Drug allergy is one type of adverse reaction to drugs and encompasses a spectrum of hypersensitivity reactions with heterogeneous mechanisms and clinical presentations. A thorough history is essential to the management of drug allergy. Laboratory testing has a very limited role in the management of drug allergy. Graded dose challenges and procedures to induce drug tolerance might be required in...

There have been substantial advances in the treatment of rheumatoid arthritis in recent years. Traditional disease-modifying antirheumatic drugs (DMARDs) have been shown to have small effects on the progression of radiographic damage. This quantitative overview summarizes the evidence for biologic DMARDs and radiographic damage either alone or in combination with methotrexate. Two outcomes were...

Generalized pustular psoriasis (GPP) is a rare form of childhood psoriasis, often requiring systemic therapy, which is challenging as there is a paucity of randomized controlled trials and standardized guidelines. Biologic agents have been used in adults and in pediatric plaque psoriasis, but evidence regarding their efficacy in pediatric GPP has slowly become available. The objective of this s...

The last 15 years has seen a revolution in the development of a drug therapy armamentarium for treating patients with rheumatoid arthritis (RA) [1]. Prior to that general practitioners and rheumatologists were relatively limited in the number of agents which had shown clinical efficacy in the treatment of RA patients. Besides the use of gold in some RA patients, non-steroidal anti-inflammatory ...

Despite conventional treatment, RA still has many deleterious consequences. From the patients' perspective, these include persistent pain, functional disability, fatigue, and depression modified by health beliefs and underlying psychological problems. Disability is a consequence of pain, active synovitis and joint damage. It is usually assessed by self-reported questionnaire; the Health Assessm...

The treatment of rheumatoid arthritis (RA) changed dramatically with the appearance of biological drugs more than 15 years ago. The release of the first anti-TNF agents, including infliximab (chimeric), adalimumab (humanized) and etanercept (soluble receptor) represented a paradigm shift in the treatment of a chronic inflammatory disease that had few treatment options and, for many, a poor prog...

The treatment of rheumatoid arthritis has improved dramatically in recent years with the advent of the latest generation of disease-modifying antirheumatic drugs. Despite these advances, in some patients inflammation is not diminished sufficiently to prevent irreversible musculoskeletal damage, thus requiring surgical intervention to reduce pain and improve function. In these cases, the orthopa...

Background Methotrexate (MTX) which has been used for 20 years in Juvenile Idiopathic Arthritis (JIA) has now become the first-choice, second-line agent for children with polyarticular course JIA. New biologic drugs are used for MTX-failing patients and have been assessed in controlled trials for effectiveness. Safety data of these drugs are slowly and selectively emerging as post-marketing dat...

Inflammatory bowel disease [IBD] is characterized by chronic inflammation of the gastrointestinal tract. Medications such as corticosteroids, thiopurines, immunomodulators and biologic agents are used to induce and maintain remission; however, response to these drugs is variable and can diminish over time. Defective autophagy has been strongly linked to IBD pathogenesis, with evidence showing t...