Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 34806634 | A computational method to differentiate rheumatoid arthritis patients using thermography d | 2022 | BACKGROUND: The traditional rheumatoid arthritis (RA) diagnosis is very complicated because it uses many clinical and image data. Therefore, there is a need to develop a new method for diagnosing RA using a consolidated set of blood analysis and thermography data. OBJECTIVE: The following issues related to RA are discussed: 1) Which clinical data are significant in the primary diagnosis of RA? 2) What parameters from thermograms should be used to differentiate patients with RA from the healthy? 3) Can artificial neural networks (ANN) differentiate patients with RA from the healthy? METHODS: The dataset was composed of clinical and thermal data from 65 randomly selected patients with RA and 104 healthy subjects. Firstly, the univariate logistic regression model was proposed in order to find significant predictors. Next, the feedforward neural network model was used. The dataset was divided into the training set (75% of data) and the test set (25% of data). The Broyden-Fletcher-Goldfarb-Shanno (BFGS) and non-linear logistic function to transformation nodes in the output layer were used for training. Finally, the 10 fold Cross-Validation was used to assess the predictive performance of the ANN model and to judge how it performs. RESULT: The training set consisted of the temperature of all fingers, patient age, BMI, erythrocyte sedimentation rate, C-reactive protein and White Blood Cells (10 parameters in total). High level of sensitivity and specificity was obtained at 81.25% and 100%, respectively. The accuracy was 92.86%. CONCLUSIONS: This methodology suggests that the thermography data can be considered in addition to the currently available tools for screening, diagnosis, monitoring of disease progression. | |
| 35365513 | Gut microbial dysbiosis in rheumatoid arthritis: a systematic review protocol of case-cont | 2022 Apr 1 | INTRODUCTION: Rheumatoid arthritis (RA) has a huge societal impact due to the high prevalence, irreversible joint damage and systemic complications. Gut microbiota plays an important role in the pathogenesis and progression of RA by regulating the host immune system. Restoring intestinal homeostasis by altering the microbiota could be an attractive strategy for the prevention and treatment of RA. However, the signature features of microbial dysbiosis in RA are still controversial. Therefore, we aim to elucidate the characteristic change in the diversity and composition of gut microbiota in RA. METHODS AND ANALYSIS: We will systematically search through PubMed, EMBASE, Web of Science and Cochrane Library, as well as dissertations and conference proceedings. The reference lists of all included studies will be also reviewed to retrieve additional relevant studies. The case-control studies that reported either the relative abundance of bacteria at the phylum or genus level or at least one of the alpha-diversity, beta-diversity indexes in both RA and healthy controls will be included. Eligible studies will be screened independently by two reviewers according to the inclusion criteria. The Newcastle-Ottawa Quality Assessment Scale will be used to assess the quality of the included studies. Data extraction, qualitative and quantitative analysis will be performed within the gut microbial dysbiosis in RA. The expected outcomes will be the identification of the specific changes in composition and diversity of the gut microbiota in patients with RA. The quality of evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluation framework. ETHICS AND DISSEMINATION: Ethical approval is unnecessary as this review does not address the data and privacy of patients. The results will be published in a peer-reviewed scientific journal and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42021225229. | |
| 34787064 | β-arrestin-2 alleviates rheumatoid arthritis injury by suppressing NLRP3 inflammasome act | 2022 Jan | Rheumatoid arthritis (RA) is a chronic inflammatory joint disorder that inflicts damage to the joints of the hands and wrist. The aim of this study was to investigate the protective effect of β-Arrestin-2 (βArr2) on RA in vivo and in vitro. The βArr2 adenovirus (βArr2-Ad) or the control (Con-Ad) was injected into the ankle joint cavity of collagen-induced arthritis (CIA) mice. According to the results, an improvement was shown in the symptoms and pathological injury of RA after an upregulation of βArr2. Correspondingly, the inflammatory response was attenuated, as evidenced by the decreased serum pro-inflammatory cytokines levels and NF-κB pathway-related proteins. Nucleotide-binding domain leucine-rich repeat and pyrin domain containing receptor 3 (NLRP3) inflammasome activation was inhibited in CIA mice treated with βArr2-Ad injection, as reflected by the diminished IL-18 level and declined protein levels of inflammasome components in the ankle joint. Likewise, the anti-inflammatory effect of macrophages was also validated by in vitro experiments. In summary, βArr2 effectively ameliorates ankle inflammation in CIA mice via NF-κB/NLRP3 inflammasome, providing theoretical and clinical basis for RA therapy. | |
