Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 12324290 | Low physical activity reduces total energy expenditure in women with rheumatoid arthritis: | 2002 Oct | BACKGROUND: Rheumatoid arthritis (RA) causes cachexia, a metabolic response characterized by loss of muscle mass and elevated resting energy expenditure (REE). However, energy expenditure in physical activity in subjects with RA is lower than that in healthy subjects. It is not known which effect predominates in regulating total energy expenditure (TEE), and thus whether the dietary energy requirements of subjects with RA are higher or lower than those of healthy subjects. OBJECTIVE: Our objective was to determine TEE in women with RA by using the reference method of doubly labeled water ((2)H(2)(18)O). DESIGN: In this case-control study, we examined 20 women with RA and 20 healthy women who were matched for age and body mass index. RESULTS: The patients with RA were cachectic (their body cell mass was 14% lower than that of the controls, P < 0.001), but REE was not elevated, reflecting good disease control. Mean (+/- SD) TEE was 1344 kJ/d lower in the patients than in the controls (9133 +/- 1335 compared with 10 477 +/- 1992 kJ/d; P < 0.02). The energy expenditure in physical activity of the patients was 1034 kJ/d lower than that of the controls (P < 0.04), which accounted for 77% of the difference in TEE between the 2 groups. The physical activity level (TEE/REE) of the patients also tended to be lower than that of the controls (1.70 +/- 0.24 compared with 1.89 +/- 0.36; P < 0.07). CONCLUSION: A low physical activity level is the main determinant of lower-than-normal TEE, and thus energy requirements, in women with RA. | |
| 12696470 | [Anti-cyclic citrullinated peptide antibodies as a diagnostic test for rheumatoid arthriti | 2003 Mar | Early diagnosis of rheumatoid arthritis (RA) is important since aggressive therapy should begin at an early stage. Diagnosis is made on a clinical basis, supported by the determination of rheumatoid factor (RF). However, RF is also positive in healthy subjects, as well as in other autoimmune and infectious diseases. Two other diagnostic markers with a high specificity for RA, antiperinuclear factor (APF) and antikeratin antibodies (AKA), are not in general use because of technical difficulties. APF and AKA are antifilaggrin antibodies (AFA) that bind to determinants rich in the unusual amino acid citrulline, generated by posttranscriptional modification of arginine residues by the enzyme peptidylarginine deiminase (PAD). Enzymatic determination of recombinant filaggrin fragments produces linear peptides, which are recognized by RA-specific autoantibodies. After substitution of serine by cysteine, a cyclic peptide is formed. The conformational change mimics the original structure of the filaggrin and enhances the affinity of the antibodies. Recently, an anti-cyclic citrullinated peptide (anti-CCP) ELISA was developed. The sensitivity of this test is usually 51%-68%, with a specificity of about 96%-98% (significantly higher than that of RF). Together with RF, anti-CCP increases the ability to diagnose patients with early RA. The test might help to predict which patients will develop persistent disease with evidence of radiologic lesions. Implementation of the highly specific anti-CCP test in conjunction with RF would enable reliable early diagnosis in some cases and allow the initiation of aggressive therapy with disease modifying anti-rheumatic drugs (DMARDs). | |
| 14711774 | Power Doppler ultrasound of rheumatoid synovitis: quantification of therapeutic response. | 2003 Dec | The aim of this study is to quantify power Doppler assessment of therapeutic response in rheumatoid synovitis. 13 patients (6 male, 7 female) with rheumatoid arthritis, who had an acute exacerbation of small joint synovitis in the hands, were examined with quantitative power Doppler, before and after intravenous corticosteroid treatment. All patients were examined by a single radiologist, using an ATL HDI 5000 ultrasound machine (ATL, Boswell). The images were analysed using a specially developed software package (HDI Lab), which quantifies power Doppler signal. All patients improved clinically following treatment, which was reflected in functional disability scores, and in the C-reactive protein levels and erythrocyte sedimentation rate. In all cases, there was a significant decrease in synovial vascularity as measured by the mean amplitude of signal on quantitative power Doppler. Quantitative power Doppler may allow objective assessment of treatment in small joint synovitis. | |
