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PMID	Title	PublicationDate	abstract
3875009	Reduction of anti-inflammatory drug costs with newer aspirin formulations.	1985 Aug	Anti-inflammatory/analgesic drugs account for a large proportion of prescriptions and prescribing costs, particularly for ambulatory patients. Although aspirin is highly effective, 95% of anti-inflammatory/analgesic prescriptions have been for the newer, more expensive alternatives. Recently two newer aspirin formulations were made available on our hospital's formulary. Subsequently aspirin prescribing rose from 5% to 14.5% (P less than 0.0005), and mean pharmacy costs for anti-inflammatory analgesics fell 5.9% over a 7-month period (P less than 0.025). This decline in costs interrupted a historic trend toward increased prescription costs and was accomplished with minimal effort or hospital resources. Increased availability and familiarity with these newer aspirin formulations may substantially reduce costs for the health care system.
6160032	[Treatment of rheumatoid arthritis. Open parallel study with the non-steroidal antirheumat	1980 Nov 14	Piroxicam and diclofenac were compared for 4 weeks in an open parallel study in 20 rheumatoid arthritis patients each. Both preparations showed good efficacy and were well tolerated, piroxicam appearing to be slightly superior in both respects. Piroxicam exercised a significant action on the inflammation-specific parameters (reduction of BSR by 6.15 mm maximum and of the alpha 2-globulin fraction by 0.75%), whereas diclofenac did not. Another advantage of piroxicam is its low effective dosage level achieved by a single daily dose.
3878988	[Clinical significance of serum sialic acid in rheumatoid arthritis and systemic lupus ery	1985 Dec 1	A study of the clinical significance of serum sialic acid (SA) in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) is presented in this paper. Because a definite correlation (n = 30, r = 0.74, P less than 0.001) between SA and erythrocyte sedimentation rate (ESR) and a good reflection of SA to disease activity in clinical course were revealed in RA patients, we were able to use SA in place of ESR as a marker of disease activity and a guide to treatment. On the other hand, although a good correlation (n = 22, r = 0.62, P less than 0.01) between SA and ESR was revealed in SLE patients, SA was inapplicable as a marker of disease activity in SLE because of a poor correlation between SA and anti-DNA antibody or serum complement which is mainly used as a marker of disease activity and a guide to treatment.
159147	Depressed primary in vitro antibody response in rheumatoid arthritis.	1979 Aug	We have studied the primary in vitro antibody response toward a hapten in cultures of peripheral blood lymphocytes from twenty-two patients suffering from regular rheumatoid arthritis (RA). These patients were not receiving immunosuppressive drugs or corticosteroids and had not taken Aspirin or non-steroidal anti-inflammatory agents for at least 72 hr. The control groups included thirty-two healthy subjects and twenty-seven control patients. The mean anti-TNP response of the RA patients was significantly lower than that of both control groups. No pre-existing anti-TNP or IgG response could be detected. A search for suppressor cells in co-cultures of RA and normal lymphocytes was negative. On the contrary, the extent of allogeneic enhancement in such co-cultures was comparable to that observed when control lymphocytes were co-cultured. RA serum added to normal lymphocytes cultures showed a dramatic inhibitory effect in only two out of nine cases. A follow-up study has strongly suggested that RA lymphocytes could increase their in vitro antibody response upon treatment.
970768	Felty's syndrome: granulocyte-bound immunoglobulin G and splenectomy.	1976 Oct	A quantitative antiglobulin consumption technique was used to measure immunoglobulin G (IgG) present on human granulocytes. Granulocytes from 50 normal subjects had less than 20 X 10(-14) g IgG per cell. Patients with granulocytopenia due to bone-marrow failure, patients with IgG multiple myeloma, patients with splenomegaly, and patients with rheumatoid arthritis without granulocytopenia had granulocyte-bound IgG within the range of normal. Four patients with rheumatoid arthritis, splenomegaly, and severe granulocytopenia (Felty's syndrome) had granulocyte-bound IgG between 30 and 220 X 10(-14) g IgG per cell. One of these patients underwent splenectomy, after which his granulocyte-bound IgG fell to normal. Seven additional patients with Felty's syndrome who had previously undergone splenectomy had normal levels of granulocyte-bound IgG. Thus quantitation of granulocyte-bound IgG appears to be useful in defining patients with immunologically mediated granulocytopenia. Studies of patients with Felty's syndrome who have undergone splenectomy suggest that the spleen may produce this neutrophile-bound immunoglobulin.
