Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 7823314 | Endpoints in rheumatoid arthritis. | 1994 Oct | The Outcome Measures in Rheumatoid Arthritis Clinical Trials Conference has significantly contributed to the field of clinical outcome measurement. Agreement was achieved in designating a preliminary core set of 8 endpoints to be used as a minimum in every rheumatoid arthritis (RA) clinical trial of > or = 1 year: acute phase reactants, disability, pain, patient global assessment, physician global assessment, swollen joint count, tender joint count, and radiographic studies of joints. The discussions and nominal group exercises provided a mandate for full scale testing of approaches to compare the validity of different assessment techniques available for these 8 measures; to determine the minimum level of clinical importance for each of the measures; and to refine and validate the aggregation of outcome measures into indices, taking special care to ensure credibility in the eyes of clinicians, patients, and policy makers. The discussions made it clear that to select one intervention definitively over another, one must additionally consider outcomes such as drug toxicity, costs, and mortality. These aspects need to be explored systematically at subsequent conferences. | |
| 8258236 | One year treatment with low dose methotrexate in rheumatoid arthritis: effect on class spe | 1993 Sep | We evaluated the effect of a one-year treatment of low dose methotrexate (MTX) on class specific rheumatoid factors in 27 patients with rheumatoid arthritis (RA). Enzyme-linked immunosorbent assay (ELISA) showed after 6 and 12 months a significant reduction of IgM-RF, IgA-RF and IgG-RF levels from the baseline values. During MTX treatment, changes of each RF isotype were not correlated with any other isotype and its corresponding immunoglobulin changes. Moreover, immunological changes were not related to the improvement of clinical parameters. Our results showed that low dose MTX can specifically affect levels of RF isotypes, which are involved in the immune pathogenesis of RA. | |
| 8403582 | Bone mineral density in ambulant, non-steroid treated female patients with rheumatoid arth | 1993 Jul | Bone mass measurements were performed in a group of 30 ambulant, non-steroid treated female patients with rheumatoid arthritis (RA) of relatively short duration (mean 4.9 years). The bone mineral density (BMD) of the lumbar spine and femoral neck was assessed by dual-energy x-ray absorptiometry (DEXA), and related to parameters of disease activity and severity. Lumbar BMD was within the range of normal while femoral BMD was decreased compared to age-matched controls. BMD values, expressed as the percentage of age-matched healthy controls (BMD%), were positively related to the body mass index and negatively related to the number of swollen joints, the erythrocyte sedimentation rate and the platelet count. No relation was found between the lumbar and femoral bone mass on the one hand and disease duration, number of disease modifying anti-rheumatic drugs ever used, Ritchie articular index, C-reactive protein, functional ability or radiological scores on the other. It is concluded that in ambulant non-steroid treated female RA patients lumbar bone mass as measured with DEXA is within the range of normal, while femoral bone mass is slightly reduced. Both lumbar and femoral bone mass are related to the body mass index and parameters of disease activity. | |
| 7789053 | Medical, physical and psychological status related to early rheumatoid arthritis. | 1995 Mar | As part of an international European research project, a longitudinal study was started by the end of 1990 in the northern part of The Netherlands. The study concentrated on recently diagnosed RA patients (N = 292), i.e., incident cases up to four years. According to the duration of the disease, five groups of patients had been formed. The early influence of rheumatoid arthritis on medical parameters, on functional status, on physical condition and on psychological well-being was evaluated. From the results, an overall statistically significant pattern related to the duration of the disease could not be distinguished. However, patients recently diagnosed did face activity restrictions, a decline in physical condition and social functioning. On medical parameters this deterioration is less profound. Furthermore, across and within the five patient groups, it seems that males and females respond differently to the influence of early RA. Based on cross-sectional data from the five onset cohorts, the present findings do not significantly suggest a steady worsening in medical, physical and psychological condition. | |