| 12614860 | [Compression of the spinal cord revealing a seronegative rheumatoid arthritis]. | 2003 Jan | INTRODUCTION: Craniocervical junction damages may result in a compression of the spinal cord. They may be caused by infectious, tumoral or inflammatory processes. Rheumatoid arthritis is probably among rheumatic diseases the most frequent cause of atlantoaxial arthritis. Nevertheless involvement of the craniocervical junction as the presenting symptom of rheumatoid arthritis is a very rare feature. EXEGESIS: We report the case of a 61 years old woman who presented with atlantoaxial involvement and spinal cord compression one year before the diagnosis of a seronegative rheumatoid arthritis. CONCLUSION: Symptomatic craniocervical junction damages may appear. Patients with damages of the craniocervical junction and negative investigations should be followed long-term; an underlying inflammatory disease may become evident after significant delay. | |
| 11978928 | Migratory pulmonary infiltrates in a patient with rheumatoid arthritis. | 2002 May | The case history is described of an elderly man with rheumatoid arthritis receiving treatment with sulfasalazine and the cyclooxygenase-2 inhibitor celecoxib who presented with severe shortness of breath, cough, and decreased exercise tolerance. The chest radiograph showed unilateral alveolo-interstitial infiltrates and a biopsy specimen of the lung parenchyma showed changes consistent with acute eosinophilic pneumonia. Antibiotic treatment was unsuccessful, but treatment with steroids and discontinuation of sulfasalazine and celecoxib resulted in a marked clinical improvement confirmed by arterial blood gas analysis. The condition may have developed as an adverse reaction either to sulfasalazine or to celecoxib, although hypersensitivity to the latter has not previously been reported. | |
| 12728834 | Experiencing health in the context of rheumatoid arthritis. | 2003 Apr | The purpose of this study was to explicate the health experience of persons with rheumatoid arthritis who manifest a strong sense of well-being. Five women and three men participated in unstructured interviews in order to answer the research question, What are the subplots that emerge in the descriptions of health given by persons with rheumatoid arthritis? A hermeneutic method was used to analyze the transcripts. Three subplots emerged: (a) The evolving--not knowing and then knowing something, but never really knowing, (b) the reframing, and (c) the relational fugue. The findings, including creation of healing spaces and an evolving relationship with assistive devices, provide evidence of turning points in the health process and are suggestive of a strong sense of well-being as a manifestation of a reorganized pattern. | |
| 14508648 | [Ulnar head prosthesis]. | 2003 Sep | The ulnar head prosthesis has been the subject of a prospective multicenter-study since 1995. Until 2000, it has been used in 57 patients by the study group. In 35 patients, the indication was painful instability of the distal end of the ulna following previous resection arthroplasties, and in 22 patients it was painful arthritis of the distal radioulnar joint (DRUJ). The mean follow-up was 38 months. Pronation increased from a preoperative mean of 63 degrees to a postoperative value of 78 degrees, while supination increased from 43 degrees to 76 degrees. Grip strength improved from a preoperative mean of 51% to a postoperative mean of 77% of the opposite limb. Pain, measured on the verbal pain scale (1-4), was reduced remarkably from a preoperative mean level of 3.6 to a postoperative mean of 1.7. Patient' satisfaction was evaluated using the visual analog scale (0-10) and improved from a preoperative mean of 2.1 to a postoperative mean of 7.9. With one exception of loosening, we consistently found bony integration of the shaft of the prosthesis. Stability of the DRUJ was achieved in all but three patients. This method has given reliable and excellent results as a salvage procedure for failed resection arthroplasties of the DRUJ with painful instability of the distal end of the ulna. We consider the method an alternative treatment option for the arthritically destroyed DRUJ. Sufficient soft tissue to stabilise the prosthesis is needed to successfully reconstruct the DRUJ. | |
| 14969048 | Is radiographic progression a realistic outcome measure in clinical trials with early infl | 2003 Sep | Radiographic progression is one of the most important outcome measures in rheumatoid arthritis (RA) clinical trials, because it reflects historic disease activity, is associated with loss of function over time, and can be reliably assessed. Trials involving patients with early inflammatory arthritis (EIA) will differ from those focusing on RA patients in many respects. They include a heterogeneous spectrum of patients, and some of them will have self-limiting arthritis, or arthritis with a low likelihood of ever becoming erosive. Furthermore, because of the early presentation a high proportion of patients with a high likelihood of erosions will still be non-erosive at presentation; and since EIA trials will aim at permanent clinical remission induced by therapy, the signs of progression will be very subtle. Current radiographic scoring methods may not be sensitive to the small changes that are expected to occur in EIA trials. This makes radiographic progression a rather unlikely single primary outcome in such trials. However, "permanent clinical remission" (with or without therapy) appears to be a most realistic outcome in such trials, and radiographic stability (the demonstration of "no progression") may serve as a key criterion in establishing whether the endpoint of permanent clinical remission is actually met. The moment at which the first erosion develops is also important in making the correct diagnosis and has implications for the prognosis. We propose here a number of recommendations for the use of radiographic progression as one of the obligatory outcome measures in clinical trials with EIA. | |
