Abstract:
PURPOSE OF REVIEW:To review the recent efficacy and safety data comparing methotrexate (MTX) and leflunomide (LEF) monotherapy, in combination with biologic therapies and in combination with each other. RECENT FINDINGS:MTX is the 'anchor drug' in all rheumatoid arthritis treatment strategies. Patients with contraindications to or intolerance of this drug pose a challenge to the treating physician. Recent studies have re-examined LEF as an alternative to MTX and demonstrated comparable clinical and radiographic efficacy both as monotherapy and in combination with certain biologic agents (tumor necrosis factor inhibitors and rituximab). Safety data, however, are less conclusive. Though some studies have shown greater withdrawal rates with LEF, the incidence of infection and elevated transaminases have been comparable. There are few new data examining the previously demonstrated added benefit of combination MTX+LEF over either alone. The safety profile of this combination, however, has been re-examined in several studies, with conflicting results. Although two meta-analyses and two small retrospective studies have demonstrated a safety profile similar to that of MTX monotherapy, data from a large population study suggested a greater degree of hepatotoxicity with combination. SUMMARY:LEF offers an alternative with comparable efficacy to MTX as both monotherapy and, as preliminary data suggest, in combination with certain biologics agents. Addition of LEF to MTX in rheumatoid arthritis patients who have failed MTX monotherapy has added therapeutic benefit. Safety data on LEF compared to MTX are less conclusive. All patients on LEF, and particularly those on combined LEF+MTX, should be monitored closely for hepatotoxicity.
journal_name
Curr Opin Rheumatoljournal_title
Current opinion in rheumatologyauthors
Singer O,Gibofsky Adoi
10.1097/BOR.0b013e328344f2e4subject
Has Abstractpub_date
2011-05-01 00:00:00pages
288-92issue
3eissn
1040-8711issn
1531-6963journal_volume
23pub_type
杂志文章,评审abstract::Shoulder injuries are common in the athletic population. Injuries can be a result of repetitive overhead use or from direct trauma. Common injury sites include the rotator cuff, glenohumeral joint, acromioclavicular joint, biceps tendon, scapulothoracic articulation, and sternoclavicular joint. The identification, phy...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200203000-00012
更新日期:2002-03-01 00:00:00
abstract:PURPOSE OF THE REVIEW:To define gout conditions and hyperuricemia. RECENT FINDINGS:Gout is defined as an arthritic condition resulting from the deposition of monosodium urate (MSU) crystals in and/or around joints, following long-standing hyperuricemia. Several recent ultrasound studies disclosed MSU deposits in a lar...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000028
更新日期:2014-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The incidence and mortality of cardiovascular disease are increased in the context of rheumatoid arthritis. The purpose of this review is to examine our evolving understanding of the pathogenesis of cardiovascular disease in rheumatoid arthritis and to underscore the importance of tailored prevention ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/01.bor.0000159924.97019.25
更新日期:2005-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Microscopic polyangiitis is defined within the context of primary systemic vasculitis. The presentation and management of renal involvement in microscopic polyangiitis is discussed, with emphasis on prognosis and outcomes. Potential roles of newer therapies are reviewed. RECENT FINDINGS:The histologi...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e3282f370d1
更新日期:2008-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Systemic lupus erythematosus is characterized by the production of antinuclear autoantibodies and dysfunction of T-cells, B-cells, and dendritic cells. Here, we review newly recognized genetic factors and mechanisms that underlie abnormal intracellular signal processing and intercellular communication...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e32832e977c
更新日期:2009-09-01 00:00:00
abstract:PURPOSE OF REVIEW:IgG4-related disease (IgG4-RD) is a recently described fibroinflammatory condition that can affect nearly any organ. Our knowledge of this condition--its manifestations, diagnosis, pathogenesis and treatment--is expanding rapidly. RECENT FINDINGS:This review highlights the most recent developments in...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000133
更新日期:2015-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Therapeutic inhibition of tumour necrosis factor-alpha strongly increases the risk of reactivation in latent tuberculosis infection. Recent blood tests based on antigen-specific T cell response and measuring production of interferon-gamma, so called interferon-gamma release assays (IGRAs), are promisi...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e328329c6cb
