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ID PMID Title PublicationDate abstract
27379740 [Medical treatment of rheumatoid arthritis in 2014 : Current data from the German Collabor 2017 Feb BACKGROUND: Since the introduction of biologic treatment in rheumatoid arthritis (RA), disease activity and treatment modalities have changed substantially. The current provision and developments in recent years are analyzed with annual data from the National Database of the Collaborative Arthritis Centers in Germany. METHODS: To analyze disease activity, diagnostics and treatment in RA patients in 2014 with regard to seropositivity and disease duration. Time trends from 2007-2014 are reported for disease activity (DAS28) distribution and biologic treatment. RESULTS: In 2014, a total of 8,084 RA patients were analyzed: 72 % were rheumatoid factor and/or ACPA positive, the mean age was 62 years and the mean disease duration 12 years. According to DAS28, 35.9 % were in remission, 19.2 % had low, 37.1 % moderate and 7.8 % high disease activity. An increase since 2007 was only observed in patients with a disease duration >2 years. Synthetic DMARDS were used for treatment in 78 %. Biologic treatment increased from 16 % (2007) to 27 % (2014). Especially those patients with a disease duration >5 years were treated more frequently with biologics. Seronegative patients had slightly less severe mean disease activity parameters. They were treated equally frequent with DMARDS but only half as often with biologics compared to seropositive patients. CONCLUSION: The use of biologics in RA patients has increased since 2007; however this was not observed in patients with short disease duration. Early intensive treatment adaption seems justified to improve disease activity in the large portion of patients who do not reach low disease activity under conventional DMARDs.
26424809 Factors affecting well-being in adults recently diagnosed with rheumatoid arthritis. 2017 Mar This article examines role stress, key psychosocial variables, and well-being in adults recently diagnosed with rheumatoid arthritis. Patients recently diagnosed with rheumatoid arthritis must often learn to balance disease and role-related responsibilities. This was cross-sectional, descriptive study ( N = 80). Data were analyzed using correlation coefficients and linear regression models. Participants were predominantly female (78%), married, and employed. Mean age and disease duration were 54.2 years and 24.2 months, respectively. The findings suggest that well-being is influenced by feelings of being self-efficacious and having balance in their roles and less to do with social support received from others.
28407999 Cost-Effectiveness of TNF-Blocker Injection Spacing for Patients with Established Rheumato 2017 Apr BACKGROUND: In patients with rheumatoid arthritis in remission, a disease activity-driven tapering of adalimumab or etanercept relying on progressive injection spacing has not been shown to be equivalent to a maintenance strategy at full dose in terms of disease activity in the Spacing of TNF-blocker injections in Rheumatoid ArthritiS Study (STRASS) trial. OBJECTIVES: To evaluate the cost-effectiveness of such a spacing strategy based on the data of the STRASS trial. METHODS: This is a cost-utility analysis of the STRASS trial, a French multicenter 18-month equivalence randomized open-label controlled trial that included patients at stable dose for at least 1 year, in remission for at least 6 months. Effectiveness was assessed in quality-adjusted life-years (QALYs). Costs involved in the study period were assessed from a payer perspective. The decremental cost-effectiveness ratio (DCER) was calculated in the complete cases sample (n = 98). Several sensitivity analyses were conducted and the impact of missing data on DCER estimate was investigated. An acceptability analysis was performed. RESULTS: In the spacing arm, TNF-blockers were stopped for 34.1% of the patients, tapered for 43.2%, and maintained at full dose for 18.2%. The spacing strategy was associated with less QALYs gain (mean difference of -0.158; 95% confidence interval [CI] -0.085 to -0.232) and reduced costs (mean difference of -€8,440; 95% CI -6,507 to -10,212). The estimated DCER of the spacing strategy over the maintenance at full dose was €53,417 saved per QALY lost (95% CI 32,230 to 104,700). CONCLUSIONS: The spacing strategy appears cost-effective, but the acceptability of such a QALY loss reported to the cost avoided remains to be evaluated, because no consensual threshold has been determined for willingness to accept as compared with willingness to pay.
