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ID PMID Title PublicationDate abstract
27156927 The establishment of a porcine rheumatoid arthritis model: Collagen induced arthritis mini 2016 Sep Rheumatoid arthritis (RA) research has been largely dependent on collagen induced arthritis (CIA) rodent models, however, they may not translate well to humans due to innate differences in the size, physiology and lifespan. The present study aimed to establish a CIA porcine model with the physical, hematological, histopathological and etiological properties closer to their human equivalent in an attempt to better meet the needs of RA research. Three month old minipigs were administered of bovine type II collagen (CII) emulsified with complete Freund's adjuvants on Day 1 and incomplete Freund's adjuvants on Day 22, via an intradermal or intra-articular route. The clinical, radiological and hematological assessments of immunized animals were made periodically until Day 43, during which period the onset and progression of arthritis was recorded and characterized. In addition, the histopathological and micro-tomographic assessments of the cartilage degradation with regard to mononuclear cell infiltration, and joint deformity indicated a higher severity in the intradermal injection group over the intra-articular group. With confirmation of the susceptibility to heterogeneous CII for arthritis induction in minipig, the potential suitability of this test system as a large animal model for RA has been demonstrated.
29071952 [Development of Researches on Cytokine Mechanisms in Analgesia and Anti-inflammation in Ac 2016 Oct 25 Cytokines are closely related to the occurrence and development of rheumatoid arthritis(RA). Acupuncture exerts anti-inflammatory and analgesic effects via elevating anti-inflammatory cytokine level and reducing pro-inflammatory cytokine level and regulating Th 1/Th 2 balance, which reflects the dual directional regulatory effect of acupuncture. However, problems exist in the current researches, such as inadequate depth, limited breadth and not so up-to-date research focus. The mediocre research level and the phenomena of some contradictory results among studies also need being concerned. Therefore, progress may be attained if a holistic, dynamic and networked study is conducted on the influence of acupuncture on cytokines by combining the latest progress in the mechanisms of network of cytokines and neuroendocrine immune network, and high throughput cytokine capture assay. In this way, the mechanism of cytokines in multi-targets (such as local joints, peripheral blood circulation, central nervous system) involving the effects of acupuncture in improving RA will be known more.
24751105 Rs7574865 polymorphism in signal transducers and activators of transcription 4 gene and rh 2015 Jan OBJECTIVES: The objective of the present meta-analysis was to investigate whether the combined evidence shows an association between the STAT4 rs7574865 polymorphism and RA. METHODS: A systematic search of all relevant studies published through April 2013 was conducted using MEDLINE, EMBASE, OVID, and ScienceDirect. The observational studies that were related to an association between the STAT4 rs7574865 polymorphism and RA were identified. The association between the STAT4 rs7574865 polymorphism and RA susceptibility was assessed using genetic models. RESULTS: Seventeen case-control studies with a total of 28 comparisons (25 300 RA patients and 26 326 controls) met the inclusion criteria. A meta-analysis was conducted for genotype TT versus GT+GG, GT+TT versus GG, TT versus GG and T-allele. The meta-analysis showed an association between RA and the STAT4 rs7574865 TT genotype, GT+TT genotype and T-allele in all subjects. Stratification of RA patients according to ethnic group showed that the TT genotype, GT+TT genotype and T-allele were significantly associated with RA in Europeans, Asians, Africans and Latin Americans. A subgroup analysis according to the absence or presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies revealed that the association between the STAT4 rs7574865 polymorphism and RA may be independent of the presence of RF and anti-CCP antibodies. CONCLUSIONS: This meta-analysis demonstrated that the STAT4 rs7574865 polymorphism confers susceptibility to RA in major ethnic groups. The association may not be dependent on the presence of RF and anti-CCP antibodies.
