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ID PMID Title PublicationDate abstract
24053746 Idiopathic membranous nephropathy preceding the onset of rheumatoid arthritis: a case repo 2013 Sep INTRODUCTION: Membranous nephropathy (MN) in the context of rheumatoid arthritis (RA), is often an iatrogenic complication due to the nephrotoxic effects of antirheumatic drugs. Rare cases of non-iatrogenic association between these two diseases were reported in the literature. CASE REPORT: A 30-year-old female patient presented in September 2005 with nephrotic syndrome. Renal biopsy showed features consistent with MN. Search for etiology was negative, particularly lupus serology which remained negative throughout the course of her illness. Accordingly, she was diagnosed as a case of idiopathic MN. Initially, she was treated with angiotensin converting enzyme inhibitors and angiotensin receptor blockers which maintained her protein excretion below nephrotic range for two years. Her nephrotic syndrome then relapsed and was treated with steroids and chlorambucil, according to the Ponticelli protocol. A few months later, she presented with early morning joint stiffness, polyarthritis involving the small joints of the hands, and strongly positive rheumatoid factor, fulfilling the diagnostic criteria of rheumatoid arthritis (RA). Her serum creatinine remained normal and a second renal biopsy revealed the same features of MN. Her RA was treated with pulsed methylprednisolone followed by oral steroids and methotrexate resulting in remission of the joints disease and the nephrotic syndrome. Remission was maintained for the last two years up to the time of this report. CONCLUSION: We hereby report a case of secondary membranous nephropathy that preceded the onset of rheumatoid arthritis by three years.
23461008 [Effect of mexidol (2-ethyl-6-methyl-3-oxypyridine succinate) on the quality of life and d 2013 A prospective, randomized controlled study of the effects of 2-ethyl-6-methyl-3-oxypyridine succinate (mexidol) on the dynamics of articular syndrome, quality of life, and clinical manifestations of depression has been performed in a group of 62 women with rheumatoid arthritis diagnosis during therapy for two weeks. The use of mexidol in the complex treatment contributed to a decrease of the intensity of rheumatoid inflammation, reduction in the severity of depressive symptoms, and improvement of the functional status and quality of life.
25026748 [Association between AIF-1 gene polymorphisms and response to rheumatoid arthritis treatme 2013 INTRODUCTION: AIF-1 is an inflammatory cytokine influencing the immune system. There are increased levels of AIF-1 in the synovial fluid of patients with rheumatoid arthritis (RA). Sulfasalazine still remains the mainstay for the treatment of RA. It has an anti-inflammatory effect, inhibiting the action of inflammatory mediators. The aim of our study was to examine the association between AIF-1 (rs2269475:C>T, rs2736182:G>A, rs2259571:A>C) polymorphisms and response to sulfasalazine treatment in RA patients. MATERIAL: A total of 112 RA patients were enrolled in the study. RESULTS: There were no statistically significant associations between AIF-1 polymorphisms and response to sulphasalazine treatment. CONCLUSION: The results of this study suggest a lack of association between AIF-1 gene polymorphisms and response to sulphasalazine treatment.
23717976 [Clinical observation of compound xiatianwu tablets in treatment of 120 cases with active 2013 Mar OBJECTIVE: To observe the clinical efficacy of Compound Xiatianwu tablets in the treatment of active rheumatoid arthritis. METHOD: One hundred and eighty cases with active rheumatoid arthritis were randomly divided into the control group (60 cases) with leflunomide, sulfasalazine, and celecoxib; the treatment group (120 cases) given compound Xiatianwu tablets on the basis of the control group, 2 tablets each time, 3 times/day, with the course of treatment of 3 month. Patients of the two groups were observed for clinical symptoms, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and immunoglobulin changes before and after the treatment. RESULT: The treatment group showed an overall efficiency of 94. 2% , the Xiatianwu group showed an overall efficiency of 80. 0%, while the control group showed an overall efficiency of 81.7%. The difference among the three groups was statistically significant (P <0. 05 or P <0. 01) , indicating that the treatment group was superior to the Xiatianwu group, while the Xiatianwu group was superior to the control group. CONCLUSION: Compound Xiatianwu tablets has remarkable effect in the treatment of active rheumatoid arthritis.
