Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1588735 | [Imaging modalities of rheumatoid arthritis]. | 1992 Mar | Modern diagnostic techniques for rheumatoid arthritis include x-ray examination, arthro- or myelography, CT scan, scintigraphy, thermography, ultrasonography, and MRI. X-ray is the simplest and most common method for assessing the degree of joint destruction. Arthrography provides information on intra-articular pathology. CT is particularly of value in visualizing changes in the axial skeleton. Joint scintigraphy, using 99m-technetium pertechnetate, is available in evaluating the degree of synovial inflammation. Thermography has been performed for a similar purpose. Ultrasound allows a real-time, dynamic study of soft tissues in and around the joint, including tendons, synovium and articular cartilage. MRI most clearly shows various pathological conditions such as pannus, degenerated cartilage or spinal cord compression, although the examination time should be shortened. | |
| 7939732 | The future of biologics in the treatment of rheumatoid arthritis. | 1994 Jun | The development of highly effective biological therapies directed against T cells in several animal models of autoimmune disease has prompted trials of similar approaches in rheumatoid arthritis (RA). However, it is unlikely that these approaches will abrogate long-standing disease. Indeed, considerable evidence indicates that although T cells likely play a critical role in induction of RA, non-T-cell-dependent pathways become increasingly dominant as the disease progresses. According to this model, specific T-cell therapies are likely to be most effective in early disease, whereas individualized combinations of biologics targeted against pathways dominating in the recipient's synovium are more likely to be efficacious in established disease. | |
| 8833049 | Historical overview of the treatment of rheumatoid arthritis with an emphasis on methotrex | 1996 Mar | We have reviewed the treatment of rheumatoid arthritis (RA) in pertinent selected literature with a focus on methotrexate (MTX). Considerable progress has been made over the last 120 years since the introduction of salicylates to treat rheumatic symptoms. Most slow acting antirheumatic drugs became widely used in the years after the second world war. MTX became widely accepted in the 1980s although early reports of its use predate that time. The historical perspective of the development of agents to treat RA indicates that most significant advances are concentrated in the last 45 years, especially the last 15 years. This trend will likely continue. | |
| 7774108 | Diverticulosis--a primary cause of life-threatening complications in rheumatoid arthritis. | 1995 Jan | OBJECTIVE: To assess the role of complicated diverticular disease as a cause of death in rheumatoid arthritis (RA). METHODS: In 1989 there were in Finland 1,666 deaths in subjects entitled to specially reimbursed medication for RA under the nationwide sickness insurance scheme. A retrospective clinical study was performed on these cases. RESULTS: In 12 subjects, four males and eight females, the underlying cause of death was diverticular disease; the expected number was two. The mean age at death was 74 years in males and 80 years in females. The duration of RA ranged from 4 to 22 years (mean 13 years). In none of these cases was the death connected in the death certificate to RA or its treatment, yet all the subjects had been taking antirheumatic medication, usually two or three different drugs, at the time of death. CONCLUSION: Complicated diverticular disease, probably related to antirheumatic medication, is a more important cause of death in patients with RA than is generally recognized. | |
| 8761188 | Evaluation of a Dutch version of the AIMS2 for patients with rheumatoid arthritis. | 1996 Aug | DUTCH-AIMS2, a Dutch version of AIMS2 and successor to DUTCH-AIMS, is an instrument to assess health status among patients with rheumatic diseases. It provides measurements of 12 areas of health status on scales for health status proper, satisfaction, attribution and arthritis impact. We assessed the reliability of its scales in terms of internal consistency and their validity according to both internal standards and external standards. Correctly completed questionnaires were returned by 231 RA patients and 131 controls. Internal consistency coefficients for the health status scales ranged from 0.66 and 0.89, but most exceeded 0.80. Within-scale factor analyses produced single factors in all composite health status scales for both patients and controls, with only two exceptions. Factor analysis also identified a physical, social and psychological dimension among 11 areas of health. External validity was established by strong correlations between DUTCH-AIMS2 health status scales and functional class, laboratory parameters, and self-assessments of fatigue, loneliness, pain, functional disability and social support. DUTCH-AIMS2 is acceptably reliable and valid for use in a variety of settings. | |