27483088 Impact of Rheumatoid Arthritis on the Mortality of Elderly Patients Who Develop Cancer: A 2017 Jan OBJECTIVE: Comorbidity among cancer patients poses additional risks for mortality. The possible impact of rheumatoid arthritis (RA) on cancer patient survival is unclear. Our objective was to examine survival among elderly patients with RA who develop cancer. METHODS: Patients diagnosed with breast, prostate, colorectal, or lung cancer between 2001 and 2010 were identified from the Texas Cancer Registry and Medicare-linked databases. The cohort was categorized into 3 groups according to the number of claims patients had with a diagnosis of RA in the year prior to the cancer diagnosis: 2-RA (patients with ≥2 claims), 1-RA (1 claim), and no claims. Overall survival was estimated for these groups and for each cancer, using Cox proportional hazards models adjusting for covariates. RESULTS: The cohort included 139,097 patients with cancer (35,026 breast, 43,181 prostate, 31,103 colorectal, and 29,787 lung); 1.7% had 1 RA claim, and 1.1% had 2 or more. Adjusted hazard ratios for patients in the 2-RA group were 1.41 (95% confidence interval [95% CI] 1.21-1.65) for breast and 1.53 (95% CI 1.26-1.85) for prostate. No significant differences were observed for those with colorectal or lung cancer. CONCLUSION: Mortality was increased by 40% and 50%, respectively, in elderly patients with RA who developed breast or prostate cancer, after controlling for other comorbidities. This association was not seen in cancers with shorter survival time (colorectal or lung). Research is needed to determine whether the increased risk is related to comorbid burden or to differential utilization of cancer or rheumatoid therapies in patients with both diseases.
29225253 An Analysis of the Neuropathic Pain Components in Rheumatoid Arthritis Patients. 2018 Feb 15 Objective To analyze the neuropathic pain (NeP) components in patients with rheumatoid arthritis (RA). Methods The painDETECT questionnaire (PD-Q) was completed by 300 RA patients (79 men, 221 women). Results Nine patients (3.0%) were categorized as likely NeP, 33 (11.0%) were categorized as possible NeP, and 258 (86.0%) were categorized as unlikely NeP. When we excluded patients with diabetes mellitus, spinal diseases, neurological diseases, and herpes zoster infection (conditions associated with NeP), 5 of the patients (1.7%) had likely NeP, and 23 (7.7%) had possible NeP without any underlying conditions. Furthermore, there were no marked differences in the percentages of these underlying conditions among the patients with likely, possible, and unlikely NeP. When we compared patients with likely and possible NeP (n=42) and unlikely NeP (n=258), the body mass index (BMI), disease activity score-28 based on the erythrocyte sedimentation rate, C-reactive protein level, pain visual analogue scale (VAS), and PD-Q score were significantly higher in the patients with likely and possible NeP than in those with unlikely NeP. A multivariate analysis showed that BMI ≥22 and not being in clinical remission were associated with NeP. Conclusion Although RA pain has usually been classified as nociceptive pain, the present study clarified that a significant number of patients might have NeP. The present findings suggest that high disease activity and being overweight are related to NeP in RA patients.
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.
29232938 Factors associated with time to diagnosis from symptom onset in patients with early rheuma 2019 Jul BACKGROUND/AIMS: To identify the factors associated with time to diagnosis after symptom onset in patients with early rheumatoid arthritis (RA). METHODS: Early RA patients with ≤ 1 year of disease duration in the KORean Observational study Network for Arthritis (KORONA) database were included in this analysis. Patients were further divided into two groups according to the time to diagnosis from symptom onset: the early diagnosis group (time to diagnosis ≤ 1 year) and the late diagnosis group (time to diagnosis > 1 year). Using the multivariable regression model, we identified factors associated with early diagnosis. RESULTS: Among 714 early RA patients, 401 patients (56.2%) and 313 patients (43.8%) were included in the early diagnosis and late diagnosis groups, respectively. The mean disease duration was 0.47 years in the early diagnosis group and 0.45 years in the late diagnosis group. In multivariable model analysis, greater age at onset (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02 to 1.05), high school education or higher (OR, 1.68; 95% CI, 1.14 to 2.47), higher income (OR, 1.48; 95% CI, 1.05 to 2.08), and initial small joint involvement (OR, 1.42; 95% CI, 1.02 to 1.98) were factors associated with early diagnosis. At diagnosis, disease activity scores using 28 joints on diagnosis (3.81 ± 1.44 vs. 3.82 ± 1.42, p = 0.92) and functional disability (0.65 ± 0.61 vs. 0.57 ± 0.62, p = 0.07) did not different between the two groups. However, hand joint erosion on X-ray (37.8% vs. 25.6%, p < 0.01) was more common in the late diagnosis group than the early diagnosis group. CONCLUSION: Older onset age, higher educational level and income, and initial small joint involvement were positive factors for early diagnosis of RA.
