Rheumatism: medication tapering off?

Expert Professor Klaus Krüger üon the request of many rheumatic patients, their medications to get rid of

How much therapy benötransparent rheumatism-ridden joints? Prof. Klaus Krüger befüthe M&ouml rwortet;of urgency, rheumatism means to taper – but only under certain conditions

The immune system is directed against the own Köbody. Immune cells not only attack viruses or bacteria, – but the joints. Diagnosis: rheumatoid ­Arthritis, short-rheumatism. Früthe f&uuml meant;r the patients häoften many operations, köphysical disabilities, diseases such as tumors or heart attacks.

But thanks to modern medications, the diagnosis has lost much of its terror. Although lärheumatism sst today not heal. But if the therapy früh starts, the Krankheitsaktivität well in the grip of wars. Many of the patients have less frequent and less severe complaints.

As soon as the symptoms are hardly more spüarray of medicines to get rid of &ndash, to germinate in many cases, however, the desire to; mostly out of fear of side effects. The pharmacies Umschau has darüber with the MüMunich rheumatologist Professor Klaus Krüeng spoken.

Professor Krüger, is the desire to take less medication, on the part of the patients really groß?

At least two-thirds of my Schäup to this desire. Many of them wüwould have even been happy on the medication. You have to convey to you that it is very good if you can reduce the dose. In any case, müthe patient left the Gefühl, that you are well.

It’s not deductible rheumatic drugs so completely?

No, that’s also been in a number of studies. Approximately 85 to 90 percent of patients, the disease worsens within a few months after a complete Discontinuation. Only a minority of the Fälle succeeds, the medication omit it altogether. And also not für eternal times, but maybe für a couple of years.

Für what are the patient of a tapering &uuml comes;in General question?

The Patient must be at least half a year continuously in sustained Remission, i.e., without Krankheitsaktivität. This does not mean that it must be completely free of symptoms. However, the symptoms dümay only be minimal.

How is this ensured?

Before the Reduce, again, the so-called disease is calculated Score. Thus, the physician ensures that the Patient über läfor a long time in the Status of Remission. According to some studies, this classification works better when imaging techniques are used. The wäbut in everyday practice too complex and is also of the Kostenträlike not paid.

What drugs exactly möwant rheumatism patients because of discontinuation?

Many develop an aversion to methotrexate, we call it MTX. This means once had a bad Image. Many patients hören so somewhere that it gefädangerous. In truth, it is for sure one of the ungefäthe most dangerous drugs – mind you with the sachgemäßhe application. And since MTX tatsäto note the take a lot.

A sequence is, what medications first k&ouml be reduced;can?

You look at the study location, is not the answer. There is no study that says that the sequence A is better than sequence b. We let the patient decide. And since the majority of daf&uuml is safe;r, first of all, the MTX to omit or at least reduce it significantly.

The methotrexate köcould be omitted completely?

Someone uses a combination of MTX and Biologic (see box) and wants to equalize the MTX exclusive, can succeed. Because biologics are highly effective substances that keep the disease, sometimes alone under control. This completely negative bodies of work, in turn, only rarely. But in many Fäcases läthe H&auml sst;frequency of injections in half. This is a realistic goal.

But this requires a secure intensive follow-up?

A prerequisite nat&uuml is;of course, that the Patient his regelmäßsolution of con-
Troll dates zuverläcasual beibehält. You have to discuss with him, that he reports between the control dates immediately, as soon as he selbst  spürt, that the Krankheitsaktivität stäamplifier. Otherwise, wäre with lasting Schäto expect the.

And the little pains in between? Not bad?

In mild discomfort due to a change in the weather or light Üdue to congestion can take the Patient at any time, if required, an anti-rheumatic pain medication such as Ibuprofen. But when it comes to complaints, you have to start again with the therapy or the dose erhöhen.

Then you get the disease üat all in the handle?

If you pick up the previously successful medication in full, then, in the ­most of all Fäcases again

Is for excited each rheumatologist if the Patient is less drugs wüwant to get?

Since it is intensively discussed, not every rheumatologist sees it as I do. Ultimately, the Patient of the co-deciders. The doctor should at least try, the desire to erfücases.

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