3873697	Rheumatic diseases in an Icelandic family. Clinical and immunological survey.	1985	We have studied 192 members of a highly inbred Icelandic family with clustering of rheumatic diseases. Twelve consanguineous marriages are known in the family and 54 of 65 surviving offsprings of these (inbred group) were traced. Thirty-nine family members were affected by rheumatic diseases; 18 of them belonged to the inbred group. Eleven of 20 family members with rheumatoid arthritis (RA) came from the same inbred group. Eleven of the inbred group had a positive Rose-Waaler test for rheumatoid factor (RF) and the inbred group had significantly higher serum levels of IgG and IgM than an age and sex matched group from the family. Serum IgM RF was significantly associated with the age of the family members, but IgA RF and IgG RF did not show any such association. The possible role of recessive genes in the rheumatic diseases, as well as the inbreeding effect regarding certain extended HLA-complotypes is discussed.
1022869	Immunoglobulin G complex interactions with rheumatoid factor and neutrophils: 51CrCl3 labe	1976 Dec	The interactions of soluble and insoluble IgG complexes with macromolecular rheumatoid factor (RF) and neutrophils have been examined in an in vitro system allowing the separate assay of the biologic activities of these elements in the rheumatoid inflammatory process. Studies utilizing soluble and insoluble 51CrCl3 labelled human IgG complexes have demonstrated uptake of only the insoluble complexes by human neutrophils. A burst of hexose monophosphate shunt activity, as evidenced by increased oxidation of glucose-l-14C to 14CO2, has been shown to occur only when neutrophils are exposed to these insoluble complexes. High titer RF sera added to the insoluble complexes prior to their incubation with neutrophils did not affect either the uptake of the complexes or the magnitude of hexose monophosphate shunt activity. Native IgG and soluble IgG complexes were not taken up by the neutrophils and did not stimulate hexose monophosphate shunt activity in the presence or absence of rheumatoid sera. The addition of high titer RF sera to soluble IgG complexes produced precipitation of RF-IgG complexes which were capable of stimulating hexose monophosphate shunt activity in normal neutrophils. RF thus has been shown to change functionally inactive soluble complexes into functionally active insoluble complexes capable of stimulating normal neutrophils. Neutrophil stimulation by insoluble complexes may be important in the continuing inflammatory process occurring in the joints of patients with rheumatoid arthritis.
6967727	Metabolism of C4 and factor B in rheumatoid arthritis. Relation to rheumatoid factor.	1980 Aug	Metabolic turnover determined by radioiodide labeled C4 and Factor B was studied in 18 patients with rheumatoid arthritis (RA) and 19 normal control subjects as a means of estimating the relative ratio of consumption of components in the classical and alternative pathways of complement activation. Predominance of fractional catabolic rate (FCR) of C4 over Factor B was demonstrated with differentially labeled C4 and Factor B. The hypercatabolism occurred in the extravascular space. C4 FCR correlated significantly with rheumatoid factor (RF) determined in a hemolytic assay (rs = 0.72), measured as IgG RF (rs = 0.57), and as IgM RF (rs = 0.45). There were no significant correlations with several other antibodies measured. These results are consistent with the hypothesis that RA is a systemic, extravascular immune complex disease, in which RF immune complexes play a significant pathogenetic role principally via activation of the classical pathway of complement.
6972690	Drug effects on autoantibodies and immune complexes.	1980	In connective tissue diseases, putatively immunosuppressive drugs may lower antinuclear antibody (ANA), anti-DNA antibody and rheumatoid factor titres. Penicillamine may induce or increase titres of antinuclear and/or anti-muscle antibodies. The mechanism of induction of penicillamine antinuclear autoimmunity evidently differs from that seen with hydrallazine and procainamide. While the latter may induce circulating immune complex formation, the effect of penicillamine on circulating immune complex levels in rheumatoid arthritis is variable. Our recent findings will be discussed.