25269176 [Management of patients with pulmonary fibrosis]. 2014 Rheumatoid arthritis (RA) is a chronic autoimmune systemic disease. Its systemic manifestations include interstitial lung lesions (ILL). According to morphological studies and X-ray computed tomography, the incidence of RA-associated ILL is 60-70% which gives reason to consider pulmonary fibrosis (PF) to be the main form of lung pathology in this disease. PF is a pathological process in the lungs characterized by high mortality rate and refractoriness to therapy. It is a heterogeneous group of disorders with progressive and irreversible destruction of lung architectonics due to scarification that in the end results in organ dysfunction, disturbed gaseous exchange and respiratory distress. Changes in the interstitial lung tissue resulting from local autoimmune rheumatoid inflammation develop by the same mechanisms that underlie idiopathic pulmonary fibrosis used as a model for classification, pathogenesis and treatment of RA-associated ILL. This review is focused on the therapeutic strategy for the management of PF in the context of consensus of the American Thoracic Society (ATS), European Respiratory Society (ERS), Japanese Respiratory Society (JRS) and Latin American Thoracic Association (ALAT, 2010/2011).
23470173 Parenting disability, parenting stress and child behaviour in early inflammatory arthritis 2013 Mar INTRODUCTION: Our study examines the association between the disease characteristics of inflammatory arthritis and patients' self-perception of mental health, parenting disability, parenting stress and child behaviour in early inflammatory arthritis (EIA). METHODS: Patients in the early phase (more than 6 weeks, less than 18 months) of inflammatory arthritis were recruited from a larger EIA registry that recorded sociodemographic data and measures of pain, physical functioning and disease activity. Patient-perceived parenting disability, parenting stress, depression and children's behaviour problems were assessed using the Parenting Disability Index, Parenting Stress Index, Center for Epidemiologic Studies--Depression Mood Scale and Child Behavior Checklist, respectively. RESULTS: Pain, physical dysfunction, number of tender joints and physician global assessment of disease activity were associated with parenting disability. Self-report measures of parenting disability were associated with those of depression and parenting stress. Parenting stress was associated with children internalizing and externalizing behaviour problems while parenting disability was associated with children externalizing behaviour problems. CONCLUSION: This study suggests a possible reciprocal relationship among physical aspects of disease activity, parenting disability and parent and child distress in EIA.
23480536 The International Classification of Functioning, Disability and Health (ICF) Core Sets: ap 2013 Oct The International Classification of Functioning, Disability and Health (ICF) framework facilitates systematic assessment of functioning across four components. ICF Core Sets are proposed to be beneficial for clinicians in multidisciplinary care settings because they provide a common language for communication. A clinical vignette of a postmenopausal woman with rheumatoid arthritis (RA) and a non-traumatic vertebral fracture is presented to discuss how the ICF Core Sets for RA and osteoporosis (OP) can be helpful in structuring clinical decisions. To demonstrate how condition-specific ICF Core Sets can be used to evaluate and treat women with two comorbidities, each component of the ICF Core Sets is compared across conditions and integrated into clinical decision-making. Topics covered include: exercise tolerance, urinary continence, bone mass, fear of falling, and environmental factors. The benefits of thorough communication with the client and a common language across healthcare disciplines are highlighted as the potential benefits of the ICF framework; however, limitations to uptake of the ICF in clinical practice are also addressed.
24533548 Presence of ultrasound subclinical synovitis and increment of serum vascular endothelial g 2014 Jul A 63-year-old male Japanese rheumatoid arthritis (RA) patient, in whom treatment with infliximab and methotrexate (MTX) had once led to drug-free remission, experienced a disease flare in July 2010. He was retreated with a combination of adalimumab and MTX, and clinical remission was achieved in 3 months. In contrast, power Doppler signals by ultrasonography with increased serum vascular endothelial growth factor still remained after he achieved sustained clinical remission, whereas no radiographic progression has been found.
25827002 [The pathogenetic substantiation of new therapeutic approach to the treatment of secondary 2014 The article concerns the efficacy of the use of new therapeutic approach in the therapy of secondary osteoarthritis in patients with rheumatoid arthritis. The dynamic of Cartilage Oligomeric Matrix Protein, activity of the disease on DAS28, cytokine profile was estimated. The analysis of the results showed the advantages of the use of inhibitor of IL-1 combined with laser therapy in the treatment of secondary osteoarthritis in patients with rheumatoid arthritis.
