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ID PMID Title PublicationDate abstract
31094031 Lipopolysaccharides-mediated injury to chondrogenic ATDC5 cells can be relieved by Sinomen 2019 Jul Sinomenine (SIN) is an isoquinoline derived from Caulis Sinomenii that has been used to treat rheumatoid arthritis and osteoarthritis for several decades in China. This study aims to reveal the effects of SIN on mouse chondrogenic ATDC5 cells growth and inflammation. SIN was used to treat ATDC5 cells injured by lipopolysaccharides (LPS). The following parameters were determined for evaluating the treatment effects of SIN: cell viability, apoptosis, reactive oxygen species generation, and pro-inflammatory cytokines release. Besides, the expression of LPS-sensitive miRNA (miR-192) and the activation of NF-κB and MAPK signaling were studied to explain SIN's function. SIN with concentration of 30 μM significantly attenuated LPS-induced cell damage via increasing cell viability, inhibiting apoptosis and reactive oxygen species generation, and declining IL-6 and TNF-α release. miR-192 was downregulated by SIN treatment. Restoration of miR-192 expression by miRNA transfection could significantly impede SIN's protective action. Besides, the inhibitory effects of SIN on the activation of NF-κB and MAPK signaling were attenuated by miR-192 overexpression. Furthermore, GDF11 was found to be a target gene of miR-192. LPS-mediated injury to chondrogenic ATDC5 cells can be relieved by SIN via downregulating miR-192 and subsequently repressing the activation of NF-κB and MAPK signaling.
30962061 Familial, long-term pollakisuria as initial manifestation of HSP4 due to the SPAST variant 2019 Jun OBJECTIVE: Hereditary spastic paraplegia type-IV (HSP4) is the most common of the autosomal-dominant HSPs. Though urinary dysfunction is a frequent phenotypic feature, long-term pollakisuria as the initial manifestation of HSP4 has not been reported. CASE REPORT: The patient is a 56yo female with an uneventful history until age 46y, when she developed pollakisuria. After another 6y she developed a coordination disorder, recognized as difficulties with running and climbing stairs. Since 6 m prior to presentation, she recognized mild dysphagia. The further history was positive for strabismus, varicosity, hepatopathy, thiamin-deficiency, niacin-deficiency, lumbago, cutaneous borelliosis, abortive psoriasis, lumbar spondylosis, osteochondrosis L5/S1, and HLA-B27-positive rheumatoid arthritis. Clinical exam revealed mild weakness for left foot extension (M5-), a right subclonic patella tendon reflex, and mildly impaired left hook transition. Nerve conduction studies revealed subclinical polyneuropathy. Ophthalmologic investigations, and MRI of the brain and spinal cord were non-informative. Genetic work-up revealed the novel variant c.683-2A > C in the SPAST gene. The family history was positive for HSP in her mother and sister. Pure HSP4 was diagnosed. CONCLUSIONS: Pure HSP4 may manifest at onset with year-long pollakisuria exclusively. HSP4 may take a mild course over years, allowing the patient to do sports and to practice a demanding job.
30773431 Development of a highly sensitive fluorescence probe for peptidyl arginine deiminase (PAD) 2019 Apr 1 Peptidyl arginine deiminases (PADs) catalyze the post-translational deimination of arginine residues to citrulline residues. Aberrant levels of PAD activity are associated with various diseases, such as rheumatoid arthritis, Alzheimer's disease, and multiple sclerosis, so there is a need for simple and convenient high-throughput screening systems to discover PAD inhibitors as candidate therapeutic agents. Here, we report a highly sensitive off/on-type fluorescence probe for PAD activity based on the donor-excited photoinduced electron transfer (d-PeT) mechanism, utilizing the specific cycloaddition reaction between the benzil group of the probe and the ureido group of the PAD product, citrulline, under acidic conditions. We synthesized and functionally evaluated a series of probes bearing substituents on the benzil phenyl group, and found that 4MEBz-FluME could successfully detect citrulline with higher sensitivity and broader dynamic range than our previously reported fluorescence probe, FGME. Moreover, we succeeded in establishing multiple assay systems for PAD subtypes activities, including PAD2 and PAD4, with 4MeBz-FluME thanks to its high sensitivity. We expect that our fluorescence probes will become a powerful tool for discovering PAD inhibitors of several subtypes. Thus, it should be suitable for high-throughput screening of chemical libraries for inhibitors of PADs.
