Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
22465003 Do patients with elderly-onset rheumatoid arthritis have severe functional disability? 2012 Aug OBJECTIVE: To identify the clinical features of elderly-onset rheumatoid arthritis (EORA) and their impact on disease outcome. METHODS: A total of 3169 rheumatoid arthritis (RA) patients were recruited as part of the Korean Observational Study Network for Arthritis, the nationwide cohort of South Korea. Patients were stratified according to age at disease onset: <40 years (younger age-onset RA, n = 1167), between the ages of 40 and 59 (middle-aged-onset RA, n = 1516), and ≥60 years (EORA, n = 486). To evaluate the significance of differences in clinical features among these 3 groups, we performed analysis of variance (anova) and the χ(2) test. We used multivariable logistic regression analysis to examine the association of onset age with functional disability measured with Health Assessment Questionnaire-Disability Index (HAQDI). RESULTS: EORA patients were associated with high HAQDI (≥1) in bivariable analysis [odds ratio (OR) 1.36, confidence interval (CI) 1.04-1.77]. However, in multivariable analysis, not elderly onset but patients' age, female gender, high disease activity, disease duration over 10 years, and comorbidity with cardiovascular disease were associated with high HAQDI. Only in a predefined subgroup with disease duration <10 years, elderly onset was an independent influencing factor for the functional disability of RA patients (OR 3.04, CI 1.85-5.67: disease duration of <5 years, OR 3.07, CI 1.64-5.74: disease duration of 5 to 10 years). CONCLUSIONS: Disease onset in older age was associated independently with functional disability of RA patients who have relatively short disease duration.
20824800 Socioeconomic determinants of disability and depression in patients with rheumatoid arthri 2011 Feb OBJECTIVE: To examine the relationship between functional limitation, socioeconomic inequality, and depression in a diverse cohort of patients with rheumatoid arthritis (RA). METHODS: The study design was cross-sectional and subjects were from the University of California, San Francisco RA Cohort. Patients were enrolled from 2 rheumatology clinics, an urban county public hospital and a university tertiary care medical center. Age, sex, race/ethnicity, disease activity, functional limitation, and medications were variables collected at clinical visits. The patient's clinic site was used as a proxy for his or her socioeconomic status. The outcome variable was depressive symptom severity measured by the Patient Health Questionnaire 9. Differences in characteristics between depressed and nondepressed patients were calculated using 2-sided t-tests or the Pearson's chi-square test. For the multivariate analysis, repeated measures with generalized estimating equations were used. RESULTS: There were statistically significant differences between depressed and nondepressed patients related to race/ethnicity, public versus tertiary care hospital rheumatology clinic, disability, and medications. In the multivariate analysis, increased functional limitation and public clinic site remained significantly associated with increased depression scores. A significant interaction existed between clinic site and disability. Mean depression scores rose more precipitously as functional limitation increased at the public hospital rheumatology clinic. CONCLUSION: There are disparities in both physical and mental health among individuals with low socioeconomic status. The psychological effects of disability vary in patients with RA such that a vulnerable population with functional limitations is at higher risk of developing depressive symptoms.
19890634 Effects of home-based exercise program on the functional status and the quality of life in 2011 Feb We previously reported the efficacy of a 4-week home-based exercise therapy for patients with rheumatoid arthritis (RA). In this study, we aimed to investigate whether short-term improvements in the functional status and quality of life were maintained at 1 year. Patients who completed 4-week home-based exercise program were advised to maintain the same exercises for 1 year duration. Changes of functional status and quality of life in patients with RA were evaluated by the Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Quality of Life Scale (RAQoL). The change of the variables at the different time points (baseline, 4 weeks, and 1 year) was assessed by the repeated measure of ANOVA test with Geisser-Greenhouse correction. Pairwise ANOVA comparisons adjusted using the Bonferroni correction were conducted. Twenty-eight (63.6%) of 44 patients were available for follow-up at 1 year. The results of repeated measure ANOVA showed that there was a statistically significant difference between three assessments in the HAQ (P = 0.015) and RAQoL (P = 0.037) scores at the end of the follow-up. Improvements in the functional status and health-related quality of life at 4 weeks were maintained at 1-year follow-up. In conclusion, we observed significant improvements in the functional status and health-related quality of life by 4-week home-based exercise program. Furthermore, these improvements were maintained at 1-year follow-up. Further studies are needed to confirm the usefulness of the home-based exercise therapy.