| 15176275 | The impact of rheumatoid arthritis on patients' sex lives. | 2004 May 18 | Rheumatoid arthritis is a chronic systemic disease that has the potential to affect all aspects of patients' lives, including their sexual activities and relationships. This article reports on a review of the literature assessing the problems that patients experience and whether they are addressed by health professionals. The literature indicates that many patients experience problems and that symptoms such as fatigue and pain impact negatively on sexual function. Some relationships suffer as a result but most partners are sympathetic. Poor communication between patient and health professionals is a common problem that needs to be addressed. | |
| 12639622 | Giant intraosseous cyst-like lesions in rheumatoid arthritis report of a case. | 2003 Feb | The term "intraosseous synovial cyst" is used to designate both the epiphyseal cyst-like lesions seen in patients with rheumatoid arthritis (RA) and mucoid cysts, which occur in a different setting. We report the case of a patient in whom a 4-cm cyst-like lesion developed in the left tibia 18 years after onset of RA and 6 years after osmic acid synovectomy of the left knee. Positive contrast arthrography and magnetic resonance imaging visualized a communication between the lesion and the joint space. Preexisting bone and joint lesions and increased intraarticular pressure play a major role in the genesis of cyst-like lesions in RA. In our patient, the osmic acid synovectomy may have contributed to the development of the lesion. "Synovial cyst" is a misnomer for these giant lesions, which are geodes rather than cysts. Despite their low incidence, these lesions deserve attention because they raise diagnostic and therapeutic problems. | |
| 12077708 | Shared epitopes and rheumatoid arthritis: disease associations in Greece and meta-analysis | 2002 Jun | OBJECTIVES: To assess the strength of the associations between HLA shared epitopes (SE) and rheumatoid arthritis (RA) susceptibility, articular disease severity, and extra-articular features in Mediterranean European populations. METHODS: One hundred and seventy-four Greek RA patients and 103 controls were evaluated. Data were then included in a meta-analysis of 9 studies of Mediterranean European populations (959 RA patients and 1,405 controls). RESULTS: In our study population, SE alleles were significantly more common in RA patients than in controls (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.4-4.3). Larsen radiologic score was predicted by SE and disease duration. SE did not increase the risk of any extra-articular manifestation. The meta-analysis showed a pooled OR of 3.7 (95% CI, 2.6-5.2) for susceptibility to RA conferred by SE (OR, 3.4 v 3.9 in Greek v non-Greek populations). CONCLUSIONS: SE determine articular destruction without increasing the risk of extra-articular manifestations. The immunogenetic associations of RA susceptibility are consistent, but their strength may depend on the SE prevalence in different ethnic groups. | |
| 15144126 | Survey of practices regarding management of early rheumatoid arthritis by rheumatologists | 2004 May | OBJECTIVE: To describe the practices of rheumatologists in France regarding the initial management of early rheumatoid arthritis (RA) and to estimate the associated costs. METHODS: A questionnaire on the diagnosis and treatment of early RA was sent to the 2485 practicing rheumatologists in France. The results of the 917 completed questionnaires (37% response rate) were analyzed, and initial investigation and treatment costs, including the first month of treatment, were calculated from a socio-economic perspective. RESULTS: For the RA diagnosis, more than 80% of the respondents recommended the erythrocyte sedimentation rate, C-reactive protein, complete blood count, rheumatoid factor, antinuclear antibody and wrist radiographs. In 40% and 60% of the cases, antikeratin antibody, liver enzymes, serum creatine, serum protein electrophoresis and radiographs (chest, foot and knee) were advocated. Initial drugs administered were non-steroidal antiinflammatory agents (88%), analgesics (76%), disease modifying anti-rheutmatic drugs (74% with methotrexate in 46% of cases, followed by hydroxychloroquine [13%], sulfasalazine [8%], leflunomide [7%], intramuscular gold therapy [6%]), and glucocorticoids (21%). Rehabilitation was recommended by 51% of the respondents. The median cost for this initial management was 273 euros (mean 301 euros, range 49-1,336 euros). CONCLUSION: Marked variations occur among French rheumatologists in the initial management of early RA. These data may be helpful in identifying obstacles to physician compliance with recommendations regarding everyday clinical practice and to set up more a specific evaluative study. | |
