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

ID PMID Title PublicationDate abstract
3242581 Variability in response to nonsteroidal anti-inflammatory analgesics: evidence from contro 1988 Dec 1. A clinical trial was conducted with flurbiprofen 100 mg three times a day by mouth in rheumatoid arthritis to determine variability in response. 2. Forty patients entered the study, but only 32 completed it. Patients were treated with flurbiprofen on two occasions at a month's interval, each being preceded by a 3 day wash out period. Pain relief and a Ritchie articular index of joint tenderness was assessed at the beginning and end of each treatment period. 3. Flurbiprofen produced significant improvement in both pain relief and articular tenderness. No significant differences were observed between the two trial periods in the mean of these outcome measures. 4. No evidence was found to support the concept of responders and non-responders.
2084236 Adverse experience with methotrexate during 176 weeks of a longterm prospective trial in p 1990 Dec Adverse experience occurred with a high frequency in a longterm (greater than 3 years), prospective, double blind, followed by an open trial of methotrexate (MTX) therapy in 45 patients with rheumatoid arthritis (RA). Adverse experiences occurred in 96% of patients, and the discontinuation rate was 44% over 176 weeks. No hepatic or pulmonary fibrosis occurred. Unusual toxicities included weight loss (2 patients), systemic fungal infections (2 patients), and transient noncirrhotic ascites (1 patient). Baseline white blood cell counts and creatinine may help predict adverse experiences. The full dose-toxicity spectrum of MTX RA is not yet fully defined.
3261967 Serum alpha 1 antichymotrypsin concentration as a marker of disease activity in rheumatoid 1988 Aug Serum alpha 1 antichymotrypsin (alpha 1ACT), C reactive protein (CRP), orosomucoid, and erythrocyte sedimentation rate (ESR) were measured sequentially in 20 patients with rheumatoid arthritis (RA) treated with gold or penicillamine. Pain score, morning stiffness, grip strength, and articular index were measured and a Mallya score calculated. Based on a total of 148 sets of observations, significant correlations were found between alpha 1ACT and other variables (p less than 0.001 except morning stiffness at p less than 0.05). The actual correlation coefficients indicated a closer association with the other laboratory tests, CRP (0.62), orosomucoid (0.69), and ESR (0.61), than with clinical measurements: pain score (0.38), articular index (0.41), grip strength (-0.3), morning stiffness (0.19), and Mallya score (0.5). Sequential data on individual patients showed differing patterns of change in the variables indicating the importance of measuring more than one acute phase protein (APP), especially when CRP is inappropriately low. Serum alpha 1ACT concentration does reflect disease activity in RA. Its potential advantages are discussed.
2947767 Decreased T-cell-mediated suppression of IgM--rheumatoid factor synthesis in rheumatoid ar 1987 Jan Circulating B-cell precursors specific for rheumatoid factor (RF) are present in normal subjects but spontaneous in vitro synthesis of RF occurs only in rheumatoid arthritis (RA). The regulatory role of RF-specific suppressor T cells in this process was studied in pokeweed mitogen-stimulated in vitro cultures of peripheral blood mononuclear cells. Addition of graded numbers of suppressor T8(+) cells from RA patients to normal B cells resulted in consistently less suppression of IgM and RF synthesis than that achieved by normal suppressor T cells. A preculture system was then used to probe for RF-specific suppressor precursor lymphocytes. RA T-cell populations failed to generate normal levels of RF-specific suppression during in vitro culture for 4 days. Incubation with human-aggregated IgG (HaIgG) resulted in an increase in RF-specific suppression to normal levels. The data indicate that induction and full expression of RF-specific suppressor T-cell function is blocked in vivo in RA but can be overcome in vitro by incubation with HaIgG.