22198665 A comparative study on the diversity of clinical features between the sero-negative and se 2012 Dec To investigate the similarities and differences in clinical features between the sero-negative and sero-positive rheumatoid arthritis (RA) patients. Two hundred and sixty-two RA patients who fulfilled the 1987 ACR RA Classification Criteria were enrolled into this study. They were divided into sero-negative and sero-positive group depending on the presence or absence of rheumatoid factor (RF) and anti-cyclic citrullinate peptide (anti-CCP). The clinical features were compared between these two groups. Forty-six (17.6%) RA patients were classified as sero-negative group. The disease onset of sero-negative RA patients was later than that of sero-positive RA patients (52.4 ± 15.9 vs. 47.4 ± 15.5 years, P < 0.05). At the end of the first 2 years after disease onset, bone erosion shown in the hand X-ray occurred in 4 out of 24 (16.7%) patients with sero-negative RA. However, only 5.2% (5/97) patients with sero-positive RA developed bone erosion (P < 0.05). In the sero-positive RA patients, the titer of RF was correlated with swollen joint counts (SJC), tender joint counts (TJC), erythrocyte sedimentation rate (ESR), and disease activity score in 28 joints (DAS28) (P < 0.05), but anti-CCP was not. Sero-negative and sero-positive RA are probably two distinct disease subtypes driven by different mechanisms.
22422621 Prognostic indicators of foot-related disability in patients with rheumatoid arthritis: re 2012 Aug OBJECTIVE: To determine the prevalence and natural history of foot-related disability in patients with rheumatoid arthritis (RA). A secondary aim was to identify explanatory variables, including forefoot bursae, that are either associated with or predictive of disabling foot complications in patients with RA. METHODS: A longitudinal prospective cohort study recruited patients with RA from a rheumatology outpatient clinic. Data were collected at baseline (n = 149) and 1-year (n = 120) and 3-year followup (n = 60). Patient-reported disabling foot complications were evaluated using the subscales of the Foot Impairment Score (FIS): foot impairment/footwear restriction (FIS(IF)) and activity limitation/participation restriction (FIS(AP)). Explanatory variables investigated included ultrasound-detectable forefoot pathology and markers of disease activity. RESULTS: Disabling foot complications were highly prevalent on all occasions. Changes in foot impairment and activity limitation were significantly associated with fluctuations in disease activity (Disease Activity Score in 28 joints using the erythrocyte sedimentation rate [DAS28-ESR]: r = 0.455, P < 0.0001; ESR: r = -0.356, P = 0.008 and DAS28-ESR: r = 0.433, P = 0.001; ESR: r = -0.439, P = 0.001 for the FIS(IF) and FIS(AP), respectively), and approaching a significant association with changes in forefoot bursae (FIS(IF): r = 0.255, P = 0.063 and FIS(AP): r = 0.255, P = 0.063). The presence of disease duration and forefoot bursae was a significant prognostic indicator of foot impairment (P = 0.009 and P = 0.012, respectively), explaining 16% of score variability in the final regression model. Disease duration, forefoot bursae, and erosion presence were identified as significant prognostic indicators of activity limitation (P = 0.002, P = 0.006, and P = 0.019, respectively), explaining 35% of score variability in the final regression model. CONCLUSION: Despite advances in disease management, patients report disability associated with foot problems. Forefoot bursae should be considered for targeted therapy.
