Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 20673155 | Perioperative management of tumor necrosis factor antagonists in patients with psoriasis a | 2011 Apr | Tumor necrosis factor alpha (TNF-α) plays an important role in host defense and possibly wound healing. It is also linked to the pathophysiology of many inflammatory diseases, including psoriasis. The TNF antagonists are a class of agents that have proven effective in treating psoriasis and psoriatic arthritis, yet the immunosuppressive effects of these agents raise concern over their use perioperatively. Currently, there is no consensus as to when TNF antagonists should be discontinued prior to surgery. Furthermore, data on the topic are limited to inflammatory bowel disease (IBD) and rheumatoid arthritis (RA). This paper reviews the literature on post-surgical outcomes in patients with RA and IBD receiving anti-TNF therapy. Although most studies reveal no statistically significant increased risk of post-surgical complications in these patients, the retrospective design and small sample size of these studies limits interpretation. Furthermore, when applying these data to psoriasis and psoriatic arthritis, physicians must also consider disease severity, individual comorbidities, and the pharmacokinetics of the different TNF antagonists. Additional studies are needed in psoriasis and psoriatic arthritis in order to develop truly evidence-based dermatologic guidelines for perioperative management of the TNF antagonists. | |
| 22562981 | Carotid ultrasound in the cardiovascular risk stratification of patients with rheumatoid a | 2012 Jun | Adequate stratification of cardiovascular (CV) risk is one of the major points of interest in the management of patients with rheumatoid arthritis (RA). A task force of the European League Against Rheumatism has proposed to adapt CV risk management calculated in RA patients according to the systematic coronary risk evaluation (SCORE) function by application of a multiplier factor of 1.5 in those patients with two of the following three criteria: disease duration >10 years, rheumatoid factor (RF) or anticyclic citrullinated peptide (anti-CCP) antibody positivity, and presence of severe extra-articular manifestations. However, a major concern when using the modified SCORE is to know whether the effect of chronic inflammation on the CV risk of RA patients can be fully determined using this tool. As increased carotid intima-media thickness (IMT) and carotid plaques have been proved to predict the development of CV events in RA, the authors suggest performing carotid ultrasound when SCORE does not yield results indicating high CV risk in RA patients with extra-articular manifestations, RF or anti-CCP positivity as well as in patients with 10 years disease duration or longer. The presence of abnormal carotid IMT (>0.90 mm) or carotid plaques would lead to these patients being considered as having high CV risk regardless of the results derived from the modified SCORE. | |
| 21496382 | Decreased mRNA expression of two FOXP3 isoforms in peripheral blood mononuclear cells from | 2011 Jan | Both the number and functional capacity of T-regulatory (Treg) cells are known to be decreased in various autoimmune diseases. FOXP3, an essential transcription factor for Treg cells, has three isoforms in humans, wild, and exon 2- and exon 2-exon 7-lacking, although their role in autoimmunity is not clearly understood. Here, we investigated the messenger RNA (mRNA) expression of the major wild and exon-2 isoforms in peripheral mononuclear cells by quantitative PCR methods in 56 subjects, consisting of 23 rheumatoid arthritis (RA) and 25 systemic lupus erythematosus (SLE) patients, and 8 healthy controls (HCs). Although mRNA expression of the two isoforms did not directly correlate with clinical disease activity, relative expression of both was significantly lower in SLE and RA patients than in HCs. Furthermore, we found a significant statistical correlation between the two isoforms, suggesting that they are similarly regulated. Decreased expression of these isoforms in RA and SLE may reflect Treg cell abnormalities in these autoimmune diseases. | |