3518030 Fibronectin in plasma and synovial fluid of patients with rheumatic diseases. 1986 Jan Fibronectin is a high molecular weight glycoprotein from plasma and other body fluids, connective tissue matrix and basement membranes. No significant differences in the mean values of plasma fibronectin were found in patients with rheumatic diseases compared to control subjects. The fibronectin in synovial fluids in these patients presented higher levels than in plasma. No other protein from the synovial fluid presented such a peculiar behaviour. The synovial fluid fibronectin/plasma fibronectin ratio is 2.49 in patients with rheumatoid arthritis, 1.56 in those with inflammatory nonrheumatoid arthritides and 1.60 in those with osteoarthritis. Statistically significant higher values of synovial fibronectin were found in patients with rheumatoid arthritis compared to those with osteoarthritis. No significant statistical correlations were found between the synovial fibronectin concentrations and the other clinical or biological parameters of the rheumatoid arthritis patients, but for synovial fluid C3. Immunohistochemical localization of fibronectin in the rheumatoid synovium showed more intense and extended specific deposits than in the control patients. These results suggest a local synthesis of fibronectin related to the chronic inflammatory process.
2745481 Osteotomy of the tibial tubercle during total knee replacement. A report of twenty-six cas 1989 Jul The cases of twenty-four patients who had twenty-six osteotomies of the tibial tubercle in conjunction with total knee replacement were analyzed with regard to complications and technical considerations. The patients were followed for a minimum of two years (average, three years and six months). Major complications related to the surgical technique occurred in 23 per cent of the knees and complications not related to the technique, in an additional 8 per cent. Rheumatoid arthritis and a history of at least one previous operation about the knee were predisposing factors for these complications.
2084857 [The use of thermography in the assessment of the rheumatoid knee--the thermographic index 1990 Oct The thermographic index (TI) and the heat distribution index (HDI) have been reported to be useful in association with the assessment of disease activity in rheumatoid arthritis. We have examined the appropriate conditions on measuring both indices. It was shown that TI and HDI should be measured at 20 degrees C and at a 20-minute equilibration time. Furthermore, a comparative evaluation of TI and HDI was made. The results showed that the HDI was more sensitive and correlated better with the clinical assessment of the severity of joint swelling than TI.
2260999 Pregnancy and the risk of developing rheumatoid arthritis. 1990 Dec There have been conflicting reports on, and no plausible biologic explanation for, a protective effect of oral contraceptive (OC) use on the development of rheumatoid arthritis (RA). Therefore, we investigated aspects of behavior related to OC use that could explain the preventive effect of OC on the onset of RA. In the present case-control study, past pregnancy, age at first pregnancy, and pregnancies with adverse outcome were studied as possible risk factors for RA. Interview information on reproductive variables was obtained from 135 young adult women with confirmed definite or classic RA of recent onset, and from 378 control patients with soft tissue rheumatic disorders or osteoarthritis. All patients had at least 2 years of followup to confirm the consistency of the diagnosis. We found a decreased risk of RA in women who had been pregnant. The risk of RA in women who had ever been pregnant compared with women who had never been pregnant was 0.49 (95% confidence interval 0.27-0.91). The earlier the first pregnancy, the lower the risk of RA. Pregnancy with adverse outcome (i.e., gestation less than 25 weeks) did not substantially change the risk of RA (relative risk 0.73, 95% confidence interval 0.50-1.07). The protective effect of pregnancy was independent of OC use, the presence of HLA-DR4, or a family history of RA. Immune modulation by female hormonal influences could be an explanation for the results of the present study.
2794705 Radio-lunate arthrodesis. 1989 Aug Radio-lunate arthrodesis has been carried out in 15 rheumatoid patients whose radiographs showed localised arthritis around the radio-lunate joint. Six patients had insertion of a Stanley-Shelley plate. The results were assessed from 1 to 3 1/2 years after operation and were excellent in nine wrists, good in three, fair in one and poor in three wrists. Continued carpal degeneration in 12 wrists suggests that long-term follow-up is required before this procedure can be generally recommended.
3828663 Measurement of proximal interphalangeal joint circumference in rheumatoid arthritis: one j 1987 Apr Serial measurements of proximal interphalangeal joint circumference using a single joint that was selected as being 'worst' on clinical grounds or the largest joint at baseline were compared with the mean of all 10 joints in patients with active rheumatoid arthritis receiving second-line drugs. Use of the worst joint gave comparable results to the mean of 10 joint measurements, while the largest joint showed earlier and greater improvement than occurred with the mean of 10 joint sizes. Measurement of a single joint saves time without loss of accuracy or sensitivity.
