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ID PMID Title PublicationDate abstract
23126558 Anti-cyclic citrullinated peptide antibodies: a comparison of different assays for the dia 2013 OBJECTIVES: Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific markers of rheumatoid arthritis (RA). Considering the heterogeneity of the target antigens involved, and the test platforms and conjugates proposed in commercial anti-CCP assays, we assessed the diagnostic performances of four fully automated anti-CCP assays in a cohort of patients with RA compared to patients with other autoimmune and inflammatory disorders. We also evaluated the agreement between the qualitative results of these immunoassays. METHOD: We evaluated three anti-CCP2 assays [Eurodiagnostica enzyme-linked immunosorbent assay (ELISA), Elecsys electrochemiluminescence immunoassay (ECLIA) on the Modular E170 Analyzer, and Zenit chemiluminescence immunoassay (CLIA) on the Zenit RA Analyzer] and one anti-CCP3 assay (Inova ELISA). ELISAs were performed on an automated workstation. Samples from 112 patients with RA and a disease control group of 136 patients (53 with autoimmune diseases, 65 non-autoimmune disorders, and 18 infectious diseases) were studied (included 161 samples submitted consecutively to the laboratory). RESULTS: At a fixed specificity of 92%, the anti-CCP3 assay presented the highest sensitivity (75%) compared to the anti-CCP2 assays evaluated (63-72%). The Zenit anti-CCP2 assay gave the most false-positive results (especially in patients with viral infections and connective tissue diseases). The agreement between assays ranged from 86.3% to 95.2% and Kappa coefficients ranged from 0.724 to 0.899. CONCLUSIONS: Recently released automated workstations provide a valuable alternative to ELISA to diagnose RA. However, differences in diagnostic performances are highlighted in our experience, especially for the Zenit assay. In our cohort, the anti-CCP3 assay gave slightly better performances than the anti-CCP2 assays (with the exception of the Zenit assay).
21961923 A computer Time Trade-Off: a feasible and reliable alternative for the interview Time Trad 2011 Sep OBJECTIVES: The Time Trade-Off (TTO) is an instrument used for valuing health-related quality of life. This study evaluated the test-retest reliability of a computer TTO in rheumatoid arthritis (RA), and compared the computer with the interview TTO regarding feasibility and agreement. METHODS: In study 1 using a cross-over design, thirty patients completed both TTOs. In study 2, twenty-nine other patients completed the computer TTO twice to examine test-retest reliability. Feasibility was measured by assessing actual and perceived time duration and general experience of the patient. Agreement between utility scores of both TTOs was measured by Bland-Altman analysis. RESULTS: Both TTOs were feasible. The computer TTO showed high test-retest reliability (ICC = 0.88). Bland-Altman analysis showed a small mean difference (0.06, SD = 0.14, effect size=0.30) between both TTOs. Limits of agreement were wide (-0.22 to 0.34). Differences between interview and computer TTO utilities did not vary over the range of scores. CONCLUSIONS: The computer TTO was feasible and reliable, but did not provide similar results as the interview TTO. However, no systematic biases in the differences were found over the range of scores.
21810022 MicroRNA 146a expression in rheumatoid arthritis: association with tumor necrosis factor-a 2011 Nov AIM: MicroRNAs (miRNAs) regulate the expression of many genes and may be involved in regulating the immune response. Expression of microRNA 146a (miRNA 146a) in peripheral blood mononuclear cells was studied by real-time polymerase chain reaction in 70 patients with rheumatoid arthritis (RA), 45 patients with knee osteoarthritis (OA), and 60 healthy controls. Disease activity of RA was assessed using disease activity score (DAS) 28 and physical disability using the Improved Health Assessment Questionnaire. RESULTS: miRNA 146a expression was significantly higher in patients with RA than in those with OA and in controls (p<0.0001) but did not differ between the latter two groups (p=0.06). Tumor necrosis factor-alpha (TNF-α) was significantly higher in RA than in OA and controls (p<0.0001) and in OA than controls (p=0.001). In patients with RA, miRNA 146a positively correlated with TNF-α (p=0.0003), erythrocyte sedimentation rate (ESR) (p=0.022), and DAS 28 (p=0.009). miRNA 146a expression did not differ between patients with RA receiving anti TNF-α and those receiving conventional therapy (p>0.05). CONCLUSION: miRNA 146a expression is upregulated in patients with RA and may be a potentially useful marker of disease activity in these patients. Lack of overexpression of miRNA 146a in the presence of increased TNF-α in OA requires further investigation.