30713247 Optimization of Individual Pharmacotherapy Based on Multiple Evaluations of Patient Data. 2019 To date, limited drug information is available for the individual optimization of pharmacotherapy. The author attempted multiple evaluations of patient data on factors related to the pharmacokinetics, drug efficacy, and adverse reactions observed in clinical settings. Through the clinical studies, drug information on the individual optimization of pharmacotherapy needed by health professionals including physicians and pharmacists was identified. Major findings were: 1) Cachectic cancer patients had high plasma concentrations of oxycodone via the reduction of CYP3A activity. The metabolic reduction in cachectic cancer patients was potentially related to the elevated serum level of interleukin-6. 2) Dopamine receptor D(2) (DRD2) genetic mutations and being female led to poor antiemetic efficacy of the treatment of opioid-induced nausea in prochlorperazine-treated patients. The opioid receptor μ1 (OPRM1) wild genotype in addition to being female and having high plasma concentrations of prochlorperazine increased prolactin secretion during oxycodone treatment. 3) Rheumatoid arthritis patients with a genetic mutation of ATP-binding cassette subfamily B member 1 (ABCB1) had high plasma concentrations of tacrolimus and its 13-O-demethylate. The ABCB1 genetic mutation and associated high plasma concentration of tacrolimus decreased kidney function. 4) Chronic inflammation increased the plasma voriconazole concentration via its poor metabolism, whereas it did not alter the plasma itraconazole concentration. Although co-administration of prednisolone did not affect the plasma concentration of triazole antifungals, it weakly increased voriconazole metabolism. 5) In breastfeeding women, the median milk/plasma concentration ratio of amlodipine was 0.85. However, the observed relative infant dose of amlodipine in most patients was less than 10%.
30633361 Nanovaccine: A novel approach in immunization. 2019 Aug Despite great advances in the field of vaccination, there are still needs for novel and effective vaccines because still no effective vaccines have been produced for some diseases such as malaria, acquired immune deficiency syndrome (AIDS), and tuberculosis. Furthermore, many of the existing vaccines have disadvantages such as failure to stimulate completely the immune system, in vivo instability, high toxicity, the need for cold chain, and multiple administrations. Nanotechnology has been raised as a powerful tool for solving these problems in this regard. Generally, nanovaccines are a new generation of vaccines using nanoparticles (NPs) as carriers and/or adjuvants. Due to the similar scale (size) between the NPs and pathogens, the immune system can be stimulated well, resulting in triggered cellular and humoral immunity responses. Other benefits of the nanovaccines include their better stability in blood flow to increase the shelf life in blood, enhanced immune system stimulation, no need for booster doses, no need to maintain the cold chain, and ability to create active targeting. In addition, nanovaccines have raised the hope to treat diseases such as rheumatoid arthritis, AIDS, malaria, and chronic autoimmune, and so forth.
30562654 Seizures as a clinical manifestation in somatic autoimmune disorders. 2019 Jan The risk of epileptic seizures seems increased in several systemic autoimmune disorders including systemic lupus erythematosus, type 1 diabetes mellitus, myasthenia gravis, celiac disease, rheumatoid arthritis, Hashimoto's encephalopathy, psoriasis, multiple sclerosis, neuromyelitis optica, and bullous pemphigoid. Immune dysfunction may be partly responsible for this association. Elevated levels of pro-inflammatory cytokines, autoantibodies seen in these autoimmune disorders and antibodies against neuronal antigens may contribute to the etiopathogenesis of seizures and epilepsy associated to immune conditions. Other unknown factors, the effect of different co-morbid conditions of epilepsy as well as shared risk factors such as common etiological factors, environmental triggers, or a common genetic predisposition may also explain the association. We review different autoimmune disorders which may present with co-morbid seizures and discuss possible underlying mechanisms of this co-occurrence focusing on a potential role of immune system dysfunction.
