Rheumatoid
arthritis (RA) is an autoimmune disease that can cause chronic inflammation of
the joints and other areas of the body. In this disease an individual’s immune
system (responsible for protecting ones health by attacking foreign substances
like bacteria and viruses) mistakenly attacks joints. The inflammation caused
by abnormal immune response can damage joints as well as the organs like heart.
Early diagnosis and prompt treatment is the key to prevent joint and organ
damage. Presently, immunotherapy in
RA is divided into three parts: conventional disease modifying anti rheumatic
drugs (cDMARDs), biological DMARDs (bDMARDs) and new agents for the treatment
of Rheumatoid arthritis.
The
main cause of Rheumatoid arthritis is not completely understood. To maintain
function and health in patients with rheumatoid arthritis, earlier, insistent
and guided immunosuppressive therapy was required to induce clinical remission.
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Conventional
disease modifying anti rheumatic drugs (cDMARDs), are considered to act by
crossing the cell membrane barrier; but the primary interaction might be
intracellular, extracellular effects that are also directly linked. A few
examples of drugs which come under this category are Leflunomide, Methotrexate
and Sulfasalazine. Few drugs that fall in this category are Methotrexate,
Sulfasalazine and Leflunomide.
In
accordance to biological disease modifying anti rheumatic drugs (bDMARDs), TNF
inhibitors are the initiators of the biologic era. The most significant side
effects of TNF inhibitors are local injection reactions and an increased risk
of all types of infections, including tuberculosis. The established first
generations of TNF inhibitors are Etanercept, Infliximab & Adalimumab.
The
new agents for the treatment of RA include Tofacitinib, the first approved
kinase inhibitor for use in patients with RA, which shows a combined inhibition
of JAK1 and JAK3. In addition targeting JAK, inhibition of Syk by Fostamatinib,
another tyrosine kinase, proved clinical efficacy and a tolerable safety
profile and therefore proceeded to an extended Phase III program. Although
efficacy of Fostamatinib has been reported, important side effects, such as
neutropenia, elevated liver enzymes, infections, diarrhea and increase of blood
pressure, need to be studied in detail, and results of the Phase III program
are eagerly awaited.
Issues
mentioned above might be of great importance in the next years to optimize the
treatment of Rheumatoid arthritis. Reduction was always the major goal of
immunotherapy,Antibody Drug Conjugate but for a long, time, it was simply not achievable.
To get more information about
immunotherapy related services you can contact Global Allied Pharmaceuticals
(GAP) by visiting www.gapsos.com.
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