29793335 Ziziphora clinopodioides ameliorated rheumatoid arthritis and inflammatory paw edema in di 2018 Jan Ziziphora clinopodioides has been used in traditional medicine for its anti-inflammatory properties. Current study is believed to first time report the potential of Z. clinopodioides extracts to ameliorate joint inflammation using model of chronic joint inflammation (FCA-induced rheumatoid arthritis). The study further investigates the effects on joint inflammation using acute inflammatory paw edema models. The anti-inflammatory effects were also supported by using xylene-induced ear edema model. Results showed that Z. clinopodioides significantly ameliorated rheumatoid arthritis as indicated by the inhibition of arthritic development and paw edema. Histopathological examination showed significant attenuation in pannus formation, bone erosion, and joint inflammation. Treatment with the plant extracts also nearly normalized counts of RBCs, platelets, and total leukocytes along with hemoglobin (Hb) content. Biochemical analysis (AST, ALT, urea, and creatinine) showed that plant extracts did not possess hepatotoxic or nephrotoxic effects. Water displacement plethysmometric analysis showed that Z. clinopodioides significantly attenuated carrageenan-induced paw edema. To evaluate the mechanism, anti-inflammatory effects were further evaluated using histamine- and serotonin-induced inflammatory paw edema models. Z. clinopodioides significantly suppressed paw edema induced by both histamine and serotonin, and also caused the inhibition of xylene-induced ear edema. This suggested the inhibition of autacoids as one of the mechanisms of anti-inflammatory effects of plant. GC-MS analysis showed that the plant is rich in essential oils, including terpenoids, esters, alcohols, furans, cyclic ketones, epoxides, oxanes, and acyclic hydrocarbons. In conclusion, current study demonstrated that Z. clinopodioides possessed significant anti-arthritic and anti-inflammatory properties which might be attributed to the inhibition of autacoids.
28398429 Antiphospholipid syndrome in a patient with rheumatoid arthritis. 2017 Mar Antiphospholipid syndrome (APS) is an autoimmune condition characterized by a thrombotic event and/or pregnancy morbidity in the presence of persistently elevated antiphospholipid (aPL) antibody titers, which are most prevalent in patients with systemic lupus erythematosus but also have been associated with other autoimmune, malignant, and infectious diseases. In contrast to the clear correlation between high aPL antibody titers and thrombotic events in patients with systemic lupus erythematosus, the pathogenic role of these autoantibodies in association with other diseases, such as rheumatoid arthritis (RA), is not as well defined. We report a case of APS manifesting as cutaneous ulceration and necrosis in a patient with severe RA.
28100358 [Study on the effect and predictive to bronchiectasis combined with rheumatoid arthritis]. 2017 Jan 12 Objective: To explore the clinical characteristics of bronchiectasis(BR)coexisting in patients with rheumatoid arthritis (RA). Methods: One hundred and forty-eight bronchiectasis patients were retrospectively analyzed. These cases were all diagnosed in the Respiratory Department of Shanghai Pulmonary Hospital and Shanghai Gongli Hospital of Pudong New Area during Jan. 2012 to Dec.2015.The patients consisted of 74 males and 74 females, aging from 45 to 79 [mean(65±11)] years. In these patients, coexisting rheumatoid arthritis was found in 34 males and 36 females, aging from 45 to 79[mean(68±12)] years(RA-BR group). Patients with bronchiectasis alone consisted of 40 males and 38 females, aging from 49 to 76 [mean(63±10)] years (BR alone group). Data between the 2 groups of patients were compared, including general clinical features, serum anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factor (RF), chest high-resolution CT (HRCT), and lung function . FACED scores were used to assess the severity of bronchiectasis. Meanwhile, we analyzed the correlation between anti-CCP and FACED scores in the 2 groups. Results: We observed an increase of serum anti-CCP in RA-BR patients compared with BR alone patients (196±68 versus 64±26, P<0.05). In addition, FACED scores in RA-BR patients were higher than those in BR patients (5.2±1.8 versus 3.1±1.4 , P< 0.05). Positive correlations between serum anti-CCP levels and FACED scores (r=0.678, r=0.461, P<0.05) in both RA-BR and BR alone groups were observed in this study. Conclusions: The disease severity scores of RA-BR patients were higher than those of patients with BR alone. Levels of serum anti-CCP may act as a predictor for the diagnosis and prognosis of bronchiectasis in patients with RA.
27679935 Serum GDF-15 level in rheumatoid arthritis: relationship with disease activity and subclin 2017 Jan OBJECTIVES: Growth differentiation factor (GDF)-15 was originally identified as a factor secreted by activated macrophages, and plays an important role in cell growth and differentiation. GDF-15 plays an important role in cell growth, signal transduction, and apoptosis regulation. The aim of this study was to evaluate the serum GDF-15 levels and their relationship with disease-related characteristics in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: Forty-six patients diagnosed with RA and 36 demographically matched healthy control subjects participated in this study. GDF-15 levels were measured in blood samples from patients and controls. The disease activity score-28 (DAS28) was used to evaluate the disease activity of RA. The quality of life was evaluated using the disease-specific rheumatoid arthritis quality of life (RAQoL) scale. The health assessment questionnaire (HAQ) was used to evaluate the functional status. The degree of joint damage was assessed according to Larsen's method. Atherosclerosis was assessed by a cardiologist with the help of echocardiography according to the carotid intima media thickness (CIMT) method; vascular stiffness was assessed by using the flow mediated dilatation (FMD) method. RESULTS: Serum GDF-15 levels were significantly higher in RA patients when compared to the control subjects (p< 0.05). RA patients were divided into two groups according to the disease activity; while 26 subjects (57%) were in the active group, 20 patients were in the non-active group (43%). Serum GDF-15 levels were significantly higher in the group that was considered to have an active disease. According to Pearson's correlation, serum GDF-15 levels were positively correlated with erythrocyte sedimentation rate (ESR) levels, morning stiffness, DAS28 score, tender joint count, and CIMT (p<0.05). CONCLUSION: GDF-15 may play a role in the pathway of disease activity, joint involvement, and atherosclerosis in patients with rheumatoid arthritis.
27825567 Prevalence of rheumatoid arthritis in the French West Indies: Results of the EPPPRA study 2017 Jul OBJECTIVES: Studies suggest that rheumatoid arthritis (RA) is less frequent in African populations. However, no recent precise data exists for Afro-Caribbeans. The EPPPRA project is a prospective epidemiological survey to describe prevalence and clinical aspects of RA in the French West Indies (Martinique, Guadeloupe, French Guiana). METHODS: EPPPRA involved all rheumatologists from the French West Indies who included all patients with a known clinical diagnosis of RA, during a one-year period. We outline here results for Martinique. RESULTS: EPPPRA estimated an overall world age-standardized prevalence of RA at 0.10% [95% CI 0.09% to 0.11%] in Martinique, with a high female predominance (88.1%) and 93.1% of self-reported Afro-Caribbeans. Mean age at diagnosis was 49.6±16.0 years. A majority of subjects presented at least 4 criteria points from the 1987 American College of Rheumatology (ACR) classification (94.4%) and at least 6 points (78.2%) from the 2010 ACR/European League Against Rheumatism (EULAR) classification. A high immune seropositivity rate was highlighted (84.2%). Despite functional impact observed in 40.5% of patients, 71.4% presented a low disease activity level. Methotrexate was the most common ongoing treatment (73%), followed by biotherapies (24.4%). Numerous patients (68.6%) received a steroid regimen. Cardiovascular risk factors were very frequent, contrasting with a very low tobacco use (8.7%), CONCLUSION: This work outlines low standardized prevalence of RA in a French Afro-Caribbean population with specific characteristics (high female predominance, high immune seropositivity, low tobacco use). Despite easy access to care and biotherapies, approximately half of RA patients still present destructive disease with functional impact.
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.
28604976 [Progress of research on TXNDC5]. 2017 Jun 10 The protein encoded by TXNDC5 is a member the protein disulfide isomerase family, which has disulfide isomerase activity and can act as the molecular chaperone to reduce the synthesis of abnormal proteins. Its biological functions include anti-oxidation, promoting angiogenesis, taking part in cellular inflammation, and energy metabolism, etc. Studies have demonstrated that the expression of TXNDC5 is increased in many types of tumors including cervical carcinoma, gastric carcinoma and colorectal cancer. Moreover, TXNDC5 is also closely associated with rheumatoid arthritis, diabetes, hepatic steatosis and vitiligo. This paper aims to summarize the latest progress in research on TXNDC5 in terms of biochemical function, relationship with diseases and the underlying mechanism.
