Análise sobre a doação de medicamento citrato de tofacitinibe pelo protocolo clínico e diretrizes terapêuticas da artrite reumatoide

Abstract

Rheumatoid arthritis (RA) is an inflammatory chronic disease, autoimmune, systemic and of progressive character. Its clinics manifestations are expresses at articulations, and eventually it can express itself by a systemic mode. Seeing the social necessity, health, and economic, was approved in the form of attachment of ordinance number 996 of September 30th, 2015, the Clinic Protocol and Therapeutic Guidelines – Rheumatoid Arthritis (CPTG - RA). To attend the population that was with the disease active between the moderate and serious level, and that had intolerance or not, they replied to the treatment already in progress. So, was adopted by CPTG a new medicine, the tofacitinib citrate (CT). This academic study is about an exploratory study, qualitative, comparative, that had begin after a bibliographic revision about rheumatoid arthritis, and its treatment, and documental that took as base the techniques orientations of the Health Ministry, and of the CPTG of RA. Been the RA considered a disease autoimmune and multifactorial, its development suffer the influence of hormones factors, environmental, and immunologic. To a confirmatory diagnostic of RA are necessaries found clinics and complementary exams as image, histopathologic, and laboratory. As a medical intervention, uses non-steroidal anti-inflammatory, corticoids, synthetic and biological drugs that can change the course of the disease, and immunosuppressive drugs. The TC stands out because it is the first Medicine Modulator of Course Disease (MMCD) with its oral administration, and its main collateral effect is the high infection of herpes zoster, in the most of the case, they are not serious. The commodity of the oral administration, dispensing a qualified person to administer it, and a cold camera to store, to be administrated in monotherapy, to be target of intranuclear action, are vantages of TC. As disadvantage has the increase of herpes zoster (HZ) infection and the high financial cost. CPTG – RA has a big interest to everyone when it is updated, and used following the requirements. The update of this protocol should be constant, adopting considerable medicines and conducts, deleting obsolete medicines conducts. Even though with the high cost of the TC, the government can reduce costs with its adoption to CPTG. In fact, the use of the TC is a positive evolution at the treatment to AR, but it is necessary a constant monitoring of the patients.