| 22718927 | Developing an effective treatment algorithm for rheumatoid arthritis. | 2012 Jul | RA is defined by the interrelated triad of disease activity, joint damage and disability. Although disease activity and its associated disability are reversible, joint damage and its associated disability are not. Thus, an important goal of RA therapy is to maximally reduce disease activity and thereby mitigate the accumulation of irreversible joint damage. Treatment for patients with RA should be initiated early and aggressively, with frequent assessments and a goal of achieving remission as quickly as possible after treatment initiation. We propose a treatment algorithm that recommends early and aggressive therapy with high-dose MTX therapy (15-25 mg/week), which may include moderate doses of glucocorticoids. The goal is to achieve low disease activity (determined by a composite measure that includes joint counts) within 3-6 months. If low disease activity is not achieved by 6 months, another conventional DMARD or a biologic agent should be added to the treatment regimen or patients should be switched to another DMARD plus a glucocorticoid. Once low disease activity is achieved, the treatment goal for the ensuing 3-6 months becomes disease remission. | |
| 22477520 | Inflammatory rheumatic disorders and bone. | 2012 Jun | Inflammatory joint diseases such as rheumatoid arthritis, as well as other rheumatic conditions, such as systemic lupus erythematosus (SLE) and ankylosing spondylitis, comprise a heterogeneous group of joint disorders that are all associated with extra-articular side effects, including bone loss and fractures. The concept of osteoimmunology is based on growing insights into the links between the immune system and bone. The pathogenesis of osteoporosis in these patients is multifactorial. We have, more or less as an example, described this extensively for patients with SLE. High disease activity (inflammation) and immobility are common factors that substantially increase fracture risk in these patients, on top of the background fracture risk based on, among other factors, age, body mass index, and gender. Although no fracture reduction has been shown in intervention studies in patients with inflammatory rheumatic diseases, we present treatment options that might be useful for clinicians who are treating these patients. | |
| 22842633 | MRI characteristics of rheumatoid arthritis in the temporomandibular joint. | 2013 | OBJECTIVES: The aim of this study was to investigate characteristic MRI findings of rheumatoid arthritis (RA) in the temporomandibular joints (TMJs). METHODS: 61 patients (122 TMJs) with RA in the TMJ and 50 patients (100 TMJs) with temporomandibular disorder (TMD) were included in this study. MR images of these patients were assessed by two oral radiologists for the presence or absence of osseous changes, disc displacement, joint effusion and synovial proliferation. These findings were compared between the two patient groups. RESULTS: Osseous changes in the condyle and articular eminence/fossa in the RA patient group were significantly more frequent than in the TMD patient group, and were often very severe. Joint effusion was also significantly more frequent in the RA patient group. Synovial proliferation was found in all TMJs in the RA patient group, whereas it was very uncommon in the TMD patient group. CONCLUSIONS: Severe osseous changes in the condyle and synovial proliferation were considered characteristic MRI findings of RA in the TMJs. | |
| 22090009 | Bucillamine-induced yellow nail in Japanese patients with rheumatoid arthritis: two case r | 2013 Mar | Yellow nail syndrome is an idiopathic condition characterized by a triad consisting of yellow nail, lymphedema, and pulmonary manifestations. Thiol compounds such as D-penicillamine have been reported to be the major cause of drug-induced yellow nail syndrome in patients with rheumatoid arthritis (RA). We recently experienced two Japanese cases with RA who developed yellow nail under treatment with bucillamine, a thiol-containing anti-rheumatic drug developed and approved in Japan. We reviewed the literature for similar cases and identified 36 RA cases with bucillamine-induced yellow nail, mostly in Japanese medical journals. Most of these cases (90.3%) showed improvement of yellow nail after discontinuation of bucillamine, whereas lymphedema and pulmonary manifestations improved only in 30.8 and 35.0% of the patients, respectively. | |
