This is a systematic review article from BMJ looking into the evidence around the title from article published between 1997 to August 2014.
Davies R.; Symmons D.P.M.; Hyrich K.L; Medicine; May 2014
Abstract: The introduction of biological therapies has resulted in improved outcomes in patients with rheumatoid arthritis (RA), although there are concerns about the long-term safety of these drugs specifically relating to lymphoma and serious infection. Biologics registers have been established worldwide to investigate long-term safety as well as effectiveness of biologic drugs in inflammatory conditions such as RA.
To date, publications from biologics registers have focused mainly on anti-tumour necrosis factor therapy (anti-TNF agents). The reports show that anti-TNF agents are effective in the treatment of RA. However, they are also associated with higher rates of serious infection. Lymphoma risk does not appear to increase, although findings are limited by mean follow-up periods of less than 5 years.
Moving forward, biologics registers will continue to capture long-term follow-up of anti-TNF drugs in RA, as well as incorporating new classes of biologics and other musculoskeletal diseases. This will further extend our knowledge of the long-term safety and effectiveness of biologic drugs, when used in ‘real life’ situations, and across conditions.
Elsevier in Medicine
Full text article available to order through our inter-library loan scheme.
BMJ Learning modules: Rheumatology
This week from BMJ Learning: A 70 year old woman with heart failure has just been discharged after her fourth hospital admission in three months. She is tolerating her medication, which includes maximum doses of an angiotensin converting enzyme inhibitor, a beta blocker, spironolactone, and digoxin, and she still seems to be getting some benefit from them. Her husband is worried about her and mentions that she seems low in spirits. What might be going on? And what should you do? If you are not sure, then this module will help. Palliative care in non-malignant disease
PLUS some of the popular modules on rheumatology. They give an important update on a range of common dilemmas.
Rheumatoid arthritis: an update on management – in association with NICE
Osteoarthritis: a guide to management in adults – in association with NICE
Acute back pain: an up to date guide
Chronic back pain: an update on diagnosis and treatment
Giant cell arteritis: diagnosis and treatment
Tip of the week: Attend the BMJ Masterclass in Rheumatology for a full update in the latest clinical developments in rheumatic diseases. Taking place Friday 22nd November in London, this masterclass is suitable for all physicians and GPs with a specialty interest
Knight, S, et al; Annals of the Rheumatic Diseases, June 2012
News from The Kings Fund: 14 October
RA and physiotherapy: a national survey
This report highlights the medical evidence around the benefits of physiotherapy in the treatment of Rheumatoid Arthritis (RA), but also uncovers problems in the way physiotherapy services are being organised and accessed throughout the UK. It calls for new measures to be introduced in England, Scotland, Wales and Northern Ireland to increase compliance with RA medical guidelines and to protect existing physiotherapy services. A survey of NRAS members with RA also uncovered low referral rates, despite clear evidence that physiotherapy improved their function and mobility.