title: Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches.
abstract: Rheumatic diseases are highly prevalent chronic disorders and the leading cause of physical disability worldwide, with a marked socio-economic impact. Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology with an autoimmune pathogenesis, characterised by arthropathy with chronic, deforming, destructive evolution and multiple systemic manifestations. The management of RA has undergone significant changes as far as objectives and approaches are concerned, ending in the current strategy known as 'treat to target'. The therapeutic array of RA includes several categories of medicinal products, of varying potential. There are several criteria for the classification of medicinal products used against this disease, one of the most important and modern of which divides such substances according to their effects on the progress of the disease: symptom-modifying antirheumatic drugs (including non-steroidal anti-inflammatory drugs and corticoids), disease-modifying antirheumatic drugs (including various substances, such as gold salts, antimalarials, sulfasalazine, D-penicillamine; non-specific immunosuppressive medication, such as methotrexate, cyclophosphamide, azathioprine and leflunomide) and biological therapy is a recent addition, providing new insight into the treatment of this disease. The selection of the optimal therapy for RA should be based on guidelines and recommendations, but also on clinical particular aspects and patient preferences.
authors.affiliation: Department of Toxicology, Faculty of Pharmacy, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 020956, Romania.
authors.forename: Carolina
authors.initials: C
authors.lastname: Negrei
authors.affiliation: Department of Internal Medicine and Rheumatology, 'Sfanta Maria' Hospital, Bucharest 011172, Romania.
authors.forename: Violeta
authors.initials: V
authors.lastname: Bojinca
authors.affiliation: Department of Internal Medicine and Rheumatology, 'Sfanta Maria' Hospital, Bucharest 011172, Romania.
authors.forename: Andra
authors.initials: A
authors.lastname: Balanescu
authors.affiliation: Department of Internal Medicine and Rheumatology, 'Ion Cantacuzino' Hospital, Bucharest 020475, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Bojinca
authors.affiliation: Department of Toxicology, Faculty of Pharmacy, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 020956, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Baconi
authors.affiliation: Department of Clinical Virology, School of Medicine, Faculty of Medicine, University of Crete, Heraklion 71003, Greece.
authors.forename: Demetrios A
authors.initials: DA
authors.lastname: Spandidos
authors.affiliation: Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion 71003, Greece.
authors.forename: Aristidis M
authors.initials: AM
authors.lastname: Tsatsakis
authors.affiliation: Department of Toxicology, Faculty of Pharmacy, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 020956, Romania.
authors.forename: Miriana
authors.initials: M
authors.lastname: Stan
keywords: biological therapy; disease-modifying antirheumatic drugs; rheumatoid arthritis; treatment