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ID PMID Title PublicationDate abstract
28521689 Relationship Between Rheumatoid Arthritis Disease Activity Assessed with the US7 Score and 2017 BACKGROUND: Rheumatoid arthritis is a chronic disease considerably affecting the quality of life of patients, their functional abilities and capability to work. In everyday clinical practice, the condition is commonly monitored by assessing the disease activity using a joint count and laboratory markers of inflammation with calculating the DAS28 or other systems for scoring the disease activity. OBJECTIVES: This study is aimed to evaluate the benefit of ultrasound examination with a standardized instrument and correlate its results with the quality of life of patients and their functional abilities as assessed by standardized questionnaire methods. METHODS: 98 rheumatoid arthritis patients were assessed clinically for disease activity and ultrasound examination with assessment of German US 7 score was performed. The data from patientreported outcomes (Stanford Health Assessment Questionnaire and the EQ-5D instrument) were collected. RESULTS: The results of ultrasound examination were correlated with both disease activity and patient- assessed quality of life and limitations to daily activities. A very good predictor of impaired quality of life mainly appears to be the presence of synovitis detected by grayscale (GS) ultrasonography, shown to be significantly negatively correlated with patient mobility (r=-0.268, p=0.017), self-care (r-0.349, p= 0.002) and usual activities (r=-0.264, p= 0.019) as well as with patients' global health assessment (r=-0.243, p= 0.031). CONCLUSIONS: The study results showed a direct relationship between rheumatoid arthritis activity assessed with the US7 and patients' impaired functional abilities, mobility, self-care and usual activities.
27432355 Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis. 2017 Mar PURPOSE: We assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA). METHODS: This longitudinal cohort of 291 patients with RA was derived from the MRI substudy of the GO-BEFORE randomised controlled trial of golimumab among methotrexate-naïve patients. Correlations between RAMRIS scores (synovitis, osteitis, bone erosion) and physical function (Health Assessment Questionnaire (HAQ)), pain and global patient scores were determined at 0, 12, 24 and 52 weeks. Correlations between interval changes were also assessed. Multivariable regression models using robust generalised estimating equations evaluated associations over all time-points and their relationship to other clinical disease activity measures. RESULTS: Greater synovitis, osteitis and bone erosion scores were positively associated with HAQ at all time-points (all p<0.05) and with pain and patient global scores at 24 and 52 weeks. Over all visits, synovitis was associated with HAQ, pain and patient global scores (p≤0.03) independent of clinical disease activity measures. Improvements in synovitis and bone erosion were also associated with improvements in PROs. Less improvement in synovitis and progression in MRI erosion at 52 weeks were both independently associated with worsening in all PROs at 52 weeks while progression on X-ray was not associated. Similar associations were observed across treatment groups. CONCLUSIONS: MRI measures of inflammation and structural damage correlate independently with physical function, pain and patient global assessments. These observations support the validity of MRI biomarkers. TRIAL REGISTRATION NUMBER: NCT00264537; Post-results.
27653044 Arterial stiffness is not increased in patients with short duration rheumatoid arthritis a 2017 Apr Patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is an independent predictor of CV events. The aim of the study was to assess arterial stiffness and inflammatory markers in patients with short duration chronic arthritis. We assessed carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), traditional CV risk factors and inflammatory and endothelial markers in 71 chronic arthritis patients (RA and AS) and in 29 healthy controls. We did not find differences in PWV (for RA, AS and controls, respectively: 10 [8.8-10.9] versus 10.7 [9.1-11.8] versus 9.2 [8.3-11.4] m/s; p = .14) and AIx (for RA, AS and controls, respectively: 24.3 ± 11.5 versus 5.7 ± 12.4 versus 10 ± 12.8%; p = .22). Both groups of arthritis patients had active disease with significantly elevated inflammatory markers compared to controls. There were no correlations between endothelial and inflammatory markers and parameters of arterial stiffness in arthritis patients. When analyzing arthritis patients according to median of PVW, there were no significant differences in inflammatory and endothelial markers. We found that in patients with short duration active RA and AS arterial stiffness was not increased and furthermore, there was no association between markers of systemic inflammation and arterial stiffness.
