Rheumatoid arthritis

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Definition

  • Seropositive inflammatory arthritis

Management

Initial

  • Methotrexate
  • Biologics
    • Anti-TNF: adalimumab
    • T-cell costimulatory inhibitor: abatacept
    • IL-6 antagonist: tocilizumab
    • IL-1 antagonist: anakinra
    • B-cell depleting agents: rituximab
    • JAK1/2/3 inhibitor: tofacitinib

Chronic

  • Vaccination
    • Can give dead vaccines: flu, pneumonia, HBV
    • Can give live zoster vaccine with methotrexate but not biologics
    • Avoid other live vaccines in both methotrexate and biologicals
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