Este protocolo se aplica a pacientes con artritis reactiva que permanecen refractarios al tratamiento convencional. Se define un enfoque de escalada dirigida, con resultados específicos y medibles para evaluar si la respuesta es adecuada a los 6 meses.
En pacientes que no han respondido adecuadamente al tratamiento convencional, este protocolo contempla el uso de un agente biológico dirigido a una vía proinflamatoria específica. La selección del agente y los detalles de administración dependen del cuadro clínico individual.
The largest patient series available has been reported by Flagg et al., who conducted an open-label trial involving 16 patients with undifferentiated or reactive arthritis treated for 6 months with etanercept 25 mg subcutaneous twice a week.
For this reason, caution on TNF inhibitor treatment of ReA patients is advisable, limiting this option to patients refractory to conventional therapy, at least until further studies will definitely exclude safety issues.
2 of the following 3 assessment measures: at least a 2-point decrease in the 10-point VAS for pain, at least a 30% decrease in tender joint count, and at least a 30% decrease in swollen joint count.
Complete remission: complete resolution of the clinical manifestation, normalisation of inflammatory markers, no recurrence of the arthritis.
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