Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1573429 | Identification of work disability in rheumatoid arthritis: physical, radiographic and labo | 1992 Feb | Work disability, a common problem in rheumatoid arthritis (RA), is known to be associated with demographic variables such as occupation, age, and formal education, as well as with disease duration. However, physical, radiographic and laboratory variables, which are included in the traditional "medical model" of work disability and collected routinely in the application process, have not been studied for their capacity to explain whether patients are working or receiving work disability payments. A cross-sectional database which included an extensively characterized group of patients with RA was examined to determine possible associations of demographic, functional, physical, radiographic and laboratory variables with work disability status. All these variables differed in patients who were receiving work disability payments and those who were working full time, but in multivariate analyses, work or disability status was best identified by demographic and functional variables. Physical, radiographic, and laboratory data did not add significantly to explanation of work disability status beyond the demographic and functional variables and disease duration, despite the fact that receipt of disability payments was used as the criterion for work disability status. | |
| 7748016 | Microalbuminuria in patients with rheumatoid arthritis. | 1995 Mar | OBJECTIVES: To assess (a) the prevalence of microalbuminuria in patients with rheumatoid arthritis, (b) the association between urinary albumin excretion and disease activity as estimated by the erythrocyte sedimentation rate and C reactive protein (CRP), and (c) the association between urinary albumin excretion and treatment with antirheumatic drugs. METHODS: Sixty five patients with rheumatoid arthritis attending two rheumatology clinics were compared with 51 control subjects matched by age and sex. The controls consisted of 20 healthy subjects, 16 patients with osteoarthritis and 15 with non-articular rheumatism. Patients with hypertension, diabetes mellitus, or evidence of previous renal disease were not included. Urinary albumin was assayed by immunoturbidimetry in random urine samples on two occasions within seven months. The results were expressed as the ratio of urinary albumin to urinary creatinine ratio. Disease activity was assessed by the erythrocyte sedimentation rate and CRP. A drug history for the year before entry to the study was obtained for each patient. RESULTS: Urinary albumin to creatinine ratio in patients with rheumatoid arthritis was significantly greater than in controls (p < 0.01). Microalbuminuria (urinary albumin to creatinine ratio 3-30 mg/mmol in either or both urine samples) was present in 27.7% of patients with rheumatoid arthritis and 7.8% of the control subjects. A significant relation was noted between urinary albumin to creatinine ratio and CRP, and the duration of disease. The number of patients treated with either gold or penicillamine was significantly greater in patients with microalbuminuria than in patients with normoalbuminuria. CONCLUSIONS: Microalbuminuria is frequently present in patients with rheumatoid arthritis. Treatment with gold and penicillamine seems to increase the risk of developing microalbuminuria. Urinary albumin measured by immunochemical methods is a simple and sensitive test to detect early subclinical renal dysfunction and drug induced renal damage in rheumatoid arthritis. Urinary albumin excretion was found to be significantly correlated with CRP and may be a sensitive indicator of disease activity in patients with rheumatoid arthritis. | |
| 8308766 | Smoking and risk of rheumatoid arthritis. | 1993 Nov | OBJECTIVE: To investigate smoking for its association with the incidence of seropositive and seronegative rheumatoid arthritis (RA). METHODS: A cohort of adult Finns was examined by the Social Insurance Institution's Mobile Clinic in 1966-72. The 24,445 women and 28,364 men who had neither arthritis nor a history of it at the start of the study were followed until the end of 1989 using record linkage with the Institution's population register to identify patients entitled to free antirheumatic medication. Sufficient information was obtained on 512 incident cases of RA, of whom 119 men and 229 women were seropositive and 42 men and 122 women seronegative. RESULTS: There was a close association between smoking and the incidence of seropositive RA in men. It was not due to confounding by age, geographical location of residence, marital status, social class, self-perceived general health, or body mass index, although these factors correlated with smoking history. As adjusted for these factors, the relative risk of seropositive RA was 2.6 (95% confidence interval, 1.3-5.3) in male ex-smokers and 3.8 (95% confidence interval, 2.0-6.9) in current smokers, in comparison with the men who had never smoked. The association persisted throughout the entire followup period, but it was most distinct after the first 14 years of followup. Smoking did not predict seropositive RA in women, nor was it predictive of seronegative RA in men or women. CONCLUSION: Exposure to tobacco smoke, or some factor or cluster of factors associated with smoking, may trigger the production of rheumatoid factors and, in interaction with the male sex, subsequently contribute to the development of clinically manifest RA. | |
| 1739863 | Effect of calcitonin on bone histomorphometry and bone metabolism in rheumatoid arthritis. | 1992 Jan | Twenty-four women (mean age +/- SD 49 +/- 13 years) with classical or definite rheumatoid arthritis (disease duration 15 +/- 8 years) were treated with synthetic salmon calcitonin (SCT) nasal spray 200 IU three times a week for 3 months. Bone biopsies from the iliac crest were taken before and after SCT treatment. Histomorphometrical quantification of undecalcified bone sections was made using the manual point-counting method. SCT decreased the resorption surface of trabecular bone (ES/BS) significantly (P less than 0.001). There was also a significant increase (P less than 0.05) in trabecular bone volume (BV/TV) after 3 months of treatment, whereas no statistically significant changes were found in osteoid parameters. There were no significant changes in biochemical analyses of bone metabolism. We conclude that SCT might be useful in the prevention of bone loss in RA. | |