3457354 The use of contemporary MMPI norms in the study of chronic pain patients. 1986 Feb In a previous study, Ahles et al. [1] compared the MMPI results of primary fibromyalgia, rheumatoid arthritis and non-pain control participants. The purpose of the present study was to reanalyze the original data using the contemporary norms of Colligan et al. [5]. The reanalysis revealed that the pattern of group differences remained the same; however, the number of primary fibromyalgia patients classified as 'psychologically disturbed' was appreciably reduced. These data have clinical relevance in that the incidence of psychopathology in chronic pain patients may be overestimated because of the use of outdated norms. Additionally the data have theoretical relevance in that a large number of patients who present with pain in the absence of a known organic pathology do not present evidence of psychopathology.
2661577 Boutonniere deformities in rheumatoid arthritis. 1989 May The emphasis in rheumatoid hand surgery has been on the MP joints, but the PIP joints are often involved with the boutonniere deformity being one common pattern. The pathology of the boutonniere begins with a synovitis of the joint, followed by elongation al the central slip, subluxation of the later bands, and contracture of the retinacular ligaments. Treatment in the early stages can include synovectomy and tendon reconstruction. In the later stages, when the joint is fixed or there is articular surface damage, a joint replacement or arthrodesis is necessary.
2198977 Intramuscular depot methylprednisolone induction of chrysotherapy in rheumatoid arthritis: 1990 Aug Fifty-nine patients commencing intramuscular sodium aurothiomalate therapy were randomized to receive three doses of 120 mg intramuscular depot methylprednisolone acetate or matching placebo at weeks 0, 4, and 8 in addition to chrysotherapy. The group receiving methylprednisolone had more rapid disease improvement. This advantage persisted for up to 12 weeks, although by 24 weeks both groups exhibited similar benefits due to continued improvement in the group treated with gold alone. Withdrawals secondary to gold-induced side-effects occurred later in the steroid group (median time to withdrawal: 15 weeks steroid; 4.5 weeks placebo, P less than 0.05), and there were fewer withdrawals due to a lack of effect in the steroid group (one steroid versus three placebo, P NS). We conclude that glucocorticoids given as intermittent, intramuscular depot injections have a significant short term benefit which can be maintained by concomitant administration of intramuscular gold.
3595703 Concentration of azapropazone in synovial tissues and fluid. 1987 The concentration-time curves of azapropazone in synovial fluid and tissues have been studied in arthritic patients after an i.v. bolus (600 mg) and under steady-state conditions. Synovial fluid and tissue samples were taken intraoperatively 0.45-60 h after administration. The azapropazone concentrations in synovial fluid, synovial tissue and plasma were correlated. The levels in synovial fluid were usually lower than corresponding plasma levels. Under steady-state conditions azapropazone did not accumulate in synovial tissues.
1805325 [Activity of natural killer cells of peripheral blood in patients with rheumatoid arthriti 1991 Oct The authors studied the activity of peripheral blood natural killer cells in 25 patients with rheumatoid arthritis by 51 Cr release assays with K-568 target cells. Data on the comparative clinico-immunological analysis by the cytotoxicity index are submitted. There is a relation between the nature of rheumatoid arthritis course and the presence of systemic manifestations such as nodules, polyneuropathy, proteinuria, carditis, levels of the rheumatoid factor, anti-DNA, CRP, cryoglobulinemia and changed activity of peripheral blood natural killer cells. Patients with rheumatoid arthritis having a combination of marked changes of humoral immunity with changed cytotoxicity of the peripheral blood natural killer cells activity can be referred to the group of risk.
