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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
9374929 Life events and disability in rheumatoid arthritis: a European cohort. 1997 Oct The objective was to study the relationship between life events (LE) and the clinical status of patients suffering from recently diagnosed rheumatoid arthritis (RA) in a 2 yr follow-up. As part of a multicentre European cohort study, 370 French and Dutch patients were questioned three times at 1 yr intervals about LE which had occurred in the previous year. Three criteria were used to quantify the degree of disease activity (Ritchie's index), the level of functional disability [Health Assessment Questionnaire (HAQ)] and perceived health [Overall Evaluation of Health (OEH)]. Total LE and desirable LE showed a weak negative correlation with the HAQ scores. On the other hand, death-related LE did not seem to modify patient status. The higher the number of health-associated LE, the greater the deterioration in HAQ and OEH scores. The results indicate that LE do not affect the course of early RA in a spectacular manner.
9501620 [Medical treatment of rheumatoid polyarthritis]. 1997 Nov 15 Treatment of rheumatoid arthritis must be instituted as early as possible when the diagnosis is established. In the severe forms, a treatment by a trained team allowing pluridisciplinar coping is needed. The general practitioner takes an important place in this team. The treatment of rheumatoid arthritis includes five points: information of patient, medico-psychological approach, local and general treatments, rehabilitation and sometimes surgery. Due to the heterogeneity of rheumatoid arthritis, the therapeutic strategy is adapted according to the evolution, the benefice/risk ratio and the prognostic factors.
10685830 On variability of effects for a metaanalysis of rheumatoid arthritis radiographic progress 2000 Feb Variance of an outcome that is the topic of a metaanalysis may be estimated in a variety of ways. Variances are also not used in the same way in every metaanalysis. The metaanalysis may be of a single measure expressed in its original units, or of several such measures simultaneously, or it may be done using unitless effect sizes. We present some observations and practical recommendations on the estimation and use of variances relating to these several approaches to metaanalysis, as they may apply in a metaanalysis of radiographic progression in rheumatoid arthritis.
9501619 [Course, follow-up and prognosis of rheumatoid polyarthritis]. 1997 Nov 15 Rheumatoid arthritis is the more frequent chronic inflammatory arthritis. It is a potentially severe disease which causes a functional handicap in nearly half the patients 10 years after the first clinical symptoms. However rheumatoid arthritis is a heterogenous disorder and no prognostic factors are universally accepted and validated. Clinical and biological data collected to date have provided a limited amount of information. Nevertheless, erythrocyte sedimentation rate, C reactive protein and rheumatoid factor titer appeared to be the more powerful available indicators or prognosis at the early stage of the disease. Recent studies strongly suggests that some autoantibodies and mainly genetic markers (HLA-DRB1 alleles) could be correlated with disease severity. Consequently, it would appear possible to distinguish immunogenetically homogeneous subpopulations of patients with rheumatoid arthritis. Serum concentrations of specific cartilage and bone molecules reflecting tissue turnover and metalloproteinases could correlate to rate of joint destruction. Finally a combination of the most pertinent markers could determine a "score of severity" of the disease.
9921004 [Comparative study of the effects of auranofin and aurothiomalate on laboratory and clinic 1998 Is there any significant difference in the effect and tolerance of the gold salts applied peroral and intramuscular in patients with rheumatoid arthritis (RA)? 97 patients with RA have been included in the research. Group used auranofin perorally comprised 30 patients with RA, 25 women and 5 men. Their average age was 53.4 years, the average disease course was 9.06 years. Group used aurothiomalate parenterally comprised 30 patients with RA, 23 women and 7 men. Their average age was 52.5 years, the average duration of their illness being 10.87 years. Control group comprised 37 patients with RA, 27 women and 10 men. Their average age was 58.2 years, the average disease course was 8.3 years. They did not use any "second line drug" or corticosteroids. During a six-month (26 week) continuous application of the gold salts (perorally and parenterally) the following parameters were observed in regular intervals: the erythrocyte sedimentation rate, the hemoglobin level in the serum, the C-reactive protein. Ritchie index, the PIP extent of the fist joints and the morning stiffness span of the small fist joints. The tolerance of the gold salts has also been controlled. The results have shown that there is no any significant difference between two forms of the gold salts in patients with RA. The statistical processing of data indicated that auranofin and aurothiomalate have significant effect on all controlled parameters. As regard of the side effects, patients accepted aurothiomalate better than auranofin.
