Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3688003 | Use of radiographs to measure outcome in rheumatoid arthritis. | 1987 Oct 30 | Currently, radiographic analysis of the hands and wrists provides the most practical, useful, and objective biologic endpoint for measurement of outcome in rheumatoid arthritis. Semiquantitative scoring methods for cartilage loss and osseous erosions developed by Sharp (Arthritis Rheum 1971; 14: 706-720) and Larsen (Scand J Rheum 1973; 2: 136-138) have established standards for sensitivity and interobserver reliability. Sharp (Arthritis Rheum 1985; 28: 16-24) has shown that in order to reliably measure change in erosion score, a certain degree of worsening (i.e., progression) must take place. At least one year is necessary, preferably two. Others have shown that rheumatoid arthritis erosions take place and progress early (Years 1 to 3) in most patients, and once destruction is established it may not be possible to adequately assess further change radiographically. Therefore, in order to perform a clinical trial of "disease modifying" agents with radiographic analysis as endpoint, the selections of a proper study population and time interval are most critical. Although it may be difficult to perform, an ideal clinical study for a therapeutic intervention would use patients with rheumatoid arthritis of less than five years' disease duration and perform radiographic analysis at a 24-month minimum interval. The selection of a proper control group may be a near impossibility under these circumstances. | |
| 3820207 | Rheumatoid-like arthritis presenting as idiopathic pulmonary hemosiderosis: a report and r | 1986 Oct | Idiopathic pulmonary hemosiderosis, an unusual form of the alveolar hemorrhage syndromes, has been reported in association with several connective tissue disorders. Rheumatoid arthritis (RA), however, rarely presents in this manner. We discuss a young adult with recent onset RA following idiopathic pulmonary hemosiderosis, and review the 3 cases previously reported. | |
| 1980313 | Challenging the pyramid. A new look at therapeutic approaches for rheumatoid arthritis. Ea | 1990 Nov | It is clear that nonsteroidal antiinflammatory drugs (NSAID) may help control the pain and swelling of rheumatoid arthritis (RA) but do not retard joint destruction. Similarly, prednisone is effective in controlling pain and swelling but it cannot be established that it prevents or delays joint damage. When added to NSAID and prednisone, second line drugs (DMARD) have the potential to provide additional control of synovitis and improve function. Each second line drug has a unique tolerability and safety profile. Patients who are more likely to have a progressive course should be evaluated for second line drugs rather than risk irreversible damage. | |
| 3740998 | A population study on rheumatoid arthritis in Lesotho, southern Africa. | 1986 Aug | Motivated by the results of a hospital study on rheumatoid arthritis (RA) in Lesotho (southern Africa) a survey of inflammatory polyarthritis (IP) and RA was undertaken in a sample of the rural population of that country. Contrary to expectations the prevalence of IP grades 2-4 (definite disease) was low (0.4%) and equal in both sexes, while probable and definite RA combined (American Rheumatism Association (ARA) criteria) occurred in 1.8% of both males and females. RA was slightly more severe than in other rural African Negro studies but less so when compared with the disease condition of the patients observed in the hospital study. Rheumatoid factor and particularly that directed against heterologous antigen occurred in 41% of the RA patients and in 16% of the controls. Two thirds of the definite cases and 29% of the combined probable and definite group showed radiological abnormalities. | |
| 2068544 | Impairment of grip function in rheumatoid arthritis--studies with a simple hand test. | 1991 | A new, simple and quick method for assessment of impaired grip function was evaluated in a rheumatology department, 208 of 211 patients with definite rheumatoid arthritis were unable to do the test, 48 of these patients had regarded their hands as unaffected when questioned. The impairment of grip function was closely related to clinical and functional observations but not related to the most common laboratory tests. The study confirms the hypothesis that almost all patients with RA are unable to do the hand test, even those who consider their hand function as normal. | |