22673898 Brief Report: to squeeze or not to squeeze, that is the question! Optimizing the disease a 2012 Oct OBJECTIVE: To optimize use of the Disease Activity Score in 28 joints (DAS28) in early rheumatoid arthritis (RA) by adding the "squeeze test" of forefeet. METHODS: The squeeze test is used to examine bilateral compression pain (BCP) across the metatarsophalangeal (MTP) joints. For this study, data for patients participating in the Treatment in the Rotterdam Early Arthritis Cohort study, an ongoing clinical trial that evaluates different induction therapies in patients with early RA, were randomly divided into 2 subsets. In subset 1 (149 patients and 819 disease activity assessments), the mathematical function of the DAS28-squeeze was constructed using a linear regression model with the DAS as the dependent variable and the DAS28 and squeeze test as the independent variables. A DAS28-BCP disease state was also constructed, in which DAS28 disease state categorizations were upgraded one state if the result of the squeeze test was positive. In subset 2 (153 patients and 754 assessments), concordance in disease states between the DAS28, DAS28-squeeze, and DAS28-BCP disease states was compared, using both the DAS and Boolean-defined remission criteria as reference. RESULTS: Agreement between the DAS and the DAS28-squeeze (82%) was significantly higher than agreement between the DAS and the DAS28 (76%). When we assessed the group of patients who had arthritis of the forefeet only (22 patients and 46 assessments), overall agreement between the DAS and the DAS28 was 40%, while agreement between the DAS and the DAS28-squeeze was 59% and that between the DAS and the DAS28-BCP disease state was 65%. Furthermore, the specificities of the DAS28-squeeze and the DAS28-BCP (80% and 81%, respectively) were higher than that of the DAS28 (76%), while the sensitivities of the DAS28, DAS28-squeeze, and DAS28-BCP to identify true remission according to the Boolean criteria were 88%, 87%, and 81%, respectively. CONCLUSION: Adding the squeeze test of forefeet to the DAS28 has value for dependably classifying the disease state in patients with early RA.
21717191 Underexpression of TIM-3 and blunted galectin-9-induced apoptosis of CD4+ T cells in rheum 2012 Apr The aim of this study is to compare the expression of TIM-3 from CD4+ T cells from rheumatoid arthritis (RA) patients and healthy controls and to evaluate the effect of galectin-9 (Gal-9) on apoptosis of CD4+ T cells in these patients. CD4+ T cells from RA patients and healthy controls were isolated from peripheral blood mononuclear cells and were activated. The expression of TIM-3 mRNA in CD4+ T cells was measured using real-time polymerase chain reaction. CD4+ T cells were activated in the presence of graded doses of Gal-9 or control, and Gal-9-induced cytotoxicity and apoptotic activity of CD4+ T cells were analyzed using MTT assays and annexin-V staining, respectively. TIM-3 mRNA expression was significantly lower in CD4+ T cells from RA patients compared with those in healthy controls (p = 0.028). CD4+ T cell survival as measured by MTT assay when incubated with Gal-9 (15 nM) was significantly higher in RA patients than in healthy controls (p = 0.002). Apoptotic activity of CD4+ T cells from healthy controls as measured by annexin staining increased with graded doses of Gal-9 (0 nM vs. 30 nM, 0 nM vs. 90 nM, p = 0.016 each). However, apoptotic activity of CD4+ T cells from RA patients did not change despite the stimulation with Gal-9. Gal-9-mediated apoptosis of CD4+ T cells is dysfunctional in RA patients. Blunted Gal-9-mediated apoptosis may be exerted through underexpression of TIM-3 that negatively regulates Th1 response. Our data suggest that TIM-3 and its interaction with Gal-9 may play an important role in the pathogenesis of RA and may represent a potential therapeutic target.