29185956 Diagnostic value of BiP or anti-BiP antibodies for rheumatoid arthritis: a meta-analysis. 2018 May OBJECTIVES: To evaluate the diagnostic value of BiP or anti-BiP antibodies in patients with rheumatoid arthritis. METHODS: Relevant studies published on PubMed and CNKI from January 1995 to July 2016 were retrieved. Two reviewers independently evaluated studies and QUADAS tool was used to assess the quality of the included studies. A random-effects model was used to combine sensitivity, specificity, positive and negative likelihood ratios and diagnostic odds ratio. Stratified analysis was performed for exploring heterogeneity and funnel plot was examined for the possibility of publication bias. RESULTS: Nine studies met our inclusion criteria. The pooled sensitivity, specificity, LR+, LR-, DOR were 0.67 (95%CI, 0.64-0.70), 0.92 (95%CI, 0.90-0.93), 7.65(95%CI, 4.08-14.36), 0.36(95%CI, 0.33-0.39), 23.73(95%CI, 13.01-43.28), respectively. CONCLUSIONS: This meta-analysis shows that BiP or anti-BiP antibodies have a moderate accuracy for the diagnosis of rheumatoid arthritis with a moderate sensitivity and high specificity. It can be an efficient supplement to the existing diagnostic method.
29187945 Association between mean platelet volume and severity of rheumatoid arthritis. 2017 INTRODUCTION: In recent years, it is suggested that platelet histogram indices, such as mean platelet volume (MPV) may be related to the activity of rheumatoid arthritis (RA). The aim of this study was to assess relationship between MPV and activity of rheumatoid arthritis. METHODS: Sixty consecutive patients fulfilling the American College of Rheumatology (ACR) criteria for RA were recruited from the rheumatology outpatient clinics in Semnan, Iran. Current disease activity score (DAS-28 score) was assessed at baseline, 2 months and 4 months after the admission time and beginning of the treatment schedule. Complete blood count (including MPV), C-reactive protein (CRP) and ESR were measured in each visit. MPV was analyzed by the Cell Dyne 3500 automated blood cell counter. RESULTS: There was a significant reduction in DAS-28 score within 4 months of total assessment (from 4.47 ± 2.24 versus 3.18 ± 1.55) (p < 0.001). There was no significant difference in MPV levels at the three study time points. No significant correlations were observed between the DAS-28 score and mean MPV levels at the same time points. The rate of positive CRP was decreased within the same period (p = 0.002); however, the trend of the changes in other laboratory parameters including MPV, platelet count and ESR values was not significant. The measurement of MPV value did not correlate with disease activity in RA patients within 4 months of treatment scheduling. CONCLUSION: Although therapeutic regimens, which improve RA manifestations, can reduce RA activity, they had no effect on MPV during this time period. It seems MPV may not be able to predict disease activity in RA patients.
27727050 Reliability testing of the Larsen and Sharp classifications for rheumatoid arthritis of th 2017 Jan BACKGROUND: Two popular systems for classifying rheumatoid arthritis affecting the elbow are the Larsen and Sharp schemes. To our knowledge, no study has investigated the reliability of these 2 systems. We compared the intraobserver and interobserver agreement of the 2 systems to determine whether one is more reliable than the other. METHODS: The radiographs of 45 patients diagnosed with rheumatoid arthritis affecting the elbow were evaluated. Anteroposterior and lateral radiographs were deidentified and distributed to 6 evaluators (4 fellowship-trained upper extremity surgeons and 2 orthopedic trainees). Each evaluator graded all 45 radiographs according to the Larsen and Sharp scoring methods on 2 occasions, at least 2 weeks apart. RESULTS: Overall intraobserver reliability was 0.93 (95% confidence interval [CI], 0.90-0.95) for the Larsen system and 0.92 (95% CI, 0.86-0.96) for the Sharp classification, both indicating substantial agreement. Overall interobserver reliability was 0.70 (95% CI, 0.60-0.80) for the Larsen classification and 0.68 (95% CI, 0.54-0.81) for the Sharp system, both indicating good agreement. There were no significant differences in the intraobserver or interobserver reliability of the systems overall and no significant differences in reliability between attending surgeons and trainees for either classification system. CONCLUSION: The Larsen and Sharp systems both show substantial intraobserver reliability and good interobserver agreement for the radiographic classification of rheumatoid arthritis affecting the elbow. Differences in training level did not result in substantial variances in reliability for either system. We conclude that both systems can be reliably used to evaluate rheumatoid arthritis of the elbow by observers of varying training levels.
