Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
2018026 A preliminary study of excess risk of cardiovascular disease in the mothers of patients wi 1991 Apr 1 Family histories were obtained from 123 patients with rheumatoid arthritis and 152 patients with other musculoskeletal complaints. The subjects were female patients aged 40 years or more seen at the Arthritis Clinic of the State University of New York Health Science Center at Brooklyn between October 1985 and February 1986. It was found that death due to heart disease or stroke was more common (adjusted p less than 0.02) in the mothers of patients with rheumatoid arthritis than in the mothers of control patients, and that heart disease was also reported to be more common in these mothers (adjusted p less than 0.005). Thus, it is possible that cardiovascular disease at least partially accounts for the previously noted (J Rheumatol 1986; 13:903-6) shorter life expectancy of the mothers of patients with rheumatoid arthritis.
3369246 [Patient education in chronic polyarthritis. 3. Intermediate results of a prospective, con 1988 Jan Efficacy and possible negative side effects of a patient education program for rheumatoid arthritis were evaluated in a controlled, prospective study over 3 months. 34 outpatients were educated over a total of 8 h in three groups within a patient-centred design. Before the program the knowledge of the disease depended only on the formal grade of education but not on disease-related variables such as disease duration or disability. Probably due to its individualizing method, the program improved the knowledge of all patients to the same extent, regardless of their intellectual and social prerequisites. The increased cognitive knowledge did not result in negative side effects like increased pain or depression. The pain score remained unchanged. Depression decreased after the education. The group sessions made us suppose that the participants may have represented a selected group of active, psychologically stable patients, who cope well with rheumatoid arthritis. In contrast, we felt that non-participation was the response of the inactive, fatalistic patients with rheumatoid arthritis, who live in social isolation and especially need our care. Therefore, future efforts must particularly focus on the problem of motivation and on an increase in the rate of participation.
3260400 Effects of piroxicam and D-penicillamine on T lymphocyte subpopulations, natural killer ce 1988 The effects of piroxicam and D-penicillamine on T lymphocytes, NK cell activity and rheumatoid factor production as well as clinical parameters were studied in patients with rheumatoid arthritis. The level of total rheumatoid factor fell during treatment with D-penicillamine (p less than 0.02) and there was a positive correlation (K greater than 0.50, p less than 0.05) between this fall in rheumatoid factor and the improvement of several clinical activity parameters. No significant change was observed in the level of rheumatoid factor during treatment with piroxicam. Natural killer cell activity decreased from 21.1 +/- 2.5 to 15.8 +/- 1.9 after treatment with piroxicam for 3 weeks (p less than 0.05) as compared with changes in the controls. No change in natural killer cell activity was seen after treatment with D-penicillamine. Moreover, no significant changes in the numbers of T4+ and T8+ lymphocytes nor in the numbers of HLA-DR positive T cells were seen in the two treatment groups. Both laboratory and clinical activity parameters improved during the treatment with D-penicillamine, while only subjective parameters improved during treatment with piroxicam.
2882608 Takayasu's arteritis diagnosed in a patient with long-standing arthralgias and arthritis. 1987 Apr A 50-year-old woman had seronegative polyarthritis for three years, followed by vascular obstruction with classic Takayasu's arteritis. She responded symptomatically to high-dose steroid therapy and remains in long-term remission (joints and vasculature) after taper of medication. Literature review documents this relationship of arthritis to vasculitis in this and other types of vascular inflammation.
3580712 Seronegative and seropositive rheumatoid arthritis: similar diseases. 1987 Jun A case control study of 50 rheumatoid factor positive (RA+) and 50 rheumatoid factor negative (RA-) patients with rheumatoid arthritis has been carried out. As expected, the RA+ group has significantly more nodules and vasculitis. In terms of clinical joint involvement, the RA- had large-joint involvement. Radiologically, seropositive disease was characterized by more severe involvement of the metacarpophalangeal joints of the thumb and index fingers and in all the metatarsophalangeal joints of the feet. There was no difference either clinically or radiologically between the two groups in terms of symmetry of joint disease or wrist involvement. Of special interest was the finding that the prevalence of HLA-DR4 was elevated to the same degree in both groups but that genetic markers for ankylosing spondylitis and for psoriasis (HLA-B27 and Cw6 respectively) were similar in both groups and not increased above control population levels. It is concluded that the entity defined as RA includes patients with and without rheumatoid factor (RF) in their serum and that this determines differences in disease expression. Whether these differences are the consequences or the cause of RF cannot be concluded on the basis of this study.