| 21622544 | Automated quantification of high-resolution CT scan findings in individuals at risk for pu | 2011 Dec | BACKGROUND: Automated methods to quantify interstitial lung disease (ILD) on high-resolution CT (HRCT) scans in people at risk for pulmonary fibrosis have not been developed and validated. METHODS: Cohorts with familial pulmonary fibrosis (n = 126) or rheumatoid arthritis with and without ILD (n = 86) were used to develop and validate a computer program capable of quantifying ILD on HRCT scans, which imaged the lungs semicontinuously from the apices to the lung bases during end-inspiration in the prone position. This method uses segmentation, texture analysis, training, classification, and grading to score ILD. RESULTS: Quantification of HRCT scan findings of ILD using an automated computer program correlated with radiologist readings and detected disease of varying severity in a derivation cohort with familial pulmonary fibrosis or their first-degree relatives. This algorithm was validated in an independent cohort of subjects with rheumatoid arthritis with and without ILD. Automated classification of HRCT scans as normal or ILD was significant in the derivation and validation cohorts (P < .001 and P < .001, respectively). Areas under receiver operating characteristic curves performed independently for each group were 0.888 for the derivation cohort and 0.885 for the validation cohort. Pulmonary function test results, including FVC and diffusion capacity, correlated with computer-generated HRCT scan scores for ILD (r = -0.483 and r = -0.532, respectively). CONCLUSIONS: Automated computer scoring of HRCT scans can objectively identify ILD and potentially quantify radiographic severity of lung disease in populations at risk for pulmonary fibrosis. | |
| 21304585 | Identification of natural bispecific antibodies against cyclic citrullinated peptide and i | 2011 Jan 27 | BACKGROUND: Previous studies indicate that natural bispecific antibodies can be readily produced in vivo when the body is simultaneously stimulated with 2 distinct antigens. Patients with rheumatoid arthritis (RA) usually exhibit persistent immune responses to various autoantigens, raising the possibility that natural bispecific antibodies against 2 distinct autoantigens might exist. METHODOLOGY/PRINCIPAL FINDINGS: We identified the presence of natural bispecific antibodies against cyclic citrullinated peptide (CCP) and immunoglobulin G (IgG) in RA patients' sera by means of a double-antigen sandwich enzyme-linked immunosorbent assay (ELISA). The spontaneous emergence of bispecific antibodies was confirmed by mixing different proportions of 1 anti-CCP-positive serum and 1 rheumatoid factor (RF)-positive serum in vitro. Among the tested samples, positive correlations were found between the presence of bispecific antibodies and both IgG4 anti-CCP antibodies and IgG4 RF (r = 0.507, p<0.001 and r = 0.249, p = 0.044, respectively), suggesting that the IgG4 subclass is associated with this phenomenon. Furthermore, bispecific antibodies were selectively generated when several anti-CCP- and RF-positive sera were mixed pairwise, indicating that factors other than the monospecific antibody titers may also contribute to the production of the natural bispecific antibodies. CONCLUSIONS/SIGNIFICANCE: We successfully identified the presence of natural bispecific antibodies. Our results suggest that these antibodies originate from anti-CCP and RF in the sera of RA patients. The natural occurrence of bispecific antibodies in human diseases may provide new insights for a better understanding of the diseases. Further investigations are needed to elucidate their precise generation mechanisms and explore their clinical significance in disease development and progression in a larger study population. | |
| 21724695 | Expression of APRIL in diffuse large B cell lymphomas from patients with systemic lupus er | 2011 Sep | OBJECTIVE: Patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have an increased risk of diffuse large B cell lymphoma (DLBCL). The cytokine A PRoliferating-Inducing Ligand (APRIL) is strongly expressed in DLBCL in the general population and is detected in high concentrations in sera from subgroups of patients with RA and SLE. To investigate a possible association between APRIL and DLBCL in RA and SLE, we examined APRIL expression in lymphoma biopsies from patients with RA and SLE and from DLBCL patients without inflammatory disease. METHODS: Lymphoma tissue from 95 RA, 12 SLE, and 63 comparator DLBCL cases were stained with anti-APRIL antibodies (Aprily-2). The percentage of positively stained cells of the comparator cases were divided into quartiles (1-4, where 4 = most stained) and compared with the results for the RA and SLE lymphomas. APRIL expression was correlated to clinical variables. RESULTS: The odds ratio for high expression of APRIL (quartiles 3 and 4) was elevated in the SLE DLBCL (OR 23.6, 95% CI 2.4-231.2), but not in the RA DLBCL (OR 0.8, 95% CI 0.3-2.0). RA patients in quartile 4 had higher cumulated RA disease activity than those in quartile 1 (p = 0.013). Epstein-Barr virus in the lymphoma tissue was associated with high APRIL expression (p = 0.009). CONCLUSION: The high expression of APRIL in DLBCL in SLE and in an RA subset might indicate an association between APRIL and lymphoma in these subsets of rheumatic diseases, but could also reflect a dysregulation of APRIL per se in these patient groups. | |
| 23149635 | Finding Rheumatoid Arthritis Impact on Life (FRAIL Study): economic burden. | 2012 Apr | INTRODUCTION: The economic impact of rheumatoid arthritis (RA) is related with the costs supported by the society. It is of the utmost importance to estimate the costs of RA in Portugal in order to access its true social impact and improve the clinical management of this disease. OBJECTIVES: To determine the yearly direct and indirect costs of RA supported by the society in Portugal. METHODS: Observational, cross-sectional study with collection of retrospective data, involving patients with RA, diagnosed accordingly to 1987 American College of Rheumatology (ACR) criteria, independently of disease stage, with attendance to a specialist visit between October and December 2009 in a Rheumatology Clinic in Portugal. Data were obtained through the fulfillment of medical and patient questionnaires. Data being covered included socio-demographic and clinical characteristics and health resources. The societal perspective was considered including direct and indirect costs. Unitary costs were obtained from official national sources. RESULTS: The FRAIL study included 353 patients, 84% females, with an average age of 59 (range: 23-85 years). In the previous year: 97.2% of patients had a Rheumatology appointment (average: 4) and 35.6% a GP appointments (average: 6); 8.2% were hospitalized at least once, 9.3% had an urgency admission and 41.4% went to the day hospital. Most of the patients (96.0%) were on DMARD; 94.3% performed routine exams; 35.7% had rehabilitation treatments; 21.4% had alternative medicine treatments; 5.7% needed house adaptations; 9.3% needed prosthesis; 5.1% needed permanent home support, 2.9% partial; 31% of the patients referred sick leave because of RA. We estimate that the annual mean cost of treating one RA patient in Portugal is about 3.415 €, of which 77.3%, 9.6% and 11.4%, corresponds to direct medical, direct non-medical and indirect cost, respectively. Total cost of the disease increase with disease activity. RA in remission has an average cost of 2.205 €/patient/year versus 5.634 € in high activity RA. CONCLUSIONS: Results of the FRAIL study allow a better understanding of the real economic impact of RA for society, which increased very significantly in the last 10 years. If we consider 35,000 patients with RA in Portugal, the annual cost would be 119,525,000 € per year. | |
| 21658422 | No evidence of association of the KLF12 gene with rheumatoid arthritis in Spanish and Dutc | 2011 Sep | The aim of the present study was to replicate the previously reported association of KLF12 gene polymorphisms with rheumatoid arthritis (RA). Two independent cohorts from Spain (1,360 RA patients and 1,520 controls) and the Netherlands (1,018 RA patients and 1,150 controls) were genotyped for KLF12 rs1887346 and rs9565072 single-nucleotide polymorphisms using a TaqMan 5'-allele discrimination assay. No evidence of association of RA with the minor T allele of rs9565072 (31.82% vs 33.73%; p = 0.14, odds ratios [OR] 0.92 [95% confidence interval (CI) 0.82-1.03]) or the minor A allele of rs1887346 polymorphism (21.60% vs 21.77%; p = 0.88, OR 0.99 [95% CI 0.87-1.13]) was observed in Spanish patients compared with healthy controls. This lack of association was also confirmed in the Dutch cohort: the minor T allele frequency of rs9565072 in Dutch RA patients was 35.34% versus 35.57% in controls; p = 0.87, OR 0.99 (95% CI 0.87-1.12); and the minor A allele frequency of rs1887346 in Dutch RA patients was 27.64% versus 28.17% in controls; p = 0.70, OR 0.97 (95% CI 0.85-1.12). A meta-analysis of published KLF12 gene association with RA revealed a pooled OR of 0.99 (95% CI 0.93-1.04) for rs1887346 and a pooled OR of 0.99 (95% CI 0.95-1.04) for rs9565072. In conclusion, our findings indicate that the KLF12 rs1887346 and rs9565072 polymorphisms do not play a relevant role in RA. | |