26411882 Infliximab as a treatment option for patients with rheumatoid arthritis and primary biliar 2015 Nov Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease which commonly requires treatment with biologic agents targeting various inflammatory pathways. Tumor necrosis factor alpha is a proinflammatory cytokine which plays a pivotal role not only in the pathogenesis of RA but also in other autoimmune diseases such as primary biliary cirrhosis. The co-existence of more than one autoimmune disorder in the same individual is very challenging in the daily practice as therapy strategies applicable to one disease setting may cause clinical and/or biochemical relapse of the other clinical entity. As a result, treatment options able to control different diseases are highly desirable among rheumatologists and other specialties. In that respect, we present a case of a 61-year-old female patient with RA and concomitant primary biliary cirrhosis with poor clinical response to conventional disease-modifying drugs for RA. The introduction of tumor necrosis factor alpha antagonist infliximab led to significant clinical improvement of RA and to stabilization of liver function. In this case review study, we discuss aspects of pathophysiology of primary biliary cirrhosis associated with tumor necrosis alpha and we review the available data of similar published cases.
26608849 [The "treat-to-target" strategies for rheumatoid arthritis and managing for bone cartilage 2015 Dec Sometime ago, there was little choice for the treatment of rheumatoid arthritis(RA)that was regarded as an untreateble disease but supportive analgesics and mild disease modified drugs. The advent of biological agents with abundant clinical researches regarding remarkable efficacy has cased dramatically the paradigm shift in the treatment of RA. The strategy for medical care to RA has now entered a new era in that treatment target should be clarified and shared between patient and rheumatologist aiming the prevention of structural damage and the maintain of long-term quality of life(QOL)by tight-control. In this review, we summarize the "treat to target"(T2T)strategies for RA and its impact to manage for bone and cartilage destructions.
26168559 Arthritis: joints inflamed. 2015 Jun ARTHRITIS IS a generic term for inflammatory joint disease. There are various forms of arthritis, including osteoarthritis, rheumatoid arthritis and spondyloarthritis. Arthritis can be a chronic debilitating condition or a transient effect of bacterial or viral infections. As a chronic condition, arthritis can cause loss of quality of life, disability and, with rheumatoid disease, early death. The economic burden of arthritis, in terms of management and loss of productivity due to disability, is high and set to increase with the ageing population. Recent advances in our understanding of the causes and progression of a number of forms of arthritis have raised hopes of better management and possible remission. Pharmacotherapy has moved from symptom management to addressing underlying disease processes. However, therapies that prevent or cure arthritis remain elusive. Current care for people with arthritis relies on a multidisciplinary approach and substantial pharmacological intervention. Nurses have a key role to play in guiding patients through treatment, ensuring they receive optimal therapy to reduce the impact of arthritis and its management on their lives.
25702242 [Study of echocardiographic parameters of rheumatoid arthritis black African without clini 2016 Apr INTRODUCTION: Research of cardiac involvement in patients with rheumatoid arthritis can prevent complications and place in a logical secondary prevention. The objective of this study was to investigate the echocardiographic parameters in a population of Senegalese patients with rheumatoid arthritis without clinically evident cardiovascular manifestations. PATIENTS AND METHOD: We conducted a descriptive cross-sectional study, which included prospectively from outpatients in the internal medicine department of university hospital center Aristide Le Dantec in Dakar, Senegal, with a diagnosis of rheumatoid arthritis without clinically evident cardiovascular disease. It focused on a sample of 73 patients of both sexes aged at least 18 years. Following clinical examination, we conducted laboratory tests (CRP, fibrinogen, ESR, rheumatoid factors: Latex and Waaler-Rose, anti-CCP, antinuclear factors and anti-ENA antibodies), ECG, echocardiography standard. Data were analyzed using a descriptive study of the different variables with the calculation of proportions for categorical variables, and the positional parameters and dispersion for quantitative variables. RESULTS: A total of 73 patients with rheumatoid arthritis without obvious cardiac events and meeting the criteria of definition of the ACR 1987 were included in the study. The mean age was 44.17±14.43 years with extremes of 18 and 75 years. The mean duration of RA was 5.93±4.78 years. The concept of family inflammatory arthritis was reported in 35.60% of cases and almost one in six patients had at least a factor of cardiovascular risk (16.96%). The abnormalities found in Doppler echocardiography were dominated by diastolic LV dysfunction (42.46%), increased left ventricular mass in 35.61%. Valvular leaks of variable grades were highlighted regarding all orifices but were rarely significant. CONCLUSION: The realization of echocardiography in patients with rheumatoid arthritis without clinically evident cardiovascular manifestations helps to highlight cardiovascular abnormalities related to the natural course of the disease.
