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ID PMID Title PublicationDate abstract
9690903 Orbital lymphoma of mucosa-associated lymphoid tissue in a patient with rheumatoid arthrit 1998 May A 75-year-old male with rheumatoid arthritis complained of proptosis of the left eye. On examination, 6-mm left proptosis was seen. A hyperemic and swollen optic disc was visible in the left fundus. Laboratory test results showed positive rheumatoid factor. Computed tomography and magnetic resonance imaging showed a mass lesion in the left orbit. Histopathologic study of the excised specimen revealed centrocyte-like cells and lymphoplasmocytoid cells. Immunohistochemical study showed positive staining of CD 20 (B cells) and lambda light chain (immunoglobulin). The combination of rheumatoid arthritis and lymphoma of mucosa-associated lymphoid tissue in the orbit, as demonstrated in our patient, is rare.
10328573 Disease-modifying antirheumatic drugs. 1999 May Rheumatologists now seem to accept that early treatment of patients with rheumatoid arthritis with disease-modifying antirheumatic drugs is required if erosions are to be prevented. Methotrexate remains the most popular disease-modifying antirheumatic drug and is used in the most popular combination treatments, although the dose needs to be reduced in the elderly and those with renal dysfunction. The combination of sulfasalazine, methotrexate with reducing high-dose prednisolone, is demonstrated to be cost-effective in patients with rheumatoid arthritis, but although several other combinations have been reported effective in patients with rheumatoid arthritis, most trials do not have the power to provide a definitive answer as to the best combination available, if one exists.
11094453 Insights into rheumatoid arthritis derived from the Sa immune system. 2000 The Sa system is a recently described immune system that has a specificity and positive predictive value of nearly 100% for rheumatoid arthritis (RA) in Asia, Europe and the Americas. Its sensitivity of 30-40% suggests that it identifies a subset of RA patients. Anti-Sa antibodies are present from disease onset and are predictive of disease severity. The immune reactants are plentiful in the target tissue: antigen is present in the synovium, IgG antibody in the fluid. Immunologically, Sa is a hapten-carrier antigen in which vimentin is the carrier and citrulline is the hapten. The citrullination of vimentin is closely related to apoptosis, and citrullinated vimentin is extremely sensitive to digestion by the ubiquitous calpains. Nevertheless, Sa is found in only a few cell lines. Calpastatin, the natural specific inhibitor of calpains, is also a RA-associated, albeit non-specific, autoimmune system. Is it possible that calpain-related apoptotic pathways could be prominent in cells containing Sa? The task is to reconcile the specificity of Sa/citrullinated proteins in a multifactorial and polygenic disease such as RA.
9366431 Treatment of a newly established transgenic model of chronic arthritis with nondepleting a 1997 Nov 15 We established a novel animal model for rheumatoid arthritis (RA) by following backcrossing to DBA/1 of (SWR/J x DBA/1)F1 TCR-beta Tg mice, previously reported to be highly susceptible to collagen-induced arthritis. These mice evolved, upon collagen type II immunization, into a chronic arthritis that histopathologically resembles RA. The availability of such a model prompted us to study the role of CD4+ T cells throughout the evolution of disease. Here, we show that administration of nondepleting anti-CD4 not only prevented the evolution of disease but also treated established arthritis. Moreover, functional analyses of T cells isolated from anti-CD4-treated mice demonstrated that the mechanism of protection is not achieved by suppression of the Th1 population but is mediated by induction of collagen type II-specific T cell anergy. Our study suggests that: 1) CD4+ T cells have a fundamental role both in the induction and in the perpetuation of disease; 2) targeting T cells may be an appropriate therapeutic option; and 3) a suitable and well-balanced anti-CD4 treatment may be a valid approach to the control of RA.