| 34894251 | Should we reconsider the definition of elderly-onset rheumatoid arthritis in an ageing soc | 2022 Feb 28 | OBJECTIVES: The management of elderly-onset rheumatoid arthritis (EORA) is challenging due to progressive functional disability, increased comorbidities, and high drug-related risks. EORA is defined as disease onset after 60 years since 1985. We assessed whether this cut-off age was optimal in a progressively ageing society. METHODS: This study used two cohorts of consecutive rheumatoid arthritis (RA) patients: the Nippon Medical School (NMS) cohort (n = 204) and the Keio cohort (n = 296). Clinical findings independently correlated with the age of RA onset were selected as 'EORA features' from previously reported EORA characteristics using univariable and multivariable regression analyses. Receiver operating characteristic curve analysis was conducted to determine the cut-off age that best selected patients with all EORA features. RESULTS: Acute onset, negative anti-cyclic citrullinated peptide antibody, and high erythrocyte sedimentation rate were selected as 'EORA features' in both cohorts. Patients with all EORA features were more numerous with age and almost exclusively older than 65 years. The optimal EORA cut-off age was 73 years with an area under the curve (AUC) of 0.82 in the NMS cohort and 68 with an AUC of 0.93 in the Keio cohort. In the NMS cohort, Health Assessment Questionnaire-Disability Index and comorbidities in patients with disease onset between 60 years and the projected cut-off age were similar to those in younger-onset RA, but differed from those in patients with disease onset older than the projected cut-off age. CONCLUSION: The optimal EORA cut-off age was greater than the conventional definition, but this needs to be validated in different patient populations. | |
| 35279059 | Inflammatory Arthritis Post Covid-19 Infection. | 2022 Jan 20 | Presentation A 63-year-old man developed polyarthritis two months post recovery from COVID-19 infection. Diagnosis We concluded that the diagnosis was rheumatoid arthritis based upon raised inflammatory markers, positive rheumatoid factor and anti-cyclic citrullinated peptide antibodies. Treatment His symptoms improved with naproxen, corticosteroids, and methotrexate. Discussion We describe a patient with late onset rheumatoid arthritis possibly triggered or unmasked by COVID-19. | |
| 35296075 | Altered Fecal Metabolomics and Potential Biomarkers of Psoriatic Arthritis Differing From | 2022 | Psoriatic arthritis (PsA) is a chronic inflammatory joint disease, and the diagnosis is quite difficult due to the unavailability of reliable clinical markers. This study aimed to investigate the fecal metabolites in PsA by comparison with rheumatoid arthritis (RA), and to identify potential diagnostic biomarkers for PsA. The metabolic profiles of the fecal samples from 27 PsA and 29 RA patients and also 36 healthy controls (HCs) were performed on ultra-high-performance liquid chromatography coupled with hybrid triple quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS). And differentially altered metabolites were screened and assessed using multivariate analysis for exploring the potential biomarkers of PsA. The results showed that 154 fecal metabolites were significantly altered in PsA patients when compared with HCs, and 45 metabolites were different when compared with RA patients. A total of 14 common differential metabolites could be defined as candidate biomarkers. Furthermore, a support vector machines (SVM) model was performed to distinguish PsA from RA patients and HCs, and 5 fecal metabolites, namely, α/β-turmerone, glycerol 1-hexadecanoate, dihydrosphingosine, pantothenic acid and glutamine, were determined as biomarkers for PsA. Through the metabolic pathways analysis, we found that the abnormality of amino acid metabolism, bile acid metabolism and lipid metabolism might contribute to the occurrence and development of PsA. In summary, our research provided ideas for the early diagnosis and treatment of PsA by identifying fecal biomarkers and analyzing metabolic pathways. | |
| 32956154 | Frequency of Polyautoimmunity in Patients With Rheumatoid Arthritis and Systemic Lupus Ery | 2022 Jan 1 | OBJECTIVE: To describe the frequency of polyautoimmunity and multiple autoimmune syndrome in patients with rheumatoid arthritis (RA) and patients with systemic lupus erythematosus (SLE). PATIENTS AND METHODS: This was a cross-sectional observational study of patients with RA, SLE, and controls without autoimmune rheumatic disease. Cases were those with RA according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria and SLE according to the 2019 American College of Rheumatology/European League Against Rheumatism criteria, consecutively recruited in a rheumatology clinic. Controls were subjects with no rheumatic autoimmune disease (AIDs) recruited in the same area. Patients filled out a questionnaire on polyautoimmunity. Variables of interest were polyautoimmunity (RA or SLE with other AIDs), whereas secondary variables were rheumatic, skin, endocrine, digestive, and neurological AIDs. Multiple autoimmune syndrome is defined as the presence of 3 or more AIDs and a family history of AIDs. Statistical analyses performed were descriptive, bivariate, and multivariate (dependent variable: polyautoimmunity). RESULTS: The study population comprised 109 patients with RA, 105 patients with SLE, and 88 controls. Polyautoimmunity was recorded in 15 patients with RA (13.8%), 43 with SLE (41%), and 2 controls (2.2%). The most frequent AID in RA was Sjögren syndrome (53.3%), followed by Hashimoto thyroiditis and psoriasis; the most frequent AIDs in SLE were Sjögren syndrome (55.8%) and antiphospholipid syndrome (30.2%), followed by Hashimoto thyroiditis. Obesity was associated with polyautoimmunity in RA (odds ratio [OR], 3.362; p = 0.034). In SLE, joint damage (OR, 2.282; p = 0.038) and anti-RNP antibodies (OR, 5.095; p = 0.028) were risk factors for polyautoimmunity, and hydroxychloroquine was a protective factor (OR, 0.190; p = 0.004). CONCLUSIONS: Polyautoimmunity is frequent in RA and even more frequent in SLE. It was associated with obesity in RA and with joint damage and anti-RNP in SLE. Hydroxychloroquine was a protector. | |
| 34987082 | Dusty trades and associated rheumatoid arthritis in a population-based study in the coal m | 2022 May | OBJECTIVES: We previously showed increased coal mining-associated risk of rheumatoid arthritis (RA). Using additional survey data, we sought to delineate this risk further. METHODS: We used data from two cross-sectional, random-digit-dial, population-based surveys (males;≥50 years) in selected counties in the Appalachian region of the inland, mid-Atlantic USA with elevated pneumoconiosis mortality. Surveys ascertained age, smoking, coal mining and non-coal silica exposure jobs. In a subset, we surveyed ergonomic exposures, scored by intensity. We queried diagnosis of RA, corticosteroid use, and, in a subset, use of disease modifying antirheumatic drugs (DMARDs). Multivariable logistic regression modelled RA risk (defined by glucocorticoid or DMARDs use) associated with coal mining employment, other silica exposure, smoking status, and age and ergonomic exposures. RESULTS: We analysed data for 2981 survey respondents (mean age 66.6 years; 15% current, 44% ex-smokers). The prevalence of glucocorticoid-treated and DMARD-treated RA was 11% and 4%, respectively. Glucocorticoid-treated RA was associated with coal mining (OR 3.5; 95% CI 2.5 to 4.9) and non-coal mining silica exposure (OR 3.2; 95% CI 2.4 to 4.4). For DMARD-treated RA, the odds associated with coal mining and other silica remained elevated: OR 2.3 (95% CI 1.18, 4.5) and OR 2.7 (95% CI 1.51, 5.0), respectively. In the same model, the highest intensity ergonomic exposure also was associated with increased odds of RA (OR 4.3; 95% CI 1.96 to 9.6). CONCLUSIONS: We observed a strong association between coal mining and other silica-exposing dusty trades and RA. Clinicians and insurers should consider occupational histories in the aetiology of RA. | |
