PMID- 18677056
OWN - NLM
STAT- MEDLINE
DCOM- 20081002
LR  - 20151119
IS  - 0917-5857 (Print)
IS  - 0917-5857 (Linking)
VI  - 18
IP  - 8
DP  - 2008 Aug
TI  - [Daily practice using the guidelines for prevention and treatment of 
      osteoporosis. The effects of anti-TNF therapy on bone and joint manifestations in 
      rheumatoid arthritis].
PG  - 1169-75
AB  - Patients diagnosed as RA should be started with disease modifying anti-rheumatic 
      drugs (DMARDs) as early as possible. Among the DMARDs, methotrexate (MTX) is 
      considered the anchor drug and should be used first in patients as risk of 
      developing persistent disease. The main goal of DMARDs treatment is to achieve 
      remission and monitoring of disease activity and adverse events should guide 
      decisions on choice and changes in treatment strategies. However, treatment of RA 
      with DMARDs including MTX often fails to control disease activity and prevent 
      structural damage in a some population of patients. Therefore, more effective 
      treatment strategies are needed. Tumor necrosis factor-alpha (TNF-alpha) , a 
      representative pro-inflammatory cytokine, plays a pivotal role in the 
      pathological process of RA by mediating initiation to autoimmunity, lymphocyte 
      accumulation and angiogenesis in the inflamed synovium, and joint destruction. 
      Treatment of RA patients with TNF inhibitors have been efficacious for a) a 
      prolonged improvement in disease activity and an induction to remission, b) 
      inhibition of radiographic progression, when they are used in combination with 
      MTX. Thus, the combined use of the TNF-inhibitor and MTX has brought about a 
      paradigm shift in the treatment goal of RA. However, their small but definite 
      risks of serious infections are also clear and their occurrence mandates that 
      TNF-inhibitors should be supervised by physicians with experience in their use.
FAU - Soen, Satoshi
AU  - Soen S
AD  - Kinki University School of Medicine, Nara Hospital, Department of Orthopaedic 
      Surgery and Rheumatology.
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PT  - Review
PL  - Japan
TA  - Clin Calcium
JT  - Clinical calcium
JID - 9433326
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adalimumab
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy/etiology
MH  - Drug Therapy, Combination
MH  - Etanercept
MH  - Humans
MH  - Immunoglobulin G/therapeutic use
MH  - Infliximab
MH  - Methotrexate/therapeutic use
MH  - Receptors, Tumor Necrosis Factor/therapeutic use
MH  - Tumor Necrosis Factor-alpha/physiology
RF  - 20
EDAT- 2008/08/05 09:00
MHDA- 2008/10/03 09:00
CRDT- 2008/08/05 09:00
PHST- 2008/08/05 09:00 [pubmed]
PHST- 2008/10/03 09:00 [medline]
PHST- 2008/08/05 09:00 [entrez]
AID - 080811691175 [pii]
PST - ppublish
SO  - Clin Calcium. 2008 Aug;18(8):1169-75.