29166759 Magnetic resonance imaging-assessed synovial and bone changes in hand and wrist joints of 2019 May BACKGROUND/AIMS: Magnetic resonance imaging (MRI) is a sensitive and useful method for the detection of synovitis and joint destruction in rheumatoid arthritis (RA) patients. However, the patterns of MRI-detected bone erosion, bone marrow edema (BME), synovitis, and tenosynovitis have received insufficient attention. Therefore, this study evaluated the patterns of bone erosion, BME, synovitis, and tenosynovitis, and calculated the RA-MRI score (RAMRIS) of patients with RA at the carpal and metacarpophalangeal (MCP) joints using MRI. METHODS: MRI datasets from 43 RA patients were analyzed. All patients had undergone MRI of one wrist. In addition, 36 patients had MCP joint images taken, and three had also received MRI of the contralateral wrist and MCP joints. The MR images were evaluated for bone erosion, BME, and synovitis in consensus by two blinded readers according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RAMRIS. The MRI-detected tenosynovitis was evaluated based on Haavardsholm's tenosynovitis score. RESULTS: The capitate, lunate, triquetrum, and hamate bones were the most common sites of erosion and BME and showed the highest RAMRIS erosion and BME scores. Moreover, MRI-detected tenosynovitis was present in 78.3% of all patients with RA, and the extensor compartment 4 and flexor digitorum profundus and superficialis were frequently affected. CONCLUSION: This study identified the distribution and prevalence of MRI-detected bone erosion, BME, synovitis, and tenosynovitis of the wrist and MCP joints in RA patients. The patterns of the MRI-detected abnormalities may help to select sites for the application of MRI protocols in clinical trials and practice.
28499372 Persons with rheumatoid arthritis challenge the relevance of the health assessment questio 2017 May 12 BACKGROUND: The Stanford Health Assessment Questionnaire-Disability Index (HAQ) is widely used to measure functional ability in persons with Rheumatoid Arthritis (RA). The instrument was developed with limited involvement from persons with RA, and their perception of the instrument has not been studied in depth. The aim of this study was to explore how persons with RA experience the use of the HAQ in care. METHODS: The study used secondary data analysis. Persons with RA participated in semi-structured interviews in previous research projects. Thirty-nine interviews were included based on data fit, and thematic analysis applied. RESULTS: The participants questioned the relevance of the HAQ but nevertheless experienced that the instrument had a profound effect on their understanding of health and how care is delivered. The analysis resulted in three themes: Problems with individual items, meaning of the summative score, and effects on care and health perceptions. CONCLUSIONS: To make the HAQ relevant to persons with RA, it needs to be revised or to include an option to select items most meaningful to the respondent. To ensure relevance, the HAQ update should preferably be co-created by researchers, clinicians and persons with RA.
28932748 Insulin Resistance in Early Rheumatoid Arthritis Is Associated with Low Appendicular Lean 2017 In established rheumatoid arthritis (RA), the presence of insulin resistance (IR) is well proven but, in the early stage of the disease, data are inconclusive. We evaluated the presence of IR and associations with body composition (BC) parameters among early RA (ERA) and control subjects. The study group consisted of 92 ERA and 321 control subjects. Using homeostatic model assessment of IR (HOMA-IR), the cut-off value for IR was 2.15. 56% of the ERA patients and 25% of the controls had IR. Of the BC parameters, patients with early RA had less fat-free mass and appendicular lean mass (ALM). In multivariable model, ERA group (b-Coefficient) (4.8, CI: 2.6-8.8), male gender (7.7, CI: 2.7-22.1), and fat mass index (1.2, CI: 1.1-1.4) were associated with IR. Insulin-resistant ERA patients had higher inflammatory markers and higher disease activity. In the multivariable model in the ERA group, IR was associated with male gender (b-Coefficient) (7.4, CI: 153-34.9), high disease activity (6.2, CI: 1.7-22.2), and lower ALM (0.03, CI: 0.001-0.97). IR develops in the early stage of RA in the majority of patients. IR is more common among males and is associated with RA disease activity and lower ALM.
