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Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
9171722 An examination of the self-care needs of clients with rheumatoid arthritis. 1997 May Investigators used Orem's self-care deficit theory to guide their examination of the needs of clients with rheumatoid arthritis. Several research questions, which were guided by the proposition that universal self-care requisites are influenced by a person's age, gender, and health state, were addressed. Interviews with 59 clients with rheumatoid arthritis were tape recorded, and transcripts of the interviews were analyzed by two experts using assigned codes of universal self-care requisites (USCRs). The most frequently reported USCRs for these clients with rheumatoid arthritis were the maintenance of a balance between activity and rest (83%), the promotion of normalcy (66%), and prevention of hazards (58%). Clients' health state and age, but not their gender, affected USCRs. The clinical and theoretical implications of the findings are described in light of clients' rehabilitation.
11148995 Autoimmune cholangiopathy associated with rheumatoid arthritis. 2000 Nov We herein describe a patient with autoimmune cholangiopathy complicated with rheumatoid arthritis. A 58-year-old female was admitted to our hospital due to complications of arthralgia in her fingers, shoulders, elbows, knees and ankles. She presented with abnormally elevated levels of transaminases, alkaline phosphatase and was also negative for hepatitis B virus, hepatitis C virus and the serum mitochondrial antibody test, but had high titers of serum antinuclear antibody, rheumatoid factor and rheumatoid arthritis hemagglutination. A liver biopsy specimen showed chronic non-suppurative destructive cholangitis. She was thus diagnosed to have autoimmune cholangiopathy and rheumatoid arthritis. She began treatment with prednisolone 40 mg per day. After 20 days of steroid therapy, her hepatic function tests improved and the arthralgia symptoms disappeared. This is, to our knowledge, the first case of autoimmune cholangiopathy associated with rheumatoid arthritis, in which both symptoms improved with steroid therapy.
9088525 Treatment of early rheumatoid arthritis patients with slow-acting anti-rheumatic drugs (SA 1997 Feb Treatment with slow-acting anti-rheumatic drugs (SAARDs) is nowadays initiated earlier in the disease course, preferably before any radiographic damage has occurred. SAARDs have the ability to decrease inflammatory synovitis as measured by clinical and laboratory variables, and there is some evidence that they improve physical function and decrease the progression rate of joint damage in patients with early rheumatoid arthritis. There is a clear difference in survival time between the various SAARDs. The efficacy/toxicity profiles of the SAARDs show equal variation. Rank order of prescription or disease duration may have an effect on drug survival, but different treatment strategies are also important sources of variation. Efficacy might be improved by combining different SAARDs (starting with a multiple drug regimen, or adding a drug to the first one), but further research is necessary to prove this hypothesis.
11022930 Association between dinucleotide repeat in non-coding region of interferon-gamma gene and 2000 Sep 2 BACKGROUND: Rheumatoid arthritis ranges from a mild, non-deforming arthropathy with little long-term disability to severe, incapacitating, deforming arthritis which may be refractory to conventional disease-modifying agents. Epidemiological studies show an important genetic influence in rheumatoid arthritis, and MHC region genes and cytokine genes within and outside this region have been considered as candidates. We did a case-control study to test whether polymorphisms in the interferon-gamma gene are associated with severity of rheumatoid arthritis. METHODS: Interferon gamma dinucleotide repeat polymorphisms were examined with quantitative genescan technology, and HLA-DR alleles were identified by PCR and restriction-fragment-length polymorphism analysis. We studied 60 patients with severe rheumatoid arthritis, 39 with mild disease, and 65 normal controls. FINDINGS: Susceptibility to, and severity of, rheumatoid arthritis were related to a microsatellite polymorphism within the first intron of the interferon-gamma gene. A 126 bp allele was seen in 44 (73%) of 60 patients with severe rheumatoid arthritis, compared with eight (21%) of 39 with mild disease (odds ratio 10.66 [95% CI 4.1-24.9]), and with eight (12%) of 65 normal controls (19.59 [7.7-49.9]). Conversely, a 122 bp allele at the same locus was found in four (7%) patients with severe disease compared with 25 (64%) of those with mild disease (0.04 [0.01-0.1]) and with 52 (80%) of controls (0.018 [0.005-0.06]). INTERPRETATION: This association may be valuable for understanding the mechanism of disease progression, for predicting the course of the disease, and for guiding therapy.