9113293 Prospective analysis of total shoulder arthroplasty biomechanics. 1997 Apr A prospective clinical trial was undertaken to evaluate preoperative and postoperative shoulder motion clinically and roentgenographically in 9 patients with severe arthritis who underwent a total shoulder arthroplasty. The relative contributions of glenohumeral and scapulothoracic motion to scapular plane abduction were determined by obtaining roentgenograms of the shoulder region with the arm in five positions before surgery and at follow-up. Before surgery, the ratio of glenohumeral to scapulothoracic motion was 0.32:0.68, or 1:2, compared with a normal ratio of 2:1, meaning that for every degree of glenohumeral movement there were 2 degrees of scapulothoracic motion. At follow-up, statistically significant improvements in pain, motion, and function were found. However, regression analysis determined the ratio of glenohumeral to scapulothoracic motion to be 1:1.3. An abnormal ratio before surgery was associated with significant pain and decreased motion in the shoulder and represented the patients' attempt to immobilize the glenohumeral joint for pain relief and maximize shoulder movement with scapulothoracic motion. The abnormal glenohumeral-to-scapulothoracic ratio after total shoulder arthroplasty indicates that for a given amount of arm abduction, less motion occurs between the prosthetic components than in a normal glenohumeral joint. Abnormal shoulder biomechanics appear to be a function of the underlying disease process and were not restored after total shoulder arthroplasty.
9712084 CC chemokine receptor 5 polymorphism in rheumatoid arthritis. 1998 Aug OBJECTIVE: Some chemokine receptors have been shown to be co-receptors for human immunodeficiency virus (HIV-1). A 32 base pair deletion allele in the CC chemokine receptor 5 gene (CCR5 delta32 allele) affects both transmission of HIV-1 and acquired immunodeficiency syndrome (AIDS)-free survival. Chemokines are suggested to be critical for establishment of inflammatory processes in autoimmune diseases such as rheumatoid arthritis (RA). We hypothesized that the defective allele may modulate the inflammatory process in RA. METHODS: Using polymerase chain reaction methods, we investigated the significance of the CCR5 delta32 allele in 163 Danish patients with RA and monitored clinical and paraclinical variables. RESULTS: The gene frequency of the CCR5 delta32 allele (0.10) did not deviate significantly from healthy controls and from that reported in healthy Caucasian populations, nor did the distribution deviate from the Hardy-Weinberg predictions (131 wild type, 30 heterozygous, 2 homozygous for the deletion allele; p = 0.85). However, a significantly increased proportion of those carrying the deletion allele were negative for IgM rheumatoid factor (RF) compared to those homozygous for the normal allele (29 vs 9%; p = 0.007). The proportion of CCR5 delta32 allele carriers with swollen joints was decreased compared to those homozygous for the normal allele (35 vs 58%, respectively; p = 0.03), as was the duration of morning stiffness (median 0 vs 60 min, respectively; p = 0.0002). CONCLUSION: The CCR5 delta32 allele seems to have some influence on RA variables including RF, which suggests that inhibition of chemokine receptors might be a potential target for disease modifying therapy in RA.
9890515 Biological importance of glycosylation. 1998 Glycosylation is the primary cause of microheterogeneity in proteins (glycoforms). These reflect complexity at both molecular and cellular levels. Protein sugar prints are conserved and not random under normal physiological conditions. There are many potential functions of glycosylation. For instance, physical properties include: folding, trafficking, packing, stabilisation, protease protection, quaternary structure and organization of water structure. Properties relating to recognition and biological triggering are characterized by: weak interactions, multiple presentation and precise geometry. Many of the properties may only operate in a specific biological context. Changes in sugar prints may both reflect and results in physiological changes, e.g. cancer and rheumatoid arthritis. It is necessary, in many systems, to evaluate glycosylation. This requires accurate monitoring of sugar prints of using automated and predictive technology. Glycosylation often affords a sensitive means of monitoring pharmaceutical products for Quality Control.
