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+--- Thread: Treatment of RA - sage2006 (/showthread.php?tid=148710)
Treatment of RA - sage2006 - ArchivalUser - 12-28-2006
When do we start to give RA patient DMARDs? which one is best choice?..can we give DMARDs in combination?
Please some experts give explanation.. It is not well described in kaplan note..
0 - ArchivalUser - 12-28-2006
dmards not started initially... but xrays are need to be taken periodically in RA
as soon as we notice any radiologic evidence of joint erosion, DMARDs are started... usually methotraxate (with leucovorin) is started first...
combination dmards given if erosion progresses as evident on x-ray and pt is already in metho..
0 - ArchivalUser - 12-28-2006
all patients with clinically active disease should be started on DMARD as soon as possible to check on joint damage (Mtx being first choice, though sulfasalsalazine or hydroxychloroquine sulfate can be used in mild disease)
http://www.aafp.org/afp/20050915/1037.html
0 - ArchivalUser - 12-28-2006
The current treatment of RA now involves the use of DMARDs much much earlier than previously employed. DMARDs are used early in the disease to prevent the irreversible effects of long-term inflammation of the joints. By the time there is radiologic evidence of joint erosion, it's probably too late.
Start DMARDs if persisting synovitis >6wks.
0 - ArchivalUser - 12-28-2006
That means DMARDs are used as soon as diagnosis of RA is made..
Leflunomide is an interesting drug, which has not been listed on Kaplan note....but UW step1 qbank has a question on this drug..ask for MOA..
ajeet, thank for the link..
Thank you guys for nice discussion..