CME - Disease remission: a goal for RA

[Guest guest]

Disease Remission: A Goal for Rheumatoid Arthritis CME

More: EULAR 2008: The European League Against Rheumatism Annual Congress

Selection from: EULAR 2008: Rheumatoid Arthritis Disease and Antitumor

Necrosis Factor Therapy

Arthur Kavanaugh, MD

Introduction

Among the many outstanding symposia at the recent EULAR 2008 was one

that was entitled " Aiming for Remission in RA. " This symposium clearly

exemplifies the significant changes in the therapeutic approaches to

rheumatoid arthritis (RA) and other autoimmune systemic inflammatory

disorders that have occurred particularly over the last decade. Recent

advances in understanding the immunopathophysiology of RA, along with

developments in biopharmaceutical production have enabled the

introduction of novel immunomodulatory therapies. These biologic

agents have revolutionized clinical practice in rheumatology. For

example, the improved efficacy achieved with agents such as the

macromolecule TNF inhibitors has certainly increased our expectations

as regards the outcomes of therapy. In years past, the idea of

remission was as sublime as it was uncommon. There was little debate

as to what specifically might define remission, as it happened

infrequently and represented a stark contrast to the level of disease

activity of most patients. At present, the expectation of ever higher

levels of disease activity has made remission a hot topic for

consideration. What is meant by remission? For example, are clinical

measures sufficient, or are more sensitive imaging techniques such as

ultrasound and magnetic resonance imaging also part of the metric? How

low a level of disease activity might a patient have and still be

considered to be in remission? Can someone still be in remission if he

or she is still on treatment, or is drug-free remission the only true

remission? Such key discussion points and others were considered

during the symposium.

*****************************************************

Read the full article here:

http://www.medscape.com/viewarticle/578162

Not an MD