| 7516430 | Interrelationship of outcome measures and process variables in early rheumatoid arthritis. | 1994 Mar | OBJECTIVE: To investigate the relationship between different outcome and process measures in early rheumatoid arthritis (RA). METHODS: A 3-year prospective study of 149 patients with early RA (symptoms < 1 year at entry). Results of serial measurements of process variables were transformed into time integrated values for comparison with the outcome measures. RESULTS: A highly significant correlation was found between the acute phase response, swollen joints, and radiological progression whereas none of these measures correlated with joint tenderness. Physical disability as estimated by the Health Assessment Questionnaire (HAQ) however, appeared to be determined by joint tenderness rather than by joint swelling. CONCLUSION: In early RA, joint swelling and acute phase reactants appear to be the most appropriate process variables for the prediction of radiological outcome, whereas joint tenderness is a strong determinant of physical disability (HAQ). | |
| 7821883 | [Differential diagnosis of "rheumatoid nodules"]. | 1994 Nov 20 | Rheumatic nodules occur in some 20 to 25% of cases of chronic polyarthritis, and need special diagnostic, in particular differential diagnostic, consideration. They have to be differentiated from numerous other nodules in rheumatoid and non-rheumatoid diseases. To achieve this, palpation, a knowledge of the preferred sites, and the use of such technical means as laboratory and x-ray investigations are all useful. | |
| 8792795 | Randomized, placebo controlled trial of withdrawal of slow-acting antirheumatic drugs and | 1996 | Patients with rheumatoid arthritis, in stable treatment with methotrexate, penicillamine, or sulfasalazine, were randomized in a double-blind fashion either to continuation of their usual treatment or to placebo. 112 patients were included; 52 patients who refused participation had no more severe disease than the others. The patients felt worse on placebo than on active drug (p = 0.002). The mean differences in number of tender, painful and swollen joints after one month were 2.4 (p = 0.08), 3.0 (p = 0.12) and 2.2 (p = 0.03), respectively. Treatment failure occurred for 42 patients of whom 33 received placebo (p = 0.000,001). There was no difference in the severity of side effects (p = 0.91). The patients guessed their treatment correctly more often than expected (p = 0.02) because of the perceived effect. None of the two observers guessed better than chance, and there were no differences between the observers' evaluations of the joints. The effect of slow-acting antirheumatic drugs was unequivocal and no observer bias occurred. | |
| 7895323 | TNF alpha as a therapeutic target in rheumatoid arthritis. | 1994 Aug | Rheumatoid arthritis (RA) is an autoimmune disease with inflammatory manifestations in the peripheral synovial joints, which are infiltrated by activated T cells, macrophages, and plasma cells. We have investigated the role of cytokines in RA and have proposed that tumour necrosis factor has a pivotal role in the pathogenesis of this disease. This chapter describes those studies, which led to the first clinical trial in RA patients using a chimeric anti TNF alpha antibody. In addition to pro-inflammatory cytokine production, at sites of inflammation such as the RA synovial joint, there is also evidence for homeostatic immunoregulatory mechanisms which include the production of cytokine inhibitors, such as soluble TNF-R and the IL-1 receptor antagonist, and cytokines with immunoregulatory properties like IL-10. The evidence for these inhibitors in RA is presented, and the relevance of this homeostatic mechanism in relation to chronic inflammatory diseases is discussed. | |
| 8832980 | Comparison of cystic rheumatoid arthritis and erosive rheumatoid arthritis. | 1996 Mar | OBJECTIVE: To test the hypothesis that cystic rheumatoid arthritis (RA), characterized as subchondral cysts as the only radiographic abnormality in hands and feet for 2 years after first abnormal radiograph, is a mild subset of RA. METHODS: Fifty-four patients with cystic RA were compared with 144 RA controls matched for age, sex, disease duration, and year of first visit. All patients were randomly selected from a database of 1580 patients with RA attending the clinic 1982-88. In 1994, data of 90% of the patients were collected by one investigator, blinded to the study groups. All available radiographs were scored for erosions and cysts by one radiologist. RESULTS: During 17 years of followup (range 2-48 yrs), the cystic RA group had less severe disease. There were fewer disease modifying antirheumatic drug prescriptions and fewer orthopedic operations in the group with cystic RA. The proportion of Rose-Waaler seropositives and the proportion of patients with extraarticular manifestations were the same for both groups. At final assessment, the median Health Assessment Questionnaire score was significantly lower for the group with cystic RA (0,88 vs 1,56; p <0.01). The final radiographic score was significantly lower for the cystic RA group (0,22 vs 0,58; p <0.01). The outcome differences remained after correcting for early radiographic score, rheumatoid factor, early erythrocyte sedimentation rate (ESR), and presence of comorbidity in a multiple regression model. Mortality was the same for both groups. CONCLUSION: Cystic RA is a relatively mild subset of RA. | |