| 15338489 | Quality of life and economic burden of illness in very early arthritis. A population based | 2004 Sep | OBJECTIVE: To measure health related quality of life (HRQOL) in patients with very early arthritis in a population based study in southern Sweden, and to compare HRQOL at baseline between the different diagnostic groups. Further, we investigated whether HRQOL at baseline correlated with the costs the patients incurred during the study. METHODS: Seventy-one adult patients with arthritis of less than 3 months' duration were referred from primary health care centers to rheumatologists. HRQOL was measured with the Arthritis Impact Measurement Scales (AIMS) and EuroQol at baseline. A comparison of HRQOL measures at baseline and the costs the patients incurred during the study was conducted in 56 of the patients. RESULTS: Twenty-seven (38%) patients had reactive arthritis (ReA), 17 (24%) undifferentiated arthritis, 15 (21%) rheumatoid arthritis (RA), 4 (6%) psoriatic arthritis, and the rest (11%) other diagnoses. Statistically significant differences were found between the 4 patient groups concerning the AIMS subscales of dexterity, household activity, activities of daily living (ADL) and pain, the patients with RA being most severely affected. There were no statistically significant differences between the 4 diagnosis groups concerning the EuroQol utility and EuroQol visual analog scale (VAS) scores. Of the AIMS subscales, the mobility, physical activity, household activity, ADL, and pain subscales correlated significantly with the incurred costs. Also the EuroQol utility scores and EuroQol VAS scores correlated significantly with the costs. Only the AIMS household activity subscale predicted the costs in the regression analysis. CONCLUSION: Patients with RA had significantly worse scores in the AIMS dexterity, household activities, ADL, and pain subscales compared to patients with other arthritides very early in the disease. The EuroQol generic quality of life instrument was less sensitive in detecting differences between patients with early arthritis than the disease-specific AIMS instrument. There was a correlation between the costs and the EuroQol utility scores and EuroQol VAS scores during the very first months of the disease, as well as with costs and the AIMS subscales of mobility, physical activity, household activity, ADL, and pain. | |
| 12910965 | [Rheumatoid arthritis in patients aged above 75 years old at onset]. | 2003 Jun | Elderly onset rheumatoid arthritis (RA) is difficult to diagnose definitively when the patients note their first symptoms of arthritis above the age of 75 years old. In this report, we reviewed the clinical features of elderly onset RA and its diagnosis. The subjects included 4 females, aged 78, 83, 84 and 93 years, respectively. The onsets were abrupt in 2 cases and more slowly arriving in the other 2. Shoulder joints and wrist joints were involved in all cases. Knee joints, finger joints and foot joints were involved in 3 cases and the elbow was involved in one case. Anti-RA treatment quickly attenuated the acute and severe arthritis and brought down the high CRP level associated with vivid inflammatory activity of RA. The RAPA value was very high in all but one of the cases. Severe destructive findings in radiography was undetectable in the major joints (e.g. shoulder, hip and knee joints). Radiographic findings in wrist and finger joints were also very difficult to differentiate from arthrosis and osteoporosis. On the other hand, RA involvement in the cervical spine was certain in the radiographs; 1 case had anterior atlantoaxial subluxation and 2 cases had subaxial intervertebral erosion. Pathological radiographic findings in the cervical spine are useful for the diagnosis of elderly onset RA. | |
| 12847894 | [Bishofit in the treatment of rheumatoid arthritis]. | 2003 | AIM: To evaluate effectiveness of a natural mineral bishofit in combined treatment of rheumatoid arthritis (RA). MATERIAL AND METHODS: The study included 71 RA patients with minimal activity of the pathological process and articular disorders of stage II. Bishofit was used in baths and compresses. 33 AR patients of group 1 took bishofit baths (14 procedures) and non-steroid anti-inflammatory drugs (NSAID), 27 RA patients of group 2 were treated with bishofit compresses (14 procesures) and NSAID, 11 patients of group 3 (controls) received NSAID alone. The effect of the treatment was assessed on the basis of clinical data, the length of the affected joint circumference, antitryptic blood activity, activity of malate dehydrogenase, lactate dehydrogenase isoenzymes, plasmin, plasminogen, ESR, sialic acids. RESULTS: Bishofit-treated patients showed earlier (by 5-6 days) and greater (by 25-35%) decrease of the pain, joint and inflammatory indices as well as duration of morning stiffness, length of the affected joint circumference and joint mobility, improvement of the tests' results. A response and an appreciable response to combined therapy with bishofit were achieved in 62.9-63.6% of cases vs 45.5% in the control group. Bishofit baths and compresses did not differ considerably by therapeutic efficacy. | |
