RABC

Browse

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

PMID	Title	PublicationDate	abstract
3493266	Prospective comparison of laser nephelometry with standard agglutination techniques for de	1987 Feb	IgM rheumatoid factor was assayed by three routine methods: latex fixation; haemagglutination; and end point laser nephelometry in 69 patients with definite or classical rheumatoid arthritis and 58 patients with other non-rheumatoid arthropathies, selected prospectively according to the American Rheumatism Association clinical criteria. The operators of the assays were unaware of the clinical diagnoses. In the group with rheumatoid arthritis 75.4% were positive by latex fixation, 73.9% by haemagglutination, and 55.1% by nephelometry. In the group with non-rheumatoid arthropathies 10.4% were positive by latex fixation, 8.6% by haemagglutination, and 10.4% by nephelometry. Thus the simple and inexpensive latex fixation test was as good as the haemagglutination test, and both were significantly better than nephelometry in the laboratory confirmation of the clinical diagnosis of definite or classic rheumatoid arthritis (chi 2 = 5.40 and 4.56, and p less than 0.025 and less than 0.05, respectively). None of these tests was significantly better or worse than the others in producing positive results in the group with non-rheumatoid arthropathies.
3020071	Arthropathies associated with calcium-containing crystals.	1986 Oct 15	Monosodium urate crystals are clearly related to acute attacks of gout and to the hard tissue destruction of chronic tophaceous gout. Fortunately, the acute attacks are readily treated with anti-inflammatory drugs, and destructive changes due to tophi may be prevented or reversed, at least in part, by the intelligent control of serum urate levels. Control of gout is one of the premier success stories of modern medicine. In contrast, the number of patients who have arthritis associated with crystals that contain calcium appears to be rising--perhaps a function of better recognition, perhaps related to the aging of the population. CPPD and BCP crystals can be associated with acute or subacute inflammation, but as in acute gout, it is easily controlled with anti-inflammatory drugs or by local injections of corticosteroids. A direct relationship of BCP and CPPD crystals to the associated destructive arthropathies has been hypothesized and is supported by clinical observations, animal studies, and in vivo experiments. Unlike gout, which is usually associated with a systemic metabolic abnormality (i.e., hyperuricemia), calcium crystals deposition seem to be a localized phenomenon, although numerous local sites in several joints are often involved in a given patient. Tissue degeneration in gout clearly follows (tophaceous) crystal deposition. Calcium crystal deposition may follow, rather than precede, destructive joint changes. Alternatively, both destructive changes and crystal deposition may derive independently from a common, still obscure, biochemical abnormality of joint tissues. P. A. Dieppe and colleagues believe that calcium crystal deposition follows either primary or secondary tissue degeneration but that the crystals exert a positive feedback effect (amplification loop) that accelerates degeneration. Each of those formulations of a pathogenetic role for crystals may be true in a given case, analogous to the etiology of primary and secondary forms of hyperuricemia and to sodium urate crystal deposition coexistent with osteoarthritis (tophus formation in Heberden's nodes). Conclusive proof of a significant role for BCP or CPPD crystals in the pathogenesis of human joint tissue damage depends on interrupting the postulated disease mechanism and showing that this prevents joint deterioration and leads to significant repair of existing damage. Our current position is somewhat analogous to that of our colleagues who had to contend with management of gouty arthritis before the advent of effective drugs for control of hyperuricemia.
2903546	[Sulfasalazine or salazosulfapyridine in the treatment of rheumatoid polyarthritis. An ope	1988 Jul	The SASP was studied in 46 patients with rheumatoid arthritis. The efficacy criteria which were selected (decrease of the sed rate by more than 50 p. cent during the first hour, morning stiffness under 20 minutes, Ritchie's index inferior to 10 and decreased cortisone and NSAID doses), explain that 25 p. cent of the patients are considered as satisfied after 12 months of trial. The patients selected, present severe forms of the disease or forms resistant to other treatments. The improvement appears significant after the first month. Half of the patients left the trial either because of ineffectiveness, or evolutive relapse (21.73 p. cent) or because of side-effects (28.26 p. cent). The most frequently observed disorders and intolerances are of digestive nature. No serious accident is to be deplored. Such results are in accordance with the data from the literature. The SASP must therefore be considered as the fundamental treatment of rheumatoid arthritis. The new galenic forms, dissolving in the gastro-intestinal tract, have enabled to markedly improve the digestive tolerance.