| 8345274 | Long-term results of Swanson silastic arthroplasty in the rheumatoid wrist. | 1993 Jun | We report a long-term follow-up of 6 to 11.8 years (mean = 8 years) of our first 50 Swanson wrist arthroplasties. All patients had long standing sero-positive rheumatoid arthritis with a mean age of 48 years. A detailed clinical and radiologic assessment was carried out on all the wrists. There was excellent sustained pain relief (mean score = 1.7) with improved activities of daily living. A mean range of wrist movement of 25 degrees of extension and 31 degrees of flexion was obtained. The prosthetic fracture rate was 22% of which 14% were symptomatic and needed re-operation. Carpal collapse was seen in all wrists, but was often symmetrical and accompanied by radial new bone formation on X-ray (86%). We feel that our long-term results justify the continued selective use of the Swanson wrist in the low-demand patient with quiescent disease who desires pain-free limited mobility and sophisticated grasp. | |
| 1497078 | Managing chronic illness: an immigrant woman's acquisition and use of health care knowledg | 1992 Aug | As occupational therapists increasingly encounter a multicultural clientele, there is growing interest in the influence of a person's culture on his or her interactions with the environment. This paper presents a case study of a Chinese-Canadian immigrant woman with rheumatoid arthritis. The case study illustrates how the subject's family, community networks, and workplace, coupled with the occupational therapy clinical setting, intermingled to shape the daily management of her illness. The case material focuses on the subject's acquisition and use of different types of health care knowledge as she responds to her illness. It shows that the subject's experiences and management decisions about her health are closely linked to the material and social conditions of her life as a working-class immigrant woman. This article suggests that attention needs to be paid to the broader systems of the environment in understanding the responses of immigrant women to occupational therapy, rather than on the cultural distinctiveness of the clients. | |
| 8796982 | Differential therapy in early and late stages of rheumatoid arthritis. | 1996 May | Early and late stages of rheumatoid arthritis differ with respect to the severity of inflammation and the progression rate of irreversible joint destruction. There are no solid data showing that disease mechanisms underlying destructive arthritis differ between the various stages of the disease. Long-term observational studies have shown that rheumatoid arthritis is a severe progressive disease in many patients, highlighting the need for new therapeutic strategies. At present many centers are exploring whether early and aggressive treatment can improve long-term morbidity and mortality. | |
| 8883434 | Quantitative assessment of the synovial membrane in the rheumatoid wrist: an easily obtain | 1996 Oct | Determination of the synovial membrane volume in the rheumatoid arthritis (RA) wrist by gadolinium-DTPA-enhanced MRI is introduced. Moreover, dynamic imaging and an MRI score of synovial hypertrophy, based on gradings in six regions, are evaluated as substitutes of the time-consuming volume calculations. Twenty-six RA wrists were examined. Synovial membrane volumes ranged from 1 to 20 ml (median 9 ml). Synovial hypertrophy scores were highly correlated to synovial volumes (Spearman r = 0.88; P < 10(-8) for uncorrelated values). The volumes and scores were significantly higher in wrists with joint swelling and/or joint tenderness than in wrists without these signs (Mann-Whitney, both P < 0.05). Suboptimal slice selection made dynamic imaging uninformative. MRI allows quantification of the synovial volume in the rheumatoid wrist. The volume is related to clinical signs of inflammation, but may also give information about the cumulated synovial proliferation in the joint. An easily obtained score of synovial hypertrophy reflects the synovial volume and may thus be a useful marker of synovial involvement. | |
