Weisman: Targeted Treatment of the Rheumatic Diseases (Expert Consult Series)

Targeted Therapies is an appropriate title for this textbook on the management of rheumatic diseases and painful musculoskeletal syndromes. Therapeutic targeting may be done on several levels. On the molecular level, increasing knowledge about the components of inflammation and immunity, and the interactions of these components with each other, has encouraged the development of agents that target specific aspects of these processes. Older examples include the xanthine oxidase inhibitor allopurinol to treat hyperuricemia and gout, and specific cyclo-oxygenase-2 inhibitors to decrease pain and inflammation. The perfection of recombinant technology has made possible the production of therapeutic proteins that mimic natural inhibitors of inflammatory cytokines, e.g., etanercept (TNF alpha soluble receptor) anakinra (IL-1 receptor antagonist); inactivate cytokines by a monoclonal antibody (infliximab, adalimumab); impair cell to cell signaling, e.g., abatacept; or destroy specific immunoactive cells, e.g., rituximab (CD-20 B cells). Successful and unsuccessful clinical trials of these specifically targeted therapeutic proteins increase knowledge about how pathogenic mechanisms differ in various chronic inflammatory diseases. Such mechanism targeted therapies are likely to be less toxic than general anti-metabolites such as cyclophosphamide or prednisone.

The increasing availability of more effective, less toxic targeted agents has encouraged the clinical application of a second level of targeting: treatment to achieve a pre-defined disease state. This philosophy has been incorporated in guidance documents for rheumatoid arthritis that advise adjusting therapies every 3 months as needed to achieve and maintain DAS remission or low disease activity state. Similar clinical targets for treatment regimens for other rheumatologic diseases will become possible as more effective agents become available. These outcomes-targeted regimens help compensate for individual variability in responses to initial agents, and adjust for the frequent loss of benefit from initially successful treatments.

A third level of targeting applies to the nuances involved in the management of clinical situations that are uniquely associated with certain rheumatic diseases, but are often unanticipated or missed in routine medical practices. Experts with special interests and experience in such diseases are often able to anticipate and avoid or manage these problems, and thus improve the quality of life for their patients.

This book has assembled an impressive group of international experts who have studied specific aspects of certain rheumatic diseases and have extensive experience with the in-depth management of patients with these diseases. They communicate their knowledge and experience to the reader in chapters that are keyed to illustrative case reports. The current best practices are described and future developments are anticipated.

Targeted Therapies is a useful text for anyone who manages patients with rheumatic diseases. Its expert contributors provide state of the art insight into the management of specific rheumatic diseases and build a solid foundation for understanding the avalanche of new targeted therapies currently being developed, that will markedly improve the quality of life and prognosis of patients with these chronic illnesses.

Key Features

• Focuses on patient management instead of disease management so that you can tailor treatment plans according to each patient’s needs.
• Covers the treatment of pediatric patients as well as adults so that you can properly address the particular needs of any patient you see.
• Features the guidance and specific recommendations of experts from United States and Europe for a state-of-the-art approach to the variety of treatments currently in use.
• Displays the clinical manifestations of rheumatic diseases in full color, along with treatment algorithms for easy at-a-glance reference.

Website Features

• Consult the book from any computer at home, in your office, or at any practice location.
• Instantly locate the answers to your clinical questions via a simple search query.
• Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.

Contents 

• Chapter 1 - Management of Rheumatoid Arthritis: Principles and Strategies for Antirheumatic  Pharmacotherapy
• Chapter 2 - Management of Rheumatoid Arthritis: The Newly Diagnosed Patient
• Chapter 3 - Management of Established Rheumatoid Arthritis
• Chapter 4 - Management of Rheumatoid Arthritis: The Patient with Extra-Articular Disease
• Chapter 5 - Management of Ankylosing Spondylitis and Other Spondyloarthropathies
• Chapter 6 - Management of Psoriatic Arthritis
• Chapter 7 - Juvenile Arthritis
• Chapter 8 - Principles in Management of Systemic Lupus Erythematosus
• Chapter 9 - Management of Nonrenal Systemic Lupus Erythematosus 2
• Chapter 10 - Management of Systemic Lupus Erythematosus Renal Disease
• Chapter 11 - Management of the Antiphospholipid Syndrome
• Chapter 12 - Management of Sjögren's Syndrome
• Chapter 13 - Management of Systemic Sclerosis and Raynaud's Phenomenon
• Chapter 14 - Targeted Treatment of the Idiopathic Inflammatory Myopathies
• Chapter 15 - Polymyalgia Rheumatica and Giant Cell Arteritis
• Chapter 16 - Management of Medium and Small Vessel Vasculitis, Including the Antineutrophil Cytoplasmic Antibody–Associated Diseases
• Chapter 17 - Management of CNS Vasculitis and Takayasu's Arteritis
• Chapter 18 - Management of Sarcoidosis, Behçet's Disease, and Other Rare Rheumatic Diseases
• Chapter 19 - Management of the Connective Tissue Diseases of Childhood
• Chapter 20 - Septic Arthritis
• Chapter 21 - Management of Lyme Disease
• Chapter 22 - Gout and Crystal Deposition Disease
• Chapter 23 - Management of Osteoarthritis: Pharmacotherapy
• Chapter 24 - Osteoporosis
• Chapter 25 - Regional Disorders of the Neck, Shoulder, Arm, and Hand
• Chapter 26 - Management of Mechanical Lumbar Spine Disease
• Chapter 27 - Mechanisms and Treatment Strategy of Complex Regional Pain Syndromes
• Chapter 28 - Management of Fibromyalgia and Unexplained Generalized Pain Syndromes
• Chapter 29 - The Significance of Behavioral Interventions for Arthritis
• Chapter 30 - Physical Activity and Exercise in Rheumatic Disease
• Chapter 31 - Management of the Patient with Rheumatic Disease During and After Pregnancy
• Chapter 32 - Economic Considerations in the Treatment of Rheumatic Diseases
• Chapter 33 - Introduction of a Biologic Agent into the Clinic

About the Authors

• Michael H. Weisman, MD, Director, Division of Rheumatology, Cedars-Sinai Medical Center, Professor of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
• Michael E. Weinblatt, MD, John R. and Eileen K. Riedman Professor of Medicine, Harvard Medical School, Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Massachusetts.
• James S. Louie, MD, Professor Emeritus of Medicine, Division of Rheumatology at CHS, David Geffen School of Medicine at UCLA, Los Angeles, California.
• Ronald F. van Vollenhoven, MD, PhD, Senior Rheumatologist, Karolinska University Hospital, Associate Professor of Rheumatology, The Karolinska Institute, Stockholm, Sweden.

Product Details

• Hardcover: 496 pages
• Publisher: Saunders; 1 Har/Psc edition (November 3, 2009)
• Language: English
• ISBN-10: 141609993X
• ISBN-13: 978-1416099932
• Product Dimensions: 11.4 x 8.9 x 0.9 inches

List Price: $195.00