3685909	Severe rheumatoid arthritis of the temporomandibular joints and its coincidence with sever	1987	The degree of arthritis of the cervical spine was retrospectively studied in cervical spine radiographs from 400 patients with rheumatoid arthritis. In the same cervical radiographs the arthritic destruction of the temporomandibular joints was measured as diminished ramal height from the mandibular angle to the palato-occipital line. Reduced ramal height was found in 76 patients, 69 women and 7 men, and in 33 patients the reduction in height was severe enough to be compatible with a total destruction of the mandibular head. An arthritic destruction of the temporomandibular joints occurred significantly more often in patients with a severe cervical arthritis than in those without cervical affection, and vice versa. Of the 76 patients with a reduced ramal height, 66% had a severe arthritis of the cervical spine and of the 100 patients with severe arthritic changes of the cervical spine, 50% had severe destructive arthritis of the temporomandibular joints.
3500213	Joint inflammation in mice induced by a MT4+ Lyt-2- T cell clone. Characteristics and the	1987 Nov 15	Joint inflammations were induced in mice by cloned MT4+ Lyt-2- T cells specific for methylated bovine serum albumin. This was done either by intra-articular or by i.v. administration of the cloned T cells, together with local injection of the antigen. Local rechallenge with methylated bovine serum albumin several weeks after waning of the joint inflammation caused a flare-up reaction. The inflammations were quantified by a 99mTc-uptake method and examined histologically. The arthritis induced by the cloned T cells showed aspects of a delayed type hypersensitivity reaction characterized by an intense infiltrate which resembles the inflammation in the human rheumatoid joint. The data presented show that joint inflammations can be induced by T cells only and that, after waning, reexposition to the original antigen can induce a flare-up reaction. The data suggest a central role of T cells in the induction and the exacerbations observed in rheumatoid arthritis.
3423748	Hand radiography of 200 patients with rheumatoid arthritis repeated after an interval of o	1987	Hand radiography of 200 patients with rheumatoid arthritis RA was repeated after an interval of 12 months. Twenty joints including ten metacarpophalangeal joints, eight proximal interphalangeal joints and two interphalangeal joints of the thumbs were assessed. The number of joints with erosion was recorded, being referred to as Erosion Score. Additionally, each joint was graded on a zero to five point scale and the gradings of the individual joints were summed to form a score referred to as Damage Score. The progression in these scores during 12 months was recorded. The radiological joint damage was found to develop rapidly during the first years after disease onset and to assume a slow rate of increase after 9 years of the disease. The results imply that the disease duration is a critical feature for therapeutic studies. We suggest that patients with disease duration of less than 36 months only are suitable for therapeutic trials of RA and that the follow-up time should be at least 18 months if radiological assessment is used.
3355250	The arthritis sufferer and the community: a comparison of arthritis sufferers in rural and	1988 Feb	One hundred and two rural patients and 100 urban patients with rheumatoid arthritis and osteoarthrosis and 203 age and sex matched controls were visited in their homes to evaluate their problems, needs, and expectations. Although one would expect disability to affect the mobility of a person, it was found that rural patients were more mobile than their urban counterparts despite the same degree of functional disability. They were more content with their lot, even though their circumstances were less favourable. Both groups of patients had little contact with their general practitioners, social workers, or district nurses, and lacked information about their disease and the availability of financial grants or home adaptations. The main problem for the individual patient was not pain, but the frustration of being unable to do things they used to do and of dependency on others.