28397166 Characterization of IgG glycosylation in rheumatoid arthritis patients by MALDI-TOF-MS(n) 2017 Jun An analytical method based on the combination of multistage mass spectrometry (MS(n)) and capillary electrophoresis (CE) was developed for the analysis of immunoglobulin G (IgG) glycosylation in rheumatoid arthritis (RA) patients. It has been recently suggested that IgG glycosylation defect may be involved in RA immunopathogenesis. Complete characterization of glycans, including both qualitative and quantitative analysis, requires a combination of different techniques, and accurate, robust, sensitive, and high-throughput methodologies are important for analysis of clinical samples. In the present study, N-glycosylation of IgG in RA patients and in healthy people was characterized through identification of the released glycans using multistage matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS(n)), and quantitation by CE. Assignment of the IgG N-glycan structures was made through branching pattern analysis by MS(n) with high-throughput. Further accurate quantitation indicated that galactosylation and sialylation of IgG N-glycans in RA cases were significantly lower than in healthy subjects. The results indicate that CE coupled with MS(n) can identify abnormal glycosylation of IgG in RA patients compared with healthy people, and that the present work is useful for RA mechanism studies and RA diagnosis. Graphical Abstract Qualitative and quantitative analysis of IgG glycosylation in rheumatoid arthritis patients by MALDI-TOF-MS(n) and capillary electrophoresis.
28120218 Platelet-rich plasma inhibits inflammatory factors and represses rheumatoid fibroblast-lik 2017 Nov Rheumatoid arthritis (RA) is a chronic disease affecting daily life of numerous patients, and uncontrolled proliferation of synovial fibroblasts plays vital role during the pathology of RA. Platelet-rich plasma (PRP), widely used in tissue regeneration and pain management, is rarely studied in RA. This study aims to investigate the effect of PRP on synovial fibroblasts during RA. Rheumatoid fibroblast-like synoviocyte MH7A cells were stimulated by lipopolysaccharide (LPS) to simulate RA conditions and treated with PRP, after that the concentration of inflammatory factors interleukin (IL) 1β, tumor necrosis factor alpha (TNFα) and IL6 in the supernatant of culture medium was quantified by ELISA. MTT assay, flow cytometry and tube formation assay were performed to assess changes in cell viability, apoptosis and effect on angiogenesis in vitro, respectively. Besides, the expression levels of main factors in the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signal pathway were examined. Results showed that PRP markedly inhibited the production of IL1β, TNFα and IL6 (P < 0.05) that was stimulated by LPS. LPS promoted MH7A cell viability, inhibited apoptosis and accelerated angiogenesis in vitro, while PRP could markedly relieve these effects (P < 0.05). The mRNA and protein levels of AKT1, PI3K (p58) and nuclear factor κ beta were elevated by LPS and then suppressed by PRP (P < 0.01). This study uncovered the potential of PRP in inhibiting inflammation, repressing synovial fibroblasts and regulating the PI3K/AKT signaling, providing basic proof for future application of PRP in managing RA. Further investigation is necessary to reveal detailed mechanism of PRP.
