Combination Treatment in Autoimmune Diseases

1. Front Matter

   Pages I-VI

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2. General section

   1. Front Matter

      Pages 1-1

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   2. Combination treatment in autoimmune diseases — Introduction

      • W. B. Harrison, B. A. C. Dijkmans

      Pages 3-4

   3. Combination therapy for autoimmune diseases: the rheumatoid arthritis model

      • N. Fathy, Daniel E. Furst

      Pages 5-26

   4. Methodology of combination trials

      • Maarten Boers

      Pages 27-33

   5. Regulatory aspects of evaluating combination treatments in autoimmune diseases

      • Pekka Kurki

      Pages 35-41

   6. New therapies in development for autoimmune diseases: their rationale for combination treatment

      • Vibeke Strand

      Pages 43-61

   7. Combination therapy: the risks of infection and tumor induction

      • David E. Yocum

      Pages 63-72

3. Disease specific section

   1. Front Matter

      Pages 73-73

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   2. Combination treatment in autoimmune diseases: systemic lupus erythematosus

      • G. Moroni, O. Della Casa Alberighi, Claudio Ponticelli

      Pages 75-89

   3. Combination therapy in autoimmune disease: vasculitis

      • P. Bacon, David M. Carruthers

      Pages 91-108

   4. Combination therapies for systemic sclerosis

      • C. P. Denton, Carol M. Black

      Pages 109-129

   5. Therapy of Sjögren’s syndrome

      • Niki M. Moutsopoulos, H. M. Moutsopoulos

      Pages 131-145

   6. Spondylarthropathies: options for combination therapy

      • A. M. van Tubergen, Robert B. M. Landewé, Sjef van der Linden

      Pages 147-163

   7. Combination therapy in rheumatoid arthritis

      • S. Bingham, Paul Emery

      Pages 165-183

4. Futurology

   1. Front Matter

      Pages 185-185

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   2. What will treatment of autoimmune diseases entail in 2010?

      • Tom W. J. Huizinga, F. C. Breedveld

      Pages 187-192

   3. Stem cell transplantation for autoimmune diseases

      • John Moore, P. Brooks

      Pages 193-213

W. B. Harrison, B. A. C. Dijkmans During the last decade intervention has been instituted for all kinds of disease- even in a premorbid state, as early as possible, to control the activity of the disease, to avoid further damage and to maintain quality of life. Apart from the principle 'Treat now, not later", emphasis is laid on aggressive initial therapy. These adagia have influenced in recent times all fields of medicine, from oncology to infectious diseases and also - the topic of the present edition - the "autoimmune diseases". As an example of the latter, rheumatoid arthritis (RA) demonstrates how the attitude of physicians has been changed. From an expectant point of view in the eighties (primum nil nocere) the attitude has been changed, as we approached and entered the new millennium, to initial ag­ gressive therapy especially in patients with a poor prognosis. Despite the advance of instituting monotherapy with a single optimised disease-modifying anti-rheumatic drug (DMARD) - with methotrexate as prototype agent in RA - adequate disease re­ mission is not often achieved, and adverse events may well prevent the use of higher dosages of the single agent in question. Therefore, the next step was to combine two or more DMARDs. The choice of combining DMARDs can be purely practical and based upon the anti-rheumatics most used in daily practice, for instance methotrexate and sulphasalazine. The choice of combining drugs can be influenced by different toxicity patterns to avoid cumulative toxicity.

• Autoimmune diseases
• Sjögren's syndrome
• autoimmune disease
• cell
• diseases
• erythematosus
• immunotherapy
• infection
• pathology
• rheumatoid arthritis
• spondyloarthropathies
• stem cell transplantation
• systemic sclerosis
• transplantation
• vaculitis

• Novartis Pharmaceuticals, Australia Pty. Ltd., North Ryde, Australia

  W. B. Harrison

• Academic Hospital, Department of Rheumatology, Vrije Universiteit, Amsterdam, The Netherlands

  B. A. C. Dijkmans

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