2960494	Etodolac versus naproxen in rheumatoid arthritis: a double-blind crossover study.	1987	Etodolac and naproxen were compared using a randomized double-blind, crossover method in 39 hospital out-patients with rheumatoid arthritis. Patients received 200 mg etodolac twice daily or 500 mg naproxen twice daily each for a 6-week period with 2-week wash-out periods at baseline and crossover. Objective and subjective clinical assessments were made before and after treatment. These included number of swollen and painful joints, pain intensity, grip strength, morning stiffness, functional class, articular index, erythrocyte sedimentation rate and global evaluations by the patient and investigator. The results of the assessments indicated that, overall, both drugs were equally effective. After 6-weeks' therapy, patients receiving etodolac showed a statistically significant improvement in their global self-evaluation and erythrocyte sedimentation rate compared to naproxen. Articular index, investigator's global evaluation, pain intensity and grip strength all showed an improvement over baseline greater than with naproxen although the improvement did not attain significance. Patient complaints and laboratory parameters were analyzed for treatment differences to evaluate tolerance. Patient complaints were similar in nature and incidence with both groups, gastro-intestinal side-effects being the most commonly reported. There were no clinically significant changes in laboratory variables during treatment with either drug.
1679571	[A comparative evaluation of parenteral and oral preparations of gold and D-penicillamine	1991	Analysis is made of the results of the treatment with parenteral (crysanol and myochrysine) and oral (ridaura) gold drugs as well as with small doses of D-penicillamine (DP) of patients suffering from rheumatoid arthritis with the signs of nephropathy. The latter ones were identified, respectively, in 18 out of 80 patients who began receiving treatment, in 17 out of 72, and in 16 out of 61 patients. The clinical, laboratory, instrumental and morphological manifestations of nephropathy are described and analysis of their dynamics under the treatment impact is provided. It is noted that these types of basic therapy produce a beneficial effect on the manifestations of rheumatoid nephropathy. That referred to a greater measure to the gold drugs than to the small doses of DP. The degree of counteracting the symptoms of renal pathology agreed well with a good clinical effect in respect to the articular syndrome and inflammatory responses of blood. Among patients receiving crysanol, iatrogenic nephropathy was recorded in 8.75% of cases, among those on ridaura, in 2.8%, and those on DP, in 8.2% of cases. The authors provide evidence for the use of gold drugs and DP in patients suffering from rheumatoid nephropathy.
3624710	Management of patients using unproven regimens for arthritis.	1987 Sep	Such treatments as vegetarian diets, fresh or raw diets, allergy diets, no-dairy-products diets, fasting, vitamin and mineral supplementation, apple cider vinegar, and honey drinks are touted in the popular press as effective for the treatment of arthritis. In contrast to conventional therapies, the unproven treatments promise not only relief from symptoms but freedom from the disease as long as the diet regimen is followed. Several of the remedies appear to be harmless, but others are dangerous, especially if followed for prolonged periods. Nutrition professionals should be aware of the nature of these treatments and be prepared to offer sound, scientifically based but nonjudgmental care and information.
2267734	[Possibilities of dialysis therapy in irreversible renal failure in rheumatoid arthritis w	1990 Nov	The authors discuss their initial experience with the treatment of secondary amyloidosis in rheumatoid arthritis with irreversible renal failure in patients included in a regular dialyzation programme. The hitherto assembled 15-month experience justifies the inclusion of patients with this cause of irreversible renal failure in a dialyzation programme. The reverse is not only wrong from the medical aspect but is inhuman and interferes with the life of families of these patients. Although the procedure during a regular dialyzation programme of these patients with rheumatoid arthritis with secondary amyloidosis is more complicated, more pretentious and more responsible, it is our medical duty to carry this burden together with the patient.