28681250 Prevalence of comorbidities in Mexican mestizo patients with rheumatoid arthritis. 2017 Sep Patients with rheumatoid arthritis (RA) have a high risk for comorbid conditions which increase mortality, hospital admissions, costs of care and inability. To evaluate the prevalence of comorbidities in Mexican mestizo patients with RA and determine the associated risk factors. Cross-sectional study in which RA patients admitted to our outpatient clinic were consecutively enrolled. We collected data regarding demographics, disease characteristics and comorbidities at the time of the patient's visit to the clinic. We analyzed 225 patients. Their mean age was 55.7 ± 8.3 years; disease duration, 9.5 (3.8-15.5) years; female gender, 93.8%; Disease Activity Score using 28 joints-C-reactive protein, 3 (2-4); methotrexate use, 84.9%; use of any other conventional disease modifying anti-rheumatic drug, 65.7%; use of biological agents, 8%. The most frequently associated diseases were: hypertension, 29.8%; dyslipidemia, 27.1%; osteoporosis, 19.1%; diabetes, 12.4%; hypothyroidism, 6.2%; solid malignancies 4.4%. Risk factors were also evaluated, the most prevalent was overweight in 101 (44.9%) of our patients. A total of 71 (31.6%) had obesity. We also detected high blood pressure in 12.4%, hyperglycemia in 27.1% and hyperlipidemia in 49.8%. Due to the high frequency of comorbidities among RA patients, it is important to follow existing recommendations for their timely detection and management. Cardiovascular diseases must be evaluated with priority. The initial evaluation should include a thorough examination to prevent the deleterious effect of comorbidities in RA.
28098102 Evaluation of renal lesions and clinicopathologic correlation in rheumatoid arthritis. 2017 Jan The most common causes of renal disease in rheumatoid arthritis (RA) are glomerulonephritis (GN), amyloidosis, tubulo-interstitial nephritis, and drug toxicity. Our aim was to evaluate the clinicopathologic correlation of renal lesions and to assess the course and prognosis of renal disease in patients with RA. We conducted a prospective observational study in all adult patients with RA between July 2010 and June 2015. The total number of patients studied was 90, with a female:male ratio of 2.3:1. Mean follow-up duration was 30 ± 6.5 months. About 54 patients (60%) were asymptomatic. The most common symptom was edema legs (30%), followed by oliguria (10%). About 18 patients (20%) presented with the nephrotic syndrome, 15 patients (16.6%) with nephritic syndrome, and 30 (33%) with asymptomatic urinary abnormalities. Chronic kidney disease (CKD) was seen in 48 of 90 patients (53%).The most common renal pathology noted was mesangioproliferative GN followed by membranous nephropathy (MN). IgM with C3 deposits was the most common immunofluorescence pattern observed. Among the patients who had glomerular diseases, complete remission was seen in nine patients, partial remission in 15, and persistent proteinuria in 14. Duration of RA and a high erythrocyte sedimentation rate correlated significantly with persistent proteinuria. Only one patient in the glomerular disease group progressed to dialysis-dependent renal failure. On followup, 11 out of 48 CKD patients showed a significant decrease in estimated glomerular filtration rate and worsened to the next stage of CKD. Renal disease in RA presents with varied renal pathology. MN was seen frequently and was not associated with gold or penicillamine usage. Relatively high incidence of CKD was noted. Hence, it is important to monitor renal function abnormalities periodically in these patients.
28331550 Experiences of mobility for people living with rheumatoid arthritis who are receiving biol 2017 BACKGROUND: Despite significant advancements in new treatment modalities for rheumatoid arthritis with biological therapies, foot complications remain a disabling and common feature of the disease. In this study the aim was to explore and describe the personal experiences of people with rheumatoid arthritis in receipt of biologic treatments in a bid to understand the impact of this form of medication on their mobility. METHODS: An interpretative phenomenological analysis (IPA) was undertaken to explore in depth the individual experience of rheumatoid disease through personal accounts of the patient journey spanning both 'before' and 'after' the instigation of biologic therapy. A purposive sampling strategy was adopted and in-depth semi structured interviews used to facilitate rich, detailed interview data exploring the lived experiences of individuals undertaking biological therapy and the changes to mobility experienced as a result. Thematic analysis was employed with an IPA framework to identify key meanings, and report patterns within the data. RESULTS: Five people with rheumatoid arthritis participated in the study. The mean disease duration was 20.2 years (range: 6 -32) and all were being treated with biologic therapies. Four key themes emerged from the data: 1) Life before biologic treatment, depicted in accounts as a negative experience characterised by painful and disabling symptoms and feelings of hopelessness. 2) Life with biologic treatment, often experienced as a life changing transition, restoring function and mobility and offering renewed hope. 3) Sense of self, in which the impact of rheumatoid disease and the subsequent changes arising from biologic therapy reveal a profound impact on feelings of personal identity both pre and post biologic therapy; an effect of footwear on self-image emerges as a dominant sub theme; 4) Unmet footcare needs were evident in the patient narrative, where the unrelenting if diminished impact of foot pain on mobility was viewed in the context of problematic access to foot health services. CONCLUSION: Whilst the findings from this study mirror those within the existing literature, which report improvements in physical function related to biological therapy, foot problems clearly remained an unremitting feature of life for patients with rheumatoid disease, even when in receipt of biologics.
28512992 Association of CD8(+) T-cells with bone erosion in patients with rheumatoid arthritis. 2018 Feb AIM: Bone erosion is a major problem worsening quality of rheumatoid arthritis (RA) patients' lives. However, causal factors responsible for bone erosion in RA have remained unclear. We aimed to examine genetic variants conferring bone erosion in RA using a Korean genome-wide association study (GWAS) and to search for possible biological mechanisms underlying the development of bone erosion. METHOD: We obtained genome-wide single nucleotide polymorphism (SNP) data for 711 Korean RA patients using Illumina HapMap 550v3/660W arrays. Associations between SNPs and bone erosion status based on the Steinbrocker staging system were examined using multivariate logistic regression. Cell-type-specific enrichment of the epigenomic chromatin annotation H3K4me3 at the bone erosion associated variants was further investigated using National Institute of Health Roadmap Epigenomics data. RESULTS: As we tested the associations between 439 289 SNPs and bone erosion in 385 patients with erosive RA and 326 with non-erosive RA, none of the tested SNPs reached the genome-wide significance threshold, although many loci showed modest genetic effect on bone erosion status with suggestive association (e.g., rs2741200 [P = 3.75 × 10(-6) ] in the SLA-TG locus and rs12422918 [P = 4.13 × 10(-6) ] in SRGAP1). However, the top-ranked SNPs and their linked proxies, which were mostly located in non-coding variants, were significantly co-localized with the highly tissue-specific regulatory marker H3K4me3 in CD8(+) memory T-cells (P = 0.014). CONCLUSION: Although, there was no large-effect variants associated with bone erosion in our GWAS, we have shown that CD8(+) memory T-cells may have relevance with bone erosion in patients with RA through the analysis of ChiP-seq data.
28258474 Impact of ultrasonography on treatment decision in rheumatoid arthritis: the IMPULSAR stud 2017 Jun Ultrasonography (US) has shown to be more sensitive than physical examination for diagnosis and assessment of rheumatoid arthritis (RA). It is also a useful approach for accurate monitoring and intensive treatment adjustment. However, there is limited information concerning the impact of US on therapeutic decision-making in routine daily practice. A single-center cross-sectional study in routine daily practice was conducted to determine the percentage of patients with rheumatoid arthritis (RA) in which treatment decision was modified on the basis of results of musculoskeletal ultrasonography. All consecutive patients with RA visited for the control of their disease between September and November 2014 were included. Patients were visited by their attending rheumatologist, who made a therapeutic decision according to the results of physical examination and laboratory tests. Thereafter, a musculoskeletal ultrasound (US) was performed by an independent expert sonographer. According to US findings, a change in therapeutic decision was considered, and categorized as 'negative' (maintenance of the therapeutic attitude) or 'positive' (intensification or reduction of treatment). A total of 78 patients (83% women, mean age 63.3 years) were included. In 29 patients [32%, 95% confidence interval (CI) 26.5-48.9], a change in the therapeutic decision was made, which included intensification of treatment in 18 (62.1%) and reduction of treatment in 11 (37.9%). Change of treatment was more frequent in patients with intermediate disease activity (low and moderate) than in those in clinical remission or with high activity (41.4 vs. 25%), in men than in women (53.8 vs. 33.8%), and in the presence than in the absence of bone erosions (43.6 vs. 21.7%), although differences were not statistically significant. We conclude that in patients with RA, joint US is a relevant complementary tool for treatment decisions in daily practice, particularly in patients with intermediate disease activity.
28440025 Identifying key genes in rheumatoid arthritis by weighted gene co-expression network analy 2017 Aug PURPOSE: This study aimed to identify rheumatoid arthritis (RA) related genes based on microarray data using the WGCNA (weighted gene co-expression network analysis) method. METHODS: Two gene expression profile datasets GSE55235 (10 RA samples and 10 healthy controls) and GSE77298 (16 RA samples and seven healthy controls) were downloaded from Gene Expression Omnibus database. Characteristic genes were identified using metaDE package. WGCNA was used to find disease-related networks based on gene expression correlation coefficients, and module significance was defined as the average gene significance of all genes used to assess the correlation between the module and RA status. Genes in the disease-related gene co-expression network were subject to functional annotation and pathway enrichment analysis using Database for Annotation Visualization and Integrated Discovery. Characteristic genes were also mapped to the Connectivity Map to screen small molecules. RESULTS: A total of 599 characteristic genes were identified. For each dataset, characteristic genes in the green, red and turquoise modules were most closely associated with RA, with gene numbers of 54, 43 and 79, respectively. These genes were enriched in totally enriched in 17 Gene Ontology terms, mainly related to immune response (CD97, FYB, CXCL1, IKBKE, CCR1, etc.), inflammatory response (CD97, CXCL1, C3AR1, CCR1, LYZ, etc.) and homeostasis (C3AR1, CCR1, PLN, CCL19, PPT1, etc.). Two small-molecule drugs sanguinarine and papaverine were predicted to have a therapeutic effect against RA. CONCLUSION: Genes related to immune response, inflammatory response and homeostasis presumably have critical roles in RA pathogenesis. Sanguinarine and papaverine have a potential therapeutic effect against RA.
29057700 Polymorphic lymphoproliferative disorders in patients with rheumatoid arthritis are associ 2018 Jul OBJECTIVES: The characteristics of lymphoproliferative disorders (LPD) in patients with rheumatoid arthritis (RA) remain unclear. Therefore, we retrospectively analyzed the clinical characteristics of these patients in our department. METHODS: Twenty RA patients who developed LPD between April 2003 and August 2016 in our department were analyzed. RESULTS: All of the RA patients who developed LPD had been treated with methotrexate (MTX). The median weekly and total dosages of MTX were 6.8 mg/week and 2530 mg, respectively. The median duration of MTX administration was eight years. Nineteen patients (95%) achieved complete remission (CR) and 15 (75%) achieved CR with MTX cessation alone. Based on the pathological findings, we divided MTX-associated LPD patients into two groups (n = 16); polymorphic LPD (31%) and other groups. CR with MTX cessation alone was achieved in 5 (100%) and 6 (54.5%) patients in the polymorphic LPD and other groups, respectively (p = .12). Moreover, the duration from the cessation of MTX to CR was significantly shorter in the polymorphic LPD group than in the other group (5.3 months vs 12.6 months, p = .01, respectively). CONCLUSION: Polymorphic LPD, which was the most frequent pathological diagnosis in this cohort, was associated with a higher incidence of CR and a significantly shorter duration to CR.
