Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 7728405 | The effects of elemental diet and subsequent food reintroduction on rheumatoid arthritis. | 1995 Mar | The role of diet in rheumatoid arthritis (RA) remains controversial and there have been no controlled studies on the use of elemental diet in the treatment of RA. Elemental diet is an hypoallergenic protein-free artificial diet consisting of essential amino acids, glucose, trace elements and vitamins. This study was carried out to assess the role of elemental diet and subsequent food reintroduction in RA. Elemental diet (E028) (and a small number of foods) was given to 24 patients with definite RA in order to induce a remission and then foods were gradually introduced. Where a food was suspected of causing symptoms it was removed from the diet. Twenty-three control patients supplemented their usual diet with E028. After the elemental diet there was a statistically significant improvement in the diet group in grip strength (P = 0.008) and Ritchie score (P = 0.006) but not in ESR, CRP, thermographic joint score or functional score. The diet group lost more weight than the control group and this correlated with the improvement in grip strength. This improvement was not present following food reintroduction. As the improvements took place in more subjective disease parameters and because of the difficulties in adequately blinding studies of diet in arthritis, a placebo effect must be considered. There was a high default rate, only 38% of those patients originally enrolled completed the study. In conclusion, this study shows that elemental diet can cause an improvement in a number of disease parameters in RA but this is not sustained by an individualized diet. It also illustrates some of the difficulties involved in the study of diet in arthritis. | |
| 1445441 | Psychological well-being among people with recently diagnosed rheumatoid arthritis. Do sel | 1992 Nov | OBJECTIVE: Satisfaction with abilities and perceived importance of abilities are 2 factors involved in the process of self-evaluation. We examined the role that these factors play in adjustment to rheumatoid arthritis (RA). METHODS: Data were collected, via telephone interview and mailed questionnaire, from 234 individuals with recently diagnosed RA. Disease severity information was obtained from participants' physicians. RESULTS: Consistent with study hypotheses, satisfaction was associated with psychological well-being only among those who viewed as very important the abilities being evaluated. CONCLUSION: These findings increase understanding of the conditions under which low levels of satisfaction are likely to be associated with psychological distress. | |
| 8877306 | Dynamic and static physical training in patients with rheumatoid arthritis: application of | 1996 Sep | A self-appraisal and coping model was examined using a longitudinal data set involving 56 classical or definite rheumatic arthritis patients randomly assigned to either dynamic (n = 28) or static (n = 28) physiotherapeutic training. The model considers both adaptational consequences and antecedents of training (muscular endurance, pain, self-appraisal, and coping through avoidance or painful problem-solving). Measures were obtained prior to and after a 6-week training period (partly supervised and partly self-training) at a health-care centre, and after an additional 3 months of self-training only. Path analysis supported the mediating role of self-appraisal and of avoidance in influencing muscular endurance in dynamic training patients. Regression analyses likewise supported these conclusions, suggesting some patients in dynamic training to be caught in a vicious circle of avoidance and low self-appraisal. Theoretical issues are discussed, and suggestions made for developing more effective interventions in rheumatic patients. | |
| 8478873 | Minimum important difference between patients with rheumatoid arthritis: the patient's per | 1993 Mar | OBJECTIVE: To determine the point at which differences in clinical assessment scores on physical ability, pain and overall condition are sufficiently large to correspond to a subjective perception of a meaningful difference from the perspective of the patient. METHODS: Forty patients with a diagnosis of rheumatoid arthritis participated in an evening of clinical assessment and one-on-one conversations with each other regarding their arthritic condition. The assessments included tender and swollen joint counts, clinician and patient global assessments, participant assessment of pain and the Health Assessment Questionnaire (HAQ) on physical ability. After each conversation, participants