| 1765970 | Does estrogen replacement therapy protect against rheumatoid arthritis? | 1991 Oct | The incidence of rheumatoid arthritis (RA) was compared in 2 cohorts of women aged 35-64. One consisted of 1,075 estrogen replacement therapy (ERT) users and the other was 3,251 women from general practice registers. Screening detected 32 cases; 8 postmenopausal control and 6 ERT women developed RA during the study period 1982-1986. This produced incidence rates of 19.7/10,000 and 12.3/10,000 years of observation for ERT and controls, respectively. The relative risks for ERT was 1.62 (95% CI 0.56-4.74) and reduced towards unity after adjustment for potential confounders. Despite the wide confidence interval, our data do not support the previous observation of a 4-fold reduction in RA incidence in ERT users. Indeed the incidence rate in the exposed group in this study exceeded current population estimates of RA incidence in postmenopausal women. We believe that the high incidence rates could be best explained by the self-selection for estrogen therapy at the menopause of those with undiagnosed joint symptoms. These findings underscore the difficulties in elucidating the relationship between ERT and RA. | |
| 2793403 | Severe disability in rheumatoid arthritis: assessment following comprehensive rehabilitati | 1989 Sep | 26 patients with rheumatoid arthritis (RA) who presented with severe disability to a rheumatology unit were reviewed following comprehensive rehabilitation. This comprised in-patient evaluation, alteration in drug therapy, physical and occupational therapy and in many cases, orthopaedic surgery. Sustained benefit is observed 4-6 years later in terms of disease activity and functional class. The greatest improvement in functional class was noted in those patients who underwent joint replacement. | |
| 3066920 | Staging and follow-up of rheumatoid arthritis of the knee. Comparison of sonography, therm | 1988 Oct | Twenty patients with longstanding polyarticular rheumatoid arthritis (including knee involvement) were selected for this study. The severity of the knee synovitis was assessed before and during treatment (with intra-articular corticosteroid injections) using clinical scores, sonography, and thermography. In all patients, the inflammation regressed during treatment. During follow-up, the quantity of synovial fluid, as measured sonographically 10 days after the start of therapy, correlated best with the clinical status. Maximal regression of synovial thickening was noted on delayed sonograms performed three months after treatment. Thermographic peak temperature showed good correlation with the clinical status, but the thermographic index was unreliable. | |
| 2205907 | Clinical and laboratory outcomes during the treatment of rheumatoid arthritis with methotr | 1990 | Ten clinical and three laboratory outcomes were evaluated in 86 patients completing a double-blind placebo-controlled trial of methotrexate in rheumatoid arthritis. The improvement in all measured outcomes was statistically significantly better in patients receiving methotrexate than in patients receiving placebo. The correlations of the changes in outcome measures were calculated to determine if improvement in one parameter was associated with improvement in other clinical parameters. Associations between different clinical outcomes were often statistically significant. Associations between laboratory outcomes were also often statistically significant. However, the association between clinical outcomes and laboratory outcomes was generally poor. | |
| 3482732 | Immunological aspects of the rheumatoid synovium. | 1987 | The characteristics of the immunocompetent lymphoid cells which have invaded the synovial membrane during rheumatoid arthritis, juvenile rheumatoid arthritis and related disorders are briefly reviewed. Various functional aspects of these cells are also discussed. | |
| 1812566 | [Rheumatoid arthritis and disability]. | 1991 Jul | The investigation conducted by the authors makes it possible to come to the conclusion that rheumatoid arthritis brings about early and severe invalidity mainly of young and middle-aged patients (predominantly women) persisting practically up to the pension age with further aggravation of disability. It has been also established that physicians of rural regions and interregional commissions for medical testimony are not sufficiently acquainted with the modern classification, methods of treating rheumatoid arthritis and specifying invalidity in connection with this disease. There is practically no specialized aid for the population of small towns and rural regions. The need in this aid is obvious. | |
| 2643199 | [Diet and rheumatoid arthritis]. | 1989 Jan 10 | The dietary treatment of rheumatoid arthritis is a controversial issue. Several patients have experienced that their diet does affect the disease activity. For many years this has been explained by rheumatologists either as a result of natural variations in the disease activity, or as reflecting a placebo effect. In recent years several clinical trials seem to support patients' claims of an interrelation between their diet and the disease activity. Possible explanations of this interrelation are: 1) food allergy/intolerance, 2) dietary factors which modify the inflammatory process, 3) dietary factors which modify the bacterial flora in the gastrointestinal tract. In this article we sum up the results of several clinical trials on the dietary treatment of rheumatoid arthritis, and discuss the three possible explanations of the effects. | |
