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Initial Treatment with Biological Therapy in Rheumatoid Arthritis.

Jesús Tornero Molina1,2, Blanca Hernández-Cruz3, Héctor Corominas4,5

  • 1Departamento de Reumatología, Hospital de Guadalajara, 19002 Guadalajara, Spain.

Journal of Clinical Medicine
|January 11, 2024
PubMed
Summary
This summary is machine-generated.

Initial treatment for rheumatoid arthritis (RA) with biological therapies, like TNF-alpha inhibitors, is effective and safe. This approach, especially for patients with poor prognostic factors, shows superior results compared to methotrexate monotherapy.

Keywords:
biologic therapyexperts’ opinioninitial treatmentnarrative reviewrheumatoid arthritis

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) poses significant challenges in treatment effectiveness and efficiency.
  • Biological therapies have emerged as a key area of research for RA management.

Purpose of the Study:

  • To analyze the effectiveness, efficiency, and safety of initial biological therapies for rheumatoid arthritis (RA).
  • To compare biological therapies with methotrexate monotherapy in early RA treatment.

Main Methods:

  • A scoping review of randomized clinical trials on initial biological therapies for RA was conducted.
  • Data from seventeen studies were analyzed, with quality assessed using the Jadad scale.
  • Rheumatoid arthritis experts discussed findings to generate treatment principles.

Main Results:

  • Initial treatment with TNF-alpha inhibitors and IL6R inhibitors (alone or combined with methotrexate) is effective for RA activity, function, and quality of life.
  • Biological therapies demonstrated short- and medium-term superiority over methotrexate monotherapy.
  • Long-term outcomes favored patients initially treated with biologicals over methotrexate.

Conclusions:

  • Initial treatment of RA with biological therapies is effective, efficient, and safe in the short, medium, and long term.
  • Biological therapies are particularly beneficial for rheumatoid arthritis patients with poor prognostic factors.