30396816 The diagnostic value of clinical examinations when diagnosing carpal tunnel syndrome assis 2019 Mar BACKGROUND: Our study aims to evaluate the reliability of clinical findings in diagnosing carpal tunnel syndrome (CTS), with the help of nerve conduction studies (NCSs) and the detection of comorbidities likely to be risk factors. METHODS: 512 patients were included in the study who described pain or paresthesia in the median nerve sensory distribution. Sensory and motor NCSs were performed on the median and ulnar nerves of all patients. 49 patients who showed pathological abnormalities of the ulnar nerve were excluded. Demographic information, clinical findings and comorbidities were recorded. According to the results of the NCSs, the patients were divided and analyzed as either positive and negative for the diagnosis of CTS. RESULTS: The highest sensitivity was seen from the Durkan test (95.6%) and the lowest was from thenar atrophy (22.1%). The highest specificity and positive predictive values were seen for thenar atrophy (100%) and the lowest were from the Tinel test (40.9% and 59.1%). The highest negative predictive value was the Durkan test (94%) and thenar atrophy was the lowest (57.4%). There was a significant difference in NCSs groups for clinical findings and comorbidities. CONCLUSIONS: Thenar atrophy and sensory loss were highly specific in CTS but had limited value in early detection. Due to their low specificity, provocative tests do not appear sufficient enough to establish a definite CTS diagnosis. Only Durkan's test could possibly be considered initially as it has more balanced values. Diabetes, obesity, rheumatoid arthritis, hypothyroidism and gout significantly increase the risk of CTS.
30116953 The pivotal role of microRNA-21 in osteoclastogenesis inhibition by anthracycline glycosid 2019 Jan Osteopenic disorders such as osteoporosis and rheumatoid arthritis are characterized by excessive bone resorption by osteoclasts relative to bone formation by osteoblasts. MicroRNAs are emerging as key players in bone remodeling, modulating the functions of both osteoblasts and osteoclasts. Among them, miR-21 is highly expressed in osteoclast precursors and is known to regulate genesis, differentiation, and apoptosis of osteoclasts. The pro-osteoclastogenic nature of miR-21 makes it a potential candidate as a therapeutic target to treat bone disorders. We had previously demonstrated that anthroglycoside aloin derived from Aloe vera was effective in promoting osteoblastogenesis and inhibiting osteoclastogenesis. The present study investigated the role of miR-21 in aloin's inhibitory effect on osteoclast differentiation. Aloin effectively suppressed receptor activator of nuclear factor kappa-B (NFĸB) ligand (RankL)-induced miR-21 expression via repression of NFĸB activation. MiR-21 suppression resulted in upregulation of osteoclast suppressor programmed cell death protein 4 (PDCD4), and downregulation of osteoclast marker cathepsin K. Knockdown or gain-of-function studies revealed that miR-21 was pivotal to aloin's inhibitory effect on osteoclastogenesis. This study also highlights the dynamic potential of aloin as a therapeutic agent to treat osteopenic disorders.
30080442 Exploring the binding dynamics of etoricoxib with human hemoglobin: A spectroscopic, calor 2019 Jul Etoricoxib, widely used for the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and related conditions has ample affinity to bind with globular proteins. Here, the molecular interaction between purified human hemoglobin (HHb), a major heme protein and etoricoxib, a cyclooxygenase-2 inhibitor was studied by various spectroscopic, calorimetric, and molecular modeling techniques. The binding affected hypochromic changes in the Soret band of hemoglobin (Hb) and induced remarkable quenching of the intrinsic fluorescence property of protein molecules. Synchronous fluorescence studies revealed alterations in tryptophan (Trp) and tyrosine (Tyr) microenvironments of HHb molecule in presence of etoricoxib. Flouremetric and isothermal titration calorimetric studies suggested two binding sites in HHb for etoricoxib at three different temperatures (298.15, 303.15, and 310.15 K). Negative values of Gibbs energy change (ΔG(0)) and enthalpy change (ΔH(0)) strongly suggest that it is spontaneous and exothermic reaction, mainly stabilized by hydrogen bonding as evidenced by sucrose binding assay. These findings support our in silico molecular docking study, which specified the binding site and the non-covalent interactions involved in the association. Moreover, the interaction impacts on structural integrity and functional aspects of HHb as confirmed by decreased α helicity, increased free iron release, increased rate of co-oxidation, and decreased rate of esterase activity. Overall, these studies conclude that etoricoxib leads to a remarkable alteration in the conformational aspects of binding to HHb. Communicated by Ramaswamy H. Sarma.