rated themselves relative to their conversational partner on physical ability, pain and overall condition. These subjective comparative ratings were compared to the differences of the individual clinical assessments. RESULTS: In total there were 120 conversations. Generally participants judged themselves as less disabled than others. They rated themselves as "somewhat better" than their conversation partner when they had a (mean) 7% better score on the HAQ, 6% less pain, and 9% better global assessment. In contrast, they rated themselves as "somewhat worse" when they had a (mean) 16% worse score on the HAQ, 16% more pain, and 29% worse global assessment. CONCLUSIONS: Patients view clinically important differences in an asymmetric manner. These results can provide guidance in interpreting results and planning clinical trials. | |
| 7525956 | Rheumatoid arthritis in Tlingit Indians: clinical characterization and HLA associations. | 1994 Jul | OBJECTIVE: To characterize the features of rheumatoid arthritis (RA) in Tlingit Indians, to identify the HLA-DR alleles associated with RA in the Tlingit, and to determine whether disease severity or specific clinical manifestations correlate with the presence of specific HLA antigens. METHOD: Thirty-seven Tlingit patients with RA and 75 controls were evaluated clinically; comparative HLA studies were carried out in 33 patients and 62 controls. RESULTS: The results of this clinical study of RA in the Tlingit confirms that the disease found in them is classical RA, characterized by an early age of onset, a high frequency of nodules, serum rheumatoid factor (RF) and antinuclear antibodies (ANA); an often severe clinical course, with a high frequency of erosive disease and frequent need for surgical joint repair, and an often positive family history. In Tlingit volunteers who did not have RA we also found an increased prevalence of RF and ANA. Neither HLA-DR1 nor DR4 was found to be associated with RA in the Tlingit. The commonest DR antigen in patients with RA was DR14. The most frequent DRB1 allele was DRB1*1402 (Dw16). CONCLUSION: The Tlingit population had a very high frequency of the DRB1*1402 allele, which shares key sequence homology with DRB1*0401 (Dw4) and DRB1*0101 (Dw1), associated with RA in other racial groups. No correlations were found between specific HLA-DRB1 alleles or combinations of alleles and specific disease features or severity. | |
| 8336304 | Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis. | 1993 May | OBJECTIVES: The study goals were to (1) estimate the prevalence of depressive symptoms among a community based panel of persons with rheumatoid arthritis (RA); (2) assess differences in sociodemographic characteristics of individuals with and without depressive symptoms; and (3) assess the association of depressive symptoms with clinical characteristics, function, and health services utilization. METHODS: Depressive symptoms were assessed with the Geriatric Depression Scale. Clinical characteristics examined were number of painful joints, pain rating, and self-reported health status and worsening of RA. Measures of function were the Health Assessment Questionnaire (HAQ), bed days, presence of major physical limitation, and work status. Utilization measures were RA and non-RA related physician visits and hospitalizations. Differences in sociodemographic characteristics were assessed using t tests and chi 2 tests. The association of depression with clinical, function, and utilization variables was assessed using multiple linear and logistic regression. Cross sectional analyses of data from 4 years were performed. RESULTS: 15-17% of persons reported depressive symptoms each year; 4% in every year. Depression in one year greatly increased the probability of depression in future years. Depressed individuals were less likely to be married, and had RA of longer duration and more comorbidities; there were no significant differences in age, ethnicity, sex, or education between the groups. Depression was associated with significantly poorer clinical characteristics and function on all variables in every year. Differences in utilization were less consistent, but generally the depressed group reported significantly more RA related physician visits and hospitalizations. CONCLUSION: Depressive symptoms were consistently associated with negative health and functional outcomes, and, in most cases, with increased health services utilization. | |