9137326 Incidence of ocular complications in rheumatoid arthritis and the relation of keratoconjun 1997 To investigate the incidence of ocular complications in patients with rheumatoid arthritis under modern modalities of treatment and find the relationship between its systemic activity and ocular complications, routine ophthalmological examinations were done as a prospective study in 111 consecutive patients including 89 inpatients and 22 outpatients with rheumatoid arthritis seen from April to May 1995, in a hospital with a special clinic for rheumatology. Keratoconjunctivitis sicca (secondary Sjögren's syndrome) was found in 19 patients (17.1%), scleritis in one patient (0.9%), central retinal vein occlusion in 2 patients (1.8%), and idiopathic retinal hemorrhage in 3 patients (2.7%). Patients with keratoconjunctivitis sicca had significantly higher titers of rheumatoid factor (Mann-Whitney's U-test, p = 0.0048), higher levels of IgM (p = 0.0484), and lower levels of HDL-cholesterol (p = 0.0191), compared to patients without it. The incidence of ocular complications was comparable to the previous studies and keratoconjunctivitis sicca should be considered in patients with high titers of rheumatoid factor.
11755617 Interferon gamma gene polymorphism and susceptibility to, and severity of, rheumatoid arth 2001 Dec 15 A strong association between an interferon gamma (IFN-gamma) gene polymorphism and rheumatoid arthritis susceptibility and severity has been reported in a case-control study. We investigated this polymorphism in 103 patients with early rheumatoid arthritis and 130 controls. Severity of rheumatoid arthritis was measured after 4-year follow-up with a validated radiographic score. The median radiographic score in patients increased from 1 (IQR 0-4) to 11.5 (2-35) over the 4-year follow up. The distribution of IFN-gamma alleles did not differ between patients and controls, and the distribution of radiographic scores did not differ among patients carrying the different IFN-gamma alleles. We have failed to confirm the association between the IFN-gamma gene polymorphism and rheumatoid arthritis susceptibility or severity.
10874651 Direct and indirect costs of rheumatoid arthritis to an employer. 2000 Jun This study is among the first to estimate the overall economic burden of rheumatoid arthritis (RA) from an employer perspective. The annual, per capita cost of RA was determined for beneficiaries of a major employer by analyzing medical, pharmaceutical, and disability claims data. The incremental costs related to RA were determined by matching RA patients to a case-control group of individuals with no recorded RA treatment. The utilization of health care services as well as the rate of disability among RA patients was substantially higher than among the controls. For example, annual, per capita employer expenditures for RA employees with disability were almost 3 times those for their controls ($17,822 vs $6131, respectively). Treatment to address not only the severity but also the progression of RA may substantially reduce overall employer expenditures for this disease.
11568753 Rheumatoid neutrophilic dermatitis in a woman with seronegative rheumatoid arthritis. 2001 Oct Rheumatoid neutrophilic dermatitis (RND) is an unusual cutaneous reaction in patients with rheumatoid arthritis (RA). RND is characterized by symmetric, erythematous papules, plaques, nodules, and urticarial lesions often located over the joints, extensor surfaces of the extremities, or the trunk. This entity demonstrates an intense neutrophilic dermal infiltrate without vasculitis. All patients previously reported with RND had severe RA with relatively high titers of rheumatoid factor when tested. A 67-year-old woman had a 2-month history of multiple, tender, 4 to 8 mm erythematous, crusted papules and nodules that occurred in clusters on her anterior thighs, knees, and legs. She suffered from severe disabling seronegative RA. RND may complicate seronegative RA.
10916474 [Palindromic rheumatism]. 2000 May 20 BACKGROUND: Palindromic rheumatism is an inflammatory rheumatic disease characterised by recurrent attacks of arthritis confined to one or more peripheral joints. Each episode of arthritis rarely lasts more than 14 days, and subsides without leaving any residues. MATERIAL AND METHODS: Three patients with palindromic arthritis are presented, and the literature reviewed. RESULTS: The clinical and laboratory characteristics of the three patients were similar to those generally described for palindromic rheumatism. Two patients developed seropositive rheumatoid arthritis and one patient developed chronic seronegative polyarthritis. INTERPRETATION: Palindromic rheumatism may evolve into chronic polyarthritis.
10550436 [The unstable radiocarpal joint in rheumatoid arthritis]. 1999 Oct The inflammation of the wrist occurs very early in Rheumatoid arthritis. In cases of wrist deviation the biomechanics of the hole hand are affected. Carpal collapse will severely influence the range of motion (ROM) of the fingers. Operative techniques of how to maintain hand function are discussed. There are different procedures available - partial arthrodesis, arthrodesis and arthroplasty.
10574404 Rheumatoid arthritis and simultaneous aortic, mitral, and tricuspid valve incompetence. 1999 Oct 31 We describe a 72-year-old woman with aortic, mitral, and tricuspid valve incompetence secondary to a rheumatoid granulomata. The cardiac valvular lesions developed simultaneously and deteriorated rapidly. The patient died after a transient relief of symptoms by high dose steroid therapy.
11434472 Why do patients with rheumatoid arthritis use alternative treatments? 2001 The aim of this study was to analyse the characteristics of patients with rheumatoid arthritis (RA) who make use of alternative or complementary medicine (CM). Two hundred and sixty-two randomly chosen patients with RA filled out self-assessment health status and pain questionnaires. Differences between the group of patients making use of both CM and conventional treatment (n = 52) and the group of patients who relied only on conventional treatment prescribed by their rheumatologists (n = 210) were explored with respect to demographic characteristics, duration of RA, levels of physical, psychological and social functioning, and pain-coping behaviour. We found that female patients used CM more often than did male patients, and those who used CM were younger than those who did not. There were no differences with respect to duration of RA, physical, psychological or social functioning or pain coping; however, the perceived impact of RA on several domains of life was higher in patients who used CM than in those who did not. Nevertheless, the patient groups did not differ in terms of medical consumption, except that those who used CM visited medical specialists for RA-related complaints less than those who relied only on conventional treatments. We concluded that the higher impact of RA, in the absence of worse disease, perceived by users of CM in several domains of life, especially psychosocial functioning, could be the reason they use CM. This suggests that CM cannot be substituted by additional conventional treatment prescribed by the rheumatologist, but rather by psychosocial intervention.
9710890 Interleukin-1 receptor antagonist. 1998 Aug There are three members of the IL-1 gene family: IL-1 alpha, IL-1 beta, and IL-1ra, IL-1 alpha, and IL-1 beta are both antagonist molecules with many proinflammatory effects. IL-1ra is an antagonist molecule that can inhibit the effect of IL-1 alpha and IL-1 beta by specifically blocking the IL-1 receptor on target effector cells. IL-1 alpha and IL-1 beta are considered to be pivotal cytokines in the pathogenesis of many inflammatory diseases. Anti-IL-1 treatment has been shown to cause amelioration of arthritis in animal models and in RA, suggesting that IL-1ra may be an important therapeutic option in the future management of RA.
9051854 Clinical, laboratory, and radiographic features of rheumatoid arthritis with and without n 1997 Jan To determine the significance of nodules in rheumatoid arthritis, we reviewed the medical records of 420 patients who underwent standardized clinical, laboratory, and radiological investigations during a hospitalization for rheumatoid arthritis between January 1, 1981 and December 31, 1994. Sixty-six patients (16%) had nodules and 354 (84%) did not. Age and gender distributions were similar in the two groups. Disease duration was significantly longer in the nodular than in the nonnodular group (11.3 +/- 9.4 years versus 7.6 +/- 7.3 years; P = 0.0003). When patients were stratified into five-year disease duration groups, dryness of the eyes and mouth was found to be more common in the nodular group, with the difference being largest during the first five years. Patients with nodules were more likely to have vasculitis irrespective of disease duration (odds ratio, 6.08; P = 0.028). Lee's and Ritchie's indices and radiographic alterations were more severe in the nodular group, whereas tests for inflammation were not significantly different. Patients with rheumatoid factors accounted for a larger proportion of the nodular than of the nonnodular group (odds ratio 2.48; P = 0.017). When patients were dichotomized based on latex test results, nodules were not significantly associated with antiperinuclear factor or antikeratin antibodies, whereas patients with nodules were significantly more likely to have vasculitis (odds ratio 5.3; P = 0.035), antinuclear factors (odds ratio 1.82; P = 0.043), and cryoglobulinemia (odds ratio 4.86; P = 0.0029). As compared with nonnodular rheumatoid arthritis, nodular rheumatoid arthritis was associated with more severe extraarticular disease, faster radiographic progression and a greater likelihood of rheumatoid factor and antinuclear antibody production. Each of these characteristics was associated with the presence of nodules independently from disease duration and rheumatoid factor positivity.
