Why most (but perhaps not all) DMARDs work equally well.

Autor: Landewé RBM; Department of Rheumatology & Clinical immunology, Amsterdam University Medical Center, Amsterdam, the kingdom of the Netherlands; Department of Rheumatology, Zuyderland Medical center, Heerlen, the kingdom of the Netherlands. Electronic address: landewe@rlandewe.nl., Sepriano A; Department of Rheumatology, Leiden University medical Center, Leiden, the kingdom of the Netherlands; NOVA Medical School, Universidade Nova de Lisboa, Portugal., Bergstra SA; Department of Rheumatology, Leiden University medical Center, Leiden, the kingdom of the Netherlands.
Jazyk: angličtina
Zdroj: Seminars in arthritis and rheumatism [Semin Arthritis Rheum] 2024 Feb; Vol. 64S, pp. 152316. Date of Electronic Publication: 2023 Dec 20.
DOI: 10.1016/j.semarthrit.2023.152316
Abstrakt: Biological- or targeted-synthetic DMARD-responses reported in randomized clinical trials, placebo-controlled or head-to-head, in patients with rheumatoid arthritis, psoriatic arthritis or spondyloarthritis are unbelievably similar, when looking across trials performed in the same disease and applying the same primary outcome measures. The exception to this rule may be the response to Janus-kinase-inhibitors, which seem to work 10 % better in all trials (JAK-bonus) This article provides a potential explanation for this remarkable phenomenon, including an explanation for the JAK-bonus. It seems as if JAK-inhibitors exert some inflammation-independent effects on pain, fatigue and wellbeing, and that drug treatment of rheumatic diseases is more than the inhibition of inflammation alone.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:RL received honoraria for participating in adboards of- or giving lectures for- AbbVie, Eli-Lilly, Galapagos, Jansen Pharma, Novartis, Pfizer and UCB.RL is owner of Rheumatology Consultancy BV, a small business under Dutch law.
(Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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