22948540 SKG arthritis as a model for evaluating therapies in rheumatoid arthritis with special foc 2013 May The aim was to further characterize the SKG model of rheumatoid arthritis (RA) and its potential for studying intervention treatments, with special focus on bone targeting therapies. Three individual studies were conducted, using a total of 71 SKG mice, comparing arthritis induction with mannan versus zymosan A, female versus male mice, and the effect of dexamethasone intervention treatment initiated at different time points after arthritis induction. Hind paws were embedded undecalcified in methyl methacrylate, and sections were stained with Masson-Goldner trichrome. Areal Bone Mineral Density (aBMD) of the femora was determined with pDXA. RNA was extracted from the hind paws followed by the quantification by reverse transcriptase PCR. SKG mice stimulated with mannan presented a higher arthritis score than mice stimulated with zymosan A. Female SKG mice developed a more severe arthritis than male SKG mice. Dexamethasone inhibited arthritis clinically as well as histologically when the treatment was initiated prophylactically or within the first week of arthritis. Femoral aBMD was lower in animals with arthritis than in control animals. The RANKL RNA expression was elevated in arthritic mice, whereas OPG RNA expression was unchanged. The results suggest mannan as arthritis inductor and female instead of male mice in experiments as well as an optimal time window for the initiation of treatment. Systemic bone loss as well as local up regulation of RANKL was present early in SKG arthritis. These results demonstrate that SKG arthritis is a suitable new model for evaluating therapies in RA.
22210441 Effects of 18β-Glycyrrhetinic acid in hTNFtg mice - a model of rheumatoid arthritis. 2012 Mar INTRODUCTION: Rheumatoid arthritis is a chronic autoimmune disease characterised by inflammation of joints with cartilage and bone destruction leading to progressive disability. While the cause of rheumatoid arthritis is not known and the disease cannot be cured, conventional disease modifying antirheumatic drugs and biologicals are effective treatments for many patients. However, new therapies are needed in order to achieve better relief from rheumatoid arthritis symptoms than currently possible and to fully prevent joint damage. 18β-Glycyrrhetinic acid is not only used frequently in traditional Chinese medicine, but has been reported to target some of the inflammatory mediators involved in the pathogenesis of rheumatoid arthritis. Moreover, it has been reported that liquorice, which contains high levels of 18β-Glycyrrhetinic acid, reduces inflammation and articular damage in collagen induced arthritis. Therefore, we studied the effects of 18β-Glycyrrhetinic acid in a Tumor necrosis factor (TNF) dependent mouse model of rheumatoid arthritis. MATERIAL AND METHODS: HTNFtg mice were treated with 18ß-Glycyrrhetinic acid from day 28 after birth every second or third day for 2 weeks, or 3 times a week for six weeks. TNF inhibitor treated animals served as positive control. RESULTS: Clinical scores of arthritis were not altered in animals treated with 18β-Glycyrrhetinic acid compared to placebo treated animals. Histological data also indicate no effects of 18β-Glycyrrhetinic acid on inflammatory joint destruction. TNF inhibitors, however markedly reduced not only clinical signs of TNF triggered joint inflammation but also histological signs of erosive disease. Therefore, in contrast to previous reports our data indicate that 18β-Glycyrrhetinic acid does not provide a new therapeutic option for treating patients with rheumatoid arthritis.
21431303 Angiogenesis as a therapeutic target in arthritis in 2011: learning the lessons of the col 2011 Sep The paradigm of a therapy aimed at inhibiting the formation of blood vessels, which would consequentially deprive cells and tissues of oxygen and nutrients, was born from the concept pioneered by the late Judah Folkman that blood vessel formation is central to the progression and maintenance of diseases which involve cellular metabolism and tissue expansion, and cancer in particular. The prototype targeted angiogenesis inhibitor anti-vascular endothelial growth factor (VEGF) antibody bevacizumab was approved in 2004 for colorectal cancer, and has since been approved for other cancers. Rheumatoid arthritis (RA) is a chronic inflammatory disease, during which inflamed tissue invades and destroys cartilage and bone. The tissue expansion, invasion, expression of cytokines and growth factors and areas of hypoxia which are a feature of RA have resulted in the hypothesis that angiogenesis inhibition may also be beneficial in RA, drawing on the success of bevacizumab. This review focuses on our current understanding of the importance of angiogenesis in RA, and on the lessons which may be learnt from the clinical experiences of angiogenesis blockade, particularly in colorectal cancer.