1101982	[Development and clinical approval of a micromodification of the human leukocyte migration	1975 Aug	The author suggests a new modification of the human blood leukocyte migration inhibition test. The results of the clinical approval of the test permit it to be recommended for the investigation in dynamics of the cellular immunity and the humoral factors in ptients with different immunopathological state. This modification permits to carry out 10-15 parallel investigations using small quantitites of the blood.
1278360	Antiinflammatory activity of two phenylindandione derivatives.	1976 Jun	2-5-Dibromo-2-(beta-naphtyl)indan-1,3-dione (43/63) and 4-bromo-2-phenylindan-1,3-dione (43/13) are two interesting members of a series of "indandione" derivatives which possess an antiinflammatory activity (in the following tests: carrageenin induced rat hind paw edema, cotton pellets granuloma and chronic adjuvant arthritis). The two drugs are devoided of anticoagulant activity and their antiinflammatory effect is not adrenalmediated.
6191763	Incidence and specificity of antibodies to types I, II, III, IV, and V collagen in rheumat	1983 Jul	Antibodies to human native and denatured types I, II, III, IV, and V collagens were measured using 125I-radioimmunoassay. Mean levels of binding by sera from 30 rheumatoid arthritis patients were significantly higher than those from 20 normal subjects against all of the collagens tested. The relative antibody concentration was higher in synovial fluid than in simultaneously obtained serum. Many patients with gout or various other rheumatic diseases also had detectable anticollagen antibodies. With a few notable exceptions, the majority of the reactivity detected in all patient groups was directed against covalent structural determinants present on all of the denatured collagens, suggesting a secondary reaction to tissue injury.
6982477	Proglumetacin (protacine): a promising new treatment of the rheumatic joint.	1982	Twenty-three out-patients with rheumatic disorders were treated over a period of 3 weeks with 450 mg proglumetacin per day, in two divided doses. Articular pain significantly decreased by 57% during the first week, and by 85% in Week 3. This was the result of two actions: a decrease in the number of painful joints, and in the intensity of pain in those still painful. The number of oedematous joints turned from swollen to normal in a proportion of 57% after 1 week and 87% after 3 weeks of treatment. These actions resulted in a significant recovery of mobility, expressed as both morning stiffness and hand grip strength. Erythrocyte sedimentation rate and rheumatoid factor titre also improved significantly. Proglumetacin was well-tolerated by all patients.
2414445	Interaction between fibronectin, rheumatoid factor and aggregated gamma globulins.	1985 Aug	Fibronectin (Fn) was detected in 12/14 2.5% polyethylene glycol precipitates of rheumatoid serum positive for rheumatoid factor (RF). This association led to an investigation of the capacity of Fn to interact with IgM RF and heat aggregated human IgG. Our data suggest that Fn can interact directly with both of these substances at a site in the Fc fragment of the immunoglobulin molecule. The exact cite of the interaction is still to be defined but evidence indicates that it is probably distinct from sites binding staphylococcal protein A and complement.
6758549	Adjuvant polyarthritis in rats: is this a satisfactory model for screening anti-arthritic	1982 Oct	The pathological and biochemical features of the polyarthritis in rats induced by Freund's adjuvant are briefly reviewed. The object of this is to highlight recent studies that provide a basis for specifically improving procedures employed in screening the activity and mode of action of anti-inflammatory/antiarthritic drugs--especially those with possible disease modifying activity. Current screening procedures involve the simple measurement of hind-paw or joint swelling. This may not reflect the extent of degradation or systemic changes in arthritis. It is suggested that it is possible to more precisely measure the extent of joint degradation by the following: (1) X-ray monitoring of joints afflicted with the disease, (2) Histological and morphological examination (the latter in alkali cleared--Alizarin stained preparations) of hindlimbs, (3) Quantitative histoenzymic and biochemical analysis of degradative enzymes and inflammatory mediators. Additional to this specific immunological and systemic (blood, liver) changes should be measured in primary screening in recognition that arthritis is a disease not only of joints but involving the immune, hepatic and possibly other organ systems and that these systemic components clearly have effects on joints. Only by a combined analysis of both local joint and systemic changes during drug treatment will it be possible to discriminate new drugs with disease-modifying activity.