30059414 Practical Guidance on Biosimilars, With a Focus on Latin America: What Do Rheumatologists 2019 Mar BACKGROUND/HISTORICAL PERSPECTIVE: Availability of biologic disease-modifying antirheumatic drugs (bDMARDs) has improved clinical outcomes in rheumatoid arthritis, but it also increased the cost of treatment. Biosimilars, the regulated copies of biologic products, have a potential to reduce health care costs and expand access to treatment. However, because of a complex development process, biosimilars can be considered only those noninnovator biologics with satisfactory supporting evidence (ranging from structural to clinical), as outlined in the recommendations by the World Health Organization (WHO). In Latin America, a heterogeneous regulatory landscape and nonconsistent approval practices for biosimilars create decision-making challenges for practicing rheumatologists. SUMMARY OF LITERATURE: Most Latin American countries either have adopted or are in the process of adopting guidelines for the approval of biosimilars. However, among several marketed bDMARDs in the region, currently there are only 2 products that could be considered true biosimilars, based on the WHO criteria. The rest can be considered only intended copies, whose safety and efficacy are not fully established. One such product had to be withdrawn from the market because of safety concerns. CONCLUSIONS AND FUTURE DIRECTIONS: Practicing rheumatologists in Latin America need to understand the regulatory situation for biosimilars in their countries. When considering bDMARDs that are not innovator products, clinicians should use only those that have been approved according to the WHO recommendations. For clarification, local health authorities or professional associations should be contacted.
31129018 Mesenchymal stem cells immunomodulation: The road to IFN-γ licensing and the path ahead. 2019 Jun Mesenchymal Stem Cells (MSCs) have gained prominence as an important tool in cell therapy, especially considering their capacity to control the immune system. Due to this property, the application of MSCs has been investigated for the treatment of several immune disorders, such as diabetes, rheumatoid arthritis, Crohn's disease, systemic lupus erythematosus, and graft-versus-host-disease (GvHD). The application of MSCs to treat inflammatory diseases has led to impressive results. However, individual response to treatment is still heterogeneous, and the number of cells required to treat humans is very high. The possibility of increasing the immunosuppressive potential of MSCs is seen at this point as a promising alternative to overcome such limitations. One of the most exploited strategies for this purpose has been the licensing of MSCs prior to clinical application. In this review, we will discuss the mechanisms by which MSCs modulate the immune response and the main advances in the licensing of these cells, with a special focus on the use of interferon gamma (IFN-γ). Also, we will address the main challenges ahead before licensed MSCs are finally used successfully in clinical practice.
32009958 Saussureae Involucratae Herba (Snow Lotus): Review of Chemical Compositions and Pharmacolo 2019 Saussureae Involucratae Herba is the dried ground part of Saussurea involucrata (Kar. et Kir.) Sch.-Bip, which is also named as "Snow lotus" and being used in traditional Uyghur and/or Chinese medicine. This rare herb can be found at 4,000 m elevation in western part of Tianshan Mountain, Xinjiang China. According to China Pharmacopoeia (2015), the major pharmaceutical values of "Snow lotus" (Xuě liánhuā in Chinese) are alleviating rheumatoid arthritis, accelerating blood circulation and mitigating other "cold" syndromes. Traditionally, the clinical application of "Snow lotus" includes the treatments in inflammation-associated disorder, blood circulation acceleration and heat and dampness elimination. Recent studies suggested that "Snow lotus" possessed therapeutic effects associating with anti-cancer, anti-oxidation, adipogenesis suppression and neuroprotection activities, which were proposed to be related with its bioactive constitutes, i.e. acacetin, hispidulin, and rutin. In the present review, we aim to summarize pharmacological effects and underlying cell signaling pathways of "Snow lotus" in treating various medical problems.
31993584 LC-MS metabolomics comparisons of cancer cell and macrophage responses to methotrexate and 2019 Dec Methotrexate (MTX) is a folate analogue antimetabolite widely used for the treatment of rheumatoid arthritis and cancer. A number of studies have shown that MTX delivered via nanoparticle carriers is more potent against cancer cells than free MTX, a phenomenon attributed to higher cellular uptake of the particles compared to the saturable folate receptor pathway. In this study, a cell-based global metabolic profiling approach was applied to study the effects of MTX in both free drug form and when encapsulated in -poly(lactide-co-glycolide) (PLGA) nanoparticles on a cancer cell line, A549, and also on human-like THP-1 macrophages. The results showed that MTX loaded nanoparticles had less impact on the macrophages than free MTX, and the effects on macrophages were limited to changes in nucleotide metabolism and suppression of the tricarboxylic acid cycle, whereas free MTX also led to a drop in glycolytic activity and impairment in redox homeostasis. In contrast, MTX loaded nanoparticles showed a greater impact on A549 cells than the free drug, which was in accord with studies in other cell lines in prior literature with MTX-carrier nanoparticles.