| 8295175 | Levels of urinary polyamines in patients with rheumatoid arthritis. | 1993 Oct | OBJECTIVE: To compare urinary polyamine levels in patients with rheumatoid arthritis (RA), with osteoarthritis (OA), and in healthy controls and examine the relationship between urinary polyamine levels and several disease variables in patients with RA. METHODS: We determined the concentrations of urinary polyamines in 33 patients with RA, 24 with OA, and 20 healthy controls, using the enzymatic assay method. For patients with RA relevant clinical and laboratory variables were obtained and functional and radiologic scores determined for the joints. RESULTS: Urinary polyamine levels were significantly higher in patients with RA versus those with OA and healthy controls. In patients with RA the levels of urinary polyamines correlated significantly with the concentrations of serum C-reactive protein (CRP); there was also a statistically significant negative correlation between their urinary polyamine levels and average grip strength in either hand. Moreover, the levels of urinary polyamines in patients with RA showed an increase in proportion to the degree of joint functional damage and radiologic progression. CONCLUSION: Our results confirm our previous report of an increase in the amount of free putrescine in synovial fluids and a significant correlation between the putrescine contents of synovial tissues and the serum CRP concentrations in patients with RA; they also suggest that urinary polyamine levels may be related to the activity and progression of RA, indicating that polyamine may play an important role in RA. | |
| 7586779 | Quality of life in rheumatoid arthritis: a case-control study in patients living in northe | 1995 Jul | OBJECTIVE: To study quality of life parameters in patients with rheumatoid arthritis and the possible association of these parameters with disease activity. METHODS: Fifty-two women with rheumatoid arthritis and 52 controls completed two self reporting psychiatric screening tests: the General Health Questionnaire (GHQ - 30) and the Cantril Ladder scale. The number of psychiatric cases detected was not significantly higher for either group using the GHQ score S+ as the criterion. RESULTS: Comparing the GHQ scores, patients showed a higher score compared with the controls (p = 0.02). The patients scored significantly higher on feelings of incompetance (p = 0.004), but not on the other subgroups of psychiatric factors. The patients reported lower life satisfaction on the Cantril self anchoring ladder (p = 0.0001). The functional capacity score was positively associated with the GHQ score. No association was detected between disease duration or the other disease activity parameters and either the GHQ score or the life satisfaction score. CONCLUSION: This inconsistant relationship between clinical parameters and quality of life scores may be due to the fact that RA patients suffer from a chronic disease, or it may reflect an impaired psychosocial status in the patients. This study demonstrates that the increased psychological disturbances in women with RA is mainly explained by feelings of incompetance. | |
| 8792796 | In- and out-patient rehabilitation in rheumatoid arthritis. A controlled, open, longitudin | 1996 | Twenty-six patients with rheumatoid arthritis (RA) participated either in a 21 day, community sponsored, in-patient multidisciplinary rehabilitation program (N = 20) or; received traditional, out-patient physiotherapy designed by the patient's rheumatologist (N = 6). Clinical assessments were made (prior to, immediately after, and 6 months after rehabilitation) to evaluate the response to these two quite different rehabilitative measures that included: functional classification, joint score index, subjective VAS of pain, HAQ, pain disability index, Comprehensible psychopathological rating scale, hemoglobin, and CRP measurements. Economic assessments included salary, direct and community sponsored costs, for rehabilitation and costs for sick days and production losses. No clear-cut differences between the two rehabilitation modes were detected. Both modes showed improvement in different assessment parameters; patients with higher education and, therefore, with a less joint-disturbing work profile appeared to profit more from an extensive in-patient rehabilitation program. Patients with less education and a more manually-oriented working profile, did worse and had a higher tendency to seek medical pensioning, in spite of rehabilitative measures. As the total costs for out-patient rehabilitation only add up to 15.8% of the total costs for in-patient rehabilitation, this study setting cautiously suggests that out-patient rehabilitation might be an acceptable alternative to individualized patient groups that might not compromise clinical and vocational outcome. Larger patient groups are needed, however, to confirm these findings. | |