22505698 Indirect treatment comparison of abatacept with methotrexate versus other biologic agents 2012 Jun OBJECTIVE: To compare the efficacy of abatacept and alternative biologic disease-modifying antirheumatic drugs (DMARD) in patients with rheumatoid arthritis (RA) and an inadequate response to methotrexate (MTX) in the United Kingdom. METHODS: A systematic literature search identified 11 individual studies investigating the efficacy of abatacept, infliximab, adalimumab, etanercept, certolizumab pegol, and golimumab in adult patients with RA that did not respond to MTX. The clinical trials included in this analysis were similar in trial design, baseline patient characteristics, and background therapy (i.e., MTX). The key clinical endpoints of interest were the Health Assessment Questionnaire (HAQ) change from baseline (CFB) and the American College of Rheumatology (ACR) responses at 6 months (24-28 weeks). Results were analyzed using Bayesian network metaanalysis methods, and were expressed as differences in HAQ CFB and ACR20/50/70 relative risks, with 95% credible limits (CrL). RESULTS: Analysis of HAQ CFB at 6 months showed that abatacept is more efficacious than placebo [mean difference in HAQ CFB: -0.30 (95% CrL -0.42; -0.16)] and comparable to all other biologic agents, in patients receiving MTX as background treatment. Abatacept is also expected to result in a higher proportion of ACR responders compared to placebo, with relative risks ranging from 1.90 (95% CrL 1.24; 2.57) for ACR20 to 3.72 (95% CrL 1.50; 10.52) for ACR70, and to result in comparable proportions of ACR responders as other biologic agents, at 6 months. CONCLUSION: Abatacept is expected to result in improvement in functional status comparable to other recommended biologic agents in patients with RA who are unresponsive to MTX in the UK.
23285481 Fas/FasL promoter gene polymorphism in patients with rheumatoid arthritis. 2012 Dec 20 OBJECTIVES: Fas/FasL is significantly involved in the pathogenesis of rheumatoid arthritis (RA). Fas/FasL gene polymorphism may be associated with susceptibility to rheumatoid arthritis and disease severity. AIM: To investigate the Fas 670 G/A and FasL 843 C/T genotype and allele frequency in patients with RA, and determine its potential association with susceptibility to the disease and the clinical parameters. METHODS: One hundred and one patients with RA and 105 healthy control subjects were enrolled in the study. Fas 670 A/G and FasL 843C/T genotype polymorphism was investigated by PCR-RFLP. Chi-square test was used for determining the genotype distribution and the allele incidence. RESULTS: There was no statistically significant difference between the patients with RA and the healthy subjects with respect to Fas-670 A/G and FasL-843C/T genotype distribution and allele frequency (P>0.05). While there was no statistically significant difference in disease severity and various clinical parameters, a correlation was detected between Fas-670 polymorphism and anti-CCP antibody and anemia (P<0.01 and P<0.03, respectively). CONCLUSIONS: Fas-670A/G and FasL-843C/T promoter gene polymorphisms are not considered to represent a major genetic risk factor for RA susceptibility and disease severity. However, based on these results, Fas-670 promoter polymorphism may modulate anti-CCP antibody synthesis and response in patients with rheumatoid arthritis.