| 12949686 | Efficiency of potentiated antibodies to tumor necrosis factor-alpha (Artrofoon) in the the | 2003 Jan | Antiinflammatory activity of a new preparation Artrofoon (antibodies against tumor necrosis factor-alpha in ultralow doses) and nonsteroid antiinflammatory drug diclofenac in patients with rheumatoid arthritis was compared in an open randomized trial. The course of treatment with Artrofoon more significantly improved clinical and laboratory signs in patients with the articular form of rheumatoid arthritis than diclofenac. | |
| 15060777 | [Ultrasonographic visualization of a Baker-cyst as cause of a peroneal nerve palsy in a pa | 2004 May | With this report we present a patient with rheumatoid arthritis in whom a popliteal cyst could be diagnosed quickly and conclusively by ultrasonography as the possible reason for peroneal palsy. The sonographic investigation of the knee joint revealed an effusion. Within the popliteal fossa (dorsal longitudinal and transverse section) a cyst measuring 54 x 21 x 51 mm in a typical dorsomedial position in between the heads of the gastrocnemius muscles was found. Besides extensive synovectomy, we completely removed the cyst. The common peroneal nerve was entrapped by the Baker's cyst. The complete palsy of the nerve improved postoperatively (grade 4 according to Janda). Ultrasonography is an excellent diagnostic procedure for easy, quick, and reliable differential diagnostic evaluation of a swelling within the popliteal fossa region. | |
| 14505220 | Chronic eosinophilic pneumonia associated with an initiation of rheumatoid arthritis. | 2003 Sep | Although peripheral blood eosinophilia is observed in patients with active inflammatory rheumatoid arthritis (RA), RA is not a recognised cause of pulmonary eosinophilia. We describe a 55-year-old woman affected by chronic eosinophilic pneumonia (CEP) concomitantly with an initiation of RA. Both diseases responded rapidly and completely to high-dose corticosteroid therapy. In this patient, the initiation of RA and CEP was directly related, implying a common pathogenetic link between the two diseases. | |
| 12673896 | Clinical features of patients with systemic sclerosis accompanied by rheumatoid arthritis. | 2003 Jan | OBJECTIVE: To determine the incidence of patients with both systemic sclerosis and rheumatoid arthritis (SSc-RA) and the clinical features of those with SSc-RA. METHODS: All 173 patients with systemic sclerosis in our clinic were investigated. RESULTS: Of the 173 patients with systemic sclerosis, 9 (5.2%) developed rheumatoid arthritis (RA). At the first visit, arthritis prior to Raynaud's phenomenon, increased C-reactive protein (CRP), and elevated rheumatoid factor (RF) were seen in patients with SSc-RA at a significantly higher incidence than in those without (44.4% versus 4.8%, p < 0.01; 55.6% versus 13.6%, p < 0.001; 247.2 +/- 312.1 versus 47.9 +/- 54.3 IU/ml, p < 0.001, respectively). Furthermore, in 8 of the 9 patients with SSc-RA, CRP was increased before the diagnosis of RA. CONCLUSION: These results suggest that systemic sclerosis patients with elevated RF and a history of arthralgia prior to Raynaud's phenomenon should be followed up with serial measurements of CRP due to their risk of developing RA. | |
| 12172954 | Intra-articular injection of high molecular weight hyaluronan after arthrocentesis as trea | 2002 Aug | OBJECTIVE: The aim of this study was to find if a complete synovial fluid aspiration before injection of intra-articular high molecular weight hyaluronan influences the treatment result for knees with rheumatoid arthritis (RA), including joint effusion and the prognostic factors related to clinical effect. METHODS: The arthritic knees including effusion were randomized to arthrocentesis or no arthrocentesis before the hyaluronan (1.9-2.5 x 10(6)) was injected into knee joints five times every week. All patients were followed up for 6 months. RESULTS: One hundred eighteen RA patients (80 knees in the arthrocentesis group, 81 knees in the no-arthrocentesis group) were included. The proportion of no relapses in the arthrocentesis group was higher than that in the no-arthrocentesis group. In the arthrocentesis group, regression analysis showed that duration of knee arthritis (<5 months), CRP (<4 mg/dl), and Larsen grade ( |