Download Biologics in General Medicine by W.-H. Boehncke (Editor), H.H. Radeke (Editor) PDF

By W.-H. Boehncke (Editor), H.H. Radeke (Editor)

This can be the 1st booklet to hide each perspective within the scientific program of biologics. Readers won't in basic terms locate that each one of the biologics at present authorized for scientific use are delineated in a standardized approach, but additionally the "differential treatment" with biologics in fields together with dermatology and neurology is defined intimately and summarized in remedy algorithms. Shorter sections on biologic biotechnology in addition to safeguard and regulatory matters supplement the extra clinically-oriented critical chapters.

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1 Mode of Action TNF has been implicated in the pathogenesis of many chronic autoimmune and inflammatory diseases, in particular rheumatoid arthritis (RA), psoriatic arthritis (PsA), psoriasis, ankylosing spondylitis (AS), and Crohn’s disease. Among its diverse pathologic effects, TNF triggers the production of collagenases and other proinflammatory cytokines such as interleukin (IL)-1, IL-6, and granulocyte-macrophage colony stimulating factor (Brenner et al. , endothelial leukocyte adhesion molecule1, vascular cell adhesion molecule-1, and intercellular cell adhesion molecule-1), attracting leukocytes into affected joints; upregulates matrix metalloproteinase synthesis by synovial macrophages, fibroblasts, osteoclasts, and chondrocytes; and inhibits proteoglycan synthesis in cartilage (Weinblatt et al.

Patients treated with placebo in the randomized controlled trial who had significant disease progression at 52 weeks experienced inhibition of radiographic progression and improved clinical responses when treated with adalimumab during the OLE (Keystone et al. 2004b, 2005). 2 Monotherapy The use of MTX in RA has limitations in certain patients, and many patients are unable to tolerate a high enough dose to achieve an optimal therapeutic benefit. Thus, for patients who do not tolerate MTX, monotherapy with adalimumab may be appropriate.

The percentage of patients achieving ACR20, ACR50, and ACR70 were 61 %, 46 %, and 31 %, respectively, for adalimumab-treated patients, and 54 %, 37 %, and 21 %, respectively, for those patients originally receiving placebo who were switched to adalimumab. Of 152 placebo- and 144 adalimumab-treated patients who had radiographs at baseline and 24 weeks, 141 and 133, respectively, had radiographs taken at Week 48. Notably, the mean change in modified TSS at Week 24 was maintained to Week 48 (Fig. 6).

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