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What are the sx of RA?
- Slow insidious onset
- Symmetrical presentation
- Joint pain
- MCP and PIP joints
- Grip weakness
- Functional difficulties
- Rheumatoid nodules
- Pulmonary fibrosis
- Pleural effusions
- Felty's Syndrome (triad of RA, splenomegaly, and neutropenia)
Which agents used to treat RA are adjunctive therapy?
Which agents used to treat RA are disease-modifying?
What is the MOA of NSAIDs in RA?
Inhibition of COX to assist with reducing pain, stiffness and inflammation
What are the SE of NSAIDs?
- GI upset and ulceration
- Renal toxicity
What other analgesics may be used for pain relief in RA?
What are the NSAIDs used in RA?
- Low-dose ASA
What are oral corticosteroids used for in RA?
- Bridging therapy
- Continuous low-dose therapy
- Short-term bursts for flare-ups
What are injectable corticosteroids used for in RA?
- Less frequent dosing
- IM depots up to 6wks
- IA depots a few months
What are the limiting SE of corticosteroid therapy in RA?
- Skin thinning
How long does it take to see benefit from DMARDs in RA?
weeks to months
How are DMARDs used in combination therapy in RA?
- Never more than one Biologic agent
- 2-3 non-biologics
- Non-biologics + 1 biologic
When are biologic DMARDs typically used in RA?
After failure or intolerability of non-biologics
What are the non-biologic DMARDs used in RA?
- Methotrexate (DOC)
- Leflunomide (2nd line)
What are the recommended non-biologic DMARD combinations for RA?
- MTX + HCQ and/or SSZ
- SSZ + HCQ
What are the biologic DMARDs used in RA?
- Certolizumab pegol