21385114 Kinoid of human tumor necrosis factor-alpha for rheumatoid arthritis. 2011 Apr INTRODUCTION: Anti-TNF-α drugs have dramatically changed treatment of rheumatoid arthritis (RA) in terms of both clinical control and articular damage prevention. Despite this, they hold some important drawbacks, such as frequent therapeutic failures and high costs. Anti-TNF-α active immunization, with a therapeutic vaccine against TNF-α, is a promising alternative anti-TNF-α targeting strategy, potentially devoid of treatment limitations of some of current anti-TNF blocking agents. AREAS COVERED: This review covers the preclinical proof-of-concept of anti-TNF-α vaccination with the kinoid of human TNF-α (TNFK) and analyzes the body of evidence forming the rationale for the application of this strategy in RA and other TNF-α-dependent diseases. We describe the theoretical bases of anti-TNF-α active immunization and of experimental data supporting the applicability of TNFK to human disease in terms of both safety and efficacy. EXPERT OPINION: Based on preclinical efficacy and safety data supporting its feasibility in a Phase I - II trial in Crohn's disease, anti-TNF-α vaccination with TNFK has entered the phase of clinical development and promises to be a valuable anti-TNF-α targeting strategy in human disease. The focus is made in the first clinical trial in RA (Phase II) on the efficacy in active RA patients having developed antibodies against anti-TNF mAbs.
21841734 Physiotherapy in rheumatoid arthritis: development of a practice guideline. 2011 Apr BACKGROUND: To improve the quality of the physiotherapy management in patients with rheumatoid arthritis (RA) a Dutch practice guideline, based on current scientific evidence and best practice, was developed. This guideline comprised all elements of a structured approach (assessment, treatment and evaluation) and was based on the Internatio-nal Classification of Functioning, disability and Health (ICF) and the ICF core sets for RA. METHODS: A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 10 experts from different professional backgrounds resulting in the final guideline. RESULTS: In total 7 topics were selected. For the initial assessment, three recommendations were made. Based on the ICF core sets for RA a list of health problems relevant for the physiotherapist was made and completed with red flags and points of attention. Concerning treatment, three recommendations were formulated; both exercise therapy and education on physiotherapy were recommended, whereas passive interventions (delivery of heat or cold, mechanical, electric and electromagnetic energy, massage, passive mobilization/manipulation and balneotherapy) were neither recommended nor discouraged. For treatment evaluation at the level of activities and participation, the Health Assessment Questionnaire was recommended. For evaluating specific body structures and functions the handheld dynamometer, 6-minute walk test or Ästrand bicycle test (including Borg-scale for rating the perceived exertion), Escola Paulista de Medicina Range of Motion Scale and a Visual Analog Scale for pain and morning stiffness were recommended. CONCLUSION: This physiotherapy practice guideline for RA included seven recommendations on the initial assessment, treatment and evaluation, which were all based on the ICF and the ICF Core Set for RA. The implementation of the guideline in clinical practice needs further evaluation.
23130635 The use of continuous data versus binary data in MTC models: a case study in rheumatoid ar 2012 Nov 6 BACKGROUND: Estimates of relative efficacy between alternative treatments are crucial for decision making in health care. When sufficient head to head evidence is not available Bayesian mixed treatment comparison models provide a powerful methodology to obtain such estimates. While models can be fit to a broad range of efficacy measures, this paper illustrates the advantages of using continuous outcome measures compared to binary outcome measures. METHODS: Using a case study in rheumatoid arthritis a Bayesian mixed treatment comparison model is fit to estimate the relative efficacy of five anti-TNF agents currently licensed in Europe. The model is fit for the continuous HAQ improvement outcome measure and a binary version thereof as well as for the binary ACR response measure and the underlying continuous effect. Results are compared regarding their power to detect differences between treatments. RESULTS: Sixteen randomized controlled trials were included for the analysis. For both analyses, based on the HAQ improvement as well as based on the ACR response, differences between treatments detected by the binary outcome measures are subsets of the differences detected by the underlying continuous effects. CONCLUSIONS: The information lost when transforming continuous data into a binary response measure translates into a loss of power to detect differences between treatments in mixed treatment comparison models. Binary outcome measures are therefore less sensitive to change than continuous measures. Furthermore the choice of cut-off point to construct the binary measure also impacts the relative efficacy estimates.