6749384	Neutrophil surface-bound immunoglobulin--a feature of Felty's syndrome?	1982	In a study of eight patients with Felty's syndrome, surface-bound immunoglobulin (IgG +/- IgM and complement) was demonstrated in all cases by a fluorescein-labelled antihuman globulin technique using paraformaldehyde-fixed neutrophils to prevent non-specific surface adsorption of immunoglobulin. The test was negative in control patients with rheumatoid arthritis alone. The neutrophil binding of immunoglobulin occurred in vivo and could not be reproduced with the patient's serum and normal neutrophils. The presence of alloantibodies due to previous pregnancy or transfusion can obscure this picture. A neutrophil autoantibody or cell-bound immune complexes may be the cause of this phenomenon, which may be a useful marker of Felty's syndrome in patients with rheumatoid arthritis.
6085746	The autologous mixed lymphocyte reaction in patients with rheumatoid arthritis.	1983 May	In patients with rheumatoid arthritis (RA) a significantly decreased autologous mixed lymphocyte reaction (AMLR) was observed which varied widely and did not correlate with disease activity, clinical course or treatment schedules. When supernatants of AMLR cultures were tested for the presence of soluble factors no differences were found in regard to the suppression of allogeneic and mitogen induced lymphocyte proliferation. Furthermore both test groups failed to produce detectable amounts of interferon during the course of the AMLR, in contrast to the allogeneic situation were both RA patients and normal controls exhibited a similar interferon activity in the culture supernatants.
26225	[Investigations on the plasm amino acids of old patients with rheumatoid arthritis (author	1977 Dec	The amino acids of blood plasma of 43 patients with rheumatoid arthritis (RA) and 19 controls were investigated by ion exchange chromatography. It was proofed simultaneously whether human more than 60 years old exhibit significantly different amino acid concentrations from younger individuals. It was found that RA patients more than 60 years differ significantly in 23 out of 30 amino acids. Only Asparagine was decreased, all other amino acids were increased. The controls did not show the same uniform direction of results. Older individuals exhibited differences in only 14 amino acids. Phosphoserine, Cystathionine and Arginine were increased to a great extent while Threonine, 1-Methylhistidine and Tryptophane were apparently diminished in this group of age.
910110	[Chemotaxis of human granulocytes "in vitro". Study of inflammatory rheumatic diseases].	1977 Jul	68 mesures of chemiotaxis of the blood granulocytes carried out in 42 patients suffering from systemic lupus erythematosus (SLE-17 cases), rheumatoid polyarthritis (RP-15 cases) and sclerodermia (SD-10 cases) showed a deficit in 15 cases. The deficit seen is cellular or plasmatic in the former two conditions (SLE & RP) but purely cellular in the sclerodermia. In SLE there is a relationship between the chemiotaxic deficit and a renal attack or a reduction in complement. In RP a relationship was established between chemiotaxis and a marked rise in VS (?) (synovial volume ?) and the rheumatoid factor titre. A relationship with a visceral attack was seen in SD. Contrary to other studies reporting a constant chemiotaxic deficit in these conditions, the present work shows that the deficit : 1. exists in only a minority of patients ; 2. is transitory ; 3. is not associated solely with granulocytes but may also be related to plasmatic factors. The diminution of chemiotaxis which is always seen in the acute phase of the illness may result from the reduction on the quantities of less reactive granulocytes in the peripheral blood ; the most reactive pass out through the walls of the vessels and move towards the foci of inflammation.
6223699	Twelve-week study of etodolac, aspirin, and placebo in patients with rheumatoid arthritis.	1983	Etodolac, aspirin, and placebo were evaluated for efficacy and safety in 20 patients with adult-onset active rheumatoid arthritis who entered a 12-week, double-blind, parallel-group study divided into drug titration and maintenance periods and preceded by a two-week washout period. During the maintenance period the mean daily doses of etodolac and aspirin were 319 mg and 4,701 mg, respectively. At the end of the study, patients treated with etodolac showed significant improvement from baseline values in seven of ten clinical variables, namely, painful joints, swollen joints, articular index, pain intensity, morning stiffness, and investigator's and patient's overall assessments. In patients treated with aspirin, only pain intensity was lessened significantly; in those treated with placebo, only pain intensity lessened significantly and only the patient's overall assessment improved significantly. No serious side effects were noted in patients treated with etodolac. Three patients treated with aspirin were withdrawn from the study because of adverse reactions--two experienced gastrointestinal side effects and one had elevated liver enzyme levels.