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ID PMID Title PublicationDate abstract
11958824 Interferon-gamma-induced calcium influx in T lymphocytes of multiple sclerosis and rheumat 2002 Mar Autoreactive T lymphocytes are considered to play a crucial role in orchestrating a chronic inflammation in the central nervous system (CNS) of multiple sclerosis (MS) patients and in the joints of rheumatoid arthritis (RA) patients. However, it has been suggested that the majority of T cells in the immune infiltrate are nonspecifically recruited into the CNS and into the inflamed joint. In addition, several lines of evidence suggest an important role for interferon-gamma (IFN-gamma) in the pathogenesis of MS and RA. We have studied whether peripheral blood T cells from patients with autoimmune diseases are more susceptible to activation in the presence of IFN-gamma. The results indicate that IFN-gamma mediates a sustained elevated [Ca(2+)](i) in T cells of (active) MS and RA patients as compared to healthy controls and patients with common viral infections. No [Ca(2+)](i) increase was observed in Ca(2+)-free medium, excluding an effect of IFN-gamma on Ca(2+)-release from intracellular stores. Although the IFN-gamma-activated Ca(2+)-influx is insufficient to induce T cell proliferation in vitro, our data indicate a significantly augmented proliferation in response to suboptimal doses of PHA in the presence of IFN-gamma. This study suggests that the IFN-gamma-induced Ca(2+)-influx can act as a complementary mechanism in the activation of blood T lymphocytes from MS and RA patients.
15260386 A longitudinal study of serum creatinine levels in patients of rheumatoid arthritis on lon 2003 Nov AIM: Primary: To study the effect of long term NSAID therapy on serum creatinine in patients of rheumatoid arthritis. Secondary: To study the effect of discontinuation, reduction in the dose or continuation of NSAID and of rechallenge. MATERIAL AND METHODS: Case records of RA patients with a minimum two years of follow up were analysed. Age, sex, duration of RA, type, dose and duration of NSAID and DMARD therapy, co-morbid conditions and serial serum creatinine levels were charted. RESULTS: Ninety nine case records were studied. Incidence of abnormal creatinine level (renal insufficiency) defined as rise in creatinine equal to or above the upper limit of normal was 27.7%. This rise was asymptomatic in all patients. No NSAID was particularly associated with an increased risk in renal insufficiency. The rise of serum creatinine was reversible in most patients irrespective of discontinuation or continuation of NSAID but settled at a higher level. Rechallenge resulted in rise of serum creatinine in 50% patients. Hypertension, DM, IHD and diuretics carried a higher but not statistically significant risk of renal insufficiency. CONCLUSION: NSAID-induced asymptomatic rise of creatinine in patients of RA on long term NSAIDs is common. It is mostly reversible. Regular monitoring of serum creatinine is essential.
15290730 Combination leflunomide and methotrexate (MTX) therapy for patients with active rheumatoid 2004 Aug OBJECTIVE: To obtain additional safety and efficacy data on leflunomide (LEF) treatment in combination with methotrexate (MTX) therapy in an open-label extension study in patients with rheumatoid arthritis (RA). METHODS: Following a 24 week, randomized, double-blind trial of adding placebo (PLA) or LEF to stable MTX therapy, patients could enter a 24 week extension. Subjects randomized to LEF and MTX continued treatment [(LEF/LEF) + MTX]. Subjects randomized to PLA and MTX switched to LEF (10 mg/day, no loading dose) and MTX [(PLA/LEF) + MTX]. The double-blind regarding initial randomization was maintained. RESULTS: For subjects in the extension phase, American College of Rheumatology 20% (ACR20) responder rates for the (LEF/LEF) + MTX group were maintained from Week 24 (57/96, 59.4%) to Week 48 (53/96, 55.2%). ACR20 responder rates improved in patients switched to LEF from PLA at Week 24 [(PLA/LEF) + MTX] from 25.0% (24/96) at Week 24 to 57.3% (55/96) at Week 48. Patients in the extension who switched from PLA to LEF without a loading dose exhibited a lower incidence of elevated transaminases compared to patients initially randomized to LEF. Diarrhea and nausea were less frequent during the open-label extension in patients who did not receive a LEF loading dose. CONCLUSION: Response to therapy was maintained to 48 weeks of treatment in patients who continued to receive LEF and MTX during the extension. Importantly, ACR20 response rates after 24 weeks of LEF therapy were similar between patients switched from PLA to LEF without loading dose, and those who received a loading does of LEF (100 mg/day x 2 days) at randomization. Fewer adverse events were reported in patients switched to LEF without a loading dose.