27800636 Diagnostic value of autoantibodies combined detection for rheumatoid arthritis. 2017 Sep BACKGROUND: Rheumatoid arthritis (RA) is a chronic, inflammatory and autoimmune disease, there are many autoantibodies produced during disease progression in the patients' serum, and this work is to select a best detection scheme for RA diagnosis. METHODS: Autoantibody levels including rheumatoid factor (RF), anti-cyclic citrullinated peptide (CCP), mutated citrullinated vimentin (MCV), anti-keratin antibodies(AKA), anti-perinuclear factor (APF), and Ig heavy chain binding protein (BIP), were measured, and the sensitivity, specificity, predictive values, accuracy, and Youden's index of different combining forms were all calculated in RA patients, disease, and healthy control group. The differences in the positive rates of the three groups were compared between any two of them. RESULTS: Generally speaking, the sensitivity of the autoantibodies detected in parallel combination was higher than that in tandem, which was more specific. The sensitivity of anti-MCV and RF calculated in parallel (87.61%) was obviously better than that of anyone autoantibody (P<.05), and only increased slightly even if more autoantibodies were tested in parallel (P>.05). The specificity of anti-CCP and BIP measured in tandem (95.92%) was obviously higher than that of anyone autoantibody (P<.05). While increasing the detected number of autoantibody from two kinds to three or more, the specificity was improved insignificantly (P>.05). CONCLUSION: Anti-BIP and CCP antibodies detected in tandem combination can obtain higher specificity, and have good clinical value for the differential diagnosis of RA.
27825576 Translation and adaptation of the French version of the Heart Disease Fact Questionnaire - 2017 Dec OBJECTIVES: Rheumatoid arthritis constitutes a cardiovascular risk factor as significant as diabetes, yet remains insufficiently managed. The Heart Disease Fact Questionnaire - Rheumatoid Arthritis (HDFQ-RA1&2) is a self-questionnaire that assesses patients' general knowledge about cardiovascular risk and more specifically associated with rheumatoid arthritis and its treatments. Objectives are to translate and adapt the HDFQ-RA into French and assess its psychometric properties in order for it to be used as instructional material by nurses in therapeutic education. METHODS: The questionnaire was translated into French and subsequently back-translated into English pursuant to the "Guidelines for the process of cross-cultural adaptation of self-report measures". Psychometric properties were evaluated in a sample of 60 rheumatoid arthritis patients (test-retest procedure) between June and December 2013. Item content, factor analysis, and Kuder-Richardson's-alpha were used to evaluate acceptability, internal consistency, and reproducibility. RESULTS: A culturally acceptable version for French patients was obtained. Cronbach's-alpha coefficient was higher than the usual recommended value of 0.6. Reproducibility was good (agreements measured by Kappa's coefficient >0.56 [recommended value=0.4]). Results showed that knowledge of cardiovascular risk was generally satisfactory (rate of correct responses ≥60%), but specific knowledge of the cardiovascular risk associated with rheumatoid arthritis remained poor, e.g. knowledge of the increased risk associated with rheumatoid arthritis (40% correct responses), higher risk with active rheumatoid arthritis, adverse effect of rheumatoid arthritis on lipid profile and the effects of corticosteroids and NSAIDs on cardiovascular risk. CONCLUSIONS: The French-HDFQ-RA is valid for assessing patient knowledge of cardiovascular risk in general and associated with rheumatoid arthritis and its treatments.
26476882 Application of (1)H NMR-based serum metabolomic studies for monitoring female patients wit 2016 Jan 5 Rheumatoid arthritis is a chronic autoimmune-based inflammatory disease that leads to progressive joint degeneration, disability, and an increased risk of cardiovascular complications, which is the main cause of mortality in this population of patients. Although several biomarkers are routinely used in the management of rheumatoid arthritis, there is a high demand for novel biomarkers to further improve the early diagnosis of rheumatoid arthritis, stratification of patients, and the prediction of a better response to a specific therapy. In this study, the metabolomics approach was used to provide relevant biomarkers to improve diagnostic accuracy, define prognosis and predict and monitor treatment efficacy. The results indicated that twelve metabolites were important for the discrimination of healthy control and rheumatoid arthritis. Notably, valine, isoleucine, lactate, alanine, creatinine, GPC  APC and histidine relative levels were lower in rheumatoid arthritis, whereas 3-hydroxyisobutyrate, acetate, NAC, acetoacetate and acetone relative levels were higher. Simultaneously, the analysis of the concentration of metabolites in rheumatoid arthritis and 3 months after induction treatment revealed that L1, 3-hydroxyisobutyrate, lysine, L5, acetoacetate, creatine, GPC+APC, histidine and phenylalanine were elevated in RA, whereas leucine, acetate, betaine and formate were lower. Additionally, metabolomics tools were employed to discriminate between patients with different IL-17A genotypes. Metabolomics may provide relevant biomarkers to improve diagnostic accuracy, define prognosis and predict and monitor treatment efficacy in rheumatoid arthritis.