10371280 Socio-economic consequences of rheumatoid arthritis in the first years of the disease. 1999 May OBJECTIVE: Few data have been presented to document the impact of rheumatoid arthritis (RA) on socio-economic well-being. In this study, exact figures on socio-economic consequences were assessed. METHODS: The socio-economic consequences were studied in an inception cohort (186 early RA patients, mean disease duration 3 yr) by measuring the change in work capability, income, rest during the daytime, leisure time activity, transport mobility, housing and social support occurring in the first years of the disease. RESULTS: For 89% of the patients, RA had an impact on one of the socio-economic items; for 58%, at least three of these items were affected simultaneously. Work disability appeared to be 4-15 times higher than in the general population. After 3 yr, 42% of the patients were registered as work disabled. Nearly a quarter of the patients experienced income reduction. Over 40% of the patients claimed extra rest during the daytime. Leisure activity changed towards activities with a lower joint load. There was a decline in transport mobility for 52% of the patients. Social support increased strongly. CONCLUSIONS: Socio-economic change already presents in the first years of RA and appears to be influenced by age, gender, marital status and work disability. Furthermore, physical limitation appeared to be predictive for work-related income reduction, reduced transport mobility and development of social dependency.
10821370 Methotrexate effects in patients with rheumatoid arthritis with cardiovascular comorbidity 2000 May 6 Methotrexate, an antirheumatic drug that may increase serum homocysteine, significantly increases mortality in patients with rheumatoid arthritis and cardiovascular comorbidity.
9569074 Absence of an association between mannose-binding lectin polymorphism and rheumatoid arthr 1998 Feb It has been proposed that mannose-binding lectin (MBL) interactions with agalactosyl forms of IgG immunoglobulins found in rheumatoid synovial fluid might lead to enhanced complement activation, an important mediator of the joint damage in rheumatoid arthritis (RA). In order to investigate this possible link between increased MBL-mediated activation of complement and perpetuation of rheumatoid synovitis, we have compared the frequency of an allelic form of MBL, known to be incapable of activating complement, in a group of hospital patients with severe RA and control subjects. No evidence was found to support an association between the presence of this MBL allele and protection from rheumatoid disease; genotype frequencies were similar in both groups. This suggests that complement activation via MBL-agalactosyl IgG complexes is unlikely to play a major role in the pathophysiology of RA.
10225740 Efficacy of filtration leukocytapheresis on rheumatoid arthritis with vasculitis. 1997 Aug The present study was designed to determine the efficacy of filtration leukocytapheresis (LCAP) in the treatment of rheumatoid arthritis (RA) with vasculitis. Nine RA patients with vasculitis were studied by the Malignant RA Collaborative Group formed by 8 clinical centers. A total of 7 filtration LCAP procedures using the Cellsorba column (Asahi Medical Co., Ltd., Tokyo, Japan) were performed with 1 week intervals between treatments. During each apheresis procedure, 3,000 ml of blood was filtered and returned to the patient at a flow rate of 50 ml/min for 60 min. In addition to the amelioration of arthritis, the improvement of extraarticular symptoms associated with rheumatoid vasculitis such as polyneuritis, skin ulcers, digital gangrene and rheumatoid nodules was obtained. In contrast, no improvement was observed in interstitial pneumonia or lung fibrosis. LCAP could be an optional modality for the treatment of RA with vasculitis.
9494994 General overview of rehabilitation in the rheumatoid patient. 1998 Feb This article provides a general overview of rehabilitation in the rheumatoid patient. It discusses the physical therapy management of both the systemic musculoskeletal involvement of RA and of the specific postoperative rehabilitation associated with total joint arthroplasty. It is intended to highlight the major components of treatment and to guide the clinician in assessing these challenging, yet rewarding cases. Its emphasis is to support a multidisciplinary approach to patient care.
10652648 Pharmacotherapeutic combination strategies with disease-modifying antirheumatic drugs in e 1999 Dec Pharmacotherapy is still the cornerstone in the management of rheumatoid arthritis (RA). Due to several reasons the pharmacotherapeutic strategy has changed dramatically in the past decades. It has become clear that in most cases single treatment with disease modifying antirheumatic drugs (DMARDs) is insufficient to control the disease on the long term. This is the main reason why combinations of second-line agents are increasingly being used in the treatment of established RA. Many different ways of prescribing combination treatment and a large number of different combinations have been published. However definite conclusions which drugs to combine or what strategy to apply are difficult to make as solid studies which enable these conclusions are sparse. Several studies have shown that the best opportunity to achieve a good response is to use a set-up approach, in addition different studies have shown that corticosteroids do have a profound effect on disease activity variables.