12359237 Expression of PTHrP and its cognate receptor in the rheumatoid synovial microcirculation. 2002 Oct 4 Parathyroid hormone-related protein (PTHrP), a multifunctional peptide that acts as a vasodilator as well as possible regulator of vascular development, is produced in increased amounts in the rheumatoid synovium. To understand whether PTHrP can contribute to the development and function of the rheumatoid microcirculation, studies were undertaken to identify and compare vascular sites of expression of PTHrP and its cognate receptor in the rheumatoid synovium and/or in cultured rheumatoid synovial endothelial cells. Endothelial cells, including apoptotic cells, as determined by TUNEL staining, were the primary site of vascular PTHrP expression in the rheumatoid synovium, a result confirmed in vitro in rheumatoid synovial microvascular endothelial cells. In contrast, the PTH/PTHrP receptor was primarily located in pericytes and smooth muscle cells within the vasculature. These results are consistent with a possible paracrine pathway for PTHrP action in the synovial microcirculation, wherein PTHrP peptides secreted by the synovial endothelium could act on surrounding PTH1R-positive pericytes and smooth muscle cells.
15580882 [Erythropoietin and intravenous iron to save blood in surgery]. 2004 Nov 10 Recombinant human erythropoietin (rHuEPO) and intravenous (i.v.) iron administration may be useful tools to save blood in surgery. In the perioperative period, rHuEPO should be used in slightly anemic patients for whom an autologous predonation program is not recommended (or feasible). In such cases, i.v. iron is only given if there is a functional or real iron deficiency state. In the post-operative period, i.v. iron is administered in association with rHuEPO in an attempt to rapidly correct severe post-operative anemia. The same regimen is used for patients undergoing surgery for inflammatory bowel disease and rheumatoid arthritis. Finally, other particular categories of patients, such as those with reduced body weight (< 50 kg), candidates for surgery with increased blood needs (> 5 units), or those with a too-short period of time before surgery, also benefit from the administration of these two drugs.
15730620 [Treatment of severe systemic autoimmune diseases with autologous peripheral blood stem ce 2004 Dec 17 OBJECTIVE: To investigate the feasibility, efficacy and safety of high dose immunosuppressive therapy (HDIT) and autologous peripheral blood stem cell transplantation (PBSCT) with CD(34)(+) cell selection in patients with refractory and severe autoimmune diseases. METHODS: Twenty-one patients with SLE, RA, pSS, SSc or MCTD were enrolled in the study from 1999. Autologous haemopoietic stem cells were mobilized with CTX 3 approximately 4 g/m(2) and granulocyte colony stimulating factor (G-CSF). CD(34)(+) cells were selected by CliniMACS. After conditioning with CTX (200 mg/kg) and pig antithymocyte globulin (ATG, 90 mg/kg) or CTX (150 mg/kg) and total body irradiation (TBI, 4 approximately 6 Gy), the enriched CD(34)(+) cells were reinfused. RESULTS: All patients completed the mobilization and leukapheresis procedures successfully, and proceeded to receive conditioning and transplantation. Two patients died of complication related to transplantation, one is CMV infection, the other is severe pneumonia during the course of granulocyte deficiency. A MCTD patient completed the stem cell mobilization and died of severe pulmonary hypertension and heart failure before CD(34)(+) cells reinfusing. Two SLE patients relapsed in 26, 37 months respectively and a RA patient relapsed in 15 months after transplantation. Other patients got improved, with SLE-DAI score decreasing from 17 to 4 score and proteinuria decreasing from 6.7 g to 2.3 g in SLE patients; DAS28 score from 7.9 to 2.1 in RA patient; Symptom improved and lab results recovered in SS. CONCLUSION: High dose immunosuppressive therapy followed by autologous peripheral blood stem cell transplantation with CD(34)(+) cell selection is feasible and relative safe. Patients remain free from disease active and improved continuously. Some patients could relapse after transplantation. Long-term effect need to be further observed.