24701710 [Role of imaging in the diagnosis and follow-up of rheumatoid arthritis]. 2014 Mar 12 Cross-sectional imaging techniques such as magnetic resonance imaging and ultrasound are becoming essential tools not only for making an early diagnosis of rheumatoid arthritis, but also to help clarify the prognosis of the disease and better assess the response to various therapies. This article summarises the recommendations established in 2013 by the European League Against Rheumatism on the role of imaging in the diagnosis and follow-up of rheumatoid arthritis, while adding comments and emphasising on our Swiss experience with the use of ultrasound.
22984174 Application of the 2010 ACR/EULAR classification criteria in patients with very early infl 2013 Aug OBJECTIVE: Performance of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria was analysed in an internationally recruited early arthritis cohort (≤16 weeks symptom duration) enrolled in the 'Stop-Arthritis-Very-Early' trial. This sample includes patients with a variety of diseases diagnosed during follow-up. METHODS: Two endpoints were defined: Investigators' diagnosis and disease-modifying antirheumatic drug (DMARD) treatment start during the 12-month follow-up. The 2010 criteria were applied to score Patients' baseline data. Sensitivity, specificity, predictive values and areas under the receiver operating curves of this scoring with respect to both endpoints were calculated and compared to the 1987 criteria. The optimum level of agreement between the endpoints and the 2010 classification score ways estimated by Cohen's ϰ coefficients. RESULTS: 303 patients had 12-months follow-up. Positive predictive values of the 2010 criteria were 0.68 and 0.71 for RA-diagnosis and DMARD-start, respectively. Sensitivity for RA-diagnosis was 0.85, for DMARD-start 0.8, whereas the 1987 criteria's sensitivities were 0.65 and 0.55. The areas under the receiver operating curves of the 2010 criteria for RA-diagnosis and DMARD-start were 0.83 and 0.78. Analysis of inter-rater-agreement using Cohen's ϰ demonstrated the highest ϰ values (0.5 for RA-diagnosis and 0.43 for DMARD-start) for the score of 6. CONCLUSIONS: In this international very early arthritis cohort predictive and discriminative abilities of the 2010 ACR/EULAR classification criteria were satisfactory and substantially superior to the 'old' 1987 classification criteria. This easier classification of RA in early stages will allow targeting truly early disease stages with appropriate therapy.
25087414 [The influence of intravenous laser therapy on the endothelial function and the state of m 2014 May AIM: The objective of the present work was to study effects of low-level laser irradiation on the endothelial function and selected parameters of microcirculation in the patients presenting with rheumatoid arthritis. MATERIAL AND METHODS: This study included 132 patients at the age varying from 18 to 85 years presenting with rheumatoid arthritis. They were divided into 2 groups. The patients of the main group (n = 102) underwent daily intravenous laser blood irradiation during 10 days. The control group was comprised of 30 patients. Laser therapy was performed with the help of a laser therapeutic device Matrix - VLOK ("Matrix", Russia) using alternation of two radiating heads: KI-VLOK-63 (wavelength 0.63 pm, for 15 minutes) and KI-VLOK-365 (wavelength 0.365 microm, for 5 minutes) in the continuous emission regime. The parameters of interest were measured before and after the treatment. The overall duration of intravenous laser irradiation of blood was 10 days without a break for the weekend. RESULTS: The data obtained suggest the improvement of the endothelial function and the microcirculation indices.
23877411 Achievement of sustained deep remission with adalimumab in a patient with both refractory 2013 May 27 Inflammatory bowel disease (IBD) is commonly associated with peripheral inflammatory arthritis, and it has been estimated that as many as 12% of IBD patients report these manifestations. However, rheumatoid arthritis (RA) is rarely associated with ulcerative colitis (UC). Among all the biological agents available, nine have been currently approved for the treatment of RA. Conversely, only Infliximab and recently Adalimumab have been approved for UC. In particular, the efficacy of Adalimumab in UC has been demonstrated by both recent randomized controlled trials and real-life studies. Moreover, Adalimumab is a well-established treatment for RA. Herein, we describe a patient with RA and UC treated successfully with ADA.