11600744 Radiographic joint space in rheumatoid elbow joints. A 15-year prospective follow-up study 2001 Oct OBJECTIVE: To evaluate radiographically the humeroulnar (HU) and humeroradial (HR) joint spaces in patients with long-term rheumatoid arthritis (RA). METHODS: An inception cohort of 74 patients with RA were followed for 15 yr. At the end-point, 148 elbows were radiographed by a standard method. The HU and HR joint spaces were examined from the anteroposterior radiographs by measuring the shortest tangential distance in the middle of the joints. Destruction of the elbow joints, assessed with the Larsen method on a scale of 0-5, was studied in relation to the joint-space measurements. RESULTS: Mean (s.d.) HU joint space (n=148) in RA patients was 2.5 (1.1) mm, range 0-4 mm [2.9 (0.8) mm in men and 2.4 (1.1) mm in women]. Mean (s.d.) HR joint space (n=140) was 2.3 (0.9) mm, range 0-4 mm [2.5 (0.8) mm in men and 2.3 (1.0) mm in women]. HU and HR spaces of the affected joints (Larsen grades 2-5) [1.9 (s.d. 1.1) and 1.8 (0.9) mm respectively] were notably narrower than those of the unaffected (Larsen grades 0-1) joints [3.1 (0.7) and 2.9 (0.6) mm]. All the joints graded as Larsen 4 or 5 (n=13) had a value of 0 mm for both joint spaces. Both the HU and the HR joint-space narrowing was associated with increasing destruction (Larsen grading) of the joint. [r= -0.69 (95% CI -0.77 to -0.60) and r= -0.70 (-0.78 to -0.60)]. The monotonic narrowing was significantly increasing from unaffected (Larsen 0, 1), slightly (2), moderately (3) to severely (4, 5) affected joints (P<0.001). A step in this process occurred between Larsen grades 3 and 4, when the mean joint space diminished from 1.4 and 1.5 respectively to 0 mm. CONCLUSIONS: Joint-space narrowing is a frequent consequence of rheumatoid affection of the elbow joint. HR joint space decreases together with HU joint space; however, the HR joint space is already slightly narrower at the start. The narrowing is a rather late phenomenon, occurring only after erosive destruction. This should be borne in mind when using the Larsen method to evaluate changes in the elbow joint.
10415634 Androgenizing effects of cyclosporin A in rheumatoid arthritis. 1999 Jun 22 In order to determine the influence of CsA on whole peripheral androgen metabolism, we evaluated 14 patients with RA over a period of 12 months. Patients were treated with low-dose CsA (2.5-3.5 mg/kg/day). Other drugs influencing androgen metabolism were excluded. Plasma levels of Test and of 5 alpha-androstane-3 alpha, 17 beta-diol glucuronide (Adiol-G), an important peripheral Test metabolite, were analyzed. Each patient was monthly examined for the first three months, and thereafter every three months. At each visit, the number of swollen and tender joints, as well as the visual analogic scale of pain, were evaluated. The laboratory parameters of RA activity (ESR, CRP, Hb) were also monitored, along with some safety serological indexes. Statistical analysis was performed by using nonparametrical tests. After 12 months of treatment, an evident increase in mean plasma Adiol-G concentration was observed in patients of both sexes (women's basal levels +/- SE = 2.89 +/- 0.58 ng/mL vs. 12 months = 5.71 +/- 1.33 ng/mL; men's basal levels = 4.87 +/- 0.91 vs. 9.20 +/- 0.68, respectively) (p < 0.001). The increase was already statistically significant after 4-5 weeks of treatment in male patients (p < 0.01) and after 12-14 weeks in female patients (p < 0.05). All the patients experienced the side effect of a low-degree hypertrichosis after a mean period of 4-8 weeks. Concerning clinical parameters, a significant improvement (p < 0.05) of the number of swollen and tender joints was observed after 12 months, as well as a reduction of CRP levels. No statistically significant correlation between hormonal levels and clinical or laboratory indexes of disease activity was observed. In conclusion, the appearance of a dose-related hypertrichosis and the increase in plasma androgen metabolites (Adiol-G) in CsA-treated patients should be regarded as possible markers of the influence of CsA on peripheral androgen metabolism, at the level of target cells and tissues.
9340953 [Development and evaluation of a modified version of the Larsen method for evaluating roen 1997 May AIM OF THE STUDY: To develop and evaluate a modification of the Larsen scoring method aimed at a clear definition of the different grades and a better correlation of the numerical scale with the amount of joint destruction. DESCRIPTION OF THE METHOD: While the original method described by Larsen is based on a comparison with standard reference films the modification defines the different grades semiquantitatively by the amount of destruction of the joint surface: grade II is a destruction (erosion) of the joint surface of up to 25%, in grade III it is 26-50%, in grade IV 51-75% and in grade V over 75%. Grade I is characterized by soft tissue swelling and in addition subchondral osteoporosis and remains unchanged compared with the original method. 32 joints of the hands, wrists and forefeet are counted summing up to a total score of 0-160. Examples for different joints are given. EVALUATION OF THE METHOD: Standard ap-x-rays of hands, wrists and forefeet of 24 patients with early erosive rheumatoid arthritis at baseline (T0) and after 36 months (T1) were graded by two investigators (G.H. and R.R.). The difference of the scoring between both observers (inter-observer-difference) was related to the difference between the two timepoints (T0 and T1) in the same patient (intra-patient-difference) by means of a hierarchical analysis of variance (ANOVA). The intra-patient variance (from T0 to T1) was 259.3, which is 8 times greater than the inter-observer-variance of 32.1. The square root of intra-patient-standard deviation (16.1) and inter-observer-standard deviation (5.7) is 2.8. These data show that the progression between T0 and T1 is real. The method was easily applicable to patients in a 2-year-DMARD-trial with x-rays at baseline after 6, 12 and 24 months, showing a slowing of radiologic progression after month 6 under treatment with parenteral gold and methotrexate. CONCLUSION: The modification of Larsen's scoring method is a reliable measure to assess radiologic progression in patients with RA. Possibilities for further improvement are discussed.
