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This section contains articles, written by healthcare professionals, covering a wide variety of topics related to the use of biologics in rheumatoid arthritis, as well as answers to questions posed by registered site users.
These reports are contributed by experts in the treatment of rheumatoid arthritis and offer insights into patient selection, dosing and administration, efficacy, side effects of biologic therapy, and overall disease management.
Arthur Kavanaugh, MD
Cardiovascular disease (CVD) is a significant source of morbidity and mortality in the United States. Inflammatory conditions such as rheumatoid arthritis (RA) are associated with an increased risk for cardiovascular disease. In this Expert Practice Arthur Kavanaugh, MD, discusses the impact of cardiovascular risk factors on the management of patients with RA. Topics addressed include epidemiology of CVD and related risk factors in patients with rheumatoid arthritis, how rheumatoid arthritis treatment influences cardiovascular risk factors, and the overall management of rheumatoid arthritis patients with cardiovascular risk factors.
Mark Genovese, MD
In this Expert Practice, Dr. Mark Genovese, Associate Professor in the Division of Immunology and Rheumatology at Stanford University in Palo Alto, California, discusses the concurrent use of traditional disease-modifiying antirheumatic drugs (DMARDs) with other DMARDs or in combination with biologic agents for the treatment of rheumatoid arthritis (RA). Dr. Genovese also discusses the influence of patient factors and diagnostic tests on the decision to place a patient on combination therapy.
Roy M. Fleischmann, MD
In this Expert Practice interview Dr. Fleischmann discusses long-term safety issues associated with the biologic agents currently available to treat rheumatoid arthritis (RA). He also discusses comorbidities that influence the safety of biologics, as well as the pretreatment screening process for patients who are being considered for biologic treatment.
Marc Cohen, MD
Dr. Marc Cohen discusses the concept of early treatment as it relates to rheumatoid arthritis (RA) and the use of biologics. Dr. Cohen talks about the changing definition of early RA and the diagnostic tools currently in use, as well as the goal of treatment and the role biologics may play in achieving that goal.
By Gregg J. Silverman, MD
Gregg J. Silverman, MD, director of the Rheumatic Diseases Core Center at the University of California, San Diego, discusses the targeted use of B-cell therapy to treat rheumatoid arthritis (RA). This article details how current B-cell therapies influence the pathophysiology of RA, the general safety profile of such agents, and the possibility of combination therapy aimed at multiple RA-related targets. Dr. Silverman concludes by focusing on a theoretical model illustrating how B cells interact with other immune factors to result in an overall "immune homeostasis."
In the Doctor to Doctor section, health care professionals ask our panel of experts specific questions related to the use of biologic therapy to treat rheumatoid arthritis, covering such topics as clinical trial data, the utilization of biologic therapy in day-to-day practice, and strategies for insurance reimbursement.
July 9, 2007
Question:
With recent reports of progressive multifocal leukoencephalopathy (PML) developing in patients treated with rituximab (thus far confined to patients with systemic lupus erythematosus), would it be prudent to prescreen all patients with brain magnetic resonance imaging (MRI) prior to anticipated treatment?