| 8605267 | The implications of depression for pain and disability in rheumatoid arthritis. | 1995 Dec | Depression in rheumatoid arthritis (RA) affects many, but by no means all, persons with the disease. There is evidence that depression bears a significant relationship to pain in RA, although the causal direction is not entirely clear. Likewise, there is strong evidence that depression is a major contributor to the RA disability. Therefore, prevention, early diagnosis, and aggressive treatment of depression are needed to minimize the disability associated with RA. | |
| 7588930 | 24-h ECG monitoring in patients with rheumatoid arthritis. | 1995 Jun | Although the main cardiac complication in patients with rheumatoid arthritis is subclinical pericarditis, mononuclear cell infiltrations into myocardium may cause cardiac arrhythmias and conduction defects. In order to examine these problems we evaluated 70 patients (53 women and 17 men) aged 18-83 years (average 56.7 +/- 11.2) with classic or definite rheumatoid arthritis, according to diagnostic criteria. Duration of the disease was 1-35 years (average 8.7 +/- 8.4). The control group comprised 70 patients admitted to hospital with degenerative joint disease, a duodenal ulcer, or who required treatment for ophthalmological or laryngeal reasons; these patients were matched for sex and age. In all patients standard 12-lead ECG investigations were performed, as well as 24-h ECG monitoring, using an Oxford Medical System device with two precordial leads CM5 and CS2, according to the Holter method. We analysed heart rate, conduction disturbances, and occurrence of arrhythmias, on the basis of generally assumed ECG criteria. Cardiac arrhythmias were found in 50% of patients with rheumatoid arthritis, and their occurrence was similar to that in the control group. Observed arrhythmias were independent of the progression of arthritis, the type of treatment administered, the familial occurrence of arthritis, the presence of manifestations pertaining to organs, the presence of rheumatoid factor, the stage of the disease according to Steinbrocker, or the presence of immune complexes in serum and HLA Dr antigens, which are regarded as fundamental in the pathogenesis of rheumatoid arthritis. | |
| 1602009 | Homozygosity for the HLA-DRB1 allele selects for extraarticular manifestations in rheumato | 1992 Jun | Seropositive rheumatoid arthritis is genetically linked to a group of HLA-DRB1 alleles sharing a sequence motif within the third hypervariable region. Controversy exists over the role of the distinct allelic variants in affecting not only the risk to develop disease, but also in modifying the expression of the disease. We have stratified 81 patients according to their patterns of disease manifestations and identified the HLA-DRB1 alleles by polymerase chain reaction amplification and subsequent oligonucleotide hybridization. To identify precisely the allelic combinations at the HLA-DRB1 locus, homozygosity was confirmed by locus-specific cDNA amplification and subsequent sequencing. Our study demonstrated a high correlation of allelic combinations of disease-associated HLA-DRB1 alleles with the clinical manifestations. Characteristic genotypes were identified for patients who had progressed toward nodular disease and patients who had developed major organ involvement. Rheumatoid nodules were highly associated with a heterozygosity for two disease associated HLA-DRB1 alleles. Homozygosity for the HLA-DRB1*0401 allele was a characteristic finding for RA patients with major organ involvement. Our data suggest a role of the disease-associated sequence motif in determining severity of the disease. The finding of a codominant function of HLA-DRB1 alleles suggests that the biological function of HLA-DR molecules in thymic selection might be important in the pathogenesis of RA. | |
| 7818571 | The development of depressive symptoms among women with rheumatoid arthritis. The role of | 1995 Jan | OBJECTIVE: To examine the role of function and functional changes in the development of depressive symptoms among women with rheumatoid arthritis (RA). METHODS: Data from a longitudinal panel study of persons with RA were used. Functional changes were assessed from 1989 to 1991, and depressive symptoms during 1992. RESULTS: Loss of valued activities was a significant risk factor for the developing depressive symptoms (i.e., score of > or = 7 on the Short Form Geriatric Depression Scale), but overall functional decline was not. CONCLUSION: The aspect of functional decline that leads to development of depressive symptoms is the loss of valued activities, not simply the functional impairment. | |
| 1384889 | [Rheum-orthopedics in the system of complex treatment of rheumatoid arthritis]. | 1992 | The author presents an original conceptual scheme of the complex medical rehabilitation of patients with RA on the basis of the conservative and surgical treatment of RA (3,000 cases). Successful results were attained in 70% of cases (follow-up of 5 years). | |
