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Inflammopharmacology ; 29(4): 987-1000, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33844107

ABSTRACT

Rheumatoid arthritis (RA) is an autoimmune systemic inflammatory disorder that is mostly characterised by progressive symmetrical joint destruction, particularly in the wrist and fingers, while it may also affect additional joints and several organs, such as the skin, heart, blood vessels, and lungs. It is identified by raised anti-rheumatoid factor and anti-cyclic citrullinated peptide antibodies. The chemical mediators involved in the activity of RA are IL-1ß, TNF-α, and IL-6. Pregnancy exerts a positive effect on RA that helps to modulate the disease condition. Different hypotheses are recommended to explain the ameliorating effect of pregnancy in RA. RA cannot be completely cured. The treatment goal is the attrition of pain and inflammation and the further progression of the disease. Long-term management of RA is carried out using disease-modifying antirheumatic drugs (DMARDs). Therapy of acute flares can be done with Non-steroidal anti-inflammatory drugs (NSAIDs) accompanied by ad interim usage of glucocorticoids. Biologic response modifiers are also available; they act by abolishing the activity of T- cells. However, it is necessary to select the correct treatment regimen when it comes to the management of RA in pregnancy.


Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/metabolism , Disease Management , Pregnancy Complications/drug therapy , Pregnancy Complications/metabolism , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antirheumatic Agents/pharmacology , Arthritis, Rheumatoid/immunology , Biological Products/pharmacology , Biological Products/therapeutic use , Female , Glucocorticoids/pharmacology , Glucocorticoids/therapeutic use , Humans , Pregnancy , Pregnancy Complications/immunology , Synovial Membrane/drug effects , Synovial Membrane/immunology , Synovial Membrane/metabolism
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