| 3427837 | Interactive image analysis in the rectal mucosa of rheumatoid arthritis. | 1987 Jul | Interactive measurements of 22 quantitative parameters concerning the status and inflammation of the mucosa were taken in the rectal biopsies of patients suffering from Rheumatoid Arthritis, or with mild nonspecific morphological abnormalities (M.N.M.A.) and inflammation of the lamina propria or with Infective Colitis. The results showed that mean and standard deviation values of the rheumatoid patients are generally intermediate between those of control cases and those of M.N.M.A. and Infective Colitis. The variance analysis revealed that significant differences in some of the features exist between the four groups. Stepwise discriminant analysis helped in identifying three parameters that contributed significantly to discriminating 96.30% of the cases: Mucin area/Mucosal area; Number of inflammatory cells in the lower half/Number of inflammatory cells in the upper half of the mucosal thickness; Number of Granulocytes/mm2 of the lamina propria. Of the 27 cases included in the study, only one belonging to the control group was allocated incorrectly by the computer to the Rheumatoid Arthritis category. High correlation coefficients were observed between some of the morphometric, serological and clinical data in the rheumatoid patients. The highest values were between Number of Mononuclear cells/mm2 of lamina propria and C-Reactive Protein (+0.920) as well as between Mucin area/Mucosal area and serum IgM level (-0.950). | |
| 2699674 | Pathogenesis and treatment of chronic arthritis. | 1989 | Inflammatory and 'non-inflammatory' forms of arthritis affect a large proportion of the population and these diseases can often lead to disability. Although the pain of arthritis can be relieved to some extent by the peripherally acting aspirin-like drugs, the progression of disease leading to joint destruction is largely resistant to current drug therapy. The synovial joints of patients with rheumatoid arthritis are infiltrated with neutrophils, macrophages and lymphocytes and the resident cells become activated to degrade the cartilage and bone. The inflammatory and destructive changes that occur are brought about by the action of mediators or local hormones which are produced by a variety of cell-types. Lipid mediators, such as prostaglandins, contribute to the symptoms of arthritis while polypeptide cytokines, such as interleukin 1 and tumour necrosis factor, play a key role in joint destruction by activating the synovial cells and chondrocytes to release metalloproteinases, such as collagenase. Aspirin-like drugs inhibit the production of prostaglandins from inflamed tissues and thereby blunt the symptoms of arthritis. However, these drugs do not suppress the production of collagenase from connective tissue cells and, therefore, do not halt the degeneration of joint tissues. | |
| 2662779 | Possible case of rheumatoid arthritis from Sudanese Nubia. | 1989 Jun | Due to its apparent absence in archaeologically derived skeletons, rheumatoid arthritis (RA) has generally been believed to be of fairly recent origin. A growing body of evidence now demonstrates that erosive lesions typical of RA are present in archaeological populations and that the antiquity of RA may be greater than previously expected. In support of this argument, a case of erosive arthritis is reported in a skeleton from Kulubnarti, Republic of the Sudan (c. 700-1450 A.D.). Lytic, erosive lesions and subchondral cysts are present bilaterally in the carpal and metacarpal joints of a female skeleton with an estimated age at death of 50+ years. These lesions are typical of those seen in clinically diagnosed rheumatoid patients. While their expression and distribution are highly suggestive of RA, interpretation must be made with due consideration for problems of differential diagnosis of this disease in archaeological material. | |