15624500 [Topics on immunological tests for rheumatoid arthritis]. 2004 Oct To prevent joint destruction, it is important to diagnose RA early and to speculate the prognosis. Several new laboratory tests have been developed for this purpose. In addition to rheumatoid factor (RF), IgG-RF, anti-agalactosyl IgG antibodies (CARF), and matrix metalloproteinase 3 (MMP-3) have become available as diagnostic tests for RA. Among them, anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies) have the sensitivity and specificity of 81.0% and 92.4%, respectively, which are superior to other laboratory tests by ROC analysis. Moreover, the specificity of anti-CCP antibodies to diagnose early RA was much higher than that of RF, although the sensitivity of CARF was slightly high compared with that of RF. In contrast, MMP-3 is thought to be an evaluative test for the activity of RA because a significant correlation was found between MMP-3 and CRP, but MMP-3 has a possibility as a prognostic test to know the joint damage of RA. We have shown that the progression of joint damage (Sharp score) was faster in MMP-3-positive patients than negative patients. Anti-CCP antibodies was also reported to associate with the progression of joint damage and may be used also as a prognostic test. We next examined how efficiently was the diagnosis of RA made by combining these laboratory tests. Although anti-CCP antibodies are highly specific to RA, the specificity of RF was not so high but became up to 92% when combined with MMP-3. In order to diagnose RA efficiently, we may firstly examine RF, next MMP-3 if RF is positive, and anti-CCP antibodies if RF is negative.
14970401 Up-regulation of XCR1 expression in rheumatoid joints. 2004 May OBJECTIVES: Chemokine receptor-positive cells play a crucial role in controlling synovitis in rheumatoid arthritis (RA). We studied 16 chemokine receptors of the CC, CXC, CX3C and C families by analysing venous blood and synovial fluid samples and synovial tissues from RA patients. METHODS: Mononuclear cells (MNCs) in paired synovial fluid and venous blood samples from 7 RA patients were studied for the expression of CCR1 to 9, CXCR1 to 5, CX3CR1 and XCR1 by quantitative reverse transcription polymerase chain reaction (RT-PCR). Expression of chemokine receptors on synovial tissues from 9 RA patients were examined by in situ hybridization. Levels of chemokines were measured by enzyme-linked immunosorbant assay. RESULTS: Higher expression levels of XCR1 and CCR5 in MNCs from synovial fluid, as compared with those from venous blood, were consistently demonstrated in all RA patients (P<0.01). Through in situ hybridization, XCR1 expression was detected in infiltrating MNCs and synoviocytes in synovial tissues. Levels of lymphotactin, the ligand of XCR1, were significantly higher in the joint fluid than those in the paired serum samples (P<0.01). CONCLUSIONS: We found an up-regulation of XCR1 expression in MNCs from the rheumatoid joint, and detected XCR1 expression in infiltrating MNCs in synovial tissues, as well as increased lymphotactin levels in synovial fluid. XCR1-positive cells may play a role in rheumatoid joints.
