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ID PMID Title PublicationDate abstract
30337216 Serum free amino acid levels in rheumatoid arthritis according to therapy and physical dis 2019 Jan BACKGROUND: In presented study the amino acid analysis was performed in serum derived from rheumatoid arthritis patients (RA) according to undertaken therapy and classification of physical disability. The results were compared with previously published data. METHODS: The levels of 31 free amino acids were determined in 50 serum samples derived from RA subjects and 51 controls. The RA patients were divided into two groups according to the therapy (methotrexate/leflunomide, infliximab/adalimumab/etanercept/tocilizumab, prednisolone/NSAID) and classification of physical disability of the patients. Levels of amino acids were measured by LC-MS/MS. The obtained results were subjected to multivariate statistical tests. RESULTS: According to the therapy that was being used, threonine differentiated RA patients treated with methotrexate/leflunomide - infliximab/adalimumab/etanercept/tocilizumab (p = 0.00954) and infliximab/adalimumab/etanercept/tocilizumab - prednisolone/NSAID (p = 0.03109), while tryptophan differentiated RA patients treated with methotrexate/leflunomide - infliximab/adalimumab/etanercept/tocilizumab (p = 0.01723). In the functional classification, arginine differentiated RA samples between class III and IV (p = 0.02332), while glycine differentiated them between class I+II and III of the Steinbrocker functional classification (p = 0.03366). CONCLUSIONS: An analysis of the metabolome profile requires the use of validated bioanalytical methods that are strictly dedicated for this purpose. The obtained results are not accidental (p value less than 0.05), and all of the selected amino acids play an important role in inflammation and immune response. It is suggested that studied amino acids can be considered as a markers for diagnosis of RA and monitoring pharmacotherapy of the disease.
31116056 Age and female gender associated with periodontal disease in Japanese patients with rheuma 2020 May Objectives: This study aimed to evaluate the prevalence of, and the factors associated with, periodontal disease in Japanese patients with rheumatoid arthritis (RA).Methods: Patients with RA enrolled in the Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort completed three self-administered questionnaires including questions about recent gingival bleeding during toothbrushing, a recent diagnosis of periodontitis by a dentist, and any history of periodontitis. Logistic regression analyses were used to evaluate associations with clinical variables for each questionnaire.Results: Among 5600 Japanese patients with RA, 31.0%, 18.3%, and 20.4% of patients self-reported recent gingival bleeding during toothbrushing, a recent diagnosis of periodontitis by a dentist, and a history of periodontitis, respectively. In multivariate models, younger age, fracture history, Japanese Health Assessment Questionnaire-Disability Index (JHAQ-DI), and prednisolone dosage were significantly (p < .05) associated with recent gingival bleeding during toothbrushing. Older age, female gender, and ever-smoker status were significantly correlated with a recent diagnosis of periodontitis.Conclusion: Many Japanese patients with RA experience gingival bleeding during toothbrushing and are diagnosed with periodontitis. Age, female gender, ever-smoker status, fracture history, JHAQ-DI, and prednisolone dosage appeared to be associated with periodontal disease in Japanese patients with RA.
30285533 Safety and effectiveness of high-dose methotrexate (over 8 mg/week) in 2838 Japanese pat 2020 Jan Objectives: To confirm the safety and effectiveness of high-dose (>8 mg/week) methotrexate (MTX) for the treatment of rheumatoid arthritis in Japan.Methods: A postmarketing surveillance program enrolled Japanese patients with rheumatoid arthritis starting on high-dose MTX followed up for 24 or 52 weeks. Analyses for safety, risk factors affecting safety, and effectiveness were conducted.Results: The safety/effectiveness analysis sets included 2838/2779 and 335/326 patients in the 24 and 52-week follow-up groups, respectively. Incidence of adverse drug reactions (ADRs) and serious ADRs was 21.42 and 1.66% in the 24-week and 35.52 and 2.69% in the 52-week groups, respectively. The Disease Activity Score in 28 Joints (DAS28) was significantly decreased as early as four weeks from the start of high-dose MTX; after 24-week (4.09-3.21) and 52-week treatment (3.91-2.80; both p < .001). In a majority of patients at baseline who had high-to-moderate disease activity, the remission rate (defined as DAS28-4ESR <2.6) increased three-fold from 10.6% (baseline) to 33.0% (24-week) compared to patients with low disease activity whose remission rate increased two-fold from 24.0% (baseline) to 53.6% (24 weeks).Conclusion: High-dose MTX was well tolerated in Japanese patients, resulted in improved disease control, and can be considered a step forward in achieving treat-to-target goals.
31729609 Physical exercise and low-level laser therapy on the nociception and leukocyte migration o 2020 Aug Rheumatoid arthritis denotes hyperplasia and intense inflammatory process. Treatment involves exercise protocols and use of resources such as low-level laser therapy (LLLT) to modulate the inflammatory process and maintain physical capacity. The objective was to investigate whether treatment with LLLT and exercise modulates the inflammatory process and peripheral functionality. Sample is composed of 128 male rats, separated into three groups, control, treated and untreated, in the acute and chronic period of the disease with 64 animals in each group, divided into 8 subgroups with n = 8. The animals were immunized with injection at the base of the tail and 7 days after intra-articular injection with complete Freund adjuvant (CFA) for lesion groups, and saline solution for the controls. Joint disability was evaluated by PET (paw elevation time) and joint edema and treated with LLLT and/or resisted stair climbing exercise. Normality Shapiro-Wilk test, ANOVA mixed for the functional analyses, and ANOVA one-way for the variables of cellular differentiation, with Bonferroni post hoc, p = 5% were used. For the evaluations of joint disability and nociception, there was a significant difference between the evaluations, the groups, and the interaction groups-evaluations. The treated groups showed recovery of functionality; it is still verified that laser therapy increased the nociceptive threshold of the chronic inflammatory period, and the exercise reflected in significant functional improvement and modulation of the inflammatory process both in the acute and chronic periods. LLLT, resistance exercise, or a combination of treatments had a positive effect on the modulation of the inflammatory process, reducing the migration of leukocytes, in addition to helping the return of peripheral functionality by reducing joint disability in a model of rheumatoid arthritis induced by CFA in rats.
29564803 The impact of ocular manifestations of rheumatoid arthritis on the health-related quality 2019 May Objectives To determine the patterns, predictors and overall impact of ocular manifestations of rheumatoid arthritis (RA) on the health-related quality of life and disability index. METHODS: A total of 50 Nigerian patients with RA were studied. Full ocular evaluation was done to determine the presence of each defined ocular manifestation of RA. All patients completed the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) and the Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires. RESULTS: The mean ± SD age of the patients was 47.2 ± 12.5 years. A total of 42 cases of ocular diseases were found in 23 (46%) patients. Keratoconjunctivitis sicca was found in 15 (30%) patients; cataract, 13 (26%); scleritis/episcleritis, 4 (8%); disk edema, 4 (8%); glaucoma, 3 (6%); ulcerative keratitis, 1 (2%); vitreitis, 1 (2%); and macula edema, 1 (2%) patient. There is an association of the presence of ocular manifestations with the physical component summary (PCS) [T = - 3.398, P = 0.001] and the mental component summary (MCS) [T = - 2.616, 0.012] of the SF-36 but not with the HAQ-DI (T = 1.685, 0.099). Following multiple regression analysis, the predictors of the presence of ocular manifestations were age greater than 45 years and positive anti-citrullinated protein antibody. Following linear regression analyses, Steinbrocker's functional class independently predicted the PCS while both Steinbrocker's functional class and female sex predicted the MCS. CONCLUSIONS: The development of ocular disorders associated with RA is associated with a significant negative impact on the quality of life of the patients.
31486066 Integrative analysis of genome-wide association study and expression quantitative trait lo 2020 Jan Rheumatoid arthritis (RA) is an autoimmune chronic disorder manifesting as warm, swollen, and painful joints. Multiple immune cells are implicated in the development of RA. Previous studies demonstrated that integrating the genetic information of genome-wide association studies (GWAS) and expression quantitative trait loci (eQTLs) is capable of identifying new disease-risk loci and providing novel insights into the etiology of complex human disease. In this study, we conducted an integrative pathway association analysis of RA by using GWAS summary data and five immune cell types related to eQTL datasets of RA. After combining the cell-specific eQTLs and GWAS summary of RA and performing a pathway-enrichment analysis, we detected a group of RA-associated pathways with common or cell-specific enriched in the five immune cell types. 41 pathways for B cells, 33 pathways for CD4(+) T cells, 27 pathways for CD8(+) T cells, 39 pathways for monocyte, and 25 pathways for natural killer cells are significant in RA, among which 48% are common pathways and 32% are cell-specific pathways. We detected a group of RA-associated eQTL pathways related to five different immune cell types. Our findings may provide novel insights into the pathogenesis of RA.
31483182 Validity and responsiveness of the Work Functioning Impairment Scale (WFun) in rheumatoid 2020 Sep Objective: Previous studies have not fully evaluated the measurement properties of the Work Functioning Impairment Scale (WFun) in clinical situations and there are no data from patients with rheumatoid arthritis (RA). This study aimed to investigate the convergent validity and responsiveness of the WFun in patients with RA.Methods: This substudy was a part of the multicenter, observational, prospective FIRST ACT-SC study. In total, 322 paid workers with RA received anti-rheumatic drugs at baseline. The WFun, Disease Activity Score based on 28 joints and erythrocyte sedimentation rate (DAS28-ESR), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), Work Productivity and Activity Impairment Questionnaire (WPAI), and Japanese Health Assessment Questionnaire Disability Index (HAQ-DI) were administrated at baseline and weeks 12, 24, and 52. Multilevel regression analyses were performed.Results: High average WFun scores were associated with higher score categories of the DAS28-ESR, CDAI, SDAI, WPAI and HAQ-DI. Average WFun change scores linearly decreased with decreases on each instruments.Conclusion: The findings indicate that the WFun has reasonable measurement properties: the scale demonstrated validity and responsiveness with RA patients. The WFun could be useful in assessing presenteeism in patients with RA.
31378115 Plasma levels of the soluble form of the FcγRIIa receptor vary with receptor polymorphism 2020 Soluble forms of the low-affinity immunoglobulin receptor FcγRIIa (sFcγRIIa) lacking the cytoplasmic tail have been reported in plasma however the mechanism and functional consequences are unknown. This study aimed to evaluate mechanisms of FcγRIIa release compared to GPVI release from platelets, and examine whether genetic polymorphisms at positions 27 and 131 within FcγRIIa correlate with platelet FcγRIIa stability and function. Enzyme-linked immunosorbent assays (ELISAs) were used to measure plasma sFcγRIIa and sGPVI levels. FcγRIIa genotype at positions 27 and 131 was evaluated. sFcγRIIa levels were not significantly different between non-131HH and 131HH but were significantly lower in 27W than non-27W. Treatment of platelets with aggregated immunoglobulin (Ig) G induced release of FcγRIIa and GPVI, but only sGPVI release was statistically significant, required functional FcγRIIa, and was blocked by inhibitors of signaling pathways and metalloproteinases. This indicated that sFcγRIIa was not released from platelets by metalloproteolysis. sFcγRIIa levels were not correlated with sGPVI levels in healthy individuals however levels of sFcγRIIa and sGPVI in plasma from patients with rheumatoid arthritis (RA) were significantly elevated above levels found in healthy individuals. Elevated level of sFcγRIIa in RA patients may reflect active immune-based arthritis and be predictive of active inflammation.
31189867 [Mindset for Pharmacists as an Expert of Pharmacotherapy-Case of Home-Care Rheumatoid Arth 2019 May The number of older adult patients with rheumatoid arthritis(RA)is increasing. As older adult patients tend to have multiple diseases requiringmedications, they are likely to experience side effects from the decline in their physiological functioning. In addition, suppression of disease activity leads to a decline in ADL in the case of patients livingalone, even leadingto difficulties in livingat home. In the 3-years clinical course on older adult RA patients livingalone with multiple diseases, we show the mindset that community pharmacists must have for three events(namely, hypoalbuminemia, chronic heart failure, and dehydration)in which inflammation influences medicinal or side effects.
31305353 Rheumatoid Hand and Wrist Surgery: Soft Tissue Principles and Management of Digital Pathol 2019 Nov 1 Since the advent of disease-modifying antirheumatic drugs for rheumatoid arthritis, orthopedic surgeons see fewer patients in the office who require hand surgery. However, a significant number of patients still seek surgical intervention to improve pain and function. These patients often present with isolated soft tissue pathologies, but even bone and joint pathology require meticulous soft tissue handling in this cohort. This review highlights the principles and techniques relevant to the management of soft tissue deformity in rheumatoid hand and wrist surgery, as exposure in training and practice continues to decrease.