28612349 Role of hydrotherapy in the amelioration of oxidant-antioxidant status in rheumatoid arthr 2018 Oct AIM: Rheumatoid arthritis (RA) is an inflammatory autoimmune disease. Reactive oxygen species (ROS) are involved in the pathophysiology of RA. Moderate intensity exercises have been reported to have anti-oxidant and anti-inflammatory effects. The aim of this study was to evaluate the effect of hydrotherapy on oxidant-antioxidant status in RA patients. METHODS: Forty RA patients and 30 age- and sex-matched healthy controls were included in this study. RA patients were subdivided into two groups: the first group (n = 20) received treatment with conventional RA drugs, while the second group (n = 20) received hydrotherapy along with the conventional drugs for a period of 12 weeks. Disease Activity Score of 28 joints (DAS-28), ROS level, protein oxidation, lipid peroxidation, DNA damage and the activities of antioxidant enzymes were evaluated before and after 12 weeks of treatment. RESULTS: RA patients showed a significant change in the oxidative stress biomarkers (ROS, P < 0.01; ferric reducing antioxidant potential, P < 0.001; malondialdehyde, P < 0.01; protein carbonyl, P < 0.001; tail length, P < 0.05) and decrease in the activities of anti-oxidant enzymes (superoxide dismutase [SOD], P < 0.01; glutathione peroxidase [GPx], P < 0.001). Conventional drug treatment has not produced any significant change in these parameters. However, cotreatment of drugs with hydrotherapy has decreased protein, lipid and DNA oxidation by increasing the activities of antioxidant enzymes (SOD and GPx). CONCLUSION: Our results indicate that hydrotherapy along with drugs has reduced the severity of disease (DAS-28) by ameliorating the oxidant-antioxidant status in RA patients. Thus, in addition to conventional drugs, RA patients should be advised to have hydrotherapy (moderate intensity exercise) in their treatment regimen.
28765945 Platelet-rich plasma exhibits beneficial effects for rheumatoid arthritis mice by suppress 2017 Oct Platelet-rich plasma (PRP) is a multifunctional blood product containing highly concentrated platelets, and various cell growth factors which promote cell proliferation and differentiation. PRP exhibited benefits in injurious articular cartilage repair and the removal of inflammatory factors in clinical studies. Rheumatoid arthritis (RA) is an autoimmune disease manifesting primarily as inflammatory arthritis, which is associated with notable morbidity in humans. In the present study, the therapeutic effects and primary mechanism of PRP on a type II collagen‑induced arthritis (CIA) mouse model was investigated. Inflammatory factors interleukin (IL)‑6, IL‑8, IL‑17, IL‑1β, tumor necrosis factor (TNF)‑α and interferon (IFN)‑γ were analyzed in PRP and PBS‑treated groups. Vascular endothelial growth factor (VEGF), platelet‑derived growth factor (PDGF), insulin‑like growth factor (IGF)‑1 and transforming growth factor (TGF)‑β expression in peripheral whole blood was additionally analyzed. The therapeutic efficacy of PRP for RA mice was evaluated using clinical arthritis scores. The results of the present study demonstrated that treatment with PRP alleviated arthritis, and reduced humoral and cellular immune responses, leading to beneficial effects on histological parameters as observed using joint tissue histological staining. CIA mice treated with PRP exhibited downregulated expression of IL‑6, IL‑8, IL‑17A, IL‑1β, TNF‑α, receptor activator for nuclear factor‑κB and IFN‑γ in inflammatory tissue. In addition, VEGF, PDGF, IGF‑1 and TGF‑β expression in peripheral whole blood was increased following treatment with PRP. The serum concentration of anti‑collagen antibody was decreased in PRP‑treated CIA mice. In conclusion, CIA mice treated with PRP exhibited beneficial effects, including decreased joint inflammation, cartilage destruction and bone damage, and increased repair of joint tissue. The results of the present study suggested that PRP may be an effective therapeutic agent for RA.
28486047 Prevalence of metabolic syndrome in rheumatoid arthritis patients from Northeastern Brazil 2018 Mar OBJECTIVES: To determine the prevalence of metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA) and controls from Northeastern Brazil and to verify its association with specific RA parameters and cardiovascular risk factors. METHODS: The prevalence of MetS was assessed cross-sectionally in 338 RA patients from a single center and 84 age and gender-matched controls from the local community. MetS was defined according to NCEP/ATPIII guidelines. Disease activity was assessed with CDAI, SDAI and DAS28 scores. Independent risk factors for MetS in RA patients were identified by multivariate logistic regression. RESULTS: The prevalence of MetS was higher in RA patients than in controls (51.3% vs. 21.8%; p < .001). RA patients had a higher frequency of hypertension and type-2 diabetes mellitus, greater waist circumference (WC), higher blood glucose levels and lower HDL levels. DAS28, CDAI and SDAI scores were higher and high disease activity was more frequent in MetS patients. The multivariate logistic regression identified BMI (OR = 1.12, 95% CI = 1.05-1.20; p < .001) and disease activity (OR = 1.23, 95% CI = 1.04-1.47; p = .016) as independent risk factors for MetS in patients with RA. CONCLUSION: RA in patients from Northeastern Brazil was found to be associated with increased WC, high prevalence of MetS (one of the highest in the world) and disease activity. Patients with MetS displayed a higher frequency of cardiovascular risk factors, indicating the need for better control of disease activity and modifiable risk factors for cardiovascular disease (CVD).