12898179 Inhibitory effect of cyclo-oxygenase-2 inhibitor on the production of matrix metalloprotei 2004 Jul Cyclo-oxygenase (COX)-2 has been associated with inflammation in rheumatoid arthritis (RA), but its role in joint destruction remains unclear. In this study, we investigated the effect on cultured rheumatoid fibroblast-like synoviocytes (FLS) of the selective COX-2 inhibitor celecoxib on the expression of matrix metalloproteinases (MMPs), which play an important role in tissue degradation and angiogenesis in rheumatoid synovium. Treatment with nontoxic doses of celecoxib resulted in dose-dependent inhibition of MMP-1, -2, and -3 secretion from FLS when measured by enzyme-linked immunosorbent assay. Celecoxib suppressed proinflammatory cytokines (tumor necrosis factor-alpha and interleukin-1beta) induced augmentation of the gelatinolytic activity on zymography. These results suggest that COX-2 inhibitors might influence matrix degradation or angiogenesis in RA by downregulating the expression of various MMPs in rheumatoid FLS.
15225367 Measurement of global functional performance in patients with rheumatoid arthritis using r 2004 Outcome assessment in patients with rheumatoid arthritis (RA) includes measurement of physical function. We derived a scale to quantify global physical function in RA, using three performance-based rheumatology function tests (RFTs). We measured grip strength, walking velocity, and shirt button speed in consecutive RA patients attending scheduled appointments at six rheumatology clinics, repeating these measurements after a median interval of 1 year. We extracted the underlying latent variable using principal component factor analysis. We used the Bayesian information criterion to assess the global physical function scale's cross-sectional fit to criterion standards. The criteria were joint tenderness, swelling, and deformity, pain, physical disability, current work status, and vital status at 6 years after study enrolment. We computed Guyatt's responsiveness statistic for improvement according to the American College of Rheumatology (ACR) definition. Baseline functional performance data were available for 777 patients, and follow-up data were available for 681. Mean +/- standard deviation for each RFT at baseline were: grip strength, 14 +/- 10 kg; walking velocity, 194 +/- 82 ft/min; and shirt button speed, 7.1 +/- 3.8 buttons/min. Grip strength and walking velocity departed significantly from normality. The three RFTs loaded strongly on a single factor that explained >or=70% of their combined variance. We rescaled the factor to vary from 0 to 100. Its mean +/- standard deviation was 41 +/- 20, with a normal distribution. The new global scale had a stronger fit than the primary RFT to most of the criterion standards. It correlated more strongly with physical disability at follow-up and was more responsive to improvement defined according to the ACR20 and ACR50 definitions. We conclude that a performance-based physical function scale extracted from three RFTs has acceptable distributional and measurement properties and is responsive to clinically meaningful change. It provides a parsimonious scale to measure global physical function in RA.
12666291 Early results after four years experience with the S.T.A.R. uncemented total ankle prosthe 2003 The first ankle prostheses appeared in 1973 as an alternative to ankle arthrodesis, which was until then the only valid solution for a painful degenerative, rheumatoid or posttraumatic ankle. Several designs followed, all with disappointing results. Low-constraint prostheses are now being used, with literature studies of 5 years follow-up. In this study, the authors have evaluated the results of 26 uncemented, hydroxyapatite-coated STAR prostheses, all implanted between January 1996 and December 1999, with an average follow-up of 15.8 months (range: 1.5 to 48 months). For evaluation, all patients filled out a questionnaire at three different moments in time, and all of them were clinically reviewed by one single observer. The Kofoed ankle score was used for clinical evaluation. All ankle prostheses were also radiographically reviewed, using a radiographic scoring system developed by the authors. Evaluation with the Kofoed ankle score showed 74% favourable results. When patients were asked to rate their satisfaction on a scale between 0 and 100, an average improvement of 50/100 was reached. Pain was the most important indication to surgery and is the only parameter that can be predictably influenced. The effects on motion and walking distance are less predictable. No major complications occurred and there were no revision operations. Should prosthetic failure occur, an arthrodesis can still be performed, as bone resection in the primary procedure has been minimal.
