Immunologic rheumatic disorders - 11/08/11

Abstract |
We provide the basics for clinicians who might be called on to consider the diagnosis of diseases such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) in their practice. We will emphasize clinical recognition and first-line laboratory testing. Only characteristics of the classic rheumatic inflammatory diseases (ie, RA, seronegative spondyloarthropathy, SLE, antiphospholipid syndrome, Sjögren syndrome, scleroderma, and polymyositis/dermatomyositis) will be covered. In the past decade, treatment for RA and seronegative spondyloarthropathy has substantially improved. Their treatment has been revolutionized by the use of methotrexate and, more recently, TNF inhibitors, T-cell costimulation modulators, and B-cell depletion. The goal of RA treatment today is to induce a complete remission as early as possible in the disease process, with the mantra being “elimination of synovitis equals elimination of joint destruction.” The hope is that if the major mediators of Sjögren syndrome, SLE, or scleroderma can be identified and then blocked, as in the example of TNF inhibitors in patients with RA, more specific treatments will become available. Thus RA has become an excellent model of this evolving paradigm. Through the identification of major mediators in its pathogenesis, novel and highly efficacious therapeutic agents have been developed.
Le texte complet de cet article est disponible en PDF.Key words : Rheumatoid arthritis, seronegative spondyloarthritis, juvenile rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, Sjögren syndrome, scleroderma polymyositis, dermatomyositis, and inclusion-body myositis
Abbreviations used : ACA, ACLA, ANA, Anti-CCP, APA, APLS, aPTT, AS, β2GP1, DM, DMARD, dRVVT, IBD, IBM, IVIG, JIA, JRA, MRI, NSAID, PM, PsA, RA, RF, Scl, SLE, SNSA, SS, USpA, VDRL
Plan
| Disclosure of potential conflict of interest: A. Joseph is on the speakers’ bureau for Takeda Pharmaceuticals. R. Brasington is a speaker for Centocor, UCB, Abbott, and Bristol-Myers Squibb; has received research support from BioGen Idec, Bristol-Myers Squibb, and Abbott; and has provided expert witness testimony on the topics of systemic lupus erythematosus and rheumatoid arthritis. T. P. Cheng has received research support from Abbott Pharmaceuticals. The rest of the authors have declared that they have no conflict of interest. |
Vol 125 - N° 2S2
P. S204-S215 - février 2010 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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