These drugs play an important role in the control of rheumatic fever and despite the big difference in the chemical structure and the difference in mechanism to influence the whole show the effectiveness of the control in this situation sacral.
DMARD's Currently used in medical experiments are methotrexate and gold salafasalazen (oral / parenteral) antimalarials and cyclosporine, pinisllamin and azacroben and livlonomid. Individual choice of DMARD's By clinicians alone depends on the balance between side effects and effectiveness. DMARD's Have slow effect time with unexpected response to treatment between 4-6 months.
Dose of DMARD's Must be calibrated high dose long allow the side effects and when we get to the upper allowable dose and effect is not sufficient we add DMARD Last or it is also possible first stop treatment with medication and replace it with another alternative.
The advanced knowledge and understanding of the physiological pathogenesis of rheumatic fever is steadily therapeutic approach and use amended treatment. As mentioned previously, the traditional approach to ensure the use of the "pyramid" where patients are treated initially brokered theNSAID's And then offer of DMARD's The most toxic in the advanced stages.
In spite of this, the hierarchical approach clearly failed in curb change and damage the joints associated with rheumatic fever and was later replaced a more aggressive approach.
Knowledge that the disease develops strongly during the first few years of the impact led to the use ofDMARD's early In treatment and was accompanied by an increase in the use of therapeutic participation although the benefits are not yet clear.
Initial treatment in the study of rheumatic fever use one factor. And if we do not get satisfactory response within 3-6 months from the beginning of monotherapy treatment then we are using participatory. The most favored participation is share Asalafasalazen with methotrexate. Patients who do not respond appropriately will have another treatment option is lEvlonomiand is the last therapeutic option by giving them TNF blockade therapy .
Compare the effectiveness of DMARD's Used in various pathological symptoms and laboratory studies have been fully studied over the years. And although the results were not conclusive, the more meaningful comparisons are continuing between the toxicity of the DMARD's The lack of effectiveness, or both. Challenge of continuing treatment often less than two years. Methotrexate and Sfasslazen post therapy has the longest period of up to five years by 50-60%. For gold (right) and penicillamine 5 years of treatment by up only 20% and the rate for oral administration of gold is less than 5%.
Sfasslazen and methotrexate is often considered the first-line treatment due to the effectiveness of good (response rate 40%) and greater persistence rate compared with other DMARD's.
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