| 35443429 | A Study of Haematological Profile in Newly Diagnosed Rheumatoid Arthritis and its Correlat | 2022 Apr | Rheumatoid Arthritis is a chronic inflammatory disease of unknown etiology characterised by presence of symmetric involvement of multiple joints, mainly small joints that rapidly progresses to multisystem inflammation. Common haematological abnormalities observed are anemia,leucocytosis, neutropenia, thrombocytosis, thrombocytopenia, eosinophilia and haematological malignancies. This study is aimed at the various haematological parameters observed in newly diagnosed patients of rheumatoid arthritis and correlating it with disease activity measured by indices like DAS 28 CRP and HAQDI. MATERIAL: Patients more than 16 years of age and newly diagnosed cases of rheumatoid arthritis according to the ACR EULAR 2010 criteria who presented in the rheumatology opd were included in the study. A total of 20 patients fulfilling the inclusion criteria were studied.Any patient with active blood loss from any site, infection,chronic liver or kidney disease, malignancies,hematological diseases,those already on disease modifying drugs,other autoimuune diseases were excluded from the study. OBSERVATION: Out of 20 patients of rheumatoid arthritis studied,55%(11) had anemia of chronic disease and 27.5%(5) had iron deficiency anemia,3%(1) had eosinophilia. The disease activity was measured using DAS 28 CRP and HAQ DI. A negative correlation was observed between Hb level and disease activity whereas a positive correlation was observed between platelet count and disease activity. CONCLUSION: In our study it was observed that Hb is significantly lower in patients with high disease activity whereas platelet count and MPV are significantly higher with high disease activity compared to patients with low to moderate disease activity.So, from Hb level, platelet count and MPV, we can predict disease activity in RA patients which can guide us for proper and aggressive management to prevent further disease progression. | |
| 35583282 | [Cases of eosinophilia in patients treated with Tocilizumab for rheumatoid arthritis]. | 2022 May 18 | Hypereosinophilia is a haematological complication that can lead to severe organ damage. This article describes 2 patients who presented eosinophilia under treatment with tocilizumab for rheumatoid arthritis. We will describe the evolution of eosinophilia over time, with the monitoring of medication and discuss the potential link with the treatment as well as the importance of this manifestation in the context of the disease. | |
| 34001300 | Analysis of patients with rheumatoid arthritis and higher radiographic progression: associ | 2022 Mar | OBJECTIVES: To analyse rheumatoid arthritis (RA)-patients depending on their individual peak radiographic progression. METHODS: We selected for the individual peak radiographic progression (Δ Ratingen scores/time) in patients of the Swiss registry SCQM. The baseline disease characteristics were compared using standard descriptive statistics. The change of DAS 28 (disease activity sore) and HAQ-DI (Health Assessment Questionnaire Disability Index) before and after peak progression was analysed with Wilcoxon signed rank tests. RESULTS: Of the 4,033 patients in the analysis, 3,049 patients had a peak radiographic progression rate between 0 and ≤10 in the Ratingen score per year, 773 between 10 and ≤20, 150 between 20 and ≤30, and 61 of >30 (defining groups A-D). Rheumatoid factor was more frequent in patient groups with a higher peak radiographic progression (71.1%, 79.2%, 85.3%, 88.5%, groups A-D). Peak radiographic progression at a rate >20/year (groups C-D) was not detected after December 2012. When the rate of radiographic progression before and after peak progression was analysed, it was significantly lower. The DAS 28 was significantly higher in all patient groups before peak progression and lower thereafter (p<0.001). Average HAQ-DI scores increased after peak radiographic progression in group D (p=0.005) whereas it was stable or even decreased among the patients of the other patient groups. CONCLUSIONS: These data show that the highest radiographic progression rates are rare and get less frequent over the last years. Higher disease activity precedes radiographic peak progression. Only the highest individual peak (change of Ratingen score >30/year) radiographic progression was followed by an increase of HAQ-DI scores. | |