2526101	Etodolac versus diclofenac: double-blind cross-over study in rheumatoid arthritis.	1989	A 14-day double-blind clinical study was conducted on 16 patients with clinically active rheumatoid arthritis to compare the effects of etodolac (600 mg daily) and diclofenac (150 mg daily). Admission criteria were: functional impairment between Steinbrocker's classes I to III, Ritchie's index greater than 10 and erythrocyte sedimentation rate greater than 25 mm/h, and finally active involvement of the small joints of the hands. Following a wash-out period of at least two days from their previous non-steroidal anti-inflammatory drugs, trial patients received etodolac or diclofenac for five consecutive days by random allocation; after that, and after another two day wash-out period, all patients were crossed-over to the alternate drug for another five consecutive days. One day before intake and on the last day of each treatment lap, each patient was examined in regard to the circadian grip strength (of the more severely affected hand), Ritchie's index and acute phase reactants; at the end of the second treatment period, subjective drug preference was explored. Grip strength was assessed by the patients themselves with a dynamometer at 08h00 and every two hours thereafter until 20h00. The overall daily value was calculated by measuring the area under curve (AUC) depicting the grip strength profile. Both groups of patients showed significant improvement of the Ritchie's index (p less than 0.01) and grip strength AUC (p less than 0.05), while taking medication, whereas no significant variations were noted in regard to the values of the acute phase parameters both between the two treatment groups, and within each treatment group. At termination, four patients expressed preference for etodolac, eight were in favour of diclofenac, and four gave an indifferent judgement. No statistically significant differences were detected between the two treatment groups; also no adverse events were seen in this short-term study. The results confirm the effectiveness and tolerability of etodolac in the acute stage of rheumatoid arthritis.
3496450	Regulation of interleukin-2 production in rheumatoid arthritis.	1987 Apr	The regulation of interleukin-2 (IL-2) production was investigated using mononuclear cells from synovial fluid (SF) and peripheral blood of 12 patients with classical and active rheumatoid arthritis. Decreased phytohemagglutinin (PHA) stimulated IL-2 production by lymphocytes was observed in rheumatoid peripheral blood (5.3 +/- 10.9 units/ml) and SF (3.8 +/- 5.2 units/ml) compared to peripheral blood from 12 normal donors (18.1 +/- 15.4 units/ml) and SF from 5 patients with other rheumatic diseases (11.9 +/- 10.9 units/ml). Indomethacin, phorbol myristate acetate and irradiation of suppressor cells increased IL-2 values in rheumatoid SF and peripheral blood but did not restore normal IL-2 production. IL-2 production did not correlate with clinical activity in patients with RA.
2801338	The transsynovial distribution of oxaprozin.	1989 Jun	Oxaprozin (Wy-21743) is a novel and unique compound among NSAIDs: it bears an aliphatic propionic acid function as a side chain in contrast to the large group of acetic acids and profens. The transsynovial distribution was studied in 18 RA-patients, who required articular surgery. Following a wash-out period of 7 days they were treated with 2 x 600 mg of oxaprozin. The patients were assigned to four different groups representing different treatment duration (2, 3, 4 and 5 days). 12 hours after the last dose during surgery synovial fluid and synovial tissue specimen were removed. Blood samples were taken simultaneously and analysed for oxaprozin employing HPLC. In the synovial tissue samples concentrations of 27 micrograms/g were detected. The concentrations were considerably higher than blood (10-17 micrograms/ml) or synovial fluid (4.9-7.6 micrograms/ml) levels. Oxaprozin shows a different pattern of transsynovial distribution and tissue affinity as compared to other NSAIDs.
2891860	Vasculitis in the lung.	1988 Jan	Pulmonary vasculitis occurs most commonly in the collagen vascular diseases and in granulomatous pulmonary disease. In the collagen vascular group, vasculitis causes diffuse interstitial inflammation and subsequent fibrosis, resulting in interstitial radiographic patterns, especially in the lower lung fields. Vasculitis accompanied by granulomatosis typically produces focal inflammation and is, therefore, manifested as nodules and masses. The more typical collagen vascular diseases include rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and dermatomyositis. The most common vasculitis granulomatosis is Wegener's, with similar radiographic abnormalities occurring in lymphomatoid granulomatosis. Atypical examples of vasculitis pulmonary disease include ankylosing spondylitis, in which upper-lung field fibrobullous changes are seen. Periarteritis nodosa and Behcet's syndrome include abnormalities of large vessels and thromboembolic phenomena. Bronchocentric granulomatosis and allergic granulomatosis involve airway abnormalities as well as vasculitis and granuloma formation.