| 1588729 | [Possible roles of infections and heat shock proteins in rheumatoid arthritis]. | 1992 Mar | Heat shock protein, one of the most conserved proteins from prokaryotes to man, was shown to be strongly immunogenic in bacterial and helminthic infections. Evidences have accumulated suggesting that mycobacterial hsp65 plays a crucial role in the development of adjuvant arthritis induced in rats. By analogy, the pathogenetic roles of hsp were investigated in rheumatoid arthritis in man. The evidences obtained so far are highly suggestive but still circumstantial. Hsp's strong immunogenicity and high conservation, which seem to be mutually exclusive, make this molecule very mysterious. In this regard, Coutinho's new network theory or Cohen and Young's theory of immunological homunculus nicely reconciles these aspects. | |
| 8278941 | Changes in lipid, peroxide, and anti-oxidant blood levels during piroxicam (Hotemin) treat | 1993 | The authors examined the lipid-peroxide (malondialdehyde) blood concentration of patients suffering from rheumatoid arthritis of osteoarthrosis. Of the anti-oxidant compounds, they examined the vitamin E concentration of blood plasma and catalase as well as glutathione-peroxidase enzyme activities. They also measured the oxidation capacity of blood plasma. It has been observed that the functional condition of patients in both disease groups improved following a 14-day treatment (20 md/day Hotemin). The degree of lipid-peroxidation (malondialdehyde content) as well as plasma oxidation capacity decreased in patients with osteoarthrosis, while these values did not change in patients suffering from rheumatoid arthritis. When examining the anti-oxidant enzymes in rheumatoid arthritis, a significant change was observed in glutathione-peroxidase activity. On the basis of the results it may be concluded that piroxicam has no direct anti-inflammatory action, but as an anti-oxidant, it exerts an action which is disease specific. | |
| 1359710 | [A method for the permanent maintainance aurotherapy of rheumatoid arthritis patients unde | 1992 May | A study is presented of 34 patients with rheumatoid arthritis. The authors propose a method of persistently maintained aurotherapy of patients with rheumatoid arthritis directed to prevention of recurrences and toxic effect of gold due to chrysanol treatment, the active substance of which is metallic gold. After course treatment with chrysanol (850-1020 mg) persistent treatment by maintained doses is instituted. RESULTS: prevention of recurrences of the disease and prevention of side effects due to the toxicity of cumulated gold. | |
| 8250608 | Bronchiectasis and rheumatoid arthritis: a clinical study. | 1993 Nov | OBJECTIVES: To examine the relation between rheumatoid arthritis (RA) and bronchiectasis (BR). METHODS: Disease activity, outcome, extra-articular manifestations, and laboratory features were compared in 32 patients with BR and RA (RA-BR group), 32 matched patients with RA without BR (RA group), and 31 patients with BR but without arthritis (BR group). RESULTS: In 30 of the 32 (94%) patients with RA-BR, BR preceded RA. There was no functional or radiological difference between the RA-BR and RA groups, and except for xerophthalmia, which was more common in patients with RA-BR than patients with RA, there was no difference in extra-articular or laboratory features. CONCLUSIONS: Bronchiectasis does not lead to a more aggressive disease course in RA and, despite the recognised association, BR is not an extra-articular manifestation of rheumatoid disease. | |
| 7798105 | Insall-Burstein posterior-stabilized knee prosthesis in rheumatoid arthritis. | 1995 Apr | The authors reviewed 65 Insall-Burstein (Zimmer, Warsaw, IN) total condylar posterior-stabilized knee prostheses in 50 patients with rheumatoid arthritis with a follow-up period of at least 5 years (range, 5-13 years). Forty-two knees in 31 patients were evaluated using the Knee Society knee and functional rating scores. Radiographic assessment was performed using standing long radiographs (hip to ankle). Radiolucent lines were studied using fluoroscopic-centered views. Excellent or good clinical results were obtained in 95% of the cases, and the average knee score improved from 22.5 to 90 points. No cases of radiologic loosening were observed. Incomplete radiolucent lines around the tibial component were detected in only 17% and were nonprogressive. Two patients developed hematogenous late deep infection, which required removal of the prosthesis in both, followed, at a second stage, by arthrodesis in one and prosthesis reimplantation in the other. Three knees (7%) had a painful impingement of the patella. Two of these were successfully reoperated with arthroscopic debridement of the peripatellar synovial tissues. Survivorship analysis, based on endpoints such as prosthesis removal for any cause or radiologic loosening (complete radiolucent line thicker than 1 mm, tilt, or subsidence of the component), showed a cumulative success rate of 96.2% at 13 years. | |