15485582 Patterns of use, dosing, and economic impact of biologic agent use in patients with rheuma 2004 Oct 14 BACKGROUND: Variability in dosing and costs of biologics among patients with rheumatoid arthritis (RA) is of interest to healthcare descision-makers. We examined dosing and costs among RA patients newly treated with infliximab or etanercept under conditions of typical clinical practice. METHODS: Integrated pharmacy and medical claims data were obtained from 61 U.S. health plans. RA patients newly treated with infliximab or etanercept between July 1999-June 2002 were selected. A maintenance number of infliximab vials was determined after the "loading period" (2-3 infusions); those with >or= 2 occurrences of an increase in vials or an interval between infusions of <49 days were considered to have had escalated. For etanercept patients, escalation was based on >or= 2 instances of increased average daily dose. Multiple logistic regression analyses were conducted to assess variables associated with dose escalation. RA-related costs at one year post-initiation also were examined; comparisons were made using generalized linear models. RESULTS: A total of 1,548 patients were identified (n = 598 and 950 for infliximab and etanercept respectively). Infliximab recipients were somewhat older (50.5 vs. 46.6 years for etanercept). Nearly 60% of infliximab patients increased their dose at one year, compared to 18% for etanercept. Infliximab patients who escalated dose incurred a 25% increase in mean one-year costs (20,915 dollars vs. 16,713 dollars for no increase; p < 0.0001). Costs among etanercept patients did not substantially differ based on dose escalation (14,482 dollars vs. 13,866 dollars respectively). CONCLUSIONS: Infliximab is associated with higher rates of dose escalation relative to etanercept, which contributes to substantially higher one-year medical costs.
12678571 The role of fish oils in the treatment of rheumatoid arthritis. 2003 Fish oils are a rich source of omega-3 long chain polyunsaturated fatty acids (n-3 LC PUFA). The specific fatty acids, eicosapentaenoic acid and docosahexaenoic acid, are homologues of the n-6 fatty acid, arachidonic acid (AA). This chemistry provides for antagonism by n-3 LC PUFA of AA metabolism to pro-inflammatory and pro-thrombotic n-6 eicosanoids, as well as production of less active n-3 eicosanoids. In addition, n-3 LC PUFA can suppress production of pro-inflammatory cytokines and cartilage degradative enzymes. In accordance with the biochemical effects, beneficial anti-inflammatory effects of dietary fish oils have been demonstrated in randomised, double-blind, placebo-controlled trials in rheumatoid arthritis (RA). Also, fish oils have protective clinical effects in occlusive cardiovascular disease, for which patients with RA are at increased risk. Implementation of the clinical use of anti-inflammatory fish oil doses has been poor. Since fish oils do not provide industry with the opportunities for substantial profit associated with patented prescription items, they have not received the marketing inputs that underpin the adoption of usual pharmacotherapies. Accordingly, many prescribers remain ignorant of their biochemistry, therapeutic effects, formulations, principles of application and complementary dietary modifications. Evidence is presented that increased uptake of this approach can be achieved using bulk fish oils. This approach has been used with good compliance in RA patients. In addition, an index of n-3 nutrition can be used to provide helpful feedback messages to patients and to monitor the attainment of target levels.Collectively, these issues highlight the challenges in advancing the use of fish oil amid the complexities of modern management of RA, with its emphasis on combination chemotherapy applied early.