9569079 Recommendations for the registration of drugs used in the treatment of rheumatoid arthriti 1998 Feb Rheumatoid arthritis (RA) is the commonest form of chronic inflammatory joint disease and a major target for symptom-modifying and disease-modifying drug therapy. New approaches to the treatment of RA using biological agents targeted to cellular receptors, cytokines and other mediators of inflammation, together with the availability of new methods of outcome assessment, make it timely to reconsider the classification of anti-rheumatic drugs and the requirements for the registration of new drug entities. Under the auspices of GREES (Group for the Respect of Ethics and Excellence in Science), a European Working Group of clinicians with experience in rheumatology, scientists and representatives from industry and national drug licensing authorities have formulated recommendations for the requirements for registration of anti-rheumatic drugs designed for symptom modification, structural modification and the suppression of inflammation, with particular emphasis placed on quality of life assessment by generic and disease-specific validated methods. This paper outlines the group's advice for pre-clinical testing, and Phase I, Phase II and Phase III trials to allow licences to be granted for each indication, while recognizing that a single drug may have reason to be approved under several headings.
10493668 Clinical reliability and validity of elbow functional assessment in rheumatoid arthritis. 1999 Sep OBJECTIVES: (1) To investigate the measurement characteristics of the Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment instruments, utilizing methodological criteria including feasibility, reliability, validity, and discriminative ability; and (2) to develop an efficient and disease-specific rating system for elbow function assessment (EFA) in adult patients with RA, using a combination of self-reported subjective items and objective measures, and comparing its characteristics with the HSS and Mayo Clinic scales. METHODS: (1) Selection of elbow-specific items. (2) Investigation of reliability and validity of all separate items, as well as the total HSS and Mayo Clinic scores, in 42 patients with RA (mean age 60 yrs). Direct observation of functional elbow performance was defined as the gold standard against which criterion validity was compared. (3) Reaching agreement within a team of professionals on the different scale dimensions and the assigned weight. (4) Item reduction by eliminating unreliable, inaccurate, unfeasible, and ambiguous items. Finally, the EFA scale was constructed by selecting the most reliable and accurate items. RESULTS: The EFA scale showed a superior or equal degree of reliability as reflected in intraclass correlation coefficients of more than 0.88, and also superior validity, compared with the HSS and Mayo Clinic measures. CONCLUSION: Although the elbow scoring systems currently available provide a reliable measure, they seem restricted in evaluating elbow-specific functional ability. The EFA scale was found to be most suitable to measure elbow functional ability in RA, and was also shown to be highly reliable and practical in clinical practice.
10776687 Expression of kappa-opioid receptor mRNA in human peripheral blood lymphocytes and the rel 2000 The expression of the kappa-opioid receptor on human peripheral blood cells (in rheumatoid arthritis cases and normal volunteers) was examined using reverse transcriptase polymerase chain reaction (RT-PCR), and the relationship between its expression and the inflammatory activity or chronic pain in patients with rheumatoid arthritis (RA) was determined. RT-PCR was performed on the peripheral blood cells obtained from 37 patients with RA and 13 healthy volunteers. kappa-Opioid receptor mRNA expression was exhibited on the blood cells of 37% of RA patients (14/ 37) and 54% of healthy volunteers (7/13) , and the levels of expression were lower in the RA patients than in the healthy volunteers. Regarding the relationship between the expression of kappa-opioid receptor mRNA and the symptoms in RA patients, it was noted that the expression of the receptor mRNA was significantly decreased in RA patients in whom erythrocyte sedimentation rate (ESR), Lansbury index, and visual analogue pain scores were high. The kappa-opioid receptor mRNA was expressed on four cell types, namely, T and B cells, macrophages, and natural killer (NK) cells in RA patients; however, it was expressed only on the T and B cells and macrophages (and not on NK cells) in the healthy volunteers. Our findings suggest that the levels of expression of kappa-opioid receptor mRNA were decreased in RA patients in comparison with those in healthy volunteers; and that they were significantly related to the inflammatory activity or chronic pain in the RA patients. The higher the mRNA expression level, the less severe the inflammatory changes of RA. The kappa-opioid receptor may thus play a role in the modulation of nociception and anti-inflammatory changes in chronic inflammatory disorders.