31412111 Increased Nonexudative Age-Related Macular Degeneration Diagnosis Among Medicare Beneficia 2019 Aug 1 PURPOSE: AMD is the leading cause of blindness in the United States. The role of secondary inflammatory disease on AMD progression is largely unknown. Here we investigate the association between AMD and rheumatoid arthritis (RA), using MarketScan data for patients aged ≥65 years on Medicare. METHODS: Baseline data were extracted for subjects with at least two International Classification, Ninth Revision (ICD-9) diagnosis codes of RA and control subjects (no RA) and were matched at baseline by propensity score. Matched cohort data were extracted post-baseline time and examined up to 4.5 years of follow-up for ICD-9 diagnosis code AMD records. Multivariable regression models compared risk of an AMD diagnosis post-baseline for RA subjects and matched controls. Days until first AMD diagnosis between RA patients and controls was examined using survival analysis. RESULTS: Risk of new AMD diagnosis was elevated in RA patients (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.98-2.18), with an increase in nonexudative AMD patients (P < 0.0001). Risk was elevated in female (n = 27,548) (OR 1.11; 95% CI 1.05-1.17) compared with male (n = 9704; P < 0.001) patients. The time to first AMD diagnosis was shorter for RA subjects than controls (P < 0.0001). CONCLUSIONS: Our analysis provides support of association between RA diagnosis and increased nonexudative AMD diagnosis.
30241878 Health care utilization and expenditures among adults with rheumatoid arthritis using spec 2019 Jun BACKGROUND: Despite the rising popularity of using specialty medications for patients with rheumatoid arthritis (RA), little is known about the use or spending on medical services among these patients. OBJECTIVE: The objective of this study was to investigate health care utilization and expenditures among patients with RA using specialty medications compared with those using non-specialty (i.e., traditional) medications. METHODS: This was a retrospective cohort study using Medical Expenditure Panel Survey data from 2009 through 2015. Health care use and expenditures were examined using a (zero-truncated or zero-inflated) negative binomial model and a generalized linear model with a log link function and gamma distribution (or a two-part model). RESULTS: Compared to patients with RA who were traditional medication users (TMUs), those categorized as specialty medication users (SMUs) were prescribed about 24% fewer medications (incidence rate ratio [IRR] = 0.76, 95% CI = 0.66-0.89) and received fewer office-based visits (IRR = 0.84, 95% CI = 0.70-0.99). Although SMUs' spending on emergency department visits was lower, their spending on total health care was $14,570 higher than that of TMUs. Compared with TMUs, users of both specialty and traditional medications (BMUs) had fewer emergency department visits (IRR = 0.57, 95% CI = 0.39-0.81) with less spending on emergency service use. Overall, BMUs' total health care spending was $5720 higher than TMUs' total spending. CONCLUSIONS: There were some differences in health care use and expenditures for treating RA between patients using specialty medications and those using traditional medications. Total health care spending was higher for SMUs/BMUs despite their less frequent use of some types of medical services and lower spending on emergency department visits, because of the high cost of specialty medications for RA. The high costs of specialty medications implies the importance of the efficient use of these medications.
31551223 Observation of the clinical effect of the combined therapy of zushima tablet and western m 2019 May To evaluate the clinical efficacy of combined therapy of Zushima tablet and western medicine in treatment of rheumatoid arthritis and analyze the MRI test results. A total of 170 patients who had been treated for rheumatoid arthritis at our hospital from August 2016 and June 2018, were enrolled as research objects. They were randomly divided into control group and research group, with 85 patients in each group. The patients in the control group were treated with western medicine, while patients in the research group were treated with combined therapy of Zushima tablet and western medicine. The clinical efficacies of two groups were compared. results showed that the overall effective rate of the research group was higher than that of the control group (p<0.05). Various clinical symptoms including joint swelling, joint tenderness, duration of morning stiffness for both groups before and after treatment were recorded, and results showed that the improvement of the research group was significantly better than that of the control group (p<0.05). Application of combined therapy of Zushima tablet and western medicine in treatment of rheumatoid arthritis could lead to favorable effects and improvement of the patients' clinical symptoms.
30586666 Study of the adoptive immunotherapy on rheumatoid arthritis with Thymus-derived invariant 2019 Feb BACKGROUND: The therapeutic effect of adoptive infusion of specific thymus-derived invariant natural killer T (iNKT) cells in a mouse model of rheumatoid arthritis (RA) was observed, and the mechanism of cellular immunotherapy was preliminarily explored. METHODS: Thymus-derived iNKT cells were infused to RA model mice, with α-GalCer as a positive control. Then, ankle swelling was examined, as well as inflammatory cell infiltration to the joint tissue (hematoxylin-eosin [H&E] staining). Flow cytometry (FCM) was used to assess iNKT cell and helper T lymphocyte (Th) subsets. Serum cytokine levels were determined with cytometric bead array (CBA), with protein expression levels of related transcription factors assessed by Western blot. RESULTS: The joint swelling in RA model animals were significantly improved in the cell therapy and α-GalCer positive control groups (P < 0.05). In addition, iNKT frequencies in peripheral blood, the thymus and spleen were increased significantly (P < 0.05). Meanwhile, iNKT1 subset frequencies in the thymus and spleen were decreased, as well as splenic Th1 and Th17 cell subset rates, and serum TNF-α, IFN-γ and IL-6 levels. The rates of iNKT2 and Th2 subsets as well as IL-4 and IL-10 levels were increased (P < 0.05). Thymus GATA-3 and splenic PLZF protein levels were increased (P < 0.05). CONCLUSIONS: Adoptive infusion of thymus-derived iNKT cells exerts therapeutic effects in RA mice by increasing iNKT frequency, altering the proportions of iNKT cell subsets, correcting Th cell subset imbalance and reducing the amounts of inflammatory cytokines.
