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Welcome to this second part of the Henry
Stewart Talk about "Rheumatoid Arthritis".
My name is Peter Taylor,
Professor of Musculoskeletal Sciences
at the University of Oxford.
In this second part of the talk, we're
going to consider approaches to treatment.
Look at the current drugs available for
the management of rheumatoid arthritis,
and how they're used in
contemporary practice.
In part 1 of this Henry Stewart's lecture,
we considered the nature of rheumatoid
arthritis, how it's diagnosed or
classified, its presentation,
and the pathobiology.
0:34
So, having looked at the background
of the pathogenesis and
the history of rheumatoid arthritis and
its classification,
now let's turn our attention
to contemporary treatment.
0:45
So, what are the goals of treatment,
if we look at this next slide?
Well, the overall goals are to
assess disease activity and
response to therapy with a view to
achieving remission where possible.
This is done with the help of
various pharmacotherapeutic agents.
And we're going to look
at the meaning of these.
There are a range of drugs used, and
we'll ask the question, what's a DMARD?
And there are many different types,
conventional synthetic DMARDs,
biologic DMARDs, and
targeted synthetic DMARDs.
And we'll look briefly at the safety and
also some non-pharmacological
interventions.
1:20
So, the European League Against Rheumatism
and
the American College of Rheumatology
have made recommendations for
the management of rheumatoid
arthritis which are very good.
And essentially, this requires
a goal-oriented treatment approach.
The primary target for
treatment is remission where possible,
or low disease activity as a secondary
goal if remission is not attainable.
And the treatment should start as soon
as possible, once the diagnosis or
classification is being made.
The patient is seen regularly with
a view to adjusting the treatment, and
then titrating treatment according
to response, until ideally,
the treatment goal is achieved.
It should be said, however, that even in
best practice centers that it's not always
possible to achieve the aspirational goal
of remission, or low disease activity.
The treat-to-target concept follows
these principles really with an idea of