28217885 Reductions in Radiographic Progression in Early Rheumatoid Arthritis Over Twenty-Five Year 2017 Dec OBJECTIVE: To assess the 5-year progression of erosions and joint space narrowing (JSN) and their associations with rheumatoid factor (RF) status in 2 large, multicenter, early rheumatoid arthritis cohorts, spanning 25 years. METHODS: Radiographic joint damage was recorded using the Sharp/van der Heijde (SHS) method in the Early Rheumatoid Arthritis Study (ERAS), 1986-2001, and the Early Rheumatoid Arthritis Network (ERAN), 2002-2013. Mixed-effects negative binomial regression estimated changes in radiographic damage over 5 years, including erosions and JSN, separately. RF, along with age, sex, and baseline markers of disease activity were controlled for. RESULTS: A total of 1,216 patients from ERAS and 446 from ERAN had radiographic data. Compared to ERAS, ERAN patients had a lower mean total SHS score at baseline (ERAN 6.2 versus ERAS 10.5; P < 0.001) and mean annual rate of change (ERAN 2.5 per year versus ERAS 6.9 per year; P < 0.001). Seventy-four percent of ERAS and 27% of ERAN patients progressed ≥5 units. Lower scores at baseline in ERAN were largely driven by reductions in JSN (ERAS 3.9 versus ERAN 1.2; P < 0.001), along with erosions (ERAS 1.9 versus ERAN 0.8; P < 0.001). RF was associated with greater progression in each cohort, but the absolute difference in mean annual rate of change for RF-positive patients was substantially higher for ERAS (RF positive 8.6 versus RF negative 5.1; P < 0.001), relative to ERAN (RF positive 2.0 versus RF negative 1.9; P = 0.855). CONCLUSION: Radiographic progression was shown to be significantly reduced between the 2 cohorts, and was associated with lower baseline damage and other factors, including changes in early disease-modifying antirheumatic drug use. The impact of RF status as a prognostic marker of clinically meaningful change in radiographic progression has markedly diminished in the context of more modern treatment.
28397554 Sauvé-Kapandji procedure with headless compression screw in patients with rheumatoid arth 2018 Jan OBJECTIVE: We examined the surgical outcomes of the Sauvé-Kapandji (S-K) procedure using a headless compression screw and a metal cancellous screw in patients with rheumatoid arthritis (RA). METHODS: This retrospective study included 41 RA patients who underwent the S-K procedure for distal radioulnar joint disorders with two screws: headless compression screws (HCS group, n = 20) and cannulated cancellous screws (CCS group, n = 21). Clinical and radiographic outcomes were assessed 1 year after surgery. Radiographic outcomes included bony union of the distal radioulnar joint (DRUJ), bone resorption around the screw, a screw back-out, and use of additional K-wire. We investigated any complications related to the screw head. RESULTS: All 20 patients in the HCS group showed bone fusion of the DRUJ. In the CCS group, an asymptomatic non-union was observed in one patient and additional K-wire was needed to stabilize the DRUJ in three patients. No patients complained of any complications related to the screw head in the HCS group, while the CCS group demonstrated the hardware protrusion in two patients who complained of tenderness or discomfort at the screw head. CONCLUSIONS: The use of a headless compression screw in the S-K procedure is useful in patients with RA.