androFirst thing to note is that methotrexate has been shown to have the most activity of the non biological DMARDS in reducing erosions in RA . It is typically used in combination with another DMARD . Our Patient is not responding to our best Therapy for erosive RA ---- This is refractory RA .
The algorithm generally used in Tx of R.A is that if non biological DMARDS have failed , as in our Pts , Biological therapy is initiated eg - Monoclonal antibodies against TNF alpha ( adalimumab ) or decoy receptors to TNF alpha ( etarnecept )+4
submitted by โbingcentipede(355)
This is a patient with RA not responding to steroids or MTX. Next line of therapy is a TNF-a inhibitor like adalimumab, an anti-TNF alpha antibody.