Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8997926 | A biopsychosocial model of disability in rheumatoid arthritis. | 1996 Oct | OBJECTIVE: To test and cross-validate a model using disease activity, pain, and helplessness to predict future psychological and physical disability in persons with rheumatoid arthritis (RA) across time. METHODS: Measures of disease activity, pain, helplessness, psychological function, and physical function were collected from 63 males with RA at baseline, 3 months, and 6 months. Path analytic methods were used to examine longitudinal relationships among these variables. RESULTS: Path analysis revealed that pain and helplessness were significant mediators of the relationship between disease activity and future disability in RA; the predictive model withstood two cross-validations. CONCLUSION: The findings suggest that pain and helplessness are key biopsychosocial variables that affect the development of disability in RA. | |
| 8686047 | [Microalbuminuria in rheumatoid arthritis]. | 1996 May 27 | To assess the prevalence of microalbuminuria in patients with rheumatoid arthritis and its correlation with disease activity and drug treatment, we studied 65 patients with rheumatoid arthritis and 51 sex and age matched control persons. Microalbuminuria was significantly increased in patients with rheumatoid arthritis (27.7%) as compared to 7.8% in the control group. Patients with microalbuminuria had a significantly greater median duration of disease (11.2 v 7.8 years; p < 0.001). We found a significant correlation to C-reactive protein as a marker for disease activity. Also, a significant association to treatment with gold and penicillamine was found. The measurement of microalbuminuria by immunochemical methods represents a simple and sensitive test to detect subclinical renal damage and may be a sensitive indicator of disease activity in patients with rheumatoid arthritis. We suggest its use in the monitoring of patients with rheumatoid arthritis to detect early subclinical renal dysfunction and drug induced renal damage. | |
| 8863759 | Cardiorespiratory responses of patients with rheumatoid arthritis during bicycle riding an | 1996 Oct | BACKGROUND AND PURPOSE: The purpose of this study was to compare exercise during dry-land bicycle ergometry and running in water with a flotation device in individuals with rheumatoid arthritis. SUBJECTS: Eight individuals with adult-onset rheumatoid arthritis, between the ages of 30 and 40 years (X = 35.88, SD = 2.85), participated. METHODS: Each subject did a graded maximal exercise test on a stationary bicycle and in the water wearing a flotation device, while oxygen uptake (VO2), heart rate (HR), pain, rating of perceived exertion (RPE), minute ventilation (VE), respiration rate, tidal volume (VT), and respiratory exchange ratio (R) were monitored. RESULTS: Higher maximum RPE and R were seen during water running, whereas higher VE and VT were seen during bicycle riding. Heart rate, R, and plateauing VO2 data indicated that a true physiological peak VO2 was reached during the bicycle test. Peak VO2 and HR were similar for either water or bicycle exercise. These findings show that with both forms of exercise, subjects were able to reach training levels as set by the American College of Sports Medicine. CONCLUSION AND DISCUSSION: The water exercise, therefore, provides a means of exercising for individuals with rheumatoid arthritis. It allows them to reach the needed training levels in a comfortable aquatic environment. | |
| 8619098 | Marine and botanical lipids as immunomodulatory and therapeutic agents in the treatment of | 1995 Aug | Fish and plant seed fatty acids have antiinflammatory and immunomodulating properties that make them of potential use in the treatment of rheumatoid arthritis. A better understanding of their effects on the immune system ultimately may lead to the development of more benign therapy for rheumatoid arthritis patients. | |
| 8003053 | The lag time between onset of symptoms and diagnosis of rheumatoid arthritis. | 1994 Jun | OBJECTIVE: Rheumatoid arthritis (RA) may be biologically reversible if treated in the first several months, yet it is unknown whether patients are diagnosed that early. We investigated the lag time between symptom onset and diagnosis of RA in a population with excellent access to rheumatology care. METHODS: Using review of medical records, we evaluated all patients newly diagnosed as having RA from 1987 through 1990, at a health maintenance organization in central Massachusetts. Total lag time from symptom onset to first definite diagnosis was divided into medical encounter lag time (from symptom onset to first medical encounter) and diagnosis lag time (from first medical encounter to diagnosis). RESULTS: The median total lag time was 36 weeks (range 4 weeks to > 10 years). The median medical encounter lag time was 4 weeks (not all patients included in the analysis). The median diagnosis lag time was 18 weeks. Diagnosis lag time was shorter for patients with progressive disease and positive rheumatoid factor on the initial test. Of 25 patients with symmetric arthritis and positive rheumatoid factor, only 5 (20%) were diagnosed within 2 months, and 10 (40%) were diagnosed more than 6 months after symptom onset. CONCLUSION: RA diagnosis is usually delayed for several months after symptoms begin, in large part because of delay in diagnosis by the physician. Thus, the goal of initiating treatment extremely early may be unrealistic for most patients. | |