9379248 Acute infectious arthritis. 1997 Sep Infectious arthritis is one of the few rheumatologic emergencies. Significant morbidity and mortality can occur if treatment is delayed. A high index of suspicion is required when a patient presents with an acute arthritis of one or several joints. Treatment, which is multifaceted, can prevent permanent joint dysfunction.
11669018 [Pulmonary changes in rheumatoid arthritis]. 2001 Jul A 78-year-old smoker with a medical history of rheumatoid arthritis (RA) diagnosed 23 years before death and treated for 10 years by sulfasalazine followed by 7 years of therapy by purine antimetabolite (AZAMUN, Leiras Co.). Two years before his death chemotherapy was added to treat a low grade malignant lymphoma. Pulmonary changes revealed during autopsy consisted of diffuse interstitial fibrosis, diffuse alveolar damage in its acute to subacute phase, and massive multiple bilateral ossifications. The possible side effect of RA treatment on pulmonary tissue is discussed. Post mortem low-voltage X-ray examination appears as a method which may contribute to the accurate distribution and correct diagnosis of multiple pulmonary ossification.
9465379 [Patient-centered evaluation of illness outcome in musculoskeletal diseases: selection and 1997 Oct Effectiveness research, economic evaluation, epidemiologic studies of disease consequences and clinical quality management all rely on standardized assessment of disease consequences with psychometrically sound questionnaires. For scientific, ethical and economical reasons, careful selection and evaluation of instruments is critical. Selection of instruments includes searches of medical databases (e.g. MEDLINE), testing of face-validity (does the instrument measure what we intend to measure?), and compatibility (is the instrument used internationally?). Evaluation of instruments includes the assessment of reliability, internal consistency and sensitivity. Most important is careful consideration of the practical usefulness (Interpretation of scores and scales, acceptance in the study population). Contact with instrument developers is advisable (Copyright issues, scoring, current version).
9088523 Can we predict aggressive disease? 1997 Feb This chapter will describe the reasons why prognostic factors that predict aggressive disease are helpful and what the problems are in interpreting studies in this field. A summary of cohort studies on prognosis of patients with early rheumatoid arthritis are presented. This is done separately for studies predicting radiographic damage, functional outcome and mortality. The overall conclusions of these studies and the value they have for the clinician are demonstrated.
9608324 Molecular biology of cartilage and bone destruction. 1998 May Molecular biology has provided various new insights into the mechanisms operative in the pathogenesis of rheumatoid arthritis. Reflecting the unique character of rheumatoid synovium, advances have been achieved addressing the molecular changes taking place at the area of interaction between the aggressively growing synovium and the articular cartilage and bone. Key issues in the review period addressing this interaction were hyperplasia of rheumatoid arthritis synovium, mechanisms of activation and cell cycle regulation of synovial fibroblasts, pathways of synovial attachment to cartilage and bone, and the regulation of matrix-degrading enzymes.
9002036 Problems complicating the genetic epidemiology of rheumatoid arthritis. 1997 Jan I review problems inherent in considering the genetic epidemiology of rheumatoid arthritis (RA). The major area of concern is in case definition, both in assigning criteria and in establishing time of onset of disease, since presentation fluctuates throughout life. Other problem areas include selection of case and controls and the appropriate approach to analysis. Awareness of the problems in study design and conduct is fundamental to undertaking valid studies in this area.
9672991 Cigarette smoking and pulmonary diffusion defects in rheumatoid arthritis. 1998 The pathogenesis of lung disease in rheumatoid arthritis (RA) has still to be defined. Risk factors associated with lung involvement in RA were investigated by means of pulmonary function studies in 40 RA patients without apparent lung disease. A decreased carbon monoxide (CO) diffusion capacity indicative of interstitial lung disease (ILD) was the main pulmonary function defect found in the first 20 patients. The occurrence was associated with current cigarette smoking. This association was confirmed in a case control study performed subsequently. These data suggest that ILD in RA is stimulated by smoking and provide an additional argument that modification of smoking behaviour in RA patients might lead to less severe complications.