9455092 [Intubation of a patient with rheumatoid arthritis with a 7.5-mm-ID armored endotracheal t 1997 Dec A 71-year-old male patient with rheumatoid arthritis was scheduled for posterior fusion of the cervical spine. He showed limited cervical movement and atrophic mandible. Tracheal intubation was difficult in his last anesthetic management for the same surgery. This time, we planned a special procedure for predicted difficult tracheal intubation. After induction of general anesthesia, a size-4 laryngeal mask airway was inserted. Next, a flexible fiberscope sheathed with a 6.0-mm-ID cuffed endotracheal tube was inserted through a laryngeal mask airway into the trachea, and the fiberscope was withdrawn. Then, an endotracheal tube changer was inserted through the endotracheal tube. The laryngeal mask airway and the endotracheal tube were withdrawn simultaneously leaving the tube changer. Finally, a 7.5-mm-ID armored endotracheal tube was inserted through the tube changer. The procedure applied in this case is a safe and reliable intubating method in patients with difficult tracheal intubation.
9581252 Good and relative indications for elbow arthroscopy. A retrospective study on 103 patients 1998 The purpose of this study was to present our long-term experience with arthroscopic surgery of the elbow joint with special regard to diagnosis-specific results. Out of 121 patients undergoing elbow arthroscopy 103 were evaluated, with a mean follow-up of 6.2 years. The age of the patients at time of surgery ranged between 3 and 72 years. For documentation, the Figgie score was used. The results were related to the patients' pathology. The total score improved significantly from 49.3 to 89.1 (P < 0.05). There was no age dependency of the results, but there were correlations with the preoperative duration of symptoms and the individual job situation. Comparing the different parameters of the Figgie score, the aspect pain showed the greatest improvement. While patients with free joint bodies as well as septic or rheumatoid arthritis obtained a measurable benefit from the arthroscopic procedure, the postoperative improvement for the patients with severe degenerative arthritis was only limited. Patients with unspecific preoperative complaints showed no improvement at all. Thus, while patients with free joint bodies or synovitis without degenerative joint disease are good candidates for elbow arthroscopy, there is only a limited indication for patients with severe degenerative joint disease or patients with a restricted range of motion.
9704634 Heparan sulfate proteoglycan on endothelium efficiently induces integrin-mediated T cell a 1998 Aug OBJECTIVE: To clarify the role of heparan sulfate proteoglycan (HSPG) and chemokines in integrin-mediated T cell adhesion to endothelial cells in the synovium of patients with rheumatoid arthritis (RA). METHODS: Endothelial cells were purified from RA synovium. Expression of heparan sulfate, chemokines, and adhesion molecules on the endothelium was assessed by immunohistochemical analysis or flow cytometry. The effects of chemokines and heparan sulfate on T cell adhesion to RA endothelium were estimated with relevant antibodies and signaling inhibitors. Production of chemokines from synovial T cells was detected by Northern blotting and enzyme-linked immunosorbent assay. RESULTS: The endothelium in RA synovium highly expressed HSPG. The soluble form of chemokines, macrophage inflammatory protein 1beta (MIP-1beta), induced T cell adhesion to the endothelial cells. When MIP-lalpha and MIP-1beta were immobilized on RA endothelial cells, a more efficient integrin-mediated adhesion of T cells was induced compared with their soluble form. The induced T cell adhesion was reduced by pretreatment with either heparitinase, anti-MIP-lalpha antibody, or anti-MIP-lbeta antibody, indicating that these chemokines were bound to heparan sulfate on the cells. T cell adhesion was also inhibited by pertussis toxin, wortmannin, and cytochalasin B. MIP-lalpha and MIP-1beta were found on vessels in RA synovium in vivo, which were spontaneously produced from T cells purified from RA synovium. CONCLUSION: Endothelial cells in RA synovium characteristically express HSPG, which is involved in T cell integrin triggering by "posting" chemokines, which are produced by synovial T cells, and by "relaying" them to their receptors on T cells, which activate G protein-dependent phosphoinositide 3-kinase and actin-dependent integrin triggering.