| 8067337 | An investigation of gene-environment interaction in the etiology of rheumatoid arthritis. | 1994 Sep 1 | The etiology of rheumatoid arthritis is explained by both genetic and hormonal environment factors. Using a survey of twins conducted in the British Isles in 1989, the authors have investigated the extent of a possible genetic-hormonal environment interaction in conferring susceptibility for rheumatoid arthritis. This was done by comparing the hormonal history of three groups of cases and controls: 1) disease-discordant monozygotic twins, thus matching cases and controls for genetic susceptibility; 2) disease-discordant dizygotic twins; and 3) a group of twins with rheumatoid arthritis who were age matched to population controls. When the medical histories of twins with rheumatoid arthritis were compared with those of population controls, both breast feeding and infertility problems appeared to be risk factors for the disease (odds ratios = 2.01 and 4.09, respectively). Also, oral contraceptive use appeared to have a protective effect (odds ratio = 0.43). However, when both monozygotic and dizygotic twins were compared, these effects were either less apparent or nonexistent. Our results therefore suggest that there does not exist any evidence of strong interaction between genetic and hormonal environment factors. More notably, in the absence of such an interaction, the comparison of both monozygotic and dizygotic discordant twins was overmatched and therefore of low power. The extent of any overmatching was measured using the kappa statistic. | |
| 8639167 | Guidelines for the management of rheumatoid arthritis. American College of Rheumatology Ad | 1996 May | RA is a chronic progressive polyarthritis (with varying systemic features) associated with substantial disability and economic losses. Successful treatment to limit joint damage and functional loss requires early diagnosis and timely initiation of disease-modifying agents. The goal of treatment is to arrest the disease and to achieve remission. Although remission rarely occurs, patients may still benefit from pharmacologic, nonpharmacologic, and if necessary, surgical interventions. Optimal longitudinal treatment requires comprehensive coordinated care and the expertise of a number of providers. Essential components of management include 1) establishment of the diagnosis of RA (versus other forms of polyarthritis), 2) systematic and regular evaluation of disease activity, 3) patient education/rehabilitation interventions, and initial treatment with NSAIDs, 4) use of DMARDs, 5) possible use of local or low-dose oral glucocorticoids, 6) minimization of the impact on the individual's function, 7) assessment of the adequacy of the treatment program, and 8) general health maintenance. | |
| 8441160 | Validity and reliability of the timed-stands test for patients with rheumatoid arthritis a | 1993 Jan | The timed-stands test (TST) is a simple measure of lower extremity strength which correlates with age in healthy people. We validated the TST as a functional assessment tool against other measurements of functional capacity and comorbidity in 147 patients with rheumatoid arthritis (RA) or other chronic diseases. The TST was significantly impacted by RA disease activity and by comorbidity. Age affected TST only in patients without arthritis or life threatening disease. TST is a simple, reproducible measure of lower extremity function that was valid in this patient population. | |
| 7788149 | Oral steroids as bridge therapy in rheumatoid arthritis patients starting with parenteral | 1995 Apr | The efficacy of oral prednisone as bridge therapy in rheumatoid arthritis (RA) was studied. Forty patients starting aurothioglucose were randomized to receive either prednisone or placebo for 18 weeks. The dose was 10 mg/day in the first 12 weeks, 7.5 mg/day in weeks 13 and 14, 5 mg/day in weeks 15 and 16, and 2.5 mg/day in weeks 17 and 18. Patients were followed for 44 weeks. We found that disease activity was significantly lower in the prednisone group as early as week 1 and continued up to week 12. Response to prednisone was noticed in 60% of the patients. After tapering prednisone, a rebound deterioration was noticed at weeks 20 and 24 in 58% of the responders. No significant differences in X-ray progression were found between the two groups. We concluded that oral prednisone (10 mg/day) significantly reduces short-term disease activity in 60% of patients with active RA. The rebound deterioration after tapering the dose means that bridge therapy with prednisone using this dose-reduction scheme is not recommended. | |
| 7586983 | Lymphatic obstruction in rheumatoid arthritis. | 1995 Jul | We describe four patients with rheumatoid arthritis and unilateral upper limb oedema. In all cases, qualitative lymphoscintigraphy showed lymphatic obstruction in the affected limb. | |