9479876 A case report of a patient who has pure red cell aplasia and rheumatoid arthritis. 1997 Dec Pure red cell aplasia (PRCA) as an extra-articular manifestation of rheumatoid arthritis (RA) is rare. In the present report a 40-year-old female patient, with a 4-year-history of severe anemia and pain in the small joints of the hands, was diagnosed as having PRCA by bone marrow (BM) examination. Antithymocyte globulin (ATG), methylprednisolone and cyclosporin A (CSA) were used for the treatment of PRCA. The patient's hematological values responded within 6 months but pre-existing arthralgia continued, although with some relief. The patient subsequently fulfilled the criteria for diagnosis of RA at the 16th month. A review of nine published case reports on the coexistence of PRCA with RA revealed the initial diagnosis as RA. In our case, as the initial symptoms and findings were not sufficient for the diagnosis of RA, we therefore conclude that PRCA preceded RA. Although CSA was curative in the treatment of PRCA it could not prevent the full diagnostic features of RA.
10077991 [Chemokines and Chemokine receptors in collagen diseases]. 1999 Feb The chemokine is a new class of cytokine. Now, more than 30 members of chemokine superfamily and 15 members of chemokine receptors (CXCR1-4, CCR1-8, CX3CR, CCR) have been identified. They were shown to be involved in the inflammatory response. The chemokine is classified into four subgroups (CXC, CC, C and CX3C). The local production of IL-8, MCP-1 and RANTES in rheumatoid inflamed joints has been reported. The predominance of several chemokines in other collagen diseases, such as SLE, systemic sclerosis and myositis is also described. Therefore, the inhibition of chemokines or chemokine receptors might be novel targets for various human disease, including collagen diseases.
9782813 A comparison of the Futuro wrist orthosis with a synthetic ThermoLyn orthosis: utility and 1998 Jun OBJECTIVE: To compare the short-term utility and clinical effectiveness of the commercial-made Futuro wrist orthosis with a newly developed, custom-made ThermoLyn wrist orthosis. METHODS: Using a randomized cross-over trial, 10 patients with rheumatoid arthritis used each of the two orthoses for two weeks. Outcome measures were patients' judgments with respect to different statements about utility and clinical assessments including pain and swelling of the wrist and finger joints, range of motion of the wrist, and grip strength. At the end of the study the patients were asked which of the two orthoses they preferred and why. RESULTS: Patients tended to favor the Futuro wrist orthosis with respect to pain relief and to handling the orthosis. The visual analog scale score of the appearance of the ThermoLyn wrist orthosis was a little higher than that of the Futuro wrist orthosis, but the difference was not statistically significant. Clinical parameters such as pain in the wrist, swelling of the wrist and finger joints, and movements of the wrist showed that the Futuro orthosis tended to be more effective than the ThermoLyn orthosis. None of the differences reached statistical significance. At the end of the study, 5 patients preferred the Futuro and 5 patients the ThermoLyn wrist orthosis. Arguments in favor of the ThermoLyn orthosis were better hygiene, stability, and no need to remove the orthosis during dirty and wet conditions. Arguments in favor of the Futuro orthosis were greater suppleness and freedom of movement. CONCLUSIONS: The ready-made fabric Futuro wrist orthosis appears to be as good as the more expensive individually made synthetic ThermoLyn wrist orthosis with respect to short-term utility and clinical effectiveness. The conditions under which the orthosis will be worn will help to decide which orthosis is the best for the patient. In the event that the patient wants to use the orthosis in wet and dirty conditions, the ThermoLyn wrist orthosis is a good alternative to the Futuro wrist orthosis.
11469523 Effect of treatment on the outcome of very early rheumatoid arthritis. 2001 OBJECTIVE: To evaluate the effect of treatment on the outcome of very early RA. METHODS: In a 3-year prospective study of 27 patients with very early RA (VERA) (symptoms <4 months before diagnosis) and 122 patients with early RA (symptoms between 4-24 months) the effect of active treatment on the clinical picture, functional capacity, and radiological progression was evaluated. RESULTS: Initially VERA patients had a more active clinical picture and worse functional capacity. Despite a higher number of DMARDs used in VERA patients, C-reactive protein and Ritchie index remained significantly higher in these patients (although significant improvement occurred). They also had a more rapidly progressive disease (higher Larsen score/month of symptoms) during pre-treatment period, the progression of which was retarded with early, active DMARD therapy. By the end of 3 years, the rate of progression ran parallel in both groups. CONCLUSION: Active treatment had an impact on the rate of radiological progression and clinical activity but not on the functional outcome in patients with initially active RA of short duration.