更新日期:2009-05-01 00:00:00
abstract:PURPOSE OF REVIEW:A severe decrease of CD4 T cells predisposes humans to opportunistic infections. In adults, HIV is certainly the most common cause of CD4 lymphocytopenia, but other causes, such as infections, autoimmune diseases, immunosuppressive therapy, lymphoma and idiopathic forms need to be considered. This rev...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/01.bor.0000231908.57913.2f
更新日期:2006-07-01 00:00:00
abstract::In hip replacement, prophylaxis of thromboembolism with warfarin to 1.5 times control with respect to prothrombin time remains efficacious. Further reduction of the dosage has not met with success. Confirmatory studies on the usefulness of adjusted-dose heparin and low molecular weight heparin continue. Promising new ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199204000-00013
更新日期:1992-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This review discusses the most updated literature of muscle disease in scleroderma in the past year. RECENT FINDINGS:In the past year, two studies have highlighted that fibrosis is a prevalent histopathologic feature in muscle biopsies of patients with scleroderma muscle disease. In addition, microan...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000552
更新日期:2018-11-01 00:00:00
abstract:PURPOSE OF REVIEW:As the most common arthritis and a leading cause of chronic disability, osteoarthritis is associated with substantial cost to the individual and to society. Epidemiologic studies have supplied, in addition to incidence, prevalence and risk factor data, much of what is known about the natural history o...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/01.bor.0000209426.84775.f8
更新日期:2006-03-01 00:00:00
abstract:PURPOSE OF REVIEW:This article provides an update on the recent findings on autoantibodies to modified proteins in rheumatoid arthritis (RA). RECENT FINDINGS:In the past few years, the knowledge on the autoantibodies to citrullinated antigens has expanded considerably. More specifically, it is now clear that many diff...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000166
更新日期:2015-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Pulmonary fibrosis is a devastating disease that affects millions of people worldwide. Among the most common forms of lung fibrosis are idiopathic pulmonary fibrosis (IPF) and scleroderma-related interstitial lung disease (SSc-ILD). Despite a wealth of literature regarding each of these diseases, stud...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e3283588de4
更新日期:2012-11-01 00:00:00
abstract:PURPOSE OF REVIEW:This article summarizes the current evidence on the management of primary and secondary central nervous system (CNS) vasculitis. RECENT FINDINGS:Two recent retrospective cohort studies have described the treatment and outcomes of patients with adult primary central nervous system vasculitis (PCNSV). ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000229
更新日期:2016-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Systemic lupus erythematosus (SLE) is the prototypical systemic autoimmune disease with a significant disease burden across the world among different ethnic, racial, and age groups. The pathophysiological understanding of SLE is constantly evolving and with it, the need for a better definition of the ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000480
更新日期:2018-03-01 00:00:00
abstract::Bacterial infections can clinically mimic a primary vasculitic syndrome and can directly cause a vasculitis that may respond to prompt recognition and treatment of the infection. Increasing direct and indirect evidence is establishing links between certain infections and vasculopathies, including aortitis, atheroscler...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199801000-00008
更新日期:1998-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Renal complications are important in scleroderma (systemic sclerosis) and include scleroderma renal crisis. This is a medical emergency that requires careful management. Recent cohort studies have highlighted key aspects of management and outcome and these are reviewed. RECENT FINDINGS:Two recent art...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e3283108df7
更新日期:2008-11-01 00:00:00
abstract:PURPOSE OF REVIEW:To increase awareness and review the management of chronic viral hepatitis in individuals treated with immune-modifying agents to avoid potentially severe consequences. RECENT FINDINGS:Hepatitis B virus (HBV) reactivation has been reported with a wide variety of immunosuppressive regimens ranging fro...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000067
更新日期:2014-07-01 00:00:00