26271759 Perioperative Treatment of Patients with Rheumatoid Arthritis. 2015 Sep Rheumatoid arthritis is an autoimmune disease mediated by a widespread chronic systematic inflammatory process that causes joint deterioration, which leads to pain, disability, and poor quality of life. The increased use of disease-modifying antirheumatic drugs has been shown to markedly slow disease progression, which has translated into a decrease in the need for orthopaedic intervention in this population. However, a substantial percentage of patients with the disease fail optimal pharmacologic treatment and still require surgical intervention. A thorough understanding of medical considerations in these patients and improved knowledge of the medical complications caused by the disease process and the pharmacologic therapy used to treat it may lead to improved preoperative planning and medical clearance, which may ultimately improve the overall postoperative outcome.
27614619 Influence of patient personality in the treatment of rheumatoid arthritis. 2016 Nov Individualized treatment of rheumatoid arthritis (RA) based on genetic/serologic factors is increasingly accepted. Moreover, patients are more actively involved in the management of their disease. However, personality has received little attention with respect to perception of the need and adherence to treatment. Our objective was to evaluate whether patient personality was associated with the acceptance or rejection of more aggressive early treatment. We performed a cross-sectional study in two hospitals with early arthritis clinics where sociodemographic, clinical, and therapeutic variables are systematically recorded. Patients completed Eysenck Personality Questionnaire, Multidimensional Health Locus of Control, Pain-Related Self-Statement Scale and Pain-Related Control Scale. Aggressive treatment was considered if patients received more than two DMARDs or biological agents during the first year of follow-up. Multivariate logistic regression analysis was performed to determine predictors of aggressive treatment. One hundred seventy-six RA patients were included (80 % women, disease begin median age 55 years). Treatment was considered aggressive in 57.9 % of the sample. Scores were high in extraversion in 50.8 % of patients, neuroticism in 29.5 % and psychoticism in 14.7 %. Neuroticism was the only factor associated with aggressive treatment, which was less probable (p = 0.04, OR = 0.40). Neuroticism also decreased the possibility of receiving a combination of biologics and DMARDs (p = 0.04, OR = 0.28). Patients with high scores on neuroticism are more worried, obsessive and hypochondriac, leading them to reject more aggressive therapy. It is important to educate about their disease so that they will accept more aggressive approaches in clear cases of poor outcome.
27135312 Comparison of elderly- and young-onset rheumatoid arthritis in an Asian cohort. 2017 Jun OBJECTIVE: To describe the demographic characteristics, clinical features, functional status and quality of life of elderly-onset (EORA) and young-onset (YORA) rheumatoid arthritis (RA) patients in an Asian cohort. METHODS: We studied all RA patients in our prospective disease registry, utilizing baseline data. EORA was defined as disease onset at 60 years or older. We collected data from January 2001 to December 2012. RESULTS: There were 1206 patients in our cohort, of which 178 (14.8%) had EORA, with a mean age of onset of 66.7 ± 5.6 years. There were more males in the EORA than YORA group (23.0% vs. 14.7%, P = 0.005). EORA patients were diagnosed sooner after symptom onset and had a higher number of comorbidities (median 2 [inter-quartile range 1-3] vs. 1 (0-2), P < 0.001). They were less likely to be rheumatoid factor positive, had higher erythrocyte sedimentation rate values and lower hemoglobin concentrations. There was no significant difference in joint counts, Disease Activity Score of 28 joints activity score and prevalence of radiographic erosions. Though EORA patients had worse Health Assessment Questionnaire scores and poorer functional status than YORA ones, they had lower pain scores and higher scores in the general health and mental component summary of the Short Form-36. EORA patients received significantly lower numbers of disease-modifying anti-rheumatic drugs. CONCLUSIONS: EORA and YORA patients had different demographic characteristics. Although they had similar disease activities, EORA patients received less intensive treatment. EORA patients had a higher number of RA-related co-morbidities and poorer physical functioning but they coped better emotionally and mentally.