| 9081939 | [Rheumatoid neutrophilic dermatitis--a rare dermatosis in patients with active rheumatoid | 1996 Dec | Rheumatoid neutrophilic dermatitis is a rare dermatologic disorder seen in patients with active rheumatoid arthritis. Clinically firm erythematous 3-5 mm papules are found mainly on the arms, the hips and the proximal thighs. The lesions may be pruritic leading to excoriations and crusts. Histology reveals a dense dermal infiltrate with neutrophilic granulocytes, while leukocytoclasia may be seen, vasculitits is not observed. This overview of rheumatoid neutrophilic dermatitis may help remind the practitioner to include this uncommon disorder in the differential diagnosis of rheumatoid arthritis-related dermatoses. | |
| 8162455 | Early agalactosylation of IgG is associated with a more progressive disease course in pati | 1994 Jan | The clinical significance of the percentage agalactosyl IgG oligosaccharides [%G(O)] was investigated in serum of a well-characterized cohort of 127 female RA patients who were followed for a mean duration of 6 yr. The %G(O) was determined in the first available serum sample which was obtained at a mean of 3.4 yr after symptom onset. It could be shown that patients with a %G(O) more than 2 S.D. above the mean level of controls (n = 34), had significantly more erosions, disease activity, and were treated with more second-line drugs, than patients without an increased %G(O) (n = 93), both at the time the serum sample was obtained, and during follow-up. These findings suggest that G(O) may serve as an indicator for the disease course in patients with RA. | |
| 1433002 | Recurrence of cervical spine instability in rheumatoid arthritis following previous fusion | 1992 Sep | In a retrospective study, 110 patients with rheumatoid arthritis who had cervical spine fusion were evaluated for recurrence of cervical spine instability and resultant need for further surgery. Recurrence of cervical instability was correlated with initial radiographic abnormality, primary surgical procedure and interval between the 2 surgeries. There were 55 patients who had atlantoaxial subluxation (AAS) and required C1-C2 fusion as primary surgery. Three of these patients (5.5%) developed subaxial subluxation (SAS) and had a second procedure after a mean interval of 9 years. Twenty-two patients had AAS with superior migration of the odontoid (AAS-SMO) and had initial surgery of occiput-C3 fusion. Eight of these patients (36%) developed SAS and had a second surgery after a mean interval of 2.6 years. Of the 19 patients with primary radiographic deformity of SAS, one required further surgery for subluxation of an adjacent superior vertebra after a period of 6 years. Fourteen patients had combined deformity of AAS-SMO-SAS, and one required further surgery for SAS after an interval of 22 months. Recurrence of cervical instability following a previous fusion occurred in 15% of these 110 patients. It was seen in 5.5% of patients with initial deformity of AAS vs 36% of patients with AAS-SMO. No patients with C1-C2 fusion for AAS progressed to develop superior migration of the odontoid. We conclude that early C1-C2 fusion for AAS before development of SMO decreases the risk of further progression of cervical spine instability. The pattern of progression of cervical spine involvement, as discussed in the literature, is reviewed. | |
| 8465130 | [Early-stage polyarthritis]. | 1993 Mar 23 | Prodromes, articular signs and the different courses in the early stage of rheumatoid arthritis are explained. Atypical forms and variants of rheumatoid arthritis are especially described. These are the following syndromes: palindromic rheumatism, polymyalgic rheumatoid arthritis, Sjögren-syndrome with rheumatoid arthritis, acute symmetric polyarthritis with pitting edema of elderly people. Furthermore the significance of radiological procedures and the investigation for rheumatoid factors in the early stages are discussed. Early diagnosis and consecutively early therapeutic strategies in patients suffering from rheumatoid arthritis are of paramount importance for prognosis. | |
| 8496856 | Morphometric analysis of synovial membrane blood vessels in rheumatoid arthritis: associat | 1993 Apr | The morphologic characteristics of the endothelial cells lining postcapillary venules are cytokine dependent and critical in facilitating the infiltration of mononuclear cells into synovial membrane in rheumatoid arthritis (RA). We determined the relationships between endothelial cell (EC) tallness, mononuclear cell infiltration and synovial fluid levels of interleukin 1 beta (IL-1 beta) and interleukin 6 (IL-6) at different stages of RA. EC tallness was greatest in synovial tissues obtained by needle biopsy of the knee joints from 18 patients with active RA who had never received disease modifying drugs (Group 1) (p = 0.000001 versus controls). EC tallness in tissues obtained from 18 patients with advanced disease undergoing knee arthroplasty (Group 2) was greater than controls (p = 0.001) only when vessels located in focal lymphoid aggregates were considered. Vascular proliferation was noted in both groups. Synovial fluid IL-6 levels were greatest in Group 1. IL-1 beta levels were greatest in Group 2. The total numbers of infiltrating mononuclear cells and the clinical measures of disease activity were similar in both groups. The differences in EC characteristics at different stages of RA suggest changing pathogenic mechanisms as disease progresses. Disease modifying antirheumatic drugs may contribute to the findings observed. | |
| 1548327 | Arthroscