Amningsreumatism behandling

  • amningsreumatism behandling
  • Amningsreumatism symtom
  • Amning reumatism

    • •

    A systematic review of guidelines for managing rheumatoid arthritis

    • Research article
    • Open access
    • Published:

    BMC Rheumatologyvolume 3, Article number: 42 () Cite this article

    • 25k Accesses

    • 2 Altmetric

    • Metrics details

    Abstract

    Background

    We systematically reviewed current guidelines for managing rheumatoid arthritis (RA) to evaluate their range and nature, assess variations in their recommendations and highlight divergence in their perspectives.

    Methods

    We searched Medline and Embase databases using the terms ‘clinical practice guidelines’ and ‘rheumatoid arthritis’ from January to January together with publications of national and international bodies. We included guidelines providing recommendations on general RA management spanning a range of treatments and published in English. We undertook narrative assessments due to the heterogeneity of the guidelines.

    Results

    We identified articles; 22 met our inclusion criteria. They were primarily developed by rheumatologists with variable involvement of patient and other experts. Three dealt with early RA, one established RA and 18 all patients. Most guidelines recommend regular assessments based on the

  • amningsreumatism behandling

    • •

    Rheumatoid Arthritis Treatment Guidelines

    Back

    The guidelines for treating rheumatoid arthritis have been updated by the American College of Rheumatology with physician and patient insights. Learn how they may impact your RA management.

    By Linda Rath

    The American College of Rheumatology (ACR) has published its  guideline for rheumatoid arthritis treatments. The ACR updates its guideline for the treatment of rheumatoid arthritis (RA) every few years. The last changes appeared in Since then, new drugs have hit the market, older drugs have been reassessed, and there’s more evidence for the role of nondrug treatments for RA.

    Of 44 recommendations, only seven were considered strong, meaning there’s clear evidence that the benefits of the treatment outweigh the risks and most patients endorse them. The remaining recommendations are called conditional because they lack good evidence one way or the other. The new guidelines don’t address vaccinations — particularly relevant right now — or nondrug therapies like diet and exercise. Those are expected in a later update.

    Here are some of the main takeaways:

    Methotrexate

    Methotrexate

    •

    Biologiske antireumatika til gravide og ammende kvinder eller mandlige partnere

    Tumornekrosefaktor-α-hæmmere

    Der er få studier af TNF-α-hæmmeres udskillelse inom modermælk, dock det er er store molekyler, likt kun udskilles i begrænset omfang. Skønt flere kilder angiver, at alle TNF-α-hæmmere formentlig förmå anvendes, er der størst enighed ifall anvendelsen af certolizumab pegol. Da oralt administreret certolizumab pegol nedbrydes i mave-tarm-kanalen og äger en meget lav helt biotilgængelighed, er stoffet godkendt til brug under amning [4, 20]. Andre bDMARDs absorberes måske i nogen grad fra barnets tarm. Ved sammenligning af børn, der via amning blev eksponeret for infliximab, adalimumab og certolizumab pegol, tillsammans ikkeeksponerede børn så man dog ingen forskel inom infektionsrisiko alternativt postnatal udvikling [18].

    Biologiske disease-modifying anti-rheumatic drugs tillsammans med andre virkningsmekanismer

    Evidensen bag behandling af ammende kvinder tillsammans bDMARDs tillsammans med andre virkningsmekanismer er meget begrænset, og der er rimelig enighed om at fraråde disse stoffer inom ammeperioden pga. af dem sparsomme erfaringer (Tabel 3). Standardværket »Drugs in Pregnancy and Lactation« er maximalt liberalt, og her