14623951 Chronic inflammation modulates ghrelin levels in humans and rats. 2004 Mar OBJECTIVES: The aim of this work was to investigate whether changes in plasma ghrelin, the recently discovered 28-amino acid gastric hormone that regulates growth hormone (GH) secretion and energy homeostasis, occur during inflammation in adjuvant-induced arthritis (AA) in rats. For completeness, ghrelin plasma levels were measured in rheumatoid arthritis (RA) patients. METHODS: AA was induced in male Lewis rats using Freund's complete adjuvant. Animals were monitored for weight and food intake, every 2 or 3 days, along all time-course experiments. Plasma ghrelin concentrations in 31 RA patients and 18 healthy controls, as well as in rats, were determined by a specific double-antibody radioimmunoassay. Gastric ghrelin mRNA expression was evaluated by northern blot analysis. Human GH and insulin-like growth factor (IGF)-1 were determined by quantitative chemiluminescence assay. RESULTS: Compared with controls, arthritic rats gained significantly (P < 0.01) less body weight than controls until the end of the study, when a partial recovery occurred. Ghrelin plasma levels were significantly lower at day 7 after arthritis induction than in controls (AA 7 = 91.2 +/- 5.6 pg/ml vs controls = 124.75 +/- 5.9 pg/ml), but they recovered to control levels by day 15. RA patients had ghrelin plasma levels significantly lower than healthy controls (RA = 24.54 +/- 2.57 pg/ml vs 39.01 +/- 4.47 pg/ml of healthy controls; P = 0.0041). CONCLUSION: In AA, there is a compensatory variation of ghrelin levels that relates to body weight adjustments. Recovery of ghrelin levels in the latter stage suggests an adaptive response and may represent a compensatory mechanism under catabolic conditions. In RA patients, chronic imbalance in ghrelin levels suggests that this gastric hormone may participate, together with other factors, in alterations of metabolic status during inflammatory stress.
12240779 Dose-effect relationships of nonsteroidal anti-inflammatory drugs: a literature review. 2002 Aug BACKGROUND: Many clinicians believe that higher doses of nonsteroidal anti-inflammatory drugs (NSAIDs) are more effective than lower doses for the treatment of rheumatoid arthritis (RA) and osteoarthritis (OA) but are associated with higher rates of adverse events (AEs). However, there is a lack of consensus on dose-effect relationships with the NSAIDs. OBJECTIVE: The purpose of this review was to investigate evidence for the relationship between NSAID dose, efficacy, and the occurrence of AEs from clinical trials of RA and OA of the hip and knee. METHODS: Relevant English-language publications were identified through a search of EMBASE, MEDLINE, and REFLINE using the terms aceclofenac, diclofenac, etodolac, ibuprofen, isoxicam, lornoxicam, meloxicam, nabumetone, naproxen, piroxicam, tenidap, tenoxicam, arthritis, OA (hip and knee), RA, rheumatic disorders, and musculoskeletal disorders for the period January 1970 to December 1997 (this review was conducted in 1998). Bibliographies of retrieved publications were reviewed for other potentially relevant articles. Selected publications were evaluated for quality (likelihood of bias) based on 4 factors (randomization procedure; completeness of patient and treatment information; standardization and completeness of outcome data; and reporting of attrition data). RESULTS: This review included 99 publications concerning clinical trials conducted in 24 countries and enrolling 28,239 patients. The majority of reports were published in the 1990s, particularly in the latter half of that decade. The average quality of the publications improved over time, with a significant increase in mean quality score from 5.43 in the 1970s to 9.21 during the last half of the 1990s (P < 0.05). Only 8 reports directly compared high and low doses of the same drug in relation to efficacy. CONCLUSIONS: Data on the relationship of NSAID dose to efficacy and the incidence of AEs were limited. There is a need for clinical trials directly addressing dose-effect relationships of NSAIDs, as well as reviews of more current literature and reports in languages other than English.
12713856 Flory syndrome or lymphomonocytic/low-neutrophil oligoarthritis: a diagnosis or a prognosi 2003 Mar OBJECTIVE: To individualize a new clinical entity of chronic arthritis and/or a factor indicating good prognosis of chronic arthritis. METHODS: We retrospectively studied 12 cases of monoarthritis or oligoarthritis that met none of the criteria sets for known diseases, even after more than 10 years of follow-up. RESULTS: Features in these 12 patients included recurrent effusions of inflammatory joint fluid consistently showing a predominance of lymphocytes and monocytes, long periods of remission separating the flares, absence of clinical or radiological joint lesions despite prolonged follow-up (10-40 years), an excellent response to joint aspiration and intraarticular glucocorticoid injection, unresponsiveness to second-line drugs, and young age at onset. Males and females were equally affected. Absolute lymphocyte/monocyte counts in joint fluid were similar in the 12 study patients and in 59 patients with rheumatoid arthritis, whereas absolute and differential neutrophil counts were significantly lower in the study patients. CONCLUSION: The above-described features and excellent functional outcome suggest that this clinical pattern may deserve to be viewed as a separate entity. We suggest the name "idiopathic lymphomonocytic arthritis" or, since a low-neutrophil count in joint fluid was also a conspicuous finding, "Flory syndrome", Flory being the name of the first patient in our series.