| 2741472 | Clinical significance of the immunological tests in rheumatoid arthritis. | 1989 | Of the many theoretical causes of rheumatoid arthritis(RA), the most widely held theory is the autoimmune mechanism. In order to clarify the clinical significance of the immunological tests in RA, we studied immunoglobulin and complement levels in sera and synovial fluids of 118 RA patients and the following results were obtained. 1) The levels of immunoglobulins were elevated in both serum and synovial fluid and this was more prominent in the seropositive cases than the seronegative ones. 2) The levels of C3 component were decreased in both serum and synovial fluid, while those of C4 were decreased only in synovial fluid. Serum C3 and C4 component levels were more decreased in the seropositive cases than the seronegative ones. 3) The immunoglobulin levels in serum (IgG, IgM and IgA) and synovial fluid (IgG and IgA) and the levels of C3, C4 component in serum were well correlated with the clinical forms of rheumatoid arthritis. 4) The IgA level in serum and IgM level in synovial fluid were more increased in the exacerbated cases than the chronic ones. 5) Serum IgG level was decreased after steroid medication over one month. | |
| 2719727 | Lymphoid irradiation in intractable rheumatoid arthritis. Long-term followup of patients t | 1989 May | Twenty patients with intractable rheumatoid arthritis were randomized to receive 750 or 2,000 rads of lymphoid irradiation (LI) in a double-blind comparative study, and were followed for a maximum of 48 months (mean 40 months) after treatment. During followup, sustained immunomodulation (including lymphopenia, particularly of the T helper cell subset; reduced ratio of helper cells to suppressor cells; and impaired in vitro lymphocyte proliferation in response to phytohemagglutinin and pokeweed mitogen) was observed. Significant improvements in early morning stiffness, Ritchie articular index, pain score, grip strength, and 15-meter walk time were observed in both treatment groups, but these were not sustained through the followup period. Progressive joint damage was observed radiologically in both groups during followup. Thus, LI induced sustained immunosuppression, but resulted in only short-lived clinical improvement and was associated with progressive joint erosion in these patients. | |
| 1971456 | [Does the general strategy for the treatment of rheumatoid polyarthritis need to be review | 1990 Apr 10 | At the start of the nineties, the therapeutic strategy for rheumatoid arthritis (RA) is still disappointing, and the natural history of this affection remains only slightly influenced by the treatments; a general re-assessment of the treatment seems therefore justified. Some new slow acting drugs are effective, but they cannot be considered as being therapeutic revolutions: gold salts per os, sulphasalazine, tiopronine whose efficacy is comparable to D-penicillamine without systematic cross interaction, methotrexate, cyclosporin which is difficult to manipulate. These observations encourage the search for new strategies, namely for the early treatment of the synovitis before the pannus and radiological signs appear. For this, the early and irrefutable diagnosis of RA must be made possible; and no completely reliable, early detection test is available yet. Though promising, the new therapeutic approaches, immunomanipulation or cell manipulation, do not revolutionize the evolution of this pathology. Other fields of research need to be developed, namely on the remission-inducing agents observed during pregnancy. It is still impossible to know which approach will provide the absolute weapon against RA. | |
| 2031157 | Early and late synovectomy of the knee in rheumatoid arthritis. | 1991 | The results after open knee synovectomy in the treatment of rheumatoid arthritis were investigated in a retrospective study including 44 patients with 55 knees. Median observation time was 73 months. Early synovectomy showed significant pain-relief and improvement of knee function, effusion was reduced and range of motion was unchanged. Total knee alloplasty (TKA) was performed in one knee among the patients who underwent early synovectomy, while reoperation with TKA had been performed in 12 out of 28 knees after late synovectomy. It is concluded that early synovectomy is indicated when medical treatment has failed. Late synovectomy must be regarded as a palliative procedure in order to postpone TKA. | |
| 3798043 | Painful shoulders in patients with rheumatoid arthritis. Prevalence, clinical and radiolog | 1986 | The shoulder joints of 105 patients with rheumatoid arthritis were examined. The patients were on average 62 years old and their mean RA duration 17 years. Ninety-six patients (91%) reported shoulder problems. Thirty-three patients had actual severe painful shoulder disability. The acromioclavicular joint was clinically tender in 36 shoulders and subacromial hypertrophic bursitis was recorded for 22 shoulders. One hundred and sixteen shoulders in 61 of the patients with shoulder pain were examined radiologically and classified according to the Larsen system. With increasing duration of the RA there was a progress of destructive changes and a decrease in the range of motion, indicating that intervention with surgical procedures may be warranted. |