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Osteoarthritis
1%
12/1001
Rheumatoid arthritis
96%
962/1001
Hunter syndrome (type II mucopolysaccharidosis)
8/1001
Hereditary vitamin D resistant rickets
6/1001
Gout
0%
3/1001
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TNF-alpha medical therapy has revolutionized the treatment of rheumatoid arthritis. DMARDs have revolutionized the treatment of rheumatoid arthritis, shifting the focus from treatment of symptoms to prevention of progression. Specific research into TNF-alpha modification has also shown progress in the treatment of juvenile rheumatoid arthritis, seronegative spondyloarthopathies, chronic recurrent multifocal osteomyelitis, and histiocytosis X. There are many different types and mechanisms of actions of DMARDs. One large family of medications (including etanercept) functions through antagonist action against TNF-alpha. Other types of DMARDs are anti-folate (methotrexate), IL-1 inhibitors (chloroquine), or pyrimidine synthesis inhibitors (leflunomide). Howe et al. discusses how to modify TNF antagonists in the perioperative period. They recommend for minor procedures the medication can be continued. For moderate to intensive procedures, they recommend withholding etanercept for 1 week, and plan surgery for the end of the dosing interval for adalumimab and infliximab, and restart 10-14 days postoperatively.
2.9
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