| 35057535 | Efficacy of Probiotics in Rheumatoid Arthritis and Spondyloarthritis: A Systematic Review | 2022 Jan 14 | BACKGROUND: We aimed to provide a systematic review and meta-analysis of randomized controlled trials assessing the effect of probiotics supplementation on symptoms and disease activity in patients with chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondylarthritis (SpA), or psoriatic arthritis). METHODS: A systematic literature review and meta-analysis from RA and SpA randomized controlled trials were conducted searching for articles in MEDLINE/PubMed and abstracts from recent international rheumatology meetings. The control group was a placebo or another dietary intervention. The risk of bias of the selected studies was evaluated using the Cochrane Collaboration tool and the Jadad scale. RESULTS: The initial search yielded 173 articles. Of these, 13 studies were included in the qualitative synthesis, 8 concerning a total of 344 RA patients and 2 concerning a total of 197 SpA patients. Three meta-analyses were also analyzed. Probiotic strains and quantities used were different among trials (5 studies using Lactobacillus sp., 1 trial Bacillus coagulans and the others a mix of different probiotic strains). Time to assess response ranged from 8 weeks to one year. Two studies associated probiotic supplementation with a dietary intervention. Meta-analysis showed a statistically significant decrease of C-reactive protein (CRP) concentration (mean difference (MD)) -3.04 (95% CI -4.47, -1.62) mg/L, p < 0.001; I(2) = 20%, n patients = 209) with probiotics in RA. However, after excluding high-risk-of-bias trials of meta-analysis, there was no difference between probiotics and placebo on DAS28 (standard MD -0.54; 95% CI -1.94 to 0.85, p = 0.45, I(2) 93%, n patients = 143). The two studies on SpA patients showed no efficacy of probiotics. CONCLUSIONS: Probiotic supplementation might decrease RA activity with a moderate decrease effect on CRP, but lack of evidence and studies' heterogeneity do not allow us to propose them to patients with inflammatory arthritis to control their disease. Further RCTs are required in the future to determinate the efficacy of probiotics and the optimal administration design. | |
| 35048584 | [Rheumatology: 2021 update]. | 2022 Jan 19 | In rheumatology, this year has seen an expansion of knowledge about the effects of COVID and the vaccine response in patients with autoimmune diseases, but also a re-examination of the usual doses of glucocorticoids in vasculitides and new treatments strategies for diseases such as systemic lupus erythematosus, spondylarthritis and rheumatoid arthritis. New criteria for imaging assessment in spondylarthritis and new management guidelines for patients with low back pain have also been proposed. | |
| 35236064 | [Aerobic exercise and fatigue indices in rheumatoid arthritis patients in the health resor | 2022 | Fatigue is one of the most common symptoms of rheumatoid arthritis (RA). There is strong evidence that physical activity is an effective way to reduce fatigue. OBJECTIVE: To evaluate the effectiveness of aerobic exercise (walking) to reduce fatigue in RA patients in the health resort setting. MATERIAL AND METHODS: The study involved 102 female patients with RA (age 54.38±11.3 years, body mass index 20-29 kg/m(2), DAS28-ESR ≤3.2, with severe fatigue of VAS ≥50) who received 21 days of health resort treatment. The health-improving and therapeutic complex includes dosed physical activity, aerobic exercises (walking). Visual analog scale (VAS0-100) and Bristol Rheumatoid Arthritis Fatigue Scale-Numerical Rating Scale (BRAF-NRS V2) were used to assess fatigue, and the 50-meter walking test was used to evaluate the functional status of patients. RESULTS: A correlation between walking duration and the number of steps at a distance of 50 m (p<0.001) as well as between these indices and fatigue (p<0.001) was shown. A positive effect of a standard three-week medical rehabilitation program for patients with RA on fatigue NRS severity (p=0.003) and NRS effect (p=0.037), as well as on patients' functional status (reduced time spent on the 50-meter test, p=0.01) was demonstrated. When comparing groups of RA patients with low (group 1, <5000-6000 steps per day) and optimal (group 2, ≥7000-8000 steps per day) aerobic exercise, positive results were noted in the short term (at 3 weeks) (p<0.001). CONCLUSION: Aerobic exercise is a promising intervention for treating fatigue in rheumatoid arthritis patients. Medical rehabilitation in a resort setting is the best starting point to encourage performing regular physical activity, as well as the best way to develop exercise programs tailored to rheumatoid arthritis patients. | |