24165529 Joint ventures: helping those with rheumatoid arthritis live well. 2013 OBJECTIVES: Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disorder that causes pain, swelling, stiffness, loss of joint function, and reduced quality of life. Yoga therapy may help individuals with RA manage stress and increase well-being. This study focused on the identification of therapeutic objectives and a methodology to achieve symptom relief, regain function, and enhance quality of life for individuals with RA. METHODS: Four women with RA participated in private yoga therapy sessions for 2.5 months. Assessment based, tailored home practices were developed and modified to address participant - identified goals. RESULTS: Participants reported decreased pain, fatigue, swelling, and flares; increased energy; pain-free range of motion and strength around affected joints; and a heightened sense of well-being. CONCLUSIONS: Tailored yoga therapy that emphasizes stress reduction may be beneficial for individuals with RA.
24517074 [Experiences of Professor Zhou Zhong-ying in diagnosing and treating rheumatoid arthritis 2013 Dec OBJECTIVE: To summarize Professor ZHOU Zhong-ying's academic ideas and clinical experiences in diagnosing and treating rheumatoid arthritis (RA). METHODS: Totally 153 clinical case reports were recruited. Data mining techniques like frequencies, factor analysis, and association analysis were used in order to find out laws of syndrome, pathogenesis, treatment methods, formulae and medication. RESULTS: By statistical analyses, we found 14 main symptoms, 76 commonly used clinical drugs, 8 core prescriptions for RA, and the correlation between main pathogeneses and related drugs. CONCLUSION: Results analyzed and summarized from mining his experiences in RA treatment were in line with clinical practice.
24124073 Clinical manifestations of Adult-onset Still's disease presenting with erosive arthritis: 2014 Apr Objective: Adult-onset Still's disease (AOSD) is a clinical entity with heterogeneous etiology. We have encountered patients with AOSD who had severe polyarthritis and who fulfilled the classification criteria for rheumatoid arthritis (RA); however, most patients with AOSD typically exhibit mild arthritis. In this study, we proposed two clinical subsets of AOSD and investigated the clinically significant characteristics of the two subtypes. Methods: We retrospectively analyzed 71 consecutive patients with AOSD. We reviewed the medical records of all patients who were followed up for more than 2 years. We classified all the patients with AOSD into the following 2 subsets: an RA subtype for patients who met the criteria for RA according to the American College of Rheumatology and a non-RA subtype for patients who did not meet the criteria for RA. Results: Our results indicated that the non-RA subtype was accompanied by severe inflammatory complications, including pleuritis and hemophagocytic syndrome. In addition, the serum ferritin and serum IL-18 levels were significantly higher in patients with the non-RA subtype than in those with the RA subtype. Interestingly, only 1 patient with the RA subtype had anti-CCP antibodies, and 1 non-RA subtype patient had rheumatoid factor. These findings distinguish these patients from patients with true RA. Conclusions: There were two subsets of patients with AOSD in the examined population. Patients with high levels of IL-18 or ferritin presented with severe systemic inflammatory disorders (the non-RA subtype), and patients with low levels of IL-18 or ferritin developed severe arthritis (RA subtype).
24552546 Changes and sex differences in patient reported outcomes in rheumatoid factor positive RA- 2014 Feb 20 BACKGROUND: Patient reported outcomes (PROs) are important measures in rheumatoid arthritis (RA). A register of patients with RA from all rheumatology care providers in Malmö, Sweden, was established in 1997 and has been continually updated. This register includes virtually all the RA patients in the area. The aim of this study was to analyse PROs in surveys of this population conducted between 1997 and 2009, and to assess differences in treatment and outcome in male and female patients. METHOD: In 1997, 2002, 2005 and 2009, questionnaires were sent to the RA patients in the register (n = 1016 in 1997; n = 916 in 2002; n = 1625 in 2005; n = 1700 in 2009). Response rates varied between 62 % and 74 %, and 72-74 % was women. Questionnaire data included medication and measures of disability and health related quality of life. Data on rheumatoid factor (RF) tests were retrieved from the databases of the two clinical immunology laboratories in the area. In order to limit the impact of changes in the case mix over time, the study was restricted to RF positive patients. The analyses were stratified by sex. RESULTS: Patients reported less severe outcomes for all measures in the later surveys compared to 1997, and patients' global disease activity assessment and self-reported pain were further improved in 2009 compared to 2005. Treatment with biologics increased over time from 1997 (none) to 2009 (29%), with no difference between men and women. Visual analogue scales (0-100) for patients' global assessment of disease activity [mean 45 (95 % CI (45-47) vs. 38 (35-40)] and pain [mean 46 (44-49) vs. 38 (36-40)] decreased from 1997 to 2009, with numerically greater improvement in male patients. The mean SF-36 physical component scores also improved, and were higher in men than in women in all surveys. CONCLUSION: Pharmacologic treatment of RA became more extensive over time, and there was improvement in all PROs. Despite similar treatment, male patients reported better outcomes, in particular for pain and physical function, compared to female patients. We suggest that patient reported outcomes should be reported separately in male and female patients with RA.
