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However, by 36 months, only 9% of patients in each of the methotrexate and ciclosporin arms fulfilled ACR remission criteria compared with 7% in the sulfasalazine control arm.
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Your rheumatologist will work with you to change your treatment plan if you want to conceive a baby, as some DMARDs, including methotrexate, can cause severe birth defects.
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In rat studies with NSAIDs, as with other drugs known to inhibit prostaglandin synthesis, an increased incidence of dystocia, delayed parturition, and decreased pup survival occurred.
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However, no trials have compared initial combination therapy with a rapid step-up to combinations only in patients with active disease despite monotherapy.
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Vaccines given prior to immunosuppression will be more effective than those initiated after the start of such therapy.
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Several patterns of sulfasalazine-related lung damage have been described on tissue biopsy specimens, including interstitial pneumonitis, eosinophilic pneumonia, and BOOP, suggesting a variety of different mechanisms for lung damage.
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The recent Behandelstrategieen voor Reumatoide Artritis (BeST) study found that initial parallel therapy with methotrexate, sulfasalazine and tapering high-dose steroids resulted in earlier functional improvement, higher ACR20 response rates and slower radiological progression than either sequential monotherapy or step-up combination therapy.
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The symptoms that distinguish rheumatoid arthritis from other forms of arthritis are inflammation and soft-tissue swelling of many joints at the same time (polyarthritis).
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Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice.
The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.
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Guidelines are intended to be flexible and must be distinguished from standards of care, which are inflexible and rarely violated.
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Some of the drugs can be used in combination.
Their primary benefit is in the steroid-sparing effect, rather than as an agent to be used as monotherapy to induce remission.
Individuals suffering from certain medical conditions should not use sulfasalazine.
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Many recommendations fall outside the present bounds of regulatory agency---approved labeling, but reflect common and widely accepted practices in the field.
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