2595334 Rheumatoid arthritis as seen from official data registers. Experience in Finland. 1989 Computerized public data registers are an important data base for bodies monitoring public health. They can also be used for epidemiological research. The main problems in the use of the registers are administrative and qualitative. The use, and especially the linking of different registers together, is strictly regulated by law. The trend seems to be towards more strict regulations. Another problem is the quality of the data. The registers were designed for administrative purposes and therefore, the classification of data is not always suitable for research. In addition, errors are possible at several stages of the production and filing of the data. International comparisons are difficult because of differences in legislation and administrative rules. However, despite these problems, public data registers are an important resource for research, and their importance will grow with time and improvements in the quality of the registers.
3401647 Antigens of HLA-DR locus in rheumatoid arthritis. 1988 HLA-DR1 was found in 45% and HLA-DR4 in 34% of 127 patients with rheumatoid arthritis.
3041545 A clinical and biochemical evaluation of etretinate in rheumatoid arthritis. 1988 Etretinate (Tigason; Roche), which is effective in the treatment of psoriatic arthritis has immunomodulating activity in vivo. We have therefore assessed this drug in an open clinical and biochemical assessment of 24 weeks duration in rheumatoid arthritis. The treatment dose was 1.0 mg/kg/day for the first 4 weeks reducing to 0.5 mg/kg/day thereafter. There was a modest clinical improvement though this only reached statistical significance for joint circumference at 12 and 16 weeks (P less than 0.05). Biochemical improvement only reached levels of statistical significance for IgM at week 16 (P less than 0.01). Eight out of 15 patients had discontinued the drug because of side-effects by week 12 and only three out of 15 patients showed individual improvement by week 24. Some biochemical parameters (ESR) worsened. These results suggest only modest clinical efficacy and use of the drug in rheumatoid arthritis is likely to be curtailed by unacceptable side-effects. The improvement in biochemical variables that occurs when the drug is used in psoriatic arthritis does not occur in rheumatoid arthritis.
2884932 Effect of sulphasalazine on the radiological progression of rheumatoid arthritis. 1987 May We have investigated the influence of sulphasalazine, a second line antirheumatic drug, on the radiological progression of erosions in rheumatoid arthritis over a two year period in 41 patients. Hand radiograph scores deteriorated significantly over this period, but in a group of 31 patients in whom one year films were also available this deterioration was limited to the first year. This slowing of radiological deterioration was not related to 'normalisation' of the erythrocyte sedimentation rate (ESR). Compared with a 'control' group of 10 patients who had refused offers of second line therapy, sulphasalazine treated patients showed less deterioration over the two year period, and this difference was more marked than in previous studies of gold or penicillamine. No significant change was seen in large joint radiographs in sulphasalazine treated patients over two years, but this probably represents the poor sensitivity of the method of assessment. No significant correlation was seen between changes in inflammatory indices and slowing of radiological deterioration in erosion score. Thus sulphasalazine appears to slow the progression of radiological disease of the hands over the second year of treatment in a representative sample of patients who continue to receive treatment for two years.
2012465 Exacerbation of rheumatoid arthritis by sodium fluoride treatment of osteoporosis. 1991 Apr Recent studies have suggested that sodium fluoride therapy may be an effective treatment for vertebral osteoporosis. Unfortunately, the high frequency of side effects may limit the use of this treatment modality. This report documents the repeated exacerbation of rheumatoid arthritis on three occasions after the initiation of sodium fluoride therapy. This apparent complication of sodium fluoride treatment may be mediated by stimulation of leukocyte production of reactive oxygen species and other mediators of the acute inflammatory response. We suggest that sodium fluoride should be used cautiously in patients with rheumatoid arthritis.
2949714 Remarkably similar response to gold therapy in HLA identical sibs with rheumatoid arthriti 1986 Dec Two pairs of sibs with definite rheumatoid arthritis responded in a remarkably similar way to parenteral gold therapy, in terms of both toxicity and efficacy. Both pairs proved to be HLA identical. One of the pairs possessed the HLA antigens B8 and DR3, which have been associated with both drug toxicity and excellent clinical response. The other pair did not possess either of these antigens, suggesting that the reaction to gold therapy in patients with rheumatoid arthritis may be determined by other HLA or genetic factors coded for by chromosome 6, or both.