| 1579806 | HLA-DR4-DQw8, but not DR4-DQw7 haplotypes occur in Indian patients with rheumatoid arthrit | 1992 | The distribution of HLA class II antigens in the Asian Indian patients with rheumatoid arthritis (RA) was studied in the present investigation. The results demonstrated that DR4 was significantly increased in both northern (chi 2 = 36.9, P less than 0.00001) as well as southern Indian (chi 2 = 17.3, P less than 0.0001) patients. HLA haplotype analysis revealed the presence of B17-DR4 among southern Indians. Amongst northern Indians, four DR4 haplotypes occurred significantly: A1,B17,DR4; A19,B7, DR4; A30,B13,DR4; and A33,B44,DR4. An analysis of TA10 and DQ'Wa' specificities revealed that all the DR4-DQw3 positive northern Indian RA patients were DQw8 as compared to its frequency of 33.3% in controls. A positive association observed between DR4-DQw7 and RA in some western Caucasian populations was not present in this series. A group of three DR4 positive RA patients were found to be DQw3 negative and DQ'Wa' or DQw4 positive. These results indicated that susceptibility to RA may be controlled by genes in the DR locus independent of any DQ associations. | |
| 8849359 | Regression of the nephrotic syndrome in rheumatoid arthritis and amyloidosis treated with | 1995 Dec | Secondary or reactive (AA) amyloidosis is a well-known complication of certain rheumatic diseases, particularly rheumatoid arthritis (RA). This case report describes a patient with RA complicated by amyloidosis and the nephrotic syndrome, which regressed after treatment with azathioprine. The AA amyloidosis was documented by renal and lymph node biopsies and by the presence of proteinuria. Evaluation for other etiologies of proteinuria was negative. After treatment with azathioprine, the proteinuria resolved and the serum albumin level increased from 1.9 mg/dl to normal. This is the first published report of azathioprine therapy resulting in a reversal of the nephrotic syndrome in a patient with RA and secondary amyloidosis. | |
| 7857996 | Life activities of persons with rheumatoid arthritis with and without depressive symptoms. | 1994 Jun | OBJECTIVE: Persons with rheumatoid arthritis (RA) report more activity losses than persons without RA. Persons with RA who report depressive symptoms experience lower levels of functioning. We integrated these findings and examined the association of depressive symptoms with the activities in which persons with RA participate. METHODS: We surveyed 726 persons with RA and 192 matched controls. Within each group, we examined the perceived importance and actual performance of 65 life activities by individuals with and without depressive symptoms. RESULTS: Significantly more individuals with RA reported depressive symptoms. Among persons with RA, those who had depressive symptoms performed fewer activities, particularly fewer valued activities. In contrast, among controls, those who were depressed rated fewer activities as important, but exhibited few significant differences in the performance of activities. CONCLUSIONS: Depressive symptoms and life activities are associated differently among persons with RA and controls. The higher rate of depression among persons with RA may be partially due to the inability to perform valued activities. | |
| 1430950 | The effect of elbow flexion and time of assessment on the measurement of grip strength in | 1992 Nov | Grip strength is one of the traditional outcome measures commonly used in rheumatoid arthritis trials. This study evaluated the degree of morning variation and the effect of elbow flexion in the assessment of grip strength in patients with rheumatoid arthritis. Grip strength was measured in 37 patients (1987 American Rheumatism Association criteria) at 8, 10, and 12 AM with a sphygmomanometer cuff folded on itself, taped permanently, and inflated to 20 mm Hg, with the elbow flexed at 90 degrees. At 10 AM grip strength was also measured with the elbow flexed at 30 and 130 degrees. Mean values for grip strength at 8, 10, and 12 AM were, respectively, 69, 79, and 83 mm Hg. Mean grip strength values with the elbow flexed at 30, 90, and 130 degrees were, respectively, 78, 79, and 75 mm Hg. There was a statistically significant correlation between grip strength and morning stiffness, grip strength and hand function, and grip strength and number of active joints. In rheumatoid arthritis trials, grip strength should be assessed at the same time of the day. Elbow flexion does not play a role in grip strength measurement. |