9494985 Decision making in rheumatoid arthritis. Determining surgical priorities. 1998 Feb Consideration of the individual, his or her needs, and what he or she hopes to gain through surgery is of primary importance in determining a surgical plan for the rheumatoid patient. Nevertheless, procedures undertaken to save life or prevent neurologic demise must, of course, take precedence. Alleviation of pain and correction of disabling deformity take next priority. Many other considerations go into the formulation of the list of surgical priorities. A full understanding of these considerations and a well-integrated team approach to the rheumatoid patient provide the best chance for optimal outcome following surgery.
10323446 A retrospective cohort study of cigarette smoking and risk of rheumatoid arthritis in fema 1999 May OBJECTIVE: To study the association of cigarette smoking with risk of rheumatoid arthritis (RA), among 377,481 female health professionals in the Women's Health Cohort Study. METHODS: Subjects completed mailed questionnaires regarding demographics, health habits, including cigarette smoking history, and medical history, including RA diagnosis made by a physician and date of diagnosis. Of 7,697 women who self-reported RA, 3,416 reported seropositive RA. Cox proportional hazards regression models were used to retrospectively assess the associations of smoking intensity and duration with the risk of developing RA or seropositive RA. Cigarette smoking status was treated as a time-varying exposure in these regression models. RESULTS: In multivariate analyses controlling for age, race, education, age at menarche, pregnancy history, menopausal status, and postmenopausal hormone use, duration of smoking was associated with a significantly increased risk of both RA and seropositive RA (both P < 0.01 for trend), after adjusting for smoking intensity. Women who smoked > or =25 cigarettes/day for more than 20 years experienced a 39% increased risk of RA and 49% increased risk of seropositive RA. However, smoking intensity (number of cigarettes/day) was unrelated to risk of RA or seropositive RA (both P = 0.3 for trend), after adjusting for duration of smoking. CONCLUSION: Duration, but not intensity, of cigarette smoking is associated with a modest increased risk of RA in women.
10501417 Involvement of fibroblast growth factor-2 in joint destruction of rheumatoid arthritis pat 1999 Aug OBJECTIVE: To investigate the effect of the synovial fluid from knee joints of rheumatoid arthritis (RA) patients with different severities of joint destruction on osteoclastogenesis and bone resorption. METHODS: Synovial fluid was harvested from the knee joints of 59 RA patients and 37 ostcoarthritis (OA) patients. RA patients with Larsen's knee grade 1-3 were classified as mild RA (n = 30) and those with grade 4 or 5 as severe RA (n = 29). Cytokine concentrations in synovial fluid were measured by ELISA. Osteoclastogenesis was measured by tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cell (MNC) formation in a co-culture of mouse osteoblastic cells and bone marrow cells, and bone resorption by 45Ca release from pre-labelled cultured neonatal mouse calvariae. RESULTS: The synovial fluid of severe RA patients significantly stimulated TRAP-positive MNC formation and 45Ca release compared to those of mild RA and OA patients. Among the bone-resorptive cytokines fibroblast growth factor-2 (FGF-2), tumour necrosis factor alpha (TNF-alpha), interleukin-1alpha (IL-1alpha), IL-6 and soluble IL-6 receptor (sIL-6R), only FGF-2 concentration in the synovial fluid was positively correlated to Larsen's grade, and severe RA patients showed significantly higher FGF-2 concentrations than mild RA patients. Osteoclastogenesis in a co-culture system which was stimulated by the synovial fluid of severe RA patients was significantly inhibited by a neutralizing antibody against FGF-2 and this inhibition was stronger than antibodies against other cytokines. CONCLUSION: The increase in endogenous FGF-2 levels in the synovial fluid of RA patients may play a role in the joint destruction by inducing osteoclastogenesis.
10955351 Leukocytoclastic vasculitis due to etanercept. 2000 Aug Recently etanercept, a soluble recombinant tumor necrosis factor receptor:Fc fusion protein, became available to treat patients with rheumatoid arthritis (RA). Among adverse reactions are cutaneous side effects, which occur in about 5% of patients. These have included mostly injection site reactions as well as urticarial reactions. We describe the first case of leukocytoclastic vasculitis associated with the use of etanercept in a patient with severe, deforming RA previously unresponsive to multiple therapies. Discontinuation of the drug led to complete resolution of the vasculitis.