22510391 Elaboration and validation of a questionnaire (Qualisex) to assess the impact of rheumatoi 2012 Jul OBJECTIVES: Rheumatoid arthritis (RA) may have consequences on sexual life. The objective was to develop and validate a questionnaire assessing the impact of RA on sexuality. METHODS: First, 6 patients (5 women, 1 man) with RA, 2 rheumatologists and 1 sexologist elaborated during a one-day focus-group type meeting an exhaustive list of issues relating to impact of RA on sexuality. The list was reduced by merging similar issues, then according to the relative importance for patients of each issue. A questionnaire was developed with input from these patients, with particular attention on phrasing. Psychometric properties (missing data, correlations with other disease aspects, reliability) were assessed in a multi-centre study. RESULTS: The list of 33 issues related to impact of RA on sexuality included psychological issues (9), couple/relationship issues (9), physical issues (7), and general aspects (5). A 10-question numeric rating scale questionnaire was constructed. Preliminary validation was obtained on 53 patients (44 women, mean age 50.7 years; mean disease duration 14.4 years). The mean score was 3.3±2.5, missing data were acceptable (13%). Qualisex results were correlated with disease activity and symptoms (r=0.50-0.65, p< 0.001); but not with demographics, depression or coping. Qualisex was reliable in 40 patients: the intra-class correlation coefficient was 0.83 (95% CI: 0.70-0.91). CONCLUSIONS: A simple (10 questions) and valid tool investigating impact of RA on sexuality has been developed with the involvement of patients. This tool can be useful to assess this important aspect of quality of life.
22214806 [Autoimmunity to glycolytic enzyme in rheumatoid arthritis]. 2011 Prognosis of rheumatoid arthritis (RA) patients has significantly improved with the recent use of biologics targeting TNFα, IL-6, and co-stimulatory molecule. In US and Europe, clear therapeutic benefit of anti-CD20 antibodies is also confirmed. As a disease specific marker, rheumatoid factor and anti-citrullinated protein antibody are crucial in RA, although the pathology of them is not defined. Here we focus on glycolytic enzyme such as glucose-6-phospate isomerase, that is confirmed as arthritogenic in two different mouse models, and discuss about pathogenic relevance to RA.
22101697 Effect of xinfeng capsule on the cardiac function in patients with rheumatoid arthritis. 2011 Oct OBJECTIVE: To study the changes in cardiac function of rheumatoid arthritis (RA) patients and: to observe the effect of xinfeng capsule ( XFC) on them. METHODS: Sixty-eight RA patients were: randomly assigned to two groups by a lottery: 38 patients in the treatment group treated orally with XFC, 3 capsules, thrice a day, and 30 in the control group treated with fengshi gutong capsule (FSGTC), 4 capsules, twice a day, 30 days as one course of treatment, and two courses were given for both groups. A normal control (NC) group including 20 healthy subjects was set up. The clinical efficacy was compared between the two treated groups. The changes in cardiac function, including early diastolic peak flow velocity (E), late diastolic peak flow velocity (A), left ventricular fraction shortening (FS), and E/A, as well as uric acid (UA), erythrocyte sedimentation rate (ESR), α-acid glycoprotein (α-AGP), and hypersensitive C-reaction protein (hs-CRP), were observed. The regulation T cell was determined with flow cytometry. RESULTS: (1) The total effective rate in the treatment group and the control group was 92.1%: (35/38) and 70.0% (21/30), respectively. Significant difference was shown between them (P<0.05). (2)
22507346 Can the association of Ciclosporine A and Methotrexate maintain remission/low disease acti 2012 Jan The opportunity to induce remission/low disease activity in Rheumatoid Arthritis (RA) patients has been achieved in recent years by the adoption of more sensitive diagnostic methods [Magnetic Resonance Imaging (MRI), ultrasonography] and early aggressive treatments (combination of biologics and synthetic DMARDs). On the other hand, data are still scarce and contrasting about the management of long-term remission. The aim of this preliminary study is to evaluate whether the association of Methotrexate + Ciclosporine A (MTX + CSA) therapy in early RA (eRA) patients is able to maintain remission/low disease activity and avoid structural progression, evaluated by MRI. Etanercept was suspended in patients who reached remission/low disease activity and CSA+MTX therapy was introduced (T0), all patients continued to receive MTX; at this time MRI showed mild/moderate synovitis and erosions in all the patients; 1-year after (T1), a slight reduction in mean synovitis, bone edema and total score was observed, whereas the erosion score was unchanged. The mean DAS44 remained stable from T0 to T1 and 6/7 patients maintained a low disease activity score. No side effects were reported. These results confirm the good clinical efficacy and safety of the combination therapy CSA+MTX in eRA patients and demonstrate a parallel arrest of structural damage evaluated by MRI 1-year after etanercept suspension.