27917633 [Differential diagnosis of monoarthritis]. 2016 Fall Making the diagnosis of monoarthritis can be quite difficult, because in contrast with polyarthritis just a few clinical data is available and wide diagnostic spectrum is present.The diagnosis of inflammatory rheumatic disease is usually in responsibility of a rheumatologist, but we know from experience that is necessary to carry out the basal differential diagnostic assessment as soon as possible to begin the optimal therapy. General practitioners and orthopaedists are usually first to face this problem.Monoarthritis can be divided into non-inflammatory arthritis where activated osteoarthritis and trauma belongs and inflammatory arthritis, which include gouty arthritis, chondrocalcinosis, infectious arthritis, juvenile idiopathic arthritis, spondylitis, incipient rheumatoid arthritis and many others.The article also focuses on the management of patients with monoarthritis where detailed history, careful clinical joint examination and the nature of arthritis assessment is necessary for differential diagnostic considerations. Our balance sheet further facilitate imaging, arthrocentesis with the analysis of synovial fluid and of course the laboratory examination.
26564293 Prevalence of rheumatoid arthritis in population with arthralgia presenting to a tertiary 2015 Nov OBJECTIVE: To evaluate patients presenting to healthcare facilities because of joint pain and subsequently diagnosed with rheumatoid arthritis. METHODS: The prospective study was conducted from August 1, 2013,to January 20, 2014, at Jinnah Postgraduate Medical Centre, Karachi, and comprised patients presenting with joint pain. A questionnaire was used to collect data, and patients were diagnosed using American College of Rheumatology / European League Against Rheumatism Rheumatoid Arthritis Classification Criteria. Data was analyzed using SPSS 20. RESULTS: Of the 320 patients approached, 316(98.7%) filled the questionnaire. Eighty five (26.9%) were diagnosed as rheumatoid arthritis. Sixty (70.5%) were females and 25 (26.3%) were males. The frequency of rheumatoid arthritis was higher in people in 4th, 5th and 6th decades of life. Twenty five (7.9%) patients had positive family history, 77 (90.2%) were chronic sufferers and only 53 (16%) agreed to follow recommended immunosuppressive therapies. 212 (67.1%) patients belonged to highly literate class. CONCLUSIONS: Proper guidance regarding the disease was found to be lacking in the urban centre.
26298564 Regulation and function of SIRT1 in rheumatoid arthritis synovial fibroblasts. 2016 Feb Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and destruction of synovial joints. The function of sirtuin (SIRT)1 in RA is inconclusive. In human synovial cells, SIRT1 was shown to promote cytokine production and apoptosis resistance. However, deletion of SIRT1 aggravated inflammatory arthritis in mice and increased production of pro-inflammatory cytokines in murine macrophages. In the current study, we investigated the regulation, expression, and function of SIRT1 in RA, in particular its role in adhesion and proliferation of human RA synovial fibroblasts (RASF). We found that expression of SIRT1 was increased in vivo in synovial tissues of RA smokers and in vitro by stimulation of RASF with TNFα, but decreased upon treatment with cigarette smoke extract. Synovial tissues of RA smokers showed higher leukocytic infiltration that positively correlated with enhanced levels of SIRT1. Global transcriptome analysis revealed that SIRT1 modulates expression of genes involved in the regulation of inflammatory response and cell adhesion. In functional studies, silencing of SIRT1 reduced proliferation and leukocytic adhesion to RASF but showed inconsistent results in the regulation of adhesion to plastic. In conclusion, SIRT1 modulates the proliferative and potentially also adhesive properties of RASF and can therefore promote progression of RA. KEY MESSAGES: SIRT1 is upregulated by TNFα but decreased upon CSE treatment of RASF. Upregulation of SIRT1 in RA smokers correlates with increased leukocytic infiltration. SIRT1 modulates expression of genes regulating cell adhesion and inflammation. SIRT1 regulates proliferation of RASF.