2189161 Vasculitis associated with rheumatoid arthritis. 1990 May Vasculitis may accompany rheumatoid arthritis. One must distinguish between vascular involvement associated with the pathogenesis of rheumatoid arthritis, isolated digital vasculitis, and the syndrome of clinical rheumatoid vasculitis. The cause of clinical rheumatoid vasculitis is unknown. High titers of rheumatoid factor, cryoglobulins, diminished circulating complement, an increased prevalence of HLA-DR4, and the pathologic findings suggest an immune etiology. However, similar, but perhaps less pronounced, abnormalities occur in uncomplicated rheumatoid arthritis, and these findings are not universal in complicating vasculitis. Classic cutaneous clinical manifestations include ischemic ulcers, digital gangrene, and palpable purpura. Mononeuritis multiplex is another classic presentation of rheumatoid vasculitis. Small digital infarctions may accompany other manifestations in clinical vasculitis or may occur alone as isolated digital arteritis, in which case the prognosis is relatively favorable. Weight loss, pleuritis, pericarditis, ocular inflammation, splenomegaly, hepatomegaly, and Felty's syndrome have also been reported in association with rheumatoid vasculitis. Although renal involvement has been considered unusual in rheumatoid vasculitis, several studies suggest that this may be more common than previously recognized. Ideally, a biopsy or an angiogram confirms the diagnosis of rheumatoid vasculitis, but often the diagnosis rests upon the clinical picture. In general, blind biopsies are not helpful, although one series indicated that a blind rectal biopsy may be an exception to this rule. An elevated erythrocyte sedimentation rate, increased C-reactive protein level, anemia, thrombocytosis, hypoalbuminemia, and a positive rheumatoid factor are common laboratory findings. Leukocytosis, hypergammaglobinemia, leukocytopenia, an elevated creatinine level, and minimal abnormalities of the urinary sediment also occur in patients with rheumatoid vasculitis. However, these abnormalities overlap in patients with uncomplicated rheumatoid arthritis, and their role in distinguishing rheumatoid vasculitis from uncomplicated rheumatoid arthritis is limited. Other immunologic tests have no established clinical role in diagnosing rheumatoid vasculitis. Therapy depends upon the clinical manifestation of rheumatoid vasculitis. Uncomplicated rheumatoid arthritis deserves appropriate therapy, and general attention to nutrition, cessation of tobacco, and control of blood pressure are indicated for all patients. Isolated digital vasculitis generally requires no more than the usual treatment for uncomplicated rheumatoid arthritis. Appropriate dermatologic management is indicated for ischemic ulcers. Most clinical experience in managing more symptomatic rheumatoid vasculitis has focused on glucocorticosteroids, D-penicillamine, and cytotoxic immunosuppressive drugs.(ABSTRACT TRUNCATED AT 400 WORDS)
3070725 IgA rheumatoid factor as predictor of disease activity. 1988 IgA rheumatoid factor (RF) was shown to occur in rheumatoid arthritis (RA) sera in 1963, but for almost 20 years thereafter this RF isotype received little attention. Solid-phase immunoassays, esp. ELISA, are now widely used for the detection of serum IgA RF which may be raised in RA, primary Sjögren's syndrome, systemic lupus erythematosus (SLE) and several other diseases. Over the past four years the following observations on IgA RF have been published: While IgM RF levels showed positive correlation with age, IgA RF levels did not. Gold therapy reduced IgA RF levels but the relationship to clinical improvement was not clear. In longitudinal studies, changes in overall disease activity, Ritchie articular index, grip strength and ESR showed a closer association with IgA RF than with IgM RF. Five groups have reported an association between IgA RF and the severity of erosive arthritis. In early RA, IgA RF may be a more specific predictor of disease severity than IgM RF or IgG RF. Further work is needed on the occurrence and biology of IgA RF, but measuring this isotype alone would improve the clinical specificity of routine RF tests.
2750492 The Pritchard Mark II elbow prosthesis in rheumatoid arthritis. 1989 Jun Twenty-five consecutive rheumatoid elbows treated with the Pritchard Mark II elbow prosthesis were prospectively followed for 3 (2-5) years. There were marked pain relief and increased motion after the operation. Two elbows were revised, one because of deep infection and the other because of loosening. There were no neuropathies or fractures. The major long-term complication was radiographic loosening (6/24), which mainly occurred in elbows with only moderate rheumatoid destructions.
2324026 Relationships among hardiness, social support, severity of illness, and psychological well 1990 The purpose of this study was to examine the relationships among hardiness, social support, severity of illness, and psychological well-being in women with rheumatoid arthritis who were being seen on an outpatient basis. Questionnaires were administered, to 122 women, assessing hardiness, social support, and psychological well-being. Severity of illness was determined by assessment of joint function, sedimentation rates, and length of morning stiffness. Significant correlations were found between (a) hardiness and the number of persons in the social support system, (b) hardiness and satisfaction with social support, (c) hardiness and psychological well-being, (d) the number of persons in the social support system and satisfaction with social support, (e) the number of persons in the social support system and joint function, (f) satisfaction with social support and psychological well-being, and (g) length of morning stiffness and psychological well-being. Stepwise regression analysis indicated that satisfaction with social support, hardiness, and length of morning stiffness (in that order) were the best predictors of psychological well-being. The findings suggest that these three factors play a significant role in the identification of women with rheumatoid arthritis who are more able to cope with the stressful ramifications of their disease.
