lnu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Hur effektiv och säker är en kombination av metotrexat och etanercept, jämfört med monoterapi vid behandling av Reumatoid Artrit?
Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
2018 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesisAlternative title
How effective and safe is a combination of methotrexate and etanercept, compared to monotherapy in the treatment of rheumatoid arthritis? (English)
Abstract [sv]

Reumatoid artrit (RA) är en kronisk sjukdom som drabbar kroppens leder. Sjukdomen karakteriseras av inflammerade, smärtande, svullna och stela leder. I Sverige är ungefär 0,5 % av befolkningen drabbad. Mer än hälften av de som drabbas är kvinnor och insjuknandefrekvensen är högst i 50-årsåldern. Det finns ingen behandling som botar sjukdomen. Behandlingen är istället inriktad på att förhindra eller mildra symptomen som uppstår vid RA. Patienter med RA har ett flertal behandlingsalternativ, bland annat ASA, NSAID, kortison, biologiska läkemedel och DMARDs. Biologiska läkemedel har inneburit en revolution för behandling av RA. Många patienter kan med hjälp av dessa läkemedel återfå den livskvalitet de hade innan sjukdomen bröt ut. Syftet med arbetet var att undersöka hur effektiv och säker är en kombination av metotrexat och etanercept är, jämfört med monoterapi vid behandling av reumatoid artrit. Arbetet är ett litteraturarbete där sökningar gjordes i sökbasen PubMed med sökorden ”Methotrexate rheumatoid arthritis”, ”Etanercept methotrexate”, ”Etanercept rheumatoid arthritis”. Fem studier valdes ut och utvärderades. Resultatet av studierna visar på att en kombination av läkemedlen ger en något effektivare behandling med likvärdiga biverkningar. Men med tanke på de ekonomiska aspekterna bör kombinationsbehandling endast användas vid mycket hög sjukdomsaktivitet och vid otillräcklig effekt av andra läkemedel. I framtiden bör fler studier göras för att bedöma den långsiktiga effekten av en kombination av läkemedlen.

Abstract [en]

Rheumatoid arthritis, RA, is a chronic disease affecting joints in the body. The disease is characterized by periodic inflammation causing pain, swelling and damage of joints. The patient loses quality of life. In Sweden, approximately 0.5% of the population has the diagnosis RA. More than half of those affected are women and the incidence rate is highest in the 50s.

RA cannot be cured by any treatment. The symptoms of the disease are treated symptomatically with for example NSAID and ASA. Patients can also be treated by immunomodulation therapy to decrease the inflammatory activity in the body. This helps to slow down the course of illness.

Methotrexate belongs to the class of cytotoxic agents and is a folic acid antagonist. The drug acts by inhibiting the enzyme dihydrofolate reductase that converts folic acid to tetrahydrofolic acid. Tetrahydrofolic acid is an important building block for the cell's inheritance. In RA a low dose MTX is used and the drug inhibits the immune system and inhibits disease progression.

Etanercept is a fusion protein that is genetically produced. It consists of two identical TNFR2 extracellular regions fused to an Fc domain of human IgG1. The drug blocks / neutralizes TNFα from interacting with receptors and has enabled the development of breakthrough therapies to treat a variety of autoimmune inflammatory diseases. In RA, the proinflammatory cytokine TNF stimulates the inflammation and thereby plays a central role in the process. TNF inhibitors slow down the effect of the substance and the inflammation of the joints in the body decreases.

The aim of this study was to examine how effective and safe a combination of methotrexate and etanercept is, compared to monotherapy in the treatment of RA. The searches were made in PubMed and the keywords used were “Methotrexate rheumatoid arthritis”, ”Etanercept methotrexate”, ”Etanercept rheumatoid arthritis”. Five studies were chosen. The results of the studies indicate that a combination of drugs provides a slightly more effective treatment with equivalent side effects. However, given the economic aspects, combination therapy should only be used in very high disease activity and in intolerance to other drugs. In the future, more studies should be done to assess the long-term effect of a combination of drugs.

Place, publisher, year, edition, pages
2018. , p. 36
Keywords [sv]
Reumatoid artrit, metotrexat, etanercept
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-73991OAI: oai:DiVA.org:lnu-73991DiVA, id: diva2:1204381
Subject / course
Pharmacy
Educational program
Bachelor of Science Programme in Pharmacy, 180 credits
Supervisors
Examiners
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved

Open Access in DiVA

fulltext(834 kB)8 downloads
File information
File name FULLTEXT01.pdfFile size 834 kBChecksum SHA-512
12514b5f9d62644ac95f7460138904003f5e897bc90fa3078b758f9749b74065498312dfc8e726892969109246229606407b023637e2049e247415665820cbf7
Type fulltextMimetype application/pdf

Search in DiVA

By author/editor
Johannesson, Frida
By organisation
Department of Chemistry and Biomedical Sciences
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 8 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

urn-nbn

Altmetric score

urn-nbn
Total: 113 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf