Fast Five Quiz: Do You Know Enough About Rheumatoid Arthritis?

Herbert S. Diamond, MD

Disclosures

December 05, 2019

The 2015 American College of Rheumatology (ACR) guidelines* and the 2016 European League Against Rheumatism (EULAR) guidelines* recommend methotrexate (MTX) as first-line therapy for the majority of patients with rheumatoid arthritis, based on long-term data on its safety and efficacy, as well as low cost.

MTX is a folic acid antagonist disease-modifying antirheumatic drug (DMARD) that was originally used in the early 1950s as a treatment for childhood leukemia and psoriasis. It received approval by both the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) in the late 1980s for the treatment of rheumatoid arthritis. MTX is approved for use as a monotherapy or in combination with other drugs.

Abatacept, etanercept, and sarilumab are not recommended as first-line treatments for rheumatoid arthritis but are approved treatments for patients with rheumatoid arthritis.

Abatacept is a non-tumor necrosis factor (non-TNF) inhibitor approved by the FDA and EMA for use as monotherapy or in combination with a non-TNF antagonist DMARD for adult patients with moderate to severe rheumatoid arthritis who demonstrated inadequate response to one or more DMARDs.

Etanercept is a non-TNF inhibitor approved by the FDA and EMA for the treatment of adult patients with moderate to severe rheumatoid arthritis who have demonstrated inadequate response or intolerance to MTX or other DMARDs. Etanercept may be given as monotherapy or in combination with MTX.

Sarilumab is a monoclonal antibody (interleukin-6 receptor antagonist) approved by the FDA and EMA for the treatment of adult patients with moderate to severe rheumatoid arthritis who have demonstrated inadequate response or intolerance to MTX or other DMARDs.

For more on the treatment of rheumatoid arthritis, read here.

*Updated ACR guidelines on the management of rheumatoid arthritis are expected to be released in 2020. Updated 2019 EULAR guidelines on the management of rheumatoid arthritis are also anticipated.

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