21885511 Magnetic resonance imaging in rheumatoid arthritis clinical trials: emerging patterns base 2011 Sep OBJECTIVE: The current validated magnetic resonance imaging (MRI) scoring method for rheumatoid arthritis (RA) in clinical trials, RA MRI Score (RAMRIS), incorporates all metacarpophalangeal (MCP) and wrist joints except MCP-1. The experience with radiographic scoring, however, was that excluding certain bones in the wrist improved the discriminative power for changes over time. In this study, we pool MRI data from randomized controlled clinical trails (RCT) to determine which combination of MCP and wrist joints are most sensitive and discriminative for structural changes over time. METHODS: MR images from 4 multicenter RCT, including 522 RA patients, were read by 2 radiologists, using the RAMRIS scoring system for erosion, osteitis, and synovitis. In one RCT, joint-space narrowing (JSN) was assessed cross-sectionally by one radiologist using a previously validated method. Baseline frequencies of erosion, JSN, osteitis, and synovitis of different bones and joints in the hand and wrist were compared. Intraclass correlation coefficients between readers were determined for each location. Finally, 7 different combinations of bone/joint locations were compared for their ability to discriminate subjects showing increases or decreases from baseline greater than or equal to smallest detectable changes (SDC) at Weeks 12 or 24. RESULTS: Frequency of involvement and reliability for assessing change varied by location. As in earlier analyses, excluding certain wrist bones increased the percentage of subjects showing changes greater than or equal to SDC. CONCLUSION: These findings suggest that excluding wrist bones that do not frequently or reliably demonstrate structural changes improves the discriminative power of the RAMRIS scoring system.
23259654 Short-term and long-term safety of glucocorticoids in rheumatoid arthritis. 2012 Despite over 60 years of use, glucocorticoids continue to be a controversial therapy in rheumatoid arthritis (RA). This stems largely from their measured a well as their perceived toxicity. However, a paucity of top tier evidence from clinical trials or very carefully controlled observational studies leads to limited evidence supporting potential causal relations between low-dose glucocorticoids and adverse outcomes. Several new studies have contributed to an improved understanding of these associations and they are reviewed here along with highlights from the older body of literature examining these important outcomes.
22651246 Malignancy validation in a United States registry of rheumatoid arthritis patients. 2012 May 31 BACKGROUND: Physician reporting is commonly used to ascertain adverse events or outcomes measured in epidemiologic studies. However, little is known on the accuracy of physician reported malignancies compared to pertinent medical record review in large cohort studies. METHODS: The Consortium of Rheumatology Researchers of North America (CORRONA) registry gathers physician-completed questionnaires for rheumatoid arthritis (RA) patients, including request for information on incident malignancies, approximately every three months. For incident malignancies reported from October 1st, 2001, through December 31st, 2007, we retrospectively requested completion of a Targeted Adverse Event (TAE) form for additional information as well as primary source documents to adjudicate the malignancy reports. CORRONA has employed a prospective request for source documentation for these events since 2008. We classified each malignancy as definite, probable, possible, or not a malignancy. RESULTS: From 20,837 RA patients enrolled in CORRONA, 461 incident malignancies were initially reported on physician questionnaires. After review of returned source documents with adjudication, 234 were deemed definite, 69 probable, 101 possible, and 57 not an incident malignancy. The positive predictive value (PPV) of initial physician report of a malignancy versus "definite or probable" malignancy based on adjudication was 0.66 (95% CI 0.61 - 0.70). The PPV was 0.68 (95% CI 0.63 - 0.72) when the subsequent TAE form also confirmed the presence of malignancy. When possible malignancies were included, the PPV of physician-reported malignancies without a subsequent TAE form increased to 0.86 (0.83 - 0.89), and with a subsequent TAE form, 0.89 (0.85-0.91). CONCLUSION: Twelve percent of initial physician reports of incident malignancy could not be confirmed with review of source documents. The most common reason for lack of confirmation was inability to obtain documents or insufficient data in source materials. These results suggest that timely collection of relevant medical records and an adjudication process are required to improve the accuracy of cancer reporting in epidemiologic studies.