3047380 The efficacy and safety of sulindac (400 mg vs 600 mg daily) in rheumatoid arthritis. A Ca 1988 Jun Sulindac, an indene derivative of indomethacin, was compared at 2 dosages (400 mg and 600 mg daily) in patients with rheumatoid arthritis. One hundred sixty-two patients from 19 centers completed the study--85 in the low dose group and 77 in the high dose. No difference in efficacy was found between these 2 regimens. Overall adverse reactions were more frequent with the high dose group especially with respect to blood chemistry and gastrointestinal reactions.
3690983 Undifferentiated arthritis and spondylarthropathy as a challenge for prospective follow-up 1987 Sep Diagnosis of arthritis with recent onset is still an unresolved problem. In 1984 we started an outpatient clinic for patients with early arthritis of less than one year duration. Of a total of 226 patients seen 149 (66%) had definite (n = 76; 34%) or probable (n = 73; 32%) inflammatory rheumatic disease, and 77 (34%) had degenerative or extraarticular rheumatic disease. Thirtynine patients were classified as undifferentiated arthritis. This undefined arthritis was often monoarticular (12%) and oligoarticuler (44%). One patient met 5 ARA-criteria for rheumatoid arthritis, 14 (36%) met 3-4 ARA-criteria and 25 (64%) only 1-2 ARA-criteria. ESR was elevated in only 23 (59%) patients, rheumatoid factor was positive in 7 (19%) patients and HLA-B27 was positive in 9 (23%) patients. Seventeen (44%) patients had a history of recent infections preceding the beginning of joint symptoms. Thus undifferentiated arthritis represents a heterogeneous group of diseases. Despite diagnostic progresses in recent years a high proportion of early arthritis cannot be diagnosed definitely.
2315606 Intraarticular corticosteroid injection into rheumatoid arthritis knees improves extensor 1990 Eleven arthritic knee joints in seven patients with rheumatoid arthritis were studied before and after intraarticular injection of a corticosteroid preparation. Extensor muscle torque and quantitative electromyography increased on days 7 and 14 after treatment, indicating that muscle function had been inhibited by synovitis. Clinical signs of synovitis, such as pain, range of motion and knee circumference, also improved. Synovial fluid withdrawal alone improved extensor muscle torque. Joints with instability and/or radiological cartilage involvement also improved.
1757940 Magnetic resonance imaging of the parotid gland in patients with Sjögren's syndrome. 1991 Sep To detect structure and size abnormalities, magnetic resonance imaging (MRI) of the parotid gland was performed on 36 patients with sicca complaints. Twenty-four patients had primary Sjögren's syndrome (SS) without rheumatoid arthritis (RA) or connective tissue disease; 6 had secondary SS associated with RA, whereas in another 6 cases the related disease could not be classified. Characteristic gland size and structural abnormalities were identified in patients with SS and various stages could be established, compared to patients with other parotid gland disorders, as well as healthy persons. MRI provides an accurate noninvasive technique for assessment of xerostomia in patients with SS.
2369431 Exogenous sex hormones and the risk of rheumatoid arthritis. 1990 Jul The use of exogenous sex hormones in relation to the risk of rheumatoid arthritis (RA) was examined in a cohort of married nurses 30-55 years of age followed since 1976 in the Nurses' Health Study. Baseline information on the use of oral contraceptives, replacement estrogens, and other potential risk factors was obtained in 1976 and updated every 2 years. During 8 years of followup, 217 incident cases of polyarthritis were ascertained (115 RA and 102 undifferentiated polyarthritis). When compared with women who had never used oral contraceptives, the age-adjusted relative risk was 1.0 (95% confidence interval [CI] 0.7-1.3) for past users; however, too few women were currently using oral contraceptives for a reliable estimate of its effect. Among postmenopausal women, 123 cases of RA were reported. Compared with postmenopausal women who never used replacement estrogens, current users had an age-adjusted relative risk of 1.3 (95% CI 0.9-2.0), past users had an age-adjusted relative risk of 0.7 (95% CI 0.5-1.2), and ever users had a relative risk of 1.0 (95% CI 0.7-1.4). These data do not show a protective effect of past use of oral contraceptives or replacement estrogens for RA; however, a modest protective effect of current oral contraceptive use cannot be excluded.