| 8608356 | Prognostic value of quantitative measurement of rheumatoid factor in early rheumatoid arth | 1995 Dec | The prognostic value of quantitative measurement of rheumatoid factor (RF) by immunoturbidimetry was evaluated in 78 patients with early rheumatoid arthritis (RA) during a 3-yr follow-up. After starting disease-modifying antirheumatic treatment, a significant improvement in conventional clinical and laboratory variables measuring disease activity was observed, while a steady increase was found in radiological progression. Initial RF levels correlated with radiologically determined joint damage up to 3 yr, whereas no correlation of other initially determined conventional variables of disease activity was found. High levels of RF at entry and persistent RF positivity during the follow-up were markers for destructive disease. Initial RF positivity alone was a sensitive predictor for later joint destruction, but quantitative measurement of the initial RF level and especially repeated measurements of RF seemed to add significantly to the prognostic value of RF in distinguishing between progressive and non-progressive disease in early RA. | |
| 8173289 | Nursing care of patients with rheumatoid arthritis. | 1994 Apr 14 | Many patients referred to rheumatology departments suffer from rheumatoid arthritis (RA). RA is a chronic disease with no known cure and is characterized by remissions and exacerbations of disease activity. Nurses have an invaluable role in the care of patients with RA. | |
| 1596697 | Incidence of rheumatoid arthritis in a genetically predisposed population. | 1992 Jun | A follow-up study (mean duration five years) was undertaken on 370 previously unaffected first degree relatives from multicase rheumatoid arthritis (RA) families. The objectives were to determine the incidence of RA in this group and the possible predictors of disease development. In all, 14 individuals developed RA, equivalent to an incidence of 8/1000 person-years of observation. There was no control group included in this study as the intensive-follow-up required substantial compliance from highly motivated families. Population-based estimates, however, from a number of sources would suggest an annual incidence below 0.5/1000 per year, substantially less than the rate obtained in this study. The small number of incident cases precluded definitive conclusions about risk factors within these families but there were no important effects of age or sex. Possession of HLA-DR1 or DR4 explained only some of the increased risk. The increased incidence observed in the previously unaffected relatives of such families would suggest that this familial clustering did not for the most part arise by chance and that other shared genetic or environmental influences are relevant. | |
| 8975283 | [Diagnosis and therapy of chronic polyarthritis]. | 1996 Aug | Rheumatoid arthritis (RA) is the most frequent inflammatory joint disease, and it affects about 1% of the population. The onset of arthritis is rarely acute; it is subacute and usually progresses slowly. The clinical picture of RA is variable: mild to very aggressive and destructive courses, sometimes accompanied by organ involvement, leading to severe functional impairment and early disability can be observed. RA is diagnosed according to the ACR criteria published in 1958 and modified in 1988. The appearance of a palpable joint swelling or effusion is obligatory for the clinical diagnosis of arthritis. In RA, typically involvement of the joint of the hands and feet can be seen. Laboratory parameters play an important role as both diagnostic and prognostic tools. Besides clinical features and laboratory parameters, imaging techniques provide another cornerstone in the diagnosis of RA. Until now plain X-rays, which primarily visualize osseous changes, are the most important technique in daily practice, whereas magnetic resonance imaging and ultrasound may provide information about soft tissue changes in an earlier stage of disease. The main differential diagnoses of RA to be considered are the seronegative spondylarthropathies (psoriatic arthritis, arthritides accompanying inflammatory bowel diseases, Reiter's syndrome, and spondylitis ankylosans with peripheral arthritis), Parvovirus-induced arthritis, crystal-induced arthritides and septic arthritis. Early diagnosis and therapeutic intervention seem to be of great prognostic importance. In several independently performed investigations a higher mortality was found in RA patients than in the normal population. Drug therapy of RA consists of nonsteroidal antirheumatic drugs (NSAIDs), corticosteroids and disease-modifying drugs (DMARDs). When the functional and radiological parameters were assessed, the DMARDs were found to have a disease modifying and in rare cases a remission-inducing property. Moreover, tolerance these to drugs is limited. Newer therapeutic trials have employed substances like Tenidap, Leflunomid, bacterial extracts, antibiotics and biological subcomes (e.g., monoclonal antibodies against cytokines, fusion proteins for soluble cytokinereceptors). Some promising results of these investigations need confirmation in larger patient populations, but some new perspectives for a more efficacious treatment of RA can be expected. | |