31863160 Micro-organisms and risk factors associated with prosthetic joint infection following prim 2020 Feb PURPOSE: To identify potential risk factors and micro-organisms associated with prosthetic joint infection following primary total knee replacement surgery. HYPOTHESIS OF STUDY: Our hypothesis is that body mass index (BMI), operative time, type of surgery, and order of surgery especially in bilateral simultaneous cases have a major impact on prosthetic joint infection (PJI). METHODOLOGY: We identified 4269 patients who underwent for primary knee replacement surgery between 2008 and 2018. We recorded patient demographics, comorbidities, order of surgery, type of surgery, causative micro-organism, and their antibiotic susceptibility. Multivariable logistic regression analysis was built to identify risk factors that are associated with prosthetic joint infection following primary total knee replacement. RESULTS: Forty-eight patients developed prosthetic joint infection. The factors that are found to be associated with prosthetic joint infection are BMI, operative time, type of surgery, order of surgery, diabetes, and rheumatoid arthritis. Methicillin-resistant Staphylococcus aureus (MRSA) was the major underlying pathogen seen in majority of cases. CONCLUSION: Despite low incidence of prosthetic joint infection following primary total knee replacement, there are patients at higher risk that would benefit by addressing modifying risk factors significantly associated with prosthetic joint infection.
31834954 Inhibition of Osteoclastogenesis by the RNA-Binding Protein QKI5: a Novel Approach to Prot 2020 Apr Increased osteoclastogenesis is a common feature of bone erosion, notably in osteoporosis but also in inflammatory diseases such as rheumatoid arthritis (RA) and osteoarticular infections. Human cytomegalovirus (HCMV) infection has been described to impair monocyte differentiation into macrophages and dendritic cells. However, its effect on monocyte-derived osteoclasts is yet to be determined. We showed here that in vitro HCMV infection is associated with an inhibition of osteoclastogenesis through decreased expression of colony stimulating factor 1 receptor (CSF-1R) and RANK in monocytes, which was mediated by an upregulation of quaking I-5 protein (QKI-5), a cellular RNA-interacting protein. We found that deliberate QKI5 overexpression in the absence of HCMV infection is able to decrease CSF-1R and RANK expression, leading to osteoclastogenesis inhibition. Finally, by using lentiviral vectors in a calvarial bone erosion mouse model, we showed that QKI5 inhibits bone degradation. This work identifies QKI5 as a strong inhibitor of bone resorption. Future research will point out whether QKI5 could be a target for bone pathologies. © 2019 American Society for Bone and Mineral Research.
31682163 Prevalence of ankylosing spondylitis in Spain: EPISER2016 Study. 2020 May Objective: The aim of this study was to estimate the prevalence of ankylosing spondylitis (AS) in Spain.Method: This is a cross-sectional, population-based study of people aged 20 years or older in Spain. Randomly selected individuals were contacted by telephone and rheumatic disease screening was performed. If the first screening was positive, medical records were then reviewed and/or a telephone questionnaire was conducted by a rheumatologist, followed by an appointment if necessary. Cases had to fulfil the modified New York (mNY) criteria.Results: In total, 4916 individuals were included, of whom 355 had a positive screening result for AS. Of these, 11 were classified as AS. An additional individual who reported a prior diagnosis of rheumatoid arthritis had a diagnosis of AS confirmed on review of the medical records. Estimated prevalence was 0.26% (95% CI 0.14-0.49).Conclusion: EPISER2016 is the first population-based study to estimate the prevalence of AS in Spain, which has been estimated as being similar to that in other European countries.
31476445 Antigen-specific tolerance to self-antigens in protein replacement therapy, gene therapy a 2019 Dec Trials of antigen-specific tolerance have been undertaken in the clinic for over fifty years and the results of these antigen-specific clinical trials are described in this review. Antigen-specific tolerization of the immune system in protein replacement therapy for hemophilia A is an accepted treatment. Clinical trials are ongoing for autoimmune conditions such as type 1 diabetes, multiple sclerosis, neuromyelitis optica, and rheumatoid arthritis with various antigen-specific strategies. Trials for tolerization in celiac disease aim for antigen specific tolerance to gluten, an environmental trigger, which may then halt the progression to autoimmunity targeting a self-antigen, tissue transglutaminase. Although many promising approaches have been demonstrated in pre-clinical models, this review will focus primarily on clinical trials of antigen-specific tolerance that have been taken to the clinic and with initial results reported in the peer reviewed literature. A separate article on approaches with CAR-T cells appears in this volume.
