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Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation of the joints. The disease affects 0.5% to 1% of the adult population, and causes severe pain and disability. Direct costs related to treatment, and indirect costs associated with occupational disability, is significant. RA is treated with an interdisciplinary approach, in which disease modifying anti-rheumatic drugs (DMARDs) are an important component. The recommended first choice is one or more DMARDs. In the absence of treatment effect, a biologic drug may be added. The purpose of this systematic review was to investigate the efficacy and safety of biologics, compared with DMARDs in patients with early (d"3 years) RA. The commissioner is the Norwegian Rheumatism Association, whose members are concerned with good treatment at the early stages of RA. We included a total of 12 randomised controlled trials that examined the effect of biologics infliximab, adalimumab, etanercept and abatacept. The results suggest that, compared with DMARDs alone, biologicals in combination with DMARDs give:1. more patients in remission2. neither more or less serious adverse events3. more patients who achieved a 50% improvement4. improved physical function5. less joint destruction Due to methodological weaknesses in the included studies most results contain some degree of uncertainty.

Antirheumatic agents. --- Biological products.

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Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation of the joints. The disease affects 0.5% to 1% of the adult population, and causes severe pain and disability. Direct costs related to treatment, and indirect costs associated with occupational disability, is significant. RA is treated with an interdisciplinary approach, in which disease modifying anti-rheumatic drugs (DMARDs) are an important component. The recommended first choice is one or more DMARDs. In the absence of treatment effect, a biologic drug may be added. The purpose of this systematic review was to investigate the efficacy and safety of biologics, compared with DMARDs in patients with early (d"3 years) RA. The commissioner is the Norwegian Rheumatism Association, whose members are concerned with good treatment at the early stages of RA. We included a total of 12 randomised controlled trials that examined the effect of biologics infliximab, adalimumab, etanercept and abatacept. The results suggest that, compared with DMARDs alone, biologicals in combination with DMARDs give:1. more patients in remission2. neither more or less serious adverse events3. more patients who achieved a 50% improvement4. improved physical function5. less joint destruction Due to methodological weaknesses in the included studies most results contain some degree of uncertainty.

Antirheumatic agents. --- Biological products.

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Antirheumatic agents --- Rheumatism. --- Therapeutic use.

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Rheumatic Diseases --- Antirheumatic Agents --- therapeutic use

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Covering both the scientific basis of rheumatology and practical, clinical information for rheumatologists and trainees, Rheumatology, 8th Edition, remains a leading text in this fast-changing field. Dr. Marc Hochberg and his team of worldwide editors and authors keep you abreast of recent advances in the field-- all in a user-friendly, accessible manner. Fully updated from cover to cover, this two-volume text is designed to meet the needs of all practicing and academic rheumatologists as well as arthritis-related health care professionals and scientists interested in rheumatic and musculoskeletal diseases.

Rheumatology --- Rheumatology. --- Rheumatic Diseases --- Antirheumatic Agents --- Arthritis, Rheumatoid --- therapeutic use