- All are given SC, except IV
- Used in many autoimmune diseases, either alone or in combination with Methotrexate
- ADRs - ↑bacterial, fungal, opportunistic infections – screen for TB & Hep B, ↑risk of melanoma, exacerbate CHF, antidrug antibodies, ↑risk of gi bowel perforation
IL-1 inhibitors
Anakinra, Rilonacept, Canakinumab
- Uses - used largely for cryopyrin assoc periodic syndrome), gout.
Canakinumab used in Systemic Juvenile Rheumatoid Arthritis (SJIA)
IL-6 inhibitors
Tocilizumab, Sarilimumab
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T-cell modulators
Abatacept, Belatacept
Inhibits the 2nd signal - T-cell stimulation
- ADRs – ↑risk of infections/ lymphomas
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Glucocorticoids
- Low dose, for prompt anti-inflammatory activity, to bridge till slower acting DMARDs take effect
- Prednisolone 5-10mg/ day for those with inadequate response to DMARD
- Higher doses for extra-articular manifestations (like ILD)
- Intra-articular Triamcinolone – if only 1-2 joints are severe
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