2333470 Cellular fibronectin in rheumatoid synovium and synovial fluid: a possible factor contribu 1990 Apr Mouse monoclonal antibodies against ED sequence-containing cellular fibronectin (cFn) were used to show that Fn in the inflamed synovium is distinct from the major form of plasma Fn (pFn). An accumulation of cFn was seen at sites of hyperplasia of the rheumatoid synovial membrane and in the walls of small vessels in the synovium by immunofluorescence microscopy. cFn was also found in rheumatoid synovial fluid by immunoblotting. Approximately one-fifth of the T lymphocytes from rheumatoid synovial fluid bound to Fn. The binding of synovial fluid T cells was always higher than that from peripheral blood. These results have two implications. On the one hand, the cellular type of Fn may be an indicator of synovial inflammation. On the other hand, the deposition of Fn may be a factor contributing to the infiltration of mononuclear cells into the synovium.
2359956 [Renal involvement in rheumatoid polyarthritis]. 1990 Apr 25 Urinary disorders were investigated in 162 patients with specific or standard rheumatoid disease, over a period of 5 years. 43 patients presented disturbances of the urinary laboratory tests, or 26.5 p. cent and 17 of them underwent a renal needle-biopsy. The findings were as follows: 11 isolated proteinurias, iatrogenic and reversible when the treatment in question was discontinued (gold salts, D-penicillamine), 13 microscopic hematurias, 3 isolated leucocyturias, 3 combinations hematuria-leucocyturia, 3 combinations hematuria-leucocyturia-proteinuria, 6 nephrotic syndromes including 5 of iatrogenic origin, 4 isolated renal failures. The most interesting discussion concerns microscopic hematurias. Besides the standard lesions of extra-membranous glomerulonephritis, amyloidosis and interstitial nephritis, 50 p. cent of the renal histologic examinations corresponded to lesions of mesangial glomerulonephritis. This lesion seems unrelated to long-term treatments and could be encouraged by the chronic inflammatory condition of the rheumatoid disease.
1991215 Septic arthritis as a non-surgical complication in rheumatoid arthritis: relation to disea 1991 Feb More aggressive therapy including cytotoxic drugs is increasingly used in the treatment of rheumatoid arthritis (RA), and may confer increased susceptibility to infections. Septic arthritis is one infectious complication known to be overrepresented in RA. We studied the impact of disease severity and medication in a group of nine RA patients with proven septic arthritis, excluding those occurring as a complication of orthopaedic surgery. Two control groups were used for comparison. The septic arthritis patients were functionally more incapacitated and more often treated with cytotoxic drugs. Six of the nine septic arthritis patients had received an intra-articular injection into the infected joint within 3 months prior to the onset of the septic arthritis. Only one of these occurred immediately after arthrocentesis. The annual frequency of septic arthritis was approximately 0.2%. During the 4-year period studied the frequency was 0.5%. When related to the number of glucocorticosteroid injections, a frequency of 1 per 2000 injections was found when late septic arthritis was included. The high frequency of delayed septic arthritis after intra-articular glucocorticosteroid administration should alert physicians to this complication.
3365534 Coexistence of rheumatoid arthritis, ankylosing spondylitis and dermatomyositis in a patie 1988 Apr A patient is described who had insulin-dependent diabetes mellitus for 2 years, prior to developing rheumatoid arthritis and then subsequently ankylosing spondylitis and dermatomyositis. Diagnostic criteria for all diseases are fulfilled. HLA typing revealed the presence of HLA A2, A9, B8, B27, DR3 and DR4 antigens. The concomitant coexistence of diabetes mellitus, rheumatoid arthritis, ankylosing spondylitis and dermatomyositis appears to have occurred in an individual genetically susceptible to these diseases.
3798047 Bradycardia after high-dose intravenous methylprednisolone therapy. 1986 In 5 consecutive patients with rheumatoid arthritis who received intravenous high-dose methylprednisolone (MP) therapy (1 g daily for 2 or 3 consecutive days), a decline in pulse rate was observed, most pronounced on day 4. In one of the 5 patients the bradycardia was associated with complaints of substernal pressure. Reversal to normal heart rate was found on day 7. Electrocardiographic registrations showed sinus bradycardia in all cases. No significant changes in plasma concentrations of electrolytes were found. Careful observation of patients receiving high-dose MP is recommended. High-dose MP may be contraindicated in patients with known heart disease.