Proposal for anti-TNFα therapy in adult patients with rheumatoid arthritis

Reumatoidni artritis je kronična upalna reumatska bolest s prevalencijom od oko 1 %, karakterizirana sa sinovitisom, erozivnim promjenama zglobova, bolovima i oštećenjem funkcije. Etiologija bolesti nije poznata a u patogenezi reumatoidnog artritisa ključnu ulogu imaju proupalni citokini, poglavito, čimbenik nekroze tumora (TNFα). Lijekovi, antagonisti TNFα imaju brz i kontinuiran učinak, uz prihvatljiv sigurnosni profil pa su, danas, etablirani lijekovi u ranoj i kasnoj fazi reumatoidnog artritisa. Propisuju se s kontroliranim ograničenjima prema lokalnim preporukama s obzirom na visoku cijenu liječenja. Ispred Hrvatskoga reumatološkog društva iznosimo prijedlog primjene antagonista TNFα u liječenju bolesnika s reumatoidnim artritisom.Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1 %. Rheumatoid arthritis is caracterized with synovitis, erosive changes of the joints, pain and functional deficit. Etiology is unknown. In the pathogenesis of rheumatoid arthritis the key role have proinflammatory citokines, particularly, tumour necrosis factor (TNFα). TNFα blockers have documented, fast and continuous efficacy with generally well accepted safety profile. Nowdays, TNFα antagonists are established drugs in early and late phase of rheumatoid arthritis. Prescription of TNFα antago­nists is controlled, according local restrictions, regarding high costs of the therapy. On behalf of Croatian Society for Rheumatology we propose recommendations for the TNFα antagonist therapy in rheumatoid arthritis