28205423 The age at onset of rheumatoid arthritis is increasing in Japan: a nationwide database stu 2017 Jul AIM: To determine whether the age at onset of rheumatoid arthritis (RA) has increased in Japan using a nationwide database (National Database of Rheumatic Diseases by iR-net in Japan, NinJa). METHOD: We analyzed the data of RA patients who had been diagnosed with early RA (disease duration < 2 years) and newly registered in 2003, 2008 or 2013. RESULTS: The numbers of patients who developed RA in 2002-2003, 2007-2008, and 2012-2013 were 536, 812 and 1864, respectively. The mean age at RA onset increased significantly from 55.8 years in 2002-2003 and 57.0 years in 2007-2008 to 59.9 years in 2012-2013. The peak age shifted from the 50-59 years age group in 2002-2003 to the 60-69 years age group in 2012-2013. There was no apparent difference in the age at RA onset between male and female RA patients. Notably, in the period 2002-2003, the prevalence of RA was markedly higher in the age group of 50-59 years, which included the first 'baby boomers', than in the age groups of 30-39 and 40-49 years, even with consideration of the variations in the age composition of the general population. CONCLUSIONS: We have demonstrated that the age at RA onset in Japan has increased significantly over the last decade. This can be attributed to Japan's aging population. In addition, the high prevalence of RA among the first baby boomers suggests that environmental factors might also have contributed to the increase in age at RA onset in Japan.
28599787 Anti-CD26 autoantibodies are involved in rheumatoid arthritis and show potential clinical 2017 Nov OBJECTIVES: Rheumatoid arthritis (RA) patients show low serum levels of the Ag dipeptidyl peptidase IV (DPP-IV/CD26), both soluble CD26 (sCD26) concentration and its DPP-IV activity. The aim of this study was to test if anti-DPP-IV/CD26 Abs (Anti-CD26) cleared sCD26. DESIGN & METHODS: Serum Anti-CD26 and Total titers (as comparison) of isotypes IgA, IgM and IgG as well as sCD26 concentration and DPP-IV activity were measured in a cohort of RA patients undergoing different biological and non-biological therapies (n=105) and controls (n=50). RESULTS: Anti-CD26 levels were increased approximately two-fold for each isotype in RA, were not related to the sCD26 clearance, showed several correlations with disease activity parameters, were significantly higher in smokers and they were not ACPA. Anti-CD26 Igs showed high diagnostic power (82% sensitivity and 96% specificity) and their levels differed amongst the different groups of patients stratified by the type of therapy. CONCLUSIONS: As DPP-IV/CD26 is associated to factors triggering RA in the lung and periodontal tissue, these results suggest that Anti-CD26 isotypes may participate in pathogenesis and may be useful as biomarkers for earlier diagnosis and/or precision medicine.
28322506 Hand functions in systemic sclerosis and rheumatoid arthritis and influence on clinical va 2018 Jan AIM: Hand joints are the main target in rheumatoid arthritis (RA) and hand involvement in terms of thickening of the skin and contractures are also well known in systemic sclerosis (SSc). Assessment of hand function in SSc is generally an overlooked entity with respect to RA. Therefore the aim of this study was to compare hand functions and potential influence of functional loss on patients' overall physical functions, health-related quality of life (HRQoL) and psychological status in RA and SSc. METHODS: Age- and gender-matched adult patients with SSc and RA were consecutively recruited. Patients' hand functions were evaluated by using the Duruöz Hand Index (DHI), and hand span and hand grip strength were measured. Patients were evaluated for disease-specific and generic outcome measures including disease activity parameters and HRQoL measures. RESULTS: Fifty patients (44 female, six male) with SSc and 51 (45 female, six male) with RA were included. Despite similar functioning and HRQoL, patients with RA had higher visual analog scale-pain and body mass index. In both groups DHI revealed similar functional loss and correlated with various measurements related to HRQoL. In SSc, hand span, grip strength and modified Rodnan skin score had major influences on hand functions. CONCLUSION: Assessment of hand function is an important component in the clinical evaluation of patients with RA and SSc. Loss of hand functions is an important feature contributing negatively to the overall physical status and HRQoL in patients with SSc and may be more frequent and important than expected.