| 34334358 | Risk Factors for Diagnosis of Psoriatic Arthritis, Psoriasis, Rheumatoid Arthritis, and An | 2022 Jan | OBJECTIVE: To compare potential risk factors for the diagnosis of psoriatic arthritis (PsA), psoriasis (PsO), rheumatoid arthritis (RA), and ankylosing spondylitis (AS). METHODS: Four parallel case-control studies were conducted within The Health Improvement Network using data between 1994 and 2015. Patients with PsA, PsO, RA, or AS were identified using validated code lists and matched to controls on age, sex, practice, and year. Risk factors were selected in the time prior to diagnosis. Multivariable logistic regression models were constructed for each disease using automated stepwise regression to test potential risk factors. RESULTS: Patients with incident PsA (n = 7594), PsO (n = 111,375), RA (n = 28,341), and AS (n = 3253) were identified and matched to 75,930, 1,113,345, 283,226, and 32,530 controls, respectively. Median diagnosis age was 48 (IQR 38-59), 43 (IQR 28-60), 60 (IQR 48-71), and 41 (IQR 32-54) years, respectively. In multivariable models, there were some shared and some differing risk factors across all 4 diseases: PsA was associated with obesity, pharyngitis, and skin infections; PsA and PsO were associated with obesity and moderate alcohol intake; PsA and AS were associated with uveitis; and PsA and RA were associated with preceding gout. Both RA and AS were associated with current smoking, former moderate drinking, anemia, osteoporosis, and inflammatory bowel disease. All shared former or current smoking as a risk factor; statin use was inversely associated with all 4 diseases. CONCLUSION: Shared and different risk factors for PsA, PsO, RA, and AS were identified. Statin use was inversely associated with all 4 conditions. | |
| 35475473 | Euphorbia factor L3 ameliorates rheumatoid arthritis by suppressing the inflammatory respo | 2022 Apr | Euphorbia factor L3 (EFL3) is extracted from Euphorbia lathyris and is known for its anti-inflammatory properties. This study focused on the potential anti-inflammatory and therapeutic effects of EFL3 on rheumatoid arthritis (RA) using fibroblast-like synoviocytes (FLSs) and arthritis animal models. Functional analysis showed that EFL3 could ameliorate the inflammatory phenotype of FLSs derived from RA patients, as evidenced by the decreases in cell viability, migration, invasion and cytokine production. Luciferase activity, Western blotting and immunofluorescence assays demonstrated that EFL3 inhibited the nuclear translocation of the p65 subunit and the subsequent activation of the nuclear factor kappa-Β (NF-κB) pathway. Furthermore, the therapeutic effects of EFL3 against arthritic progression were evidenced by decreases in joint swelling, arthritis scores, inflammatory factor production, synovial hyperplasia, and bone destruction in collagen-induced arthritis (CIA) and tumor necrosis factor-α (TNF-α) transgenic (TNF-tg) mouse models. Molecular analysis identified Rac family small GTPase 1 (Rac1) as the potential target that was required for EFL3-mediated suppression of the inflammatory RA FLS phenotype. In summary, this study uncovered the therapeutic potential of EFL3 in RA, which suggests its future clinical use. | |
| 33756455 | Behçet's Disease Is Associated with Multiple Sclerosis and Rheumatoid Arthritis: A Korean | 2022 | BACKGROUND: No epidemiologic study has previously reported on the associations among Behçet's disease (BD) and autoimmune disorders. OBJECTIVES: To investigate the association between BD and the autoimmune disorders multiple sclerosis and rheumatoid arthritis. METHODS: Medical records of patients newly diagnosed with BD (n = 6,214) in 2012-2017 were analyzed using data entered into a large, nationwide database from 2007 to 2017. An age- and sex-matched control population of individuals without BD was sampled at a ratio of controls:BD cases of 3:1 (n = 18,642). Both cohorts were analyzed for the presence of multiple sclerosis or rheumatoid arthritis within a minimum of 5 years prior to their BD diagnosis. RESULTS: Patients with BD had significantly higher odds ratios (ORs) for multiple sclerosis (8.85 [95% CI 2.36-33.17]) and rheumatoid arthritis (4.62 [95% CI 3.35-6.35]) than the control group after adjustment for diabetes mellitus, hypertension, and dyslipidemia. BD patients aged <40 years had a higher proportion of rheumatoid arthritis (OR 23.91, 95% CI 5.50-103.9) than older patients (OR 3.96, 95% CI 2.83-5.54). CONCLUSION: Our results suggest that BD is associated with multiple sclerosis and rheumatoid arthritis. | |
