Paul Emery, F.R ViagraDanmark.org kontakt os .C.P., Mohammed Hammoudeh, M.D., Oliver FitzGerald, M.D., Bernard Combe, M.D., Ph.D., Emilio Martin-Mola, M.D., Ph.D., Maya H. Buch, M.B., Ch.B., Ph.D., Marek Krogulec, M.D., Theresa Williams, P.A., M.S., Stefanie Gaylord, B.S.N., Ronald Pedersen, M.S., Jack Bukowski, M.D., Ph.D., and Bonnie Vlahos, M.B.A., R.N.: Sustained Remission with Etanercept Tapering in Early Rheumatoid Arthritis The duration of disease activity in persons with rheumatoid arthritis is an important factor influencing joint destruction and functional disability.1,2 Joint harm frequently starts within weeks or months after the onset of symptoms and is detectable on radiographs within 24 months.3,4 Evidence indicates that early aggressive treatment results in better improvement than therapy initiated later on in the disease course.5-8 Clinical remission, or at least low disease activity, is a critical treatment target in early arthritis rheumatoid, since control of inflammatory procedures might limit structural damage and functional impairment.10-16 Remission is achieved most rapidly with biologic agents, and remission early in the course of disease is associated with a long-term benefit.17-19 However, relatively few studies possess investigated whether remission achieved with such therapy could be maintained following the dose is reduced or the drug is discontinued, and the patients who could be the best candidates for reduction or withdrawal of therapy have not been identified.10,11,20-25 Reduced-dose regimens, step-down therapy, and treatment-free periods are desirable to handle patient preferences often, long-term safety concerns, and the cost burden of biologic therapy.
Crook, Ph.D., Timothy D. McHugh, Ph.D., Carl M. Mendel, M.D., Sarah K. Meredith, M.B., B.S., Stephen R. Murray, M.D., Ph.D., Frances Pappas, M.A., Patrick P.J. Phillips, Ph.D., and Andrew J. Nunn, M.Sc. For the REMoxTB Consortium: Four-Month Moxifloxacin-Centered Regimens for Drug-Sensitive Tuberculosis A short-term tuberculosis treatment regimen could improve rates of adherence, reduce prices of adverse events, and lower costs. Fluoroquinolones have shown promising activity against mycobacteria1 and so are established as a crucial component of the treating multidrug-resistant tuberculosis,2,3 with fluoroquinolones named having a more potent effect later. It has been proposed that these drugs may have a job in reducing the duration of tuberculosis treatment.4 Moxifloxacin has been approved for a variety of indications globally.5 It has favorable pharmacokinetics, a large volume of distribution, and penetration into epithelial-lining liquid and macrophages.6-8 The experience of moxifloxacin in vitro against Mycobacterium tuberculosis, which includes been confirmed in murine models9 and in clinical monotherapy studies,10,11 has raised the chance that the drug could be used as part of an improved regimen.1 Subsequent research in mice demonstrated that mixture regimens that included moxifloxacin had higher bactericidal activity than regular treatment and could produce cure without relapse after a shorter treatment duration.12,13 When different fluoroquinolones were substituted for ethambutol in a clinical trial, the moxifloxacin-containing regimen produced the most rapid decline in bacterial load and in the proportion of patients with culture negativity at 8 weeks.14 These findings were confirmed by investigators in Brazil.15 In contrast, substituting moxifloxacin for isoniazid in an 8-week study resulted in a non-significant enhancement in bactericidal impact.16 On the basis of supportive evidence from phase 2 studies and the uncertain relationships between 8-week bacteriologic data and the duration of effective therapy, we designed the Rapid Evaluation of Moxifloxacin in Tuberculosis study to determine whether the replacement of possibly isoniazid or ethambutol with moxifloxacin would offer effective tuberculosis treatment in 4 months, in comparison with the typical 6-month regimen.