24032610 RAPID3, an index of only 3 patient self-report core data set measures, but not ESR, recogn 2013 OBJECTIVE: To perform a longitudinal cohort study concerning the capacity of prospectively-collected erythrocyte sedimentation rates (ESR) and scores for physical function, pain, patient global estimate, and routine assessment of patient index data (RAPID3) on a multidimensional health assessment questionnaire (MDHAQ), to recognize incomplete versus adequate responses to methotrexate in rheumatoid arthritis (RA) in one usual care setting, prior to description of RAPID3. METHODS: All patients were seen in one academic setting, in which MDHAQ scores were collected in all patients at all visits in the infrastructure of care. ESR was collected in all RA patients. All 93 RA patients in whom methotrexate was initiated between 1996 and 2001 with available 5-year follow-up were analyzed. "Incomplete response" was defined as initiation of subsequent biological therapy and "adequate response" as no biological therapy over 5 years. Measures were analyzed at the baseline methotrexate visit and at a subsequent visit: in 30 "incomplete responders" when biological therapy was prescribed; and in 63 "adequate responders 2.6 years after methotrexate initiation (mean interval to biological therapy in "incomplete responders"). RESULTS: ESR fell similarly by 33% to 36% in both groups. MDHAQ scores fell by 56% to 79% over 2.6 years in adequate responders but increased by 0% to 31% in incomplete responders. Median RAPID3 fell from 10.6 to 3.6 (low severity=3.1 to 6, remission≤3) in adequate responders and rose from 14.9 to 16.2 (high severity>12) in incomplete responders. CONCLUSION: RAPID3, but not ESR, recognizes incomplete versus adequate methotrexate responses in usual clinical care, and may be useful in busy usual care settings.
24533555 Simultaneous bilateral posterior interosseous nerve palsy caused by rheumatoid synovitis o 2014 Nov A 60-year-old woman with rheumatoid arthritis (RA) developed bilateral posterior interosseous nerve palsy. Her left side recovered after conservative treatment. However, her right side, which had been affected previously, did not recover and required surgery. Although conservative therapy, including administration of biologic agents, should be conducted for tight control of RA activity, we recommend surgical treatment when there is recurrence of the disease.
25482211 Development and optimization of a high-throughput micro-computed tomography imaging method 2015 Apr Rheumatoid arthritis (RA) is a chronic autoimmune disease resulting in joint inflammation, pain, and eventual bone loss. Bone loss and remodeling caused by symmetric polyarthritis, the hallmark of RA, is readily detectable by bone mineral density (BMD) measurement using micro-CT. Abnormalities in these measurements over time reflect the underlying pathophysiology of the bone. To evaluate the efficacy of anti-rheumatic agents in animal models of arthritis, we developed a high throughput knee and ankle joint imaging assay to measure BMD as a translational biomarker. A bone sample holder was custom designed for micro-CT scanning, which significantly increased assay throughput. Batch processing 3-dimensional image reconstruction, followed by automated image cropping, significantly reduced image processing time. In addition, we developed a novel, automated image analysis method to measure BMD and bone volume of knee and ankle joints. These improvements significantly increased the throughput of ex vivo bone sample analysis, reducing data turnaround from 5 days to 24 hours for a study with 200 rat hind limbs. Taken together, our data demonstrate that BMD, as quantified by micro-CT, is a robust efficacy biomarker with a high degree of sensitivity. Our innovative approach toward evaluation of BMD using optimized image acquisition and novel image processing techniques in preclinical models of RA enables high throughput assessment of anti-rheumatic agents offering a powerful tool for drug discovery.