| 33181001 | Global Rural and Remote Patients With Rheumatoid Arthritis: A Systematic Review. | 2022 Apr | OBJECTIVE: Rural and remote patients with rheumatoid arthritis (RA) are at risk for inequities in health outcomes based on differences in physical environments and health care access potential compared to urban populations. The aim of this systematic review was to synthesize epidemiology, clinical outcomes, and health service use reported for global populations with RA residing in rural and remote locations. METHODS: Medline, Embase, HealthStar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library were searched from inception to June 2019 using librarian-developed search terms for RA and rural and remote populations. Peer-reviewed published manuscripts were included if they reported on epidemiologic, clinical, or health service use outcomes. RESULTS: Fifty-four articles were included for data synthesis, representing studies from all continents. In 11 studies in which there was an appropriate urban population comparator, rural and remote populations were not at increased risk for RA; 1 study reported increased prevalence, and 5 studies reported decreased prevalence in rural and remote populations. Clinical characteristics of rural and remote populations in studies with an appropriate urban comparator showed no significant differences in disease activity measures or disability, but 1 study reported worse physical function and health-related quality of life in rural and remote populations. Studies reporting on health service use provided evidence that rural and remote residence adversely impacts diagnostic time, ongoing follow-up, access to RA-care-related practitioners and services, and variation in medication access and use, with prominent heterogeneity noted between countries. CONCLUSION: RA epidemiology and clinical outcomes are not necessarily different between rural/remote and urban populations within countries. Rural and remote patients face greater barriers to care, which increases the risk for inequities in outcomes. | |
| 33818268 | Geographic variations in rheumatoid arthritis treatment in Japan: A nationwide retrospecti | 2022 Jan 5 | OBJECTIVES: To characterize the treatments for rheumatoid arthritis (RA) among institution types and prefectures in Japan. METHODS: Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan in the 2017 fiscal year, we investigated disease-modifying antirheumatic drug (DMARD) and oral corticosteroid prescription trends across 825 thousand RA patients. These data were compared between specialized and non-specialized institutions and by prefecture. RA specialized institutions (SIs) were defined as either institutions registered in the rheumatology training program at the Japan College of Rheumatology or institutions where board-certified rheumatologists were employed. RESULTS: The overall percentage of patients who never visited an SI was 31.8% and increased with age (16-29 years old = 15.6%; ≥80 years = 42.8%). In twelve prefectures (25.5%), the proportions of patients who never visited an SI were at least 10% higher than the overall average. The proportions of patients who only visited SIs and were prescribed methotrexate and biological DMARDs were ranged from 51.9-72.9% and 19.5-33.2%, respectively. However, those of patients who had never visited an SI and were prescribed those medications were 44.0-71.6% and 7.2-28.0%, respectively. CONCLUSIONS: This is the first study evaluating the trends in RA treatments by prefecture and institution specialty by using the NDB Japan. Opportunities of patients with RA for visiting SI was unevenly distributed in Japan, affecting some aspects of treatment provided. | |
| 35215510 | Fish Consumption and Risk of Rheumatoid Arthritis: Findings from the E3N Cohort Study. | 2022 Feb 18 | Fish consumption has been thought to reduce the risk of rheumatoid arthritis (RA), but the reported data are conflicting. We aimed to assess the association between fish consumption (overall, lean fish, and oily fish) and the risk of RA. The E3N Study is a French prospective cohort study including 98,995 women since 1990. Dietary data were collected via a validated food frequency questionnaire in 1993. Cox proportional hazards models were used to calculate HRs and 95% CIs for incident RA. Models were adjusted for age and for the main potential confounders including cigarette smoking. Among 62,629 women, 480 incident cases of RA were identified. In the overall population, we did not find a linear association between overall fish consumption and RA risk (p for trend 0.65), but a moderate consumption of fish was associated with a decreased risk of RA (HR 0.74; 95% CI 0.59-0.94 for tertile 2 compared with tertile 1), especially among current or former smokers (HR 0.61; 95% CI 0.44-0.85). Although not statistically significant, a trend towards an inverse association was only found with oily fish consumption (HR 0.81; 95% CI 0.65-1.02), but not with lean fish. Our results suggest that moderate fish consumption could reduce the risk or RA and potentially counterbalance the increased risk of RA induced by smoking. This inverse association might be explained by the omega-3 fatty acid content of oily fish. |