1717688	Clinical evaluation of a sustained release compared to a standard formulation of tiaprofen	1991 Jul	A double blind, randomized, parallel group clinical therapeutic trial, comparing a sustained release formulation with a standard preparation of tiaprofenic acid (Surgam), was performed in 119 patients with rheumatoid arthritis. The sustained release preparation was prescribed as two 300 mg capsules taken once a day, and the standard formulation as one tablet of 300 mg taken twice a day. From baseline up to the 3rd and 6th week of treatment, a statistically significant difference (p less than 0.001) was observed in both treatment groups for all the variables, indicating objective or subjective changes in the clinical signs and symptoms of the patients. For most of these variables, no significant differences were observed between the sustained release and the standard formulations. Also, no significant differences were observed between the 2 formulations in the incidence of side effects and abnormal laboratory findings.
3281603	Cyclosporin in rheumatoid arthritis: a double blind, placebo controlled study in 52 patien	1988 Feb	The efficacy and safety of cyclosporin A (CyA) for patients with rheumatoid arthritis were assessed in a four month double blind, placebo controlled study using an initial dosage of 5 mg/kg daily. Six patients withdrew from the study (two in the placebo group because of inefficacy of treatment and four in the CyA group because of side effects). These six patients were considered therapeutic failures. At the end of the trial the study treatment was considered as good or very good by 14 out of the 26 CyA group patients and by only two out of the 26 placebo group patients. Moreover, in the CyA group significant improvement was observed in five of the seven clinical assessment criteria. Clinical improvement was correlated with a decrease in C reactive protein, alpha 1 glycoprotein levels, and platelet count but not with erythrocyte sedimentation rate or rheumatoid factor titres. Renal toxicity (13 cases) remained the major problem in the management of these patients. This study shows that CyA is effective in active rheumatoid arthritis but requires close monitoring for toxicity.
1947308	Suspected acute deep vein thrombosis in patients with rheumatoid arthritis.	1991 Aug	Real-time venous ultrasound has replaced phlebography for making the diagnosis of clinically relevant lower extremity DVT. Phlebography is still useful in suspected calf vein thrombosis when an immediate diagnosis is required and in the postoperative patient. A combination of sonography and contrast phlebography is used to sort out the extent of chronic and acute venous changes in patients with chronic deep vein thrombosis.
2462347	A new look at the shared epitope hypothesis.	1988 Dec 23	The striking correlation observed between T cell recognition and the sharing of the DR-beta-1 gene sequences (position 67-74) among patients with rheumatoid arthritis studied suggests that the third hypervariable region might be an important contribution to one restriction site for the putative causative agent(s) in rheumatoid arthritis. The fact that this sequence was found in DR1, DR4,Dw14, and DR4,Dw15 beta-1 genes lends support to the hypothesis that, in some cases, human leukocyte antigen and disease association may involve the association of discrete disease-related epitopes rather than entire human leukocyte antigen genes and that these epitopes are immunologically relevant in terms of T cell recognition. The association of these polymorphisms with susceptibility to rheumatoid arthritis would then support the hypothesis that binding and presentation of "arthritogenic peptides" by major histocompatibility complex class II molecules is one of the pathogenic events in developing rheumatoid arthritis.
2155476	Effects of non-steroidal anti-inflammatory drugs and prednisolone on synovial fluid white	1990	Altogether 53 patients (31 women, 22 men) with definite rheumatoid arthritis were randomly divided into groups of 5-6 patients and treated for one day only with one of the following non-steroidal anti-inflammatory drugs (NSAIDs): acetylsalicylic acid, carprofen, diclofenac, indomethacin, naproxen, proquazone, timegadine, tolfenamic acid or paracetamol, and with prednisolone, in recommended doses. Synovial fluid samples were collected before and after the treatment. White cell count and its differentiation as well as the concentrations of protein, cyclic adenosine-3',5'-monophosphate (cAMP), prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) were measured from the synovial fluid. Synovial fluid leukocyte counts correlated with PGE2 concentrations, but showed no correlation with LTB4 levels before treatment. Significant changes were seen in the form of lowered PGE2 values following treatment with the clinically and experimentally most potent NSAIDs, and as depressed LTB4 levels following prednisolone treatment. The other markers of inflammation are obviously more resistant, changing only slowly during prolonged treatment, and may thus be, at least in part, secondary to the changes in prostanoids.