22571727 Long-term stability of anti-cyclic citrullinated peptide antibody status in patients with 2012 May 9 INTRODUCTION: The utility of reassessing anti-cyclic citrullinated peptide (anti-CCP) antibody status later in disease in patients presenting with early undifferentiated inflammatory polyarthritis, particularly in those who test negative for both anti-CCP and rheumatoid factor (RF) at baseline, remains unclear. We aimed therefore to determine the stability of CCP antibody status over time and the prognostic utility of repeated testing in subjects with early inflammatory polyarthritis (IP). METHODS: Anti-CCP and RF were measured at baseline and 5 years in 640 IP patients from the Norfolk Arthritis Register, a primary care-based inception cohort. The relation between change in anti-CCP status/titer and the presence of radiologic erosions, the extent of the Larsen score, and Health Assessment Questionnaire (HAQ) score by 5 years was investigated. RESULTS: With a cut-off of 5 U/ml, 28% subjects tested positive for anti-CCP antibodies, 29% for RF, and 21% for both at baseline. Nine (2%) anti-CCP-negative patients seroconverted to positive, and nine (4.6%) anti-CCP-positive individuals became negative between baseline and 5 years. In contrast, RF status changed in 17% of subjects. However, change in RF status was strongly linked to baseline anti-CCP status and was not independently associated with outcome. Ever positivity for anti-CCP antibodies by 5 years did not improve prediction of radiographic damage compared with baseline status alone (accuracy, 75% versus 74%). A higher baseline anti-CCP titer (but not change in anti-CCP titer) predicted worse radiologic damage at 5 years (P < 0.0001), even at levels below the cut-off for anti-CCP positivity. Thus, a titer of 2 to 5 U/ml was strongly associated with erosions by 5 years (odds ratio, 3.6 (1.5 to 8.3); P = 0.003). CONCLUSIONS: Repeated testing of anti-CCP antibodies or RF in patients with IP does not improve prognostic value and should not be recommended in routine clinical practice.
21710216 [Arthroplasty for rheumatic elbow joints]. 2011 Jul Without proper treatment rheumatoid arthritis can lead to pain, instability and destruction of the elbow joint. As with artificial knee replacement various designs are available and in general non-constrained and semi-constrained designs are preferred. Fully constrained designs should be avoided due to high loosening rates. Results have shown a significant pain reduction, however, a restricted range of motion has to be expected. Restrictions in load-bearing and mobility are among the major problems after elbow arthroplasty in patients with rheumatoid arthritis which have to be discussed with the patient before surgery. Future studies will have to evaluate the effectiveness of new modular designs.
22018184 The origins, results and consequences of the 1995 Arthritis Research Campaign Low-Dose Glu 2011 Sep The discovery and subsequent therapeutic use of glucocorticoids, which took 30 years, was stimulated by clinical observation and achieved by persistent investigation. Early reports of the potential of glucocorticoids to modify the underlying course of rheumatoid arthritis (RA) were overshadowed by pharmaceutical innovations with symptom relieving non-steroidal anti-inflammatory drugs (NSAIDs), and it was not until 1995 that clear-cut evidence of a powerful glucocorticoid disease-modifying action was published as the Arthritis Research Campaign Low-dose Glucocorticoid Study. This review reports how the study came to be designed and implemented, adds some additional information from the study not previously published, and considers the subsequent impact of the 1995 paper. Eighty years after Hench and colleagues made their first suggestion of benefit the UK National Health Service suggested all patients newly diagnosed with RA should have early access to glucocorticoid treatment.