31359708 [Chemical components and pharmacological action of Aconiti Radix]. 2019 Jun Aconiti Radix is a commonly used traditional Chinese medicine( TCM) herb in clinic,with the effects in expelling wind and removing damness,warming menstruation and relieving pain. With a long medicinal history and high medicinal value,it was used for anemofrigid-damp arthralgia,arthralgia,cold hernia and anesthesia analgesia. Modern pharmacological studies have shown that Aconiti Radix has a good therapeutic effect on rheumatoid arthritis,neuropathic pain and hypertension. As a well-known toxic TCM herb,its main pharmacodynamic and toxic components are alkaloids,which can lead to neurotoxicity and cardiotoxicity while exerting anti-inflammatory,analgesic,anti-tumor and other pharmacodynamic effects. Therefore,it is often processed to reduce its toxicity or combined with Paeoniae Radix Alba and Stephaniae Tetrandrae Radix to achieve the purpose of reducing toxicity and increasing efficacy in clinic.In recent years,with the deepening of the study on the incompatibility of TCM represented by " eighteen incompatible herbs",there have been new findings about TCM incompatibility. It has been found complementary effect,rather than no obvious toxic and side effects after the combination with incompatible herbs of Aconiti Radix. To provide the basis for further study and clinical application of Aconiti Radix,this paper reviewed chemical components,pharmacological action,toxicity and compatibility of Aconiti Radix by consulting relevant literatures published in recent years at home and abroad. Meanwhile,this paper also described the relationship between chemical constituents,as well as anti-inflammatory,analgesic,anti-tumor and other pharmacological effects and toxicity.
31054984 Use of Leflunomide for Treatment of Cytomegalovirus Infection in Recipients of Allogeneic 2019 Sep Cytomegalovirus (CMV) reactivations are common after allogeneic stem cell transplants, and pre-emptive therapy has been found to be effective. However, in India, treatment options are limited because of high cost and toxicity of ganciclovir and unavailability of cidofovir and foscarnet. Leflunomide is a cheap and easily available anti-rheumatoid arthritis drug that has been shown to have anti-CMV properties both in vitro and in vivo. It also has been used effectively for CMV reactivation after renal transplants. In this retrospective analysis, we analyzed 70 allogeneic stem cell transplants that were conducted between April 2015 and February 2017. There were 49 episodes of CMV reactivations in 43 patients in this period. Leflunomide was used in 24 episodes. It was effective in CMV clearance in 9 of the 24 episodes (38%). When the CMV copy number was <2 × 10(3) copies/mL, leflunomide was effective in 9 of 17 (53%) episodes, but when the copy number was >2 × 10(3), leflunomide was ineffective in all of the 7 episodes. This difference was statistically significant (P= .022 by Fisher exact test), suggesting that leflunomide may be more effective in clearance of CMV when copy numbers are low.
30924367 Multistate Comparison of Cost, Trends, and Complications in Open Versus Endoscopic Carpal 2021 Jan Background: Surgical carpal tunnel release is performed by either open carpal tunnel release (OCTR) or endoscopic carpal tunnel release (ECTR). The purpose of this study was to assess differences in intraoperative and postoperative complications, trends, and costs between OCTR and ECTR. Methods: State Ambulatory Surgery and Services Databases (SASD) files for California, Florida, and New Jersey were queried for patients who underwent OCTR and ECTR between 2000 and 2014. Patient demographics, comorbidities, intraoperative and postoperative complications, and cost were compared between OCTR and ECTR. The frequency of each procedure was used to formulate trends in OCTR and ECTR. Results: A total of 571 403 patients were included in this study. Sex was significantly different by a small percentage (OCTR = 64.8% female, ECTR = 65.4% female). A higher proportion of Hispanic patients underwent ECTR (P < .001). The patients who underwent OCTR had a greater comorbidity burden in terms of diabetes and rheumatoid arthritis (P < .001). None of the aforementioned complication rates were statistically significant between the 2 procedures. Endoscopic carpal tunnel release was significantly more costly by almost $2000. Open carpal tunnel release has remained stable over the years studied, whereas ECTR increased 3-fold. Conclusions: Our findings demonstrate no significant differences between OCTR and ECTR regarding intraoperative and postoperative complications and patient outcomes. Endoscopic carpal tunnel release was found to be significantly more costly.