| 22702039 | [Surgical technique and clinical results of total knee arthroplasty in treating endstage g | 2012 May | OBJECTIVE: To investigate the surgical technique and the clinical results of total knee arthroplasty (TKA) in treating end-stage gonarthrosis combined with valgus knee deformity. METHODS: Between November 1998 and October 2010, 64 patients (72 knees) with end-stage gonarthrosis combined with valgus knee deformity underwent TKA by a medial parapatellar approach. Of the 64 patients, 18 were male and 46 were female with an average age of 62.5 years (range, 23-82 years), including 44 cases (49 knees) of osteoarthritis, 17 cases (20 knees) of rheumatoid arthritis, 2 cases (2 knees) of haemophilic arthritis, and 1 case (1 knee) of post-traumatic arthritis. Bilateral knees were involved in 8 cases, and single knee in 56 cases. The flexion and extension range of motion (ROM) of the knee joint was (82.2 +/- 28.7) degrees; the femur-tibia angle (FTA) was (18.0 +/- 5.8) degrees; according to Knee Society Score (KSS) criterion, the preoperative clinical score was 31.2 +/- 10.1 and functional score was 37.3 +/- 9.0. According to Krackow's classification, there were 65 knees of type I and 7 knees of type II. By medial parapatellar approach, conventional osteotomy and Ranawat soft tissue release were performed in all cases. Prosthesis of preserved posterior cruciate ligament were used in 7 cases (7 knees), posterior stabilize prosthesis in 54 cases (60 knees), constrained prosthesis in 4 cases (5 knees). RESULTS: Incisions healed by first intention in all cases. Peroneal nerve palsy occurred in 1 patient with haemophilic arthritis, severe valgus deformity (FTA was 41 degrees), and flexion contracture (20 degrees), which was cured after 1 year of conservative treatment. Revison surgery was performed in 1 case of deep infection at 2 years after surgery. All the patients were followed up 4.9 years on average (range, 1-13 years). At last follow-up, the FTA was (7.0 +/- 2.5) degrees, showing significant difference when compared with preoperative value (t = 15.502, P = 0.000). The KSS clinical score was 83.0 +/- 6.6 and functional score was 85.1 +/- 10.5, the flexion and extension ROM of the knee joint was (106.1 +/- 17.0) degrees, all showing significant differences when compared with preoperative values (P < 0.05). Five patients had 12-15 degrees valgus knee deformity, but the function of the affect knees were good. CONCLUSION: TKA is an effective way for the patients with end-stage gonarthrosis combined with valgus knee deformity by medial parapatellar approach combined with conventional osteotomy and Ranawat soft tissue release. The correction of deformity and improvement of joint function can be achieved significantly. The clinical result is satisfactory. | |
| 21415050 | Certolizumab pegol plus methotrexate provides broad relief from the burden of rheumatoid a | 2011 Jun | OBJECTIVE: To assess the impact of certolizumab pegol (CZP) on patient-reported outcomes (PROs) in rheumatoid arthritis (RA), and to interpret these results using number needed to treat (NNT), and associations between PRO responses and longer term outcomes. METHODS: A total of 619 patients with active RA were randomised to CZP 200 or 400 mg, or placebo plus methotrexate (MTX). PROs assessed included pain, patient's global assessment of disease activity (PtGA), physical function, fatigue and health-related quality of life. Treatment impact on PROs, NNT to achieve simultaneous improvements in multiple PROs and correlations between PROs were calculated. Times to onset of improvements greater than or equal to minimum clinically important differences (MCIDs) in pain as a determinant of clinical outcomes at week 24 were compared between week 6 and 12 responders, and in patients with improvements in pain ≥ MCID at week 12 (week 12 