27003861 [International quality indicators in rheumatology. Suggestions for rheumatoid arthritis]. 2016 Apr Quality measurement of medical care has become increasingly important in Germany in recent years. Essentially, three areas can be distinguished: the quality of structure, process and outcome. For the measurement of quality, quality indicators are necessary. The Federal Joint Committee has recently been responsible for defining such quality indicators. Because proposals for quality indicators for the indication for rheumatoid arthritis in have already been published in international rheumatology, we selected and translated the three most important European publications in order to present them to the rheumatology community. The ultimate aim is the initiation of a process for the joint development of quality indicators within the professional association and the two associations in Germany in order to then be able to adequately discuss these with policy-makers.
26857028 Bidirectional associations between rheumatoid arthritis and depression: a nationwide longi 2016 Feb 9 Rheumatoid arthritis (RA) and depression may be associated with each other pathophysiologically, but few studies have been conducted on the interplay between these two diseases using longitudinal measurement. Therefore, we used the National Health Insurance Research Database of Taiwan to investigate the bidirectional associations between RA and depression. One cohort was included to analyze RA predicting the onset of depression and a second cohort for analysis of depression predicting RA. A sex- and age-matched control group was included for both. The incidence of depression in RA subjects was higher than in non-RA subjects [15.69 vs. 8.95 per 1,000 person-years (PYs)], with an adjusted hazard ratios (HRs) of 1.69 [95% confidence interval (CI), 1.51-1.87]. The incidence of RA was higher in depressed than non-depressed individuals (2.07 vs. 1.21 per 1,000 PYs), with an adjusted HRs of 1.65 (95% CI, 1.41-1.77). This population-based cohort study suggested strong bidirectional relationships between RA and depression. Healthcare providers are recommended to facilitate the implementation of more effective therapeutic interventions to achieve favorable prognosis, especially for those with new-onset or younger cases.
25989126 Examining rheumatoid arthritis patients' trust in their provider over time: the effects of 2015 May BACKGROUND: Patients who trust their providers have better health outcomes; a trusting patient-provider relationship is needed for optimal management of rheumatoid arthritis (RA), a chronic autoimmune disease. PURPOSES/METHODS: An observational study design (N = 100 RA patients) was used to: RESULTS: : Patients' trust in their providers decreased over time. Less-educated persons and those who accessed information from the Internet reported less trust in their providers. Patients who consulted a larger number of information sources rated trust in their provider more positively. CONCLUSION: RA patients' trust in providers is a dynamic construct influenced by education and health information.
27639946 [Sub-maximal aerobic capacity and quality of life of patients with rheumatoid arthritis]. 2017 Jan BACKGROUND: Studies about sub-maximal aerobic capacity of patients with rheumatoid arthritis are scarce. AIMS: To assess the sub-maximal aerobic capacity of these patients through the 6-min walk test, estimated age of the "muscular and cardiorespiratory" chain. METHODS: Thirty-seven consecutive patients (aged 20 to 60 years) with newly diagnosed rheumatoid arthritis will be included. Non-inclusion criteria will be: use of drugs (e.g.; methotrexate, beta-blockers), orthopaedic or rheumatologic conditions (other than rheumatoid arthritis) that may alter walking ability and recent infections. Exclusion criteria will be: 6-min walking test contra-indications and imperfect performance of the required lung function and walking maneuvers. Signs of walking intolerance will be: test interruption, distance ≤lower limit of normal, dyspnea score ≥5/10 (visual analogue scale) at the end of the test, haemoglobin oxygen saturation (SpO(2)) drop ≥5%, cardiac frequency at the end of the test ≤60% of maximum predicted. An estimated "muscular and cardiorespiratory chain" age higher than the chronological one will be considered as a sign of accelerated ageing. EXPECTED RESULTS: A high percentage of patients suffering from rheumatoid arthritis would show evidences of walking limitation and accelerated "muscular and cardiorespiratory chain" ageing. There would be a significant correlation between the walking test and clinical, biological, radiological and pulmonary function data and the patients' quality-of-life status.