31606775 Cardiovascular risk factors' behavior during the early stages of the disease, in Hispanic 2020 Mar Rheumatoid arthritis (RA) patients from Latin America present distinctive characteristics relevant when assessing their cardiovascular (CV) risk. The objective was to monitor CV risk factor behavior in the early stages of the disease and to identify predictors of major CV outcomes (MACE). A recent-onset RA cohort was initiated in 2004; data from 185 patients with ≥ 1 year of follow-up were analyzed. Patients underwent prospective assessments of CV risk factors. Incident MACE were confirmed according to standardized definitions. Appropriated statics was used based on the distribution of the variables. At baseline, patients were primarily middle-aged females (87.6%), with active disease (69.7%). Most prevalent CV risk factors were C-reactive-protein > 1 mg/L (90.3%), Castelli ratio > 3 (83.8%), and low-high-density lipoprotein levels (73.5%). The number of patients with an incident CV risk factor after 1 year was higher for a Castelli ratio > 3 (23%), low-high-density lipoprotein serum cholesterol (16.3%), high total serum cholesterol (10.6%), and BMI ≥ 30 kg/m(2) (10%). A minority of patients met the age-range criteria for the application of ACC/AHA 2013 criteria and Reynolds Risk Score (45.8% and 34.1%, respectively). Fifteen patients were classified with high-CV risk during the first year of follow-up, according to ACC/AHA 2013 criteria. Until June 2018, the cohort underwent 1358 patient/years follow-up; six patients developed incidental MACE; high-CV risk at baseline failed to predict MACE. Recent-onset RA Hispanic patients present a distinctive pattern and first-year behavior of CV risk factors. During follow-up, few patients developed incidental MACE.
30729266 An integrated proteomic and glycoproteomic study for differences on glycosylation occupanc 2019 Mar Rheumatoid arthritis (RA) is an autoimmune disease in which certain immune cells are dysfunctional and attack their own healthy tissues. There has been great difficulty in finding an accurate and efficient method for the diagnosis of early-stage RA. The present shortage of diagnostic methods leads to the rough treatments of the patients in the late stages, such as joint removing. Nowadays, there is an increasing focus on glyco-biomarkers discovery for malicious disease via MS-based strategy. In this study, we present an integrated proteomics and glycoproteomics approach to uncover the pathological changes of some RA-related glyco-biomarkers and glyco-checkpoints involved in the RA onset. Among 39 distinctly expressive N-glycoproteins, 27 N-glycoproteins were discovered with over twofold expression significances. On the other hand, 13 proteins have been distinguished with significant differences in 53 distinctly expressed proteins identified in this study. Such an integrated approach will provide a comprehensive strategy for new potential glyco-biomarkers and checkpoints discovery in rheumatoid arthritis.
31017534 Automatic localization of anatomical regions in medical ultrasound images of rheumatoid ar 2019 Jun The pace of population aging is growing faster worldwide. The quality of life of the aging population is mostly affected by rheumatic diseases. With the increasing rate of rheumatoid arthritis in the aging population, technological advances in the field of automatic image processing and analysis have paved way for automatic detection and diagnosis of arthritis based on how the grade of the synovial region is designed. The proposed method is based on spatial analysis using intensity-based approach to segment the skin border, thresholding and connectivity algorithm for bone region segmentation, hit-or-miss transform for bone line segmentation and distance measure with image profile to detect the joint region. After this process of localization, the synovial region is determined using the active contour technique. In arthritis condition, synovitis also occurs which is categorized into four different grades based on the fluid expansion in the synovial region. The different grades are defined and analyzed through deep learning. Convolutional neural network in a deep learning algorithm is used to diagnose the particular grade of synovitis to describe the nature of arthritis. With these results, a module to detect the nature of arthritis automatically is defined.
