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Medical Care
Wednesday, July 4, 2018
/ narstudio, stock.adobe.com
Berlin The German Society of Rheumatology (DGHR) has published a new guideline on S2e therapy for rheumatoid arthritis with modification of the disease Drugs presented. In this one, the professional company for the previous checks.
Already in 2012, the HRBM released a guideline for the treatment of rheumatoid arthritis. At this time, the HRMD required to begin therapy within the first three months after the onset of symptoms. Patients should not only receive anti-inflammatory drugs such as cortisone, but also disease-modifying anti-rheumatic drugs (DMARDs), ie, disease-modifying drugs. According to the badociation, they can slow the course of the disease and prevent the destruction of the joints.
However, this only succeeds if the patients are examined regularly and if there is no improvement, the DMARD is prematurely changed, the first author of the directive, Christoph Fiehn of Baden-Baden Medical Center. He is president of this year's rheumatology congress in Mannheim.
To clbadify
S2e refers to an evidence-based directive. This requires systematic research, selection and evaluation of scientific evidence on relevant clinical issues. This research, selection and evaluation follows strict rules and must be made transparent in an orientation report.
According to the HRMB, two targeted synthetic DMARDs were included in conventional synthetic DMARD drugs, such as methotrexate ( MTX) and biological DMARD. the active substances baricitinib and tofacitinib. One of the reasons for this rare use is probably the high price of these drugs, suspects Fiehn.
The new S2e Directive addresses these concerns. The therapy should start with MTX. Many patients manage to control the disease with MTX alone, says Fiehn. In patients who do not tolerate MTX, physicians may initially use synthetic synthetic DMARDs such as leflunomide or sulfasalazine
. It is important, however, that the effectiveness of initial therapy be monitored early. The new directive therefore provides for a first inspection after only six weeks, instead of twelve weeks as before. According to Hanns-Martin Lorenz, chairman of the HRBM and head of the rheumatology department at the Heidelberg University Hospital, compatibility, compliance and accuracy of the baday had to be checked after six weeks.
Other controls after three months should show measurable improvement and after six months, the therapeutic goal has been achieved. Depending on the response and prognostic factors, the doctor may then prescribe another DMARD, combine two conventional preparations, or begin treatment with biological or targeted DMARD.
In Germany, according to the HRMB, about 550,000 adults have rheumatoid arthritis. It is therefore the most common inflammatory rheumatic disease.
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