15657632 Etanercept (Enbrel) -- an update. 2004 Dec Etanercept is a tumor necrosis factor antagonist with anti-inflammatory effects. It is currently approved in the US for psoriasis, psoriatic arthritis, ankylosing spondylitis, rheumatoid arthritis and juvenile rheumatoid arthritis. Clinical trials have shown this agent to have an excellent safety profile and to be well tolerated by both adult and pediatric patients.
12854279 [Effectiveness and tolerability of celecoxib in outpatient department practice]. 2003 Jan OBJECTIVES: Object of this work is to evaluate activity and tolerance of Celecoxib in out-patient's department practice. PATIENTS AND METHODS: In this study we enlisted 46 patients, affected by pain of inflammatory or degenerative origin; any of them ever did continued therapy with NSAIDs before. We administered 200 mg daily dose of Celecoxib for at least three months. Each patient has been evaluated by the Visual Analogic Score (VAS) Scale before and after the therapy. RESULTS: The data We obtained agree with those of multicenter studies like CLASS. Celecoxib had similar efficacy respect with traditional NSAIDs, with good control of pain in both osteoarthrosic and arthritic pain (p < 0.000). Not good results were obtained for control of acute-onset pain. In our population We didn't find side-effects different from those included in the technical-form of the drug. The only patient who complained of epigastric pain did not stop the treatment, because the symptom resolved with assumption of the drug during meals. CONCLUSIONS: By the analysis of the results We consider Celecoxib useful for the control of pain in the treatment of osteoarthrosis and autoimmune diseases like Rheumatoid Arthritis. Anyway, treatment with Celecoxib (as with all Coxib-family drugs) should be reserved for long-lasting treatments in patients at risk for gastrointestinal bleeding.
15184985 SLC22A4 and RUNX1: identification of RA susceptible genes. 2004 Sep Recently we reported that SLC22A4 and RUNX1 are associated with rheumatoid arthritis (RA). SLC22A4 is an organic cation transporter with unknown physiological function, and RUNX1 is a hematological transcriptional regulator that has been shown to be responsible for acute myelogenic leukemia. It is suggested that the association of RUNX1 with RA is due to its regulation of expression of SLC22A4. Because the physiological function of SLC22A4 is still unclear, further investigation is needed into how SLC22A4 affects RA susceptibility. Although the association of RUNX1 with RA was identified as a regulatory factor of SLC22A4, it is possible that RUNX1 is a key molecule in autoimmunity, as it has been reported to be associated with systemic lupus erythematosus and psoriasis, two other autoimmune diseases.
12662147 Adalimumab - a new TNF-alpha antibody for treatment of inflammatory joint disease. 2003 Apr Tumour necrosis factor alpha (TNF-alpha) is a pro-inflammatory cytokine with various roles in inflammatory processes. Several TNF blockers are currently approved for use in rheumatoid arthritis (RA) as well as in other inflammatory arthropathies. The latest of these compounds is the human monoclonal antibody, adalimumab, which was obtained using phage display technology and successfully produced in a mammalian expression system. Clinical application of this compound led to significant improvement in patients suffering from RA, both as monotherapy and in combination with various disease modifying antirheumatic drugs (DMARDs), including methotrexate (MTX). Moreover, radiographic progression is significantly inhibited and quality of life improved. This article summarises the available information.