| 8605269 | From early twinges to mastery: the process of adjustment in living with rheumatoid arthrit | 1995 Dec | OBJECTIVE: To describe the experiences of women who have learned to live with rheumatoid arthritis (RA), and to explore how women manage this chronic illness and the demands of their everyday lives. METHODS: Thirty women with a diagnosis of RA were interviewed in their homes. The women were encouraged to "tell their story of living with RA," from the first symptom to the present, using a semistructured questionnaire. Qualitative data were analyzed using a constant comparative analytic process. RESULTS: Learning to live with RA was characterized by periods of uncertainty, of learning about the illness, discovering strategies that allowed the women to meet the expectations of their roles as women, and the establishment of new patterns of daily life. The women became experts at managing their RA and developed a sense of mastery in coping with their symptoms. CONCLUSIONS: Persons with RA need support and guidance, beginning with the onset of the disease, to facilitate achieving mastery in living with this chronic illness. | |
| 8862678 | Transgenic models for arthritis: useful clues to be gained? | 1996 Aug | Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of unknown aetiology. Much of our understanding regarding the pathogenesis of this disease has been derived from studies in rodents induced to develop arthritis with injected agents. More recently with the advent of transgenic mouse technology, animal models of arthritis have been generated either by design or by serendipity, and have provided insight into the role of cytokines in particular in contributing to the pathogenesis of arthritis. This short editorial summarizes recent advances in this field and how this has increased our understanding of RA. | |
| 7918721 | Evaluation of the Jebsen hand function test for use in patients with rheumatoid arthritis | 1994 Mar | PURPOSE: We have evaluated the Jebsen [corrected] hand function (JHF) test for use in patients with rheumatoid arthritis (RA). METHODS: The JHF test was administered to 25 patients with RA. Results were compared to normative data and related to ability to perform activities of daily living (ADL), pain, and deformity. RESULTS: The JHF test detects differences between patients with RA and normals; all components except for writing show correlations with ADL and deformity. There were no significant correlations with pain. CONCLUSIONS: The JHF test is a useful adjunct to evaluation of the hand in RA. | |
| 1422664 | Single- versus dual-energy quantitative computed tomography for spinal densitometry in pat | 1992 Oct | Lumbar bone mineral density was measured by both single- and dual-energy quantitative computed tomography in 109 patients with rheumatoid arthritis. The results were corrected for the age-related increase in vertebral fat content by converting them to percentages of expected densities, using sex and energy-level specific regression equations obtained in a normal reference population. The percentages of expected density are approximately 10% lower in the single- than in the dual-energy mode, both in the patients with and without prednisone therapy. This difference is statistically highly significant, and is positively correlated with the duration of the disease and with the degree of radiological joint destruction. The data suggest that the vertebral fat content may be increased in patients with rheumatoid arthritis, as a consequence of disease-dependent mechanisms. | |
| 8318039 | Increased levels of leukemia inhibitory factor in synovial fluid from patients with rheuma | 1993 Jul | OBJECTIVE: To examine synovial fluid (SF) from patients with arthritis, for the presence of the cytokine leukemia inhibitory factor (LIF). METHODS: SF from 152 subjects was examined for LIF, using a radioreceptor competition assay. RESULTS: LIF was present at concentrations of 1-43 ng/ml in the SF of 23% of patients with rheumatoid arthritis (RA) or other inflammatory or infectious arthritides but in only 1 of 29 patients with osteoarthritis (P < 0.01). In the RA patients, the SF LIF concentration correlated significantly with the peripheral blood white blood cell count (WBC) (P < 0.05) and the SF WBC count (P < 0.01), but not with other clinical or radiologic parameters of disease activity or progression. CONCLUSION: LIF is implicated as a potential mediator of the local or systemic inflammatory response or the joint destruction seen in inflammatory arthritis. | |