21753786 Influence of variations across the MMP-1 and -3 genes on the serum levels of MMP-1 and -3 2012 Jan Matrix metalloproteinases (MMPs) are involved in joint destruction in rheumatoid arthritis (RA), and are strongly associated with levels of inflammation. To understand the relationship between MMP-1 and -3 variants and MMP levels in RA, we investigated the genotypic and haplotypic relationships of the MMP-1 and -3 genes with circulating levels of these MMPs. The genotypes of single-nucleotide polymorphisms (SNPs) rs1799750 (1G/2G, MMP-1 promoter), rs495366 (G/A, intergene), rs679620 (A/G, MMP-3 coding region) and rs3025058 (5A/6A, MMP-3 promoter) were determined in 430 RA patients. Each polymorphism was associated with serum levels of MMP-1 (P trend <0.0001 for each SNP), with haplotype 1G-G-A-5A associated with the highest level. The intergenic and MMP-3 SNPs were associated with MMP-1 levels independent of the MMP-1 promoter SNP. The MMP-3 SNPs were associated with serum MMP-3 level (P trend <0.0001 for each SNP), and were each associated with mean time-averaged disease activity (DAS28) in patients followed up for 2 years (P=0.003). Our findings indicate that several closely linked polymorphisms in the MMP-1-MMP-3 loci have an important role in determining the circulating levels of these MMPs in RA, and that MMP-3 polymorphism is associated with the level of disease activity over time.
21872357 Antiphospholipid antibodies and atherosclerosis: insights from rheumatoid arthritis--a fiv 2011 Dec OBJECTIVES: Life expectancy in rheumatoid arthritis (RA) patients is reduced by 3-10 years, probably due to cerebrovascular and cardiovascular diseases associated with atherosclerosis. In the present study, we wanted to verify if previously reported IgA anti-beta 2-glycoprotein I (2GPI) antibodies possibly represented an independent risk factor for atherosclerosis in RA patients during a longer period of follow up. METHODS: The follow-up study (after 5.5 years) comprised all initially included patients and controls (premenopausal women, non-diabetic, normotensive at the start of the study), except for two RA patients (one died and one not available). The same clinical, laboratory and ultrasound assessments were performed. RESULTS: Patients and controls were divided into three categories: Intima-media thickness (IMT) progressors, plaque progressors, IMT and plaque progressors. In controls, 55% represented IMT progressors and 5% IMT and plaque progressors. No statistically significant differences were detected comparing the progressors with delta (Δ=difference between follow-up and baseline study for each group in a time span of 5.5 years) LDL cholesterol, homocysteine and IgA anti-β2GPI. In patients, there were 48.5% IMT progressors, 5.8% plaque progressors and 19.1% IMT and plaque progressors. The progression was statistically significant associated with the levels of Δ homocysteine and Δ apolipoprotein B but not with LDL cholesterol and IgA anti-β2GPI. CONCLUSIONS: The follow-up study showed advanced atherosclerosis in RA patients compared to sex and age matched controls. However, we were not able to confirm our initial impression that IgA anti-β2GPI might represent an independent risk factor for atherosclerosis.