21953343 Disability in rheumatoid arthritis in the era of biological treatments. 2012 Feb OBJECTIVE: Rheumatoid arthritis (RA) is a disabling disease. The authors studied the impact of new, expensive and occasionally toxic biological treatments on disability outcomes in real-world populations of patients with RA. METHODS: The authors analysed Health Assessment Questionnaire Disability Index data on 4651 adult patients with RA collected prospectively from 1983 to 2006. They studied trends in disability using multilevel mixed-effects multivariable linear regression (mixed) models that adjusted for the effects of time trends in gender, ethnicity, age, smoking behaviour and disease duration. RESULTS: Overall, the patients were predominantly female (76%), were predominantly white (88%), had 13 years of education and have had RA for 13 years, on average. The time period from 1983 to 2006 saw major increases in the use of disease-modifying agents and biological agents, and a decrease in smoking. After adjustments, the disability rates declined at annual rates of 1.7% (1.5-1.8%) overall and 2.7% (2.4-3.1%) among men. The annual rate of disability declines in the biological era was greater than that in the preceding period, suggesting accelerated improvement. These declines were documented in all patient subgroups such as men, women, African-Americans, obese, older age groups and early disease (p<0.001), but not among the 1401 patients (where disability remained stable) who died on follow-up. CONCLUSION: Aggressive use of traditional disease-modifying agents and introduction of biological agents were associated with substantial gains in disability outcomes. Our finding supports the prevailing notion that 'tight inflammation control' is a desirable therapeutic strategy.
20859242 Anticyclic-citrullinated protein antibodies in the diagnosis of ophthalmic inflammatory di 2011 Jan While rheumatoid factor (RF) testing has been previously used in the detection of rheumatoid arthritis (RA), its effectiveness has been limited by poor rates of sensitivity and specificity and its positivity in multiple other disease states. Given its enhanced specificity, quantification of anticyclic-citrullinated protein (anti-CCP) antibodies has emerged as a standard in molecular testing for RA. Despite the importance of this test in clinical rheumatology, we are unaware of any reports of its use in the detection of uveitis or orbital disease. In this report, we characterize the first use of anti-CCP in the diagnosis of orbital disease.
23265051 [The criteria of differentiated diagnostics of early arthritis on the basis of analysis of 2012 Oct The study analyzed serum hyaluronidase and deoxyribonuclease activity in patients with early arthritis--early rheumatoid arthritis and acute reactive arthritis. The criteria of their differential diagnostics were developed on the basis of data obtained. The genuine methods were applied to analyze hyaluronidase and deoxyribonuclease activity of blood serum based on formation of clot of etacridine acetate (rivanol) with hyaluronic acid and DNA inversely proportionally to their polymerization under the impact of enzymes. The increased serum hyaluronidase and deoxyribonuclease activity was established in patients with early arthritis as compared with control group (p < 0.001). The prevalence of mentioned types of activity under early rheumatoid arthritis as compared with acute reactive arthritis was detected too. The rests for differentiate diagnostics of early rheumatoid arthritis and acute reactive arthritis were developed conformed to criteria of the most useful diagnostic tests in rheumatology.
21600203 MicroRNAs in rheumatoid arthritis. 2011 Dec 1 Rheumatoid arthritis (RA) is a chronic and severe autoimmune disease that affects joint tissues, bone, and cartilage. However, the pathogenesis of RA is still unclear. Autoantibodies such as rheumatoid factor and anti-cyclic citrullinated peptide are useful tools for early diagnosis, monitoring disease activity, and predicting prognosis. Recently, many groups have focused their attention on the role of microRNAs in the pathogenesis of RA, as well as a potential biomarker to monitor RA. In fact, the expression of some microRNAs, such as miR-146a, is upregulated in different cell types and tissues in RA patients. MicroRNAs in RA could also be considered as possible future targets for new therapeutic approaches.