responders/non-responders). RESULTS: CZP 200 and 400 mg plus MTX were associated with rapid, clinically meaningful improvements in all PROs. The NNT for subjects to report changes ≥MCID in up to five PROs was two to three, and five for all six PROs (pain, PtGA, physical function, fatigue and short-form 36-item Physical and Mental Component Summary Scores). More patients with improvements ≥MCID in pain at week 6 than those at week 12 had lower disease activity at week 24. Week 12 pain responders had better clinical outcomes at week 24 than non-responders. CONCLUSIONS: The data demonstrate that CZP provides broad relief from the burden of RA. Trial registration number NCT00160602. | |
| 21954118 | Is routine viral screening useful in patients with recent-onset polyarthritis of a duratio | 2011 Nov | OBJECTIVE: To study the contribution of routine viral screening tests in patients with early rheumatoid arthritis (RA) or a potential for progressing to RA. METHODS: Eight hundred thirteen patients with swelling of at least 2 joints for at least 6 weeks and a symptom duration of less than 6 months in the ESPOIR cohort were screened for parvovirus B19 (IgG and IgM anti-parvovirus B19 antibodies), hepatitis B virus (HBV; hepatitis B surface antigen), hepatitis C virus (HCV; anti-HCV antibodies), and human immunodeficiency virus (HIV; anti-HIV-1 and -2 antibodies). RESULTS: Parvovirus B19 testing was performed in 806 patients and showed longstanding immunity in 574 (71.2%) and no antibodies in 223 (27.7%). Among the 9 remaining patients (7 IgG positive/IgM positive, 1 IgG negative/IgM positive, and 1 IgG indeterminate/IgM positive), only 2 (0.25%; 95% confidence interval [95% CI] 0-0.99%) had a positive polymerase chain reaction test for parvovirus B19; these patients (women ages 34 and 40 years) had no extraarticular signs. HIV seroprevalence was 0.12% (n = 1 of 813; 95% CI 0.01-0.8%) and HCV seroprevalence was 0.86% (n = 7 of 808, 95% CI 0.38-1.86%). HCV-related arthritis was diagnosed in 4 patients (0.5%). HCV-seropositive patients had significantly higher transaminase levels than the other patients (P = 0.001), with no significant differences for the other laboratory data. HBV seroprevalence was 0.12% (n = 1 of 808; 95% CI 0.01-0.8%); the positive HBV status was known before study inclusion, and the patient had no diagnosis of HBV-related arthritis. Finally, routine viral testing identified 2 patients with parvovirus B19 infection and 3 with HBV infection (0.6%; 95% CI 0.2-1.5%). Cost was €85.05 per patient (total €68,720). CONCLUSION: Routine serologic testing did not contribute substantially to the diagnosis in this context. | |
| 21794767 | [Interleukins network in rheumatoid arthritis pathophysiology: beyond proinflammatory cyto | 2011 Mar | Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by synovitis and progressive destruction of the joint cartilage and underlying bone, together with diverse extra-articular manifestations. Cytokines act as soluble effector mediators of the inflammatory process. Therapeutic neutralization with monoclonal antibodies against the pro-inflammatory cytokines TNF-alpha and interleukin 1 (IL-1) has shown a clear efficacy on inflammation and clinical manifestations of RA, although a percentage of patients do not respond. This review covers new relevant cytokines in the RA physiopathology and potential biomarkers of inflammation. The current challenge is to develop biomarkers that enable an earlier diagnosis, as well as prognostic markers and new therapeutic candidates. Combined administration of several of these cytokines could eventually address a personalized treatment approach for each patient. | |
| 22442978 | [Changes in oxidative stress and apoptosis parameters of neutrophils in rheumatoid disease | 2012 Jan | AIM: Study parameters of oxidative stress and apoptosis of neutrophils in patients with ankylosing spondylitis, systemic lupus erythematosus, systemic scleroderma and rheumatoid heart disease. MATERIALS AND METHODS: 240 patients with rheumatoid diseases and 25 healthy control group volunteers were examined. Neutrophil isolation from peripheral blood was performed by using double density gradient of ficoll-urografin. Cell functional activity was studied by chemiluminescence method. Pro-apoptosis antigen bak expression by neutrophils was studied by using streptavidin-biotin method. Griss