| 8565258 | Neutrophilic dermatosis in association with rheumatoid arthritis. | 1995 Mar | Extra-articular involvement of the skin in patients with rheumatoid arthritis is not uncommon. A patient with this condition is reported who developed an unusual cutaneous eruption associated with systemic upset. Skin biopsy showed a dense dermal neutrophilic infiltrate and after treatment with standard immunosuppressive agents had failed he responded to dapsone. The rash recurred on withdrawal of the dapsone but has responded to sulphamethoxypyridamine. It is proposed that this condition is a rare but specific entity of unknown cause associated with rheumatoid arthritis. | |
| 8846653 | Guidelines for the use of cyclosporine in rheumatoid arthritis. | 1995 Sep | Cyclosporine has now been tested in over 10 clinical trials in Rheumatoid Arthritis. These show that it provides clinically important benefit in 30-50% of patients with severe rheumatoid arthritis with an acceptable side-effect profile. It should be offered to patients who fail to (or only partially respond to methotrexate. The use of Cyclosporine in combination with other slow acting agents shows promise and should be tested at different points in the natural history of the disease. | |
| 7983643 | Outcome in rheumatoid arthritis. A 1985 inception cohort study. | 1994 Aug | OBJECTIVE: Our purpose was to describe the clinical status and outcome of a 1985 inception cohort of patients with rheumatoid arthritis (RA), retrospectively established. METHODS: All patients with RA in Edmonton, with a possible onset of disease in 1985, and who consulted a rheumatologist at any time from January, 1985 through June, 1991 were considered for inclusion in the cohort. Patients were contacted and assessed between August, 1991 and June, 1992. The following indices were used as outcome measures: joint counts, radiological scores of hand radiographs and the modified Health Assessment Questionnaire for activities of daily living (MHAQ). RESULTS: One hundred and twenty eight patients were included in the cohort (70% were women; age at onset was 52 +/- 13 years). At the time of the assessment, 41 patients (32%) had no articular swelling. Twenty-nine patients (23%) had a radiological score of 0, and 39 (31%) had no erosions. The mean MHAQ score was 0.49 +/- 0.47; 39 patients (31%) had a score of 0 (normal function). Rheumatoid factors and nodules were related to more severe outcomes. Sex, age at onset and mode of onset were not related to prognosis. Most patients had received 2nd line therapy within the first 3 years of RA. CONCLUSION: Our results suggest that the prognosis of RA after 6-7 years of disease is not as ominous as has been suggested by others. Since most of the previous studies have been conducted in prevalent cases attending tertiary centers, a selection bias may be responsible for some of these results. Since these patients were treated early in the course of the disease, the beneficial effects of prompt 2nd line therapy cannot be excluded. | |
| 9038384 | Immunocytomorphopathological studies on the pathogenesis of rheumatoid arthritis. | 1996 Jan | Thirty cases of rheumatoid arthritis were submitted to cytomorphological, histopathological (HE, VG, PAS Alcian, Gömöri, Safranine O), histoenzymological (Acid Phosphatase, chondroitin-sulphatase, Peroxidase) and immunological (rheumatoid factor (RF)) studies; circulating immune complexes, anti-collagen antibodies II, Reactive C protein (CRP), Complementary C3 fraction were also assessed. The synoviocytogram of the rheumatoid synovial fluid (SF) indicated a cytosis with polynucleosis and ragocytosis compared to the hydroarthrosic SF defined by lymphocytosis (47.8%). Enzymologically, especially for high titres of rheumatoid factor, a phosphatase and peroxidase activity was observed in polymorphonuclear cells of a ragocytary type and in phagocytic mononuclear cells. The severe forms of rheumatoid arthritis (RA) were correlated histopathologically with chronic villous synovitis associated with some processes of obliterant vascularitis, fibrosis and sclerosis. At the level of synovio-cartilage junction, fissures and a homogenization of the cartilaginous fundamental substance in the vicinity of disintegrated synovial structures were noticed. Histoenzymologically, a lysosomal and oxidative activity was found in chondrocytes and in synovial macrophages. Immunological assessments (73 serum and 60 synovial fluid samples) showed pathological values of circulating immune complexes, anti-collagen antibodies and C reactive protein. The complementary synovial depletion of the C3 fraction underlines the immune character of the rheumatoid synovitis. The immunocytomorphologic data correlation demonstrates the involvement of immunologic and enzymatic factors in the evolution of Rheumatoid Arthritis. |