| 8608681 | The expression of rheumatoid arthritis in Saudi Arabia. | 1995 Nov | This retrospective study describes the characteristics of rheumatoid arthritis patients seen at the King Khalid University Hospital, Riyadh over a period of 5 years. One hundred and ninety-five patients with rheumatoid arthritis seen during this period were reviewed. There were 155 females and 40 males (F:M ratio 4:1). Females had a younger age at onset than males (38.6 +/- 13.4 vs 42.9 +/- 13.3 year for male - p = 0.037). The majority of patients (76.4%) described an insidious onset. 45.1% used one or more forms of local medicine. Constitutional symptoms were reported in 78 (40%). Rheumatoid factor was positive in 79.5%. The most frequently involved joints were the proximal interphalangeal (PIP) joints, knees and metacarpophalangeal (MCP) joints. Rheumatoid nodules were observed in 15.9% and keratoconjunctivitis sicca in 14.4%. Most patients used second line drugs. The majority of patients (57.4%) were in functional class 1 and 2. The disease pattern and joint distribution resemble more the pattern reported in developed countries. | |
| 8324958 | A defect in the neuroendocrine axis in rheumatoid arthritis: pathogenetic implications. | 1993 Mar | Evidence is presented that there is a defect in the hypothalamic response to inflammatory stimuli in patients with rheumatoid arthritis which leads to a subnormal cortisol response. This defect may be one factor contributing to the chronicity of RA. | |
| 7955599 | Cervical spine involvement in rheumatoid arthritis: a clinical, neurological and radiologi | 1994 Jul | OBJECTIVE: This study was designed to reveal any correlation between radiological signs and clinical findings of cervical spine involvement in rheumatoid arthritis (RA). METHODS: Fifty patients with definite rheumatoid arthritis were evaluated for cervical spine involvement by a clinical neurological examination, a somatosensory evoked potential (SEP) study and different radiological techniques including tomograms, computerized tomography (CT) and magnetic resonance imaging (MRI). RESULTS: Anterior atlantoaxial subluxation was a common finding, frequently associated with superior migration of the dens and subaxial subluxation. Two patients presented a posterior atlantoaxial subluxation due to complete erosion of the dens. Both had cervical cord compression and one of them had hypoglossal nerve paresis. The delineation of peridental pannus formation was clearly demonstrated by MRI. In the majority of cases cervical cord compression was caused by pannus formation or by vertical atlantoaxial subluxation. CONCLUSION: The correlation between the severity of the radiological findings and the clinical-neurological signs was poor. A 4-limb SEP study appeared to be a useful screening method for the detection of cervical medullary compression. | |
| 7768055 | Clinical and biological polymorphism of rheumatoid arthritis. | 1994 Nov | Rheumatoid arthritis (RA) is a frequent disease, leading in more than 50% of cases to severe disability within 5 years of evolution, and sometimes to the premature death of the patient. It is therefore of crucial importance to diagnose, evaluate, and treat this crippling disease as soon as possible. We need accurate clinical, biological, immunological and radiographic parameters which will permit both early diagnosis and evaluation of the patient's prognosis. However, RA is a very heterogeneous disease which is sometimes considered as a clinical syndrome. The clinical heterogeneity of RA is well known; some cases are very mild and self-limiting, while others are seriously progressive and include extra-articular manifestations which can be life-threatening. There is also a biological and immunological heterogeneity of RA, depending on the presence or absence of: rheumatoid factor, high levels of serum IgA, and antinuclear, anti-Ro, antiperinuclear, or anti-stratum corneum antibodies. The association between HLA DR antigens and the severity of RA has been demonstrated in recent studies including some by our group. HLA DRB1*0401 or 0404 homozygous, or HLA DRB1*0401/0404/0408 heterozygous, or HLA DRB1*04 + HLA DRB1*0101 are associated with severe and erosive RA. Extra-articular manifestations such as nodules, vasculitis or Felty syndrome are very often observed in patients homozygous for HLA DRB1*0401 or 0404. The presence of HLA DR4 seems to be correlated with the articular erosions and not with rheumatoid factor. There is a clear need for a 'staging' of RA in order to define more homogeneous clusters of patients.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 1457487 | Sensitivity to change of the health assessment questionnaire (HAQ) and other clinical and | 1992 Sep | To obtain evidence concerning short-term and long-term efficacy of clinical and health status measures in rheumatoid arthritis (RA), we conducted two observational studies--a 6-month study of 233 patients receiving methotrexate and a 10-year study of 157 patients receiving multiple treatments in a rheumatic disease clinic. Results of the 6-month study yielded effect sizes for treatment similar to the meta-analyses reported by Felson [corrected] et al. (Arthritis Rheum 33:1449-1461, 1990) and the controlled trials of methotrexate reported by Weinblatt et al. (Arthritis Rheum 33:330-338, 1990), suggesting that observational studies provide valid measurements of treatment effect. The effect size for the Health Assessment Questionnaire (HAQ) was 0.5. By contrast, the 10-year study suggested that standard clinical variables changed little and were not useful in assessing RA outcome, while the effect size of the HAQ was -2.39. These data continue to underscore the differences between short-term trials and the long-term outcome of RA, and suggest an important place for the HAQ or similar instruments in all phases of RA evaluation and assessment. |