9235649 [The characteristics of arterial hypertension in rheumatoid arthritis]. 1997 Among 138 inpatients with rheumatoid arthritis (RA) 18.1% had arterial hypertension (AH). AH in RA appeared in subjects with hereditary predisposition to AH. The presence of AH in RA is associated with rheumatoid vasculitis as the number of extraarticular manifestations of RA in AH patients is higher and is unrelated to renal affections. The levels of free radical lipid peroxidation in plasma and saliva are determined to a large extent by the hereditary factor in RA and are related to the presence of predisposition to AH.
10849916 [The case of severe craniocervical dislocation due to rheumatoid arthritis]. 2000 Jan The authors describe a case of craniocervical dislocation secondary to rheumatoid arthritis producing important canal narrowing: ventrally by migrated odontoid and dorsally by posterior arch of C-1 with medullary compression. Symptoms of hyperreflexia, spasticity and left hemiparesis with Babinski sign were present. SURGICAL PROCEDURE: transoral odontoidectomy was performed followed by suboccipital approach, C-1 laminectomy and occipitocervical fixation (Olerud device and bone graft). Outcome with neurologic improvement. CONCLUSIONS: Transoral odontoidectomy combined with occipitocervical decompression and fixation is effective approach for treatment of severe craniocerebral dislocation. Its advantages: ventral and dorsal decompression combined with immediate stabilisation.
11077529 [The use of plasmathrombocytapheresis in the combined treatment of rheumatoid arthritis]. 2000 Sep One of the possible ways to correct platelet hemostasis in active rheumatoid arthritis (RA) is inclusion of plasmathrombocytapheresis (PTCA) into complex therapy. This operation is pathogenically approved in changes of platelet morphofunctional state. To perform PTCA it is possible to use the blood fractionator BF-3.5. PTCA represents the transfusiologic operation consisted of premedication, vascular approach, hemodilution, blood stabilization and the main part of operation. The positive effect during the PTCA use according to our program was achieved in 93 +/- 2% of the cases. PTCA can be considered as the procedure of choice in complex therapy of RA patients with disorders in platelet chain of hemostasis that permits to decrease rapidly the disease activity and to reduce the period of patient hospital treatment.
9972990 A proposed 30-45 minute 4 page standard protocol to evaluate rheumatoid arthritis (SPERA) 1999 Feb A proposed 4 page, 30-45 minute standard protocol to assess rheumatoid arthritis (SPERA) is described that includes all relevant measures of inflammatory activity such as joint swelling, measures of joint damage such as joint deformity, and outcomes such as joint replacement surgery, to monitor patients in longterm observational studies. Forms are included: (1) a patient self-report modified health assessment questionnaire (MHAQ) to assess function, pain, fatigue, psychological distress, symptoms, and drugs used; (2) assessor-completed forms: "RA clinical features" --criteria for RA, functional class, family history, extraarticular disease, comorbidities, joint surgery, radiographic score, and laboratory findings. (3) A 32 joint count with 5 variables: (a) a "shorthand" normal/abnormal so that normal joints require no further detailed assessment; (b) tenderness or pain on motion; (c) swelling; (d) limited motion or deformity; (e) previous surgeries; physical measures of function, i.e., grip strength, walk time, and button test. (4) Medication review of previous disease modifying antirheumatic drugs (DMARD), work history, and years of education. The forms allow cost effective acquisition of all relevant measures of activity, damage, and outcomes in routine clinical care, and allow recognition that measures of activity may show similar or improved values over 5-10 years, while measures of damage and outcomes indicate severe progression in the same patients. The SPERA is feasible to acquire most known relevant measures of activity, damage, and outcomes in RA in 30-45 min in usual clinical settings, to provide a complete database for analyses of longterm outcomes.