22833240 The prevalence of rheumatoid arthritis in Estonia: an estimate based on rheumatology patie 2013 Apr Sound epidemiological data are a basic requirement for decision making on the allocation of health care resources. Unfortunately, this is not the case in Estonia, where the paucity of epidemiological data has impeded health care planning for rheumatic conditions. The current paper presents the first effort to explore the epidemiology of rheumatoid arthritis (RA) in Estonia. Electronic databases of all rheumatology units of Harju County, three national and one private, were searched for the records of RA (ICD-10 diagnoses M05 and M06.0) patients who had visited a rheumatologist during 2006 or 2007. Prevalence of RA was calculated for the age 20 years and older and for subsets according to age and gender, using the numbers from the patients' database in the numerator and the corresponding population numbers in the denominator. The total number of prevalent RA cases was 1,897, of which 85 % (n = 1,605) were women. The overall crude period prevalence 2006-2007 of RA in Harju County for the age group 20 years and older was 0.46 %. RA prevalence for both sexes increased with age until the age of 70-79 years and decreased subsequently. Prevalence of RA was significantly higher for women compared with men in all age groups. The prevalence of RA among women and men 20 years and older was 0.70 % (6.68-7.37) and 0.16 % (1.42, 1.79), respectively. Age-standardized (European population) prevalence rate was 0.44 %. The results are concordant with epidemiological data on RA prevalence derived recently in other European countries.
20349068 Development of interstitial pneumonia in a patient with rheumatoid arthritis induced by is 2012 May Here, we report a 56-year-old patient with rheumatoid arthritis (RA) who had been treated with methotrexate and sulfuasalazine, but the disease activity remained high. Therefore, we planned TNF-blocker treatment for this patient. A tuberculin skin test was positive, we started anti-tuberculosis (TB) chemoprophylaxis with isoniazid (INH). However, liver dysfunction was appeared after 2 weeks from the start of INH. Therefore, we discontinued INH transiently and tried the desensitization of INH. However, interstitial pneumonia was developed 2 weeks after the re-start of INH, we decided to stop the INH prophylaxis. Interstitial pneumonia was improved by corticosteroid treatments. This case report shows that INH-induced IP can be occurred during the course of anti-TB chemoprophylaxis in patients with RA.
21371146 The relationship between self-care agency, disability levels and factors regarding these s 2012 Jan AIMS AND OBJECTIVES: To assess the relationship between self-care agency scores, disability levels and factors regarding these situations among Turkish patients with rheumatoid arthritis. BACKGROUND: Rheumatoid arthritis is characterised by severe to slight synovial joint inflammation that can lead to pain, stiffness and joint destruction with subsequent physical deformities, disabilities and reduced self-care. Self-care is an important component of comprehensive chronic disease management such as rheumatoid arthritis. If patients have high levels of self-care and adhere to rheumatoid arthritis treatment, it can be expected that they will have fewer symptoms and better functional capabilities. DESIGN: A cross-sectional, design was used. METHOD: This study was conducted with 467 rheumatoid arthritis patients who applied at the Rheumatology Outpatient Department of Gaziantep University between September 2008-February 2009. The data collection instruments used in this study were the Demographic Data Form, Health Assessment Questionnaire (including disability index and pain scale) and Self-as-Carer Inventory. The frequency, mean, Student's t-test, one-way anova, Kruskal-Wallis, chi-square, correlation and regression analysis were used; p < 0·05 was accepted as statistically significant. RESULTS: For patients the self-care agency classification of 13·7% and 86·3% were 'moderate' and 'poor', respectively; while the disability levels of 12·2 51·2 and 36·6% were 'mild', 'moderate' and 'severe', respectively; and their pain average was 'moderate'. It was also determined that, as the patients' self-agency scores declined, their disability levels deteriorated even further and their pain levels increased even more. CONCLUSIONS: In conclusion we found that in Turkish patients with Rheumatoid Arthritis, the higher disability and pain rate were, the lower self-care agency score was. RELEVANCE TO CLINICAL PRACTICE: Nurses should strive to provide individuals with RA the knowledge, skills and resources necessary for active participation in self-care, as this might promote the capacity for self-care.