22935383 Metabolic cardiovascular risk burden and atherosclerosis in African black and Caucasian wo 2013 Jan OBJECTIVES: The impact of metabolic risk factors on atherosclerotic cardiovascular disease (ACVD) in patients with rheumatoid arthritis (RA) from developing populations is currently unknown. We examined the relationships of the metabolic syndrome (MetS) and its components with carotid artery atherosclerosis in African women with rheumatoid arthritis (RA) from a developing black and developed Caucasian population. METHODS: We assessed the associations of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) defined MetS and its criteria with high resolution B-mode ultrasound determined common carotid artery intima-media thickness (cIMT) and carotid artery plaque in multivariable regression models in 104 black and 93 Caucasian women with RA. RESULTS: The MetS prevalence was 30.8% in black compared to 9.7% in Caucasian women with RA (adjusted odds ratio [95% confidence interval]=10.11 [1.76-58.03] [p=0.009]). Population origin impacted on the relationships of metabolic risk factors with atherosclerosis. In Caucasian women, the MetS was associated with cIMT (p=0.036) and MetS triglycerides and the number of MetS criteria were each associated with both cIMT (p=0.01 and p=0.028, respectively) and plaque (p=0.049 and p=0.02, respectively); by contrast, in black women, MetS blood pressure was related to cIMT (p=0.04). CONCLUSIONS: A high overall metabolic cardiovascular risk burden as disclosed by markedly prevalent MetS in women with RA from developing groups of black African descent was not associated with atherosclerosis. This calls for systematic rigorous cardiovascular risk management irrespective of metabolic risk factor profiles in African black women with RA.
20621983 Lack of seroconversion of rheumatoid factor and anti-cyclic citrullinated peptide in patie 2011 Feb OBJECTIVE: Serological markers are thought to be useful in predicting which patients with early inflammatory arthritis (EIA) will progress to RA. The objective of this study is to determine the per cent RF and anti-CCP seroconversion in EIA patients at 1-5 years of follow-up: 80% of established RA is RF or CCP positive. METHODS: We conducted a systematic literature review of all English publications and recent abstracts from ACR and EULAR. Patients ≥16 years of age with at least one swollen joint and symptoms < 2 years were included. RESULTS: Twelve publications met the criteria: 10 studies included data on RF, while only 5 addressed anti-CCP. Sample sizes ranged from 15 to 395 and follow-up was 6-60 months. There was marked heterogeneity between studies; therefore, results could not be pooled for a meta-analysis. Baseline RF and anti-CCP positivity was also highly variable: 8-55 and 4-45%, respectively. Seroconversion rates for EIA were 1.9-5.0% at up to 30 months follow-up for RF and 1.3-8.9% at up to 60 months follow-up for anti-CCP. CONCLUSION: There is minimal change in RF or anti-CCP positivity up to 5 years of follow-up. Prevalence data for RF in established RA is significantly higher than the baseline values reported here. The low rates of seroconversion would suggest a lower prevalence in EIA and the reason for this difference remains unknown. It is unclear whether antibody-negative patients are more likely to remit and be lost to follow-up in established RA populations.
21343167 The distribution of human endogenous retrovirus K-113 in health and autoimmune diseases in 2011 Jul OBJECTIVE: During the evolution of the human genome, a number of retroviral integrations have occurred creating a group of human endogenous retroviruses (HERVs). As of now several studies have pointed to the association of HERVs with certain autoimmune diseases such as RA, SLE, multiple sclerosis (MS) and SS as well as various neoplasms. In this study, we investigated the prevalence of HERV-K113 in patients with RA, SLE and in healthy subjects in the Polish population. METHODS: Genomic DNA samples from 155 RA patients, 139 SLE patients and 261 newborns (as controls) were tested for the presence of the HERV-K113 allele using PCR. Each individual's DNA was genotyped for null, homozygous or heterozygous insertion of HERV-K113. RESULTS: Our data revealed statistically significant differences in the insertion frequencies of HERV-K113 between the groups of RA and SLE patients vs healthy controls (provirus DNA was found in 14.19, 15.11 and 8.05% of individuals, respectively). No homozygous individuals for the K113 allele were found in each of the groups. There was no evidence for HERV-K113 association with clinical features in either group. CONCLUSION: Our study-the first such performed for the Polish population-provides a consistent observation with previous reports on the genetic association of HERV-K113 integrations in autoimmune disorders. Here, we found that the prevalence of insertionally polymorphic HERV-K113 was significantly increased in Polish patients with SLE and RA.