Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative review

The range of therapeutic options available for rheumatoid arthritis (RA) is becoming increasingly diverse. Conventional synthetic disease-modifying antirheumatic drugs (DMARDs), biologic DMARDs, and targeted synthetic DMARDs offer the rheumatologist a far greater breadth of treatment options than be...

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Main Authors: Richard Conway, Luke Corcoran, Elena Nikiphorou
Format: Article
Language:English
Published: SAGE Publishing 2021-01-01
Series:Indian Journal of Rheumatology
Subjects:
Online Access:http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=5;spage=92;epage=100;aulast=Conway
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author Richard Conway
Luke Corcoran
Elena Nikiphorou
author_facet Richard Conway
Luke Corcoran
Elena Nikiphorou
author_sort Richard Conway
collection DOAJ
description The range of therapeutic options available for rheumatoid arthritis (RA) is becoming increasingly diverse. Conventional synthetic disease-modifying antirheumatic drugs (DMARDs), biologic DMARDs, and targeted synthetic DMARDs offer the rheumatologist a far greater breadth of treatment options than before. When choosing a treatment in the individual patient, several important factors need to be considered, one of which is the safety in RA interstitial lung disease (RA-ILD). Rheumatologists frequently encounter RA patients with RA-ILD or other co-existing lung diseases. The pulmonary safety profile of our medications is difficult to ascertain and as they are generally infrequent, adverse events are rarely identified in the initial treatment trials. The concern for the safety of these treatments has largely emerged from real-world observational data and has often been based on small numbers of case studies or retrospective analyses of observational studies. The evidence has been controversial with many agents implicated both in the context of predisposing or worsening the risk of ILD and at the same time as potentially beneficial treatments in delaying the onset or progression of ILD. As a result, clear guidance on the treatment of RA-ILD is generally lacking. The purpose of this article, therefore, is to detail our current knowledge of the safety of DMARDs in RA-ILD.
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spelling doaj-art-bd53f0e3512544bebada643d4b8117112025-02-03T11:42:10ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012021-01-011659210010.4103/0973-3698.332983Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative reviewRichard ConwayLuke CorcoranElena NikiphorouThe range of therapeutic options available for rheumatoid arthritis (RA) is becoming increasingly diverse. Conventional synthetic disease-modifying antirheumatic drugs (DMARDs), biologic DMARDs, and targeted synthetic DMARDs offer the rheumatologist a far greater breadth of treatment options than before. When choosing a treatment in the individual patient, several important factors need to be considered, one of which is the safety in RA interstitial lung disease (RA-ILD). Rheumatologists frequently encounter RA patients with RA-ILD or other co-existing lung diseases. The pulmonary safety profile of our medications is difficult to ascertain and as they are generally infrequent, adverse events are rarely identified in the initial treatment trials. The concern for the safety of these treatments has largely emerged from real-world observational data and has often been based on small numbers of case studies or retrospective analyses of observational studies. The evidence has been controversial with many agents implicated both in the context of predisposing or worsening the risk of ILD and at the same time as potentially beneficial treatments in delaying the onset or progression of ILD. As a result, clear guidance on the treatment of RA-ILD is generally lacking. The purpose of this article, therefore, is to detail our current knowledge of the safety of DMARDs in RA-ILD.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=5;spage=92;epage=100;aulast=Conwaybiologic disease-modifying antirheumatic drugsinterstitial lung diseasejak inhibitorsmethotrexaterheumatoid arthritis
spellingShingle Richard Conway
Luke Corcoran
Elena Nikiphorou
Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative review
Indian Journal of Rheumatology
biologic disease-modifying antirheumatic drugs
interstitial lung disease
jak inhibitors
methotrexate
rheumatoid arthritis
title Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative review
title_full Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative review
title_fullStr Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative review
title_full_unstemmed Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative review
title_short Efficacy and safety of conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis-interstitial lung disease: A narrative review
title_sort efficacy and safety of conventional synthetic biologic and targeted synthetic disease modifying antirheumatic drugs in rheumatoid arthritis interstitial lung disease a narrative review
topic biologic disease-modifying antirheumatic drugs
interstitial lung disease
jak inhibitors
methotrexate
rheumatoid arthritis
url http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=5;spage=92;epage=100;aulast=Conway
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AT elenanikiphorou efficacyandsafetyofconventionalsyntheticbiologicandtargetedsyntheticdiseasemodifyingantirheumaticdrugsinrheumatoidarthritisinterstitiallungdiseaseanarrativereview