abstract::The molecular mechanisms of the primary immunodeficiencies have been further explored and provide insights into the regulation of the immune response and its role in autoimmune disease, infection, and malignancy. The critical role of CD40-CD40 ligand-mediated effects in T cell-dependent B cell activation, shown throug...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199601000-00010
更新日期:1996-01-01 00:00:00
abstract:PURPOSE OF REVIEW:To highlight recent evidence regarding the contribution of traditional and nontraditional [e.g. inflammatory markers, rheumatoid arthritis (RA) features] risk factors toward the excess cardiovascular risk in RA. RECENT FINDINGS:The impact of traditional risk factors on the development of cardiovascul...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e32834ff2fd
更新日期:2012-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic periaortitis is characterized by a fibro-inflammatory process spreading from the abdominal aorta and the iliac arteries. Originally, chronic periaortitis was considered a localized inflammatory response to severe aortic atherosclerosis. However, subsequent studies have shown that chronic peria...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e328341137d
更新日期:2011-01-01 00:00:00
abstract::Assessment of children and adults with rheumatic diseases, both in clinical practice and controlled clinical trials in rheumatology, has traditionally focused on the measurement of disease activity. More recently emphasis has been placed on the need to incorporate estimates of physical, social, and mental functioning ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199709000-00011
更新日期:1997-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To review studies that clarify the rheumatic manifestations of autoimmune hepatitis, elucidate shared pathogenic pathways, and encourage innovative site-specific therapies. RECENT FINDINGS:Autoimmune hepatitis has clinical manifestations, serological markers, pathogenic mechanisms, genetic predisposi...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e328010c56b
更新日期:2007-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Wound healing is a normal physiological response to tissue injury which can occur in any organ. Mechanisms that orchestrate wound healing in different organs are surprisingly generic, involving generation of fibroblasts and myofibroblasts by differentiation processes that require extensive alterations...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e32835b13e1
更新日期:2013-01-01 00:00:00
abstract::Estimates of the prevalence and incidence of knee osteoarthritis increase with age and are higher for women. Other differences in such estimates arise due to methodologic variables, including radiographic techniques. The risk for knee osteoarthritis increases with increasing body weight, long-term occupational joint s...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Longitudinal studies of large cohorts of patients with Raynaud's Phenomenon have addressed the predictors of developing a secondary disease. New insights have been reported into the pathogenesis of Raynaud's phenomenon and the consequences of ischemia. Studies have suggested that more than one defect may cause Raynaud...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1996-11-01 00:00:00
abstract::Systemic lupus erythematosus and Sjögren syndrome remain elusive in the description of their underlying etiologic causes and pathogenic mechanisms. Although underlying genetic predisposition appears to contribute to both diseases based on twin and other genetic studies, additional factors must play a role. Over the de...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200109000-00005
更新日期:2001-09-01 00:00:00
abstract:PURPOSE OF REVIEW:It is an understatement to say that drug approvals in systemic lupus erythematosus (SLE), lupus nephritis, and Sjogren's syndrome have lagged far behind those in other autoimmune diseases, such as rheumatoid arthritis and psoriatic arthritis. Reasons for this are multiple and include the molecular and...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章
doi:10.1097/BOR.0000000000000754
更新日期:2020-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Modern molecular biology offers a unique opportunity to gain a comprehensive picture of gene expression in a disease state. This review presents recent findings in the field of synovial fibroblast biology contributing to knowledge of the pathogenesis of rheumatoid arthritis. RECENT FINDINGS:Recently ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/01.bor.0000218947.42730.dd
更新日期:2006-05-01 00:00:00
abstract::Cytokines and growth factors are important in bone tissue as mediators of cell-to-cell and matrix-to-cell communication. Cytokines also locally mediate the effects of several hormones on bone cells. Indeed, calciotropic hormones modulate the bone-cell production rate of these factors and, conversely, can change the nu...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199305030-00012
更新日期:1993-05-01 00:00:00