30081788 The Effect of Neuropathic Pain Symptoms on Remission in Patients with Early Rheumatoid Art 2019 BACKGROUND: The presence of neuropatic pain (NeP) is common in subjects with established Rheumatoid Arthritis (RA), and it can influence the disease remission. These aspects have not been investigated in patients with Early Rheumatoid Arthritis (ERA). OBJECTIVE: To investigate the effect of NeP on the achievement of remission in patients with ERA. METHOD: The study involved consecutive ERA patients with moderate or high disease activity. The painDETECT Questionnaire (PDQ), the 36-item Short Form Health Survey (SF-36), and the Euro- QoL-5 Dimensions (EQ-5D) were administered to all the patients, and their co-morbidity data were used to calculate their modified Rheumatic Disease Comorbidity Index (mRDCI). After six months' follow-up, the presence or otherwise of NeP in each individual patient was calculated, and whether or not the Boolean remission criteria were satisfied. RESULTS: The study was completed by 115 patients (76% females) whose PDQ scores indicated that 13% had probable NeP. At the end of the follow-up period, 25 patients (21.7%) met the Boolean remission criteria. Logistic regression analysis showed that baseline PDQ scores (p=0.0023) and the mRDCI (p=0.0054) were the strongest predictors of not being in Boolean remission. Only one of the 15 patients with concomitant NeP achieved Boolean remission. CONCLUSION: The presence of NeP may affect the achievement of remission in ERA patients. The PDQ can be a useful tool to measure central pain sensitisation in such patients.
30822490 The effect of periodontal treatment on patients with rheumatoid arthritis: The ESPERA rand 2019 Oct OBJECTIVES: To assess the effect of periodontal treatment on clinical and biochemical parameters of rheumatoid arthritis (RA) and quality of life (QoL) in patients with moderately active RA who were diagnosed with periodontitis. METHODS: In this open-label randomised controlled trial, RA subjects (n = 22) were allocated to "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral hygiene instructions). The main outcome was the 3-month change on the Disease Activity Score 28 based on the Erythrocyte Sedimentation Rate (DAS28-ESR). The Health Assessment Questionnaire and the General Oral Health Assessment Index were used to assess general and oral health QoL, respectively. RESULTS: Periodontal health significantly improved after periodontal treatment (P = 0.03). Periodontal treatment appeared to be safe but led to no significant effects on the DAS28-ESR (adjusted mean difference with 95% confidence interval (aMD) of -0.03 [-0.98; 0.92]). There was no evidence of improvement in the general QoL after periodontal treatment and no significant effect was found for the oral health QoL, despite a positive trend in the "psychological impacts" domain (aMD of 0.13 [-0.07; 0.33], P = 0.20). CONCLUSIONS: Although no clinical effect of periodontal treatment on RA was identified, this trial provides important data to support periodontal care in RA patients. Periodontal treatment is safe and reduces oral inflammation with a possible effect on oral health QoL. Since both periodontitis and RA are complex and multifactorial chronic diseases, it is likely that patient-centred approaches involving both oral health professionals and rheumatologists will contribute to optimal patient care. ISRCTN79186420.
30836028 Relationship of callosities of the forefoot with foot deformity, Health Assessment Questio 2020 Mar Objectives: We aimed to investigate the relationship of callosities of the forefoot with foot deformity, the Health Assessment Questionnaire Disability Index (HAQ-DI) and modified total Sharp score (TSS) in patients with rheumatoid arthritis (RA).Methods: A total of 202 patients and 404 feet were enrolled. We examined the prevalence of callosities. Clinical data included the HAQ-DI, TSS, hallux valgus angle (HVA), and calcaneal pitch angle (CPA). The analysis of factors associated with callosities of the forefoot was performed by comparing patients with and without callosities of the forefoot.Results: The prevalence of callosities was 31.2% of all patients and 24.0% of all feet. The patients with callosities of the forefoot had significantly higher TSS of the foot. The presence of callosities affected the HAQ-DI walking score. HVA and CPA were identified as being associated with callosities of the forefoot. Analyzing from the cutoff values, the odds ratios of HVA, CPA, and HVA and (combined) CPA were 4.64, 1.73, and 2.99, respectively.Conclusion: Hallux valgus and flatfoot were related to callosities of the forefoot in RA. This study suggested that to prevent callosities of the forefoot, early diagnosis and foot care for hallux valgus and flatfoot are needed in daily practice.