| 1379430 | Immunopathology of rheumatoid arthritis. Antikeratin antibodies precede the clinical disea | 1992 Aug | OBJECTIVE: We sought to determine whether circulating antikeratin antibodies (AKA) precede the onset of rheumatoid arthritis (RA). METHODS: By matching the registers of 2 previous population studies with the registry of patients receiving antirheumatic drugs several years later, pre-illness serum specimens could be obtained from 39 individuals who subsequently developed RA. AKA were assayed with the standard indirect immunofluorescence technique. RESULTS: Ten of 39 serum specimens from individuals who subsequently developed seropositive RA, and 1 of 15 sera from individuals who developed seronegative RA, were positive for IgG-class AKA by immunofluorescence assay. The AKA-positive sera were also positive for rheumatoid factors. CONCLUSION: The findings focus attention on the role of pre-illness immunologic events in the pathogenesis of RA. | |
| 8484095 | Serological profile of rheumatoid arthritis in west Africa. | 1993 | Rheumatoid arthritis (RA) in West Africa is atypical in a number of respects. In order to investigate this we evaluated the serological profile of a series of West African patients diagnosed as having RA. We found the presence of a wide range of autoantibodies including antinuclear antibodies (ANA), anticardiolipin antibodies and antineutrophil cytoplasmic antibodies but the pattern of these autoantibodies was similar to that reported in other studies. Our serological studies support the hypothesis that these patients do have RA and the presence of these autoantibodies is of interest with regards to implications for diagnosis. | |
| 8371205 | Low prevalence of rheumatoid arthritis in the urbanized Chinese of Hong Kong. | 1993 Jul | OBJECTIVE: To establish the prevalence of rheumatoid arthritis (RA) in the urbanized Chinese of Hong Kong. METHODS: 2000 adults in 2 housing blocks were screened using a structured interview. Those who screened positive had an examination, rheumatoid factor analysis and radiographs taken. Subjects were classified using the Rome, New York and 1987 ACR criteria (modified and unmodified) for RA. RESULTS: The prevalence of RA, using the modified 1987 ACR criteria, was 0.35%. This is significantly lower than published data for European Caucasians (standardized morbidity ratio = 0.27; 95% CI 0.09-0.63). CONCLUSION: RA is rare in urbanized Chinese. | |
| 1629826 | Polymyalgia rheumatica and seronegative rheumatoid arthritis may be the same entity. | 1992 Feb | Of 159 patients with either polymyalgia rheumatica, seronegative rheumatoid arthritis (RA) or an undifferentiated syndrome with features of both who were followed for at least 30 months, synovitis recurred in 57. Twenty of the 57 patients had one episode of polymyalgia and another that looked like RA. Recurrences responded to prednisone and no joint destruction was seen. Temporal arteritis was seen with both diagnoses. These observations suggest that a benign symmetric synovitis occurs in older patients and may present as polymyalgia or as a polyarthritis that resembles RA. | |
| 8121849 | Rheumatoid arthritis. Complications beyond the joints. | 1994 Mar | In addition to affecting the joints, rheumatoid arthritis may wreak havoc on a number of organs in the body, including the heart, lungs, and eyes. Results of long-term studies suggest that morbidity and mortality increase in patients with rheumatoid arthritis. It is hoped that the new approach to pharmacologic treatment that uses aggressive medications shortly after onset of symptoms will alter the disease course, diminish morbidity, and eliminate the excess mortality seen in patients with long-standing rheumatoid arthritis. | |
| 7481659 | [Assessment of disease course in chronic rheumatoid arthritis: new quantitative dimensions | 1995 Oct 21 | Longterm follow-up of patients with rheumatoid arthritis requires systematic measurement of all relevant disease dimensions. The disease process can be measured reliably with the disease activity score (DAS) which integrates the erythrocyte sedimentation rate and the number of swollen and the number of tender joints out of 28 defined joints. Cumulatively the disease process may result in joint damage which can be measured with a radiological score averaging the level of destruction of 10 key joints. Synovitis and/or joint damage lead to reduced joint mobility and muscle strength which may be quantified using a muscle strength index (MSI) which integrates the information of isometric muscle strength of knee and elbow extension and flexion. The most important outcome dimensions are symptoms and physical functional disability, which can be measured comprehensively with a symptom-oriented rheumatoid arthritis disease activity index (RADAI) and the health assessment questionnaire (HAQ). Reduction of a wide range of information to a few valid indices representing all relevant disease dimensions allows interpretable but comprehensive evaluation of the disease course. | |
| 10127760 | Rheumatology. | 1993 Jul | Arthritis disables more people than all other diseases and injuries put together. Given the high cost of some of the techniques used for rheumatoid arthritis, the long-term nature of the disease and the growth in demand, it is increasingly important to pose and answer questions of cost effectiveness and priority-important to clinician and manager alike. | |