reagent was used for nitrogen oxide production analysis. RESULTS: An increase of oxygen dependent neutrophil metabolism processes was detected in patients with ankylosing spondylitis in comparison with systemic lupus erythematosus and systemic scleroderma patients. Systemic lupus erythematosus is characterized by higher biocidity of neutrophils in comparison with systemic scleroderma and rheumatoid heart disease. Increase of neutrophil granulocyte activity in ankylosing spondylitis is accompanied by an increase of superoxide-anion formation. In spite of high level of metabolic activity neutrophils in patients with ankylosing spondylitis have a low functional reserve, and neutrophils in patients with systemic scleroderma have the highest reserve potential. CONCLUSION: Differences in expression parameters of oxidative stress by neutrophils depend on nosological form, varying by production level and active oxygen form formation reserve. | |
| 22089340 | Model-based meta-analysis for comparative efficacy and safety: application in drug develop | 2011 Dec | High development cost, low development success, cost-disciplined health-care policies, and intense competition demand an efficient drug development process. New compounds need to bring value to patients by being safe, efficacious, and cost-effective as compared with existing treatment options. Model-based meta-analysis (MBMA) facilitates integration and utilization of summary-level efficacy and safety data, providing a quantitative framework for comparative efficacy and safety assessment. This Commentary discusses the application and limitations of MBMA in drug development. | |
| 21724698 | Nonsteroidal antiinflammatory drug withdrawal in patients with stable rheumatoid arthritis | 2011 Oct | OBJECTIVE: To evaluate the effect of nonsteroidal antiinflammatory drug (NSAID) withdrawal on blood pressure (BP), 44-joint Disease Activity Score (DAS44), and functional assessments in patients with stable rheumatoid arthritis (RA). METHODS: NSAID was withdrawn from 30 patients with stable RA (DAS44 ≤ 2.8). Other prescribed medication continued. Clinical and laboratory measures were taken at baseline, 6 weeks, and 12 weeks. RESULTS: No participants required NSAID reintroduction during the study period. Significant improvement in systolic BP was noted: maximal median reduction was 7 mm Hg (baseline to 12 weeks). There was no significant deterioration in DAS44 or function. Eleven participants required additional intervention. CONCLUSION: NSAID withdrawal resulted in improvement in BP without loss of disease control. | |
| 22360422 | Parity in patients with chronic inflammatory arthritides childless at time of diagnosis. | 2012 May | OBJECTIVE: To assess parity in women with chronic inflammatory arthritides (CIA) childless at time of diagnosis. METHODS: Patients were selected from the Norwegian Disease-Modifying Anti-Rheumatic Drug (NOR-DMARD) registry. Each patient was matched by year of birth with 100 reference women from the Norwegian Population Registry. Data linkage for patients and references with the Medical Birth Registry of Norway (MBRN) identified all offspring until time of linkage (October 2007). Patients and corresponding references childless at the time of diagnosis were included in the analyses. Kaplan-Meier curves visualized the proportion of childless women and were compared by a log rank test. RESULTS: In all, 156 rheumatoid arthritis (RA), 107 other chronic arthritides (OCA), and 75 juvenile idiopathic arthritis (JIA) patients were childless at time of diagnosis. At the time of data linkage, the proportions (%) of childless RA/OCA/JIA patients versus references were 61.5/62.6/57.3 versus 46.9/42.9/41.0, respectively, all differences statistically significant. The log rank test showed lower parity in all diagnostic groups compared with references (p < 0.001 for RA and OCA and p = 0.002 for JIA). No difference in parity was observed between RA and OCA patients, but both diagnostic groups had lower parity than JIA patients (p = 0.001). Disease characteristics were similar between childless and fertile patients. CONCLUSIONS: Reduced parity was observed in all diagnostic groups compared with references. RA and OCA patients had lower parity than JIA patients, indicating that having the disease as a young adult may influence parity more than having the disease in childhood. |