DMARDs and gout therapy in patients with chronic arthritis and end-stage renal disease: a descriptive guide - PubMed
6 hours ago
- #End-Stage Renal Disease
- #DMARDs
- #Chronic Arthritis
- Treatment in patients with end-stage renal disease (ESRD) and chronic arthritis requires balancing efficacy and safety due to drug removal during dialysis and risks of overdose.
- In ESRD, methotrexate is contraindicated, leflunomide is safe/effective, sulfasalazine and hydroxychloroquine are not recommended, biological DMARDs are safe/effective, and JAK inhibitors are generally not recommended.
- For gout in dialysis patients, urate-lowering therapy is needed; starting with lower doses of allopurinol or febuxostat is effective and well tolerated, with low-dose colchicine also safe.
- Treatment decisions should be individualized with strict monitoring due to a lack of evidence-based guidelines, relying on existing literature summaries.