| 8493588 | [Development of multiple subcutaneous nodules in a patient with rheumatoid arthritis durin | 1993 Feb | A 59-year-old woman with a 14 years' history of seropositive nodular rheumatoid arthritis (RA) who developed multiple subcutaneous nodules during methotrexate therapy was reported. Weekly pulse methotrexate therapy (5-7.5 mg) was initiated in June, 1990 for exacerbation of RA. By January 1991 (total dose of methotrexate: ca 240-310 mg), marked clinical and laboratory improvements were observed. However, subcutaneous which were present prior to methotrexate administration, increased in number and size. The excised nodules showed typical histological features of rheumatoid nodules. The subcutaneous were also characterized by their presence in atypical locations such as the extensor surfaces of finger joints and toes. Recent reports which describe development of subcutaneous nodules and vasculitic lesions in RA patients following methotrexate therapy indicate different pathogenetic mechanisms might be involved in articular disease and nodular lesions. | |
| 7794980 | Dissatisfaction, disability, and rheumatoid arthritis. | 1995 Mar | OBJECTIVES: To investigate dissatisfaction with function in patients with rheumatoid arthritis (RA), and to see if dissatisfaction can be adequately explained by level of function. METHODS: Fifty patients with RA were assessed for disease activity, psychological status, disability, expectation of future disability, and satisfaction with both global function and individual activities of daily living (ADL). RESULTS: Fifty percent of patients expressed dissatisfaction with global function, which correlated more strongly with pain (r = 0.474) and psychological status than with function (r = 0.398). Only 10% predicted improvement in global function. Seventy-two percent expressed dissatisfaction with performing at least one ADL. CONCLUSIONS: Patient dissatisfaction with both global function and individual ADL function is high and cannot adequately be explained by disability alone. Correlation with pain and psychological status implies that modifying these variables (perhaps through education programs about pain relief or relaxation) could reduce dissatisfaction. | |
| 7626571 | Inflammation after cataract extraction and intraocular lens implantation in patients with | 1995 Jun | AIMS: The purpose of this study was to examine whether preoperative activity of rheumatoid arthritis influences the extent of anterior chamber inflammation after cataract extraction and intraocular lens implantation. METHODS: The medical records of 23 consecutive patients (33 eyes) with rheumatoid arthritis, who underwent cataract extraction with intraocular lens implantation, were reviewed during a 4 year period from April 1990 to March 1994. RESULTS: Eleven patients who still showed a 1+ level of aqueous cells 1 month after the surgery had significantly higher titres of rheumatoid factor preoperatively, compared with the other 12 patients who showed no aqueous cells (p = 0.0019, Mann-Whitney U test). The persistence of aqueous cells also had a significant correlation with extracapsular cataract extraction compared with phacoemulsification (p = 0.0391, chi 2 test). Multivariate analysis showed that the titre of rheumatoid factor was the more significant element to determine the persistent aqueous inflammation. All the eyes, except for four which had a macular hole, optic disc atrophy, or retinitis pigmentosa gained visual acuity of 20/30 or better. The aqueous cells cleared 3 months after the surgery and left no complications in any of the eyes. CONCLUSION: Intraocular lens implantation is basically a safe procedure for patients with rheumatoid arthritis, although postoperative aqueous inflammation tends to be persistent in patients with high titres of rheumatoid factor. | |
| 8448608 | Autoantibody to the nuclear antigen RA33: a marker for early rheumatoid arthritis. | 1993 Mar | Sera from 47 patients with early (< 3 months) arthritis of any type were investigated for anti-RA33, a new anti-nuclear autoantibody characteristic of RA, and the diagnoses determined within the following 8-14 months. In addition, seven patients with unclassified arthritis of > 4 months duration, who were all anti-RA33 positive, were followed for up to 2 years to establish their final rheumatologic diagnoses. Four of 47 early arthritis patients' sera were anti-RA33 positive at the initial evaluation; 14 of these 47 patients (30%) could be classified as RA (according to established criteria) at the final evaluation. All four anti-RA33 positive patients belonged to the RA group (27% of RA patients); of the 33 non-RA patients none had anti-RA33 (P = 0.005). Rheumatoid factor was found in four RA (none of whom had anti-RA33), but also in two non-RA patients (P = 0.05). Finally, the study involved seven additional patients with longer standing, initially unclassified, anti-RA33 positive arthritis: in all of them a diagnosis of RA could be established within 3 years of disease onset. These results suggest that anti-RA33 helps to discriminate early RA from other forms of early arthritis and, in the absence of an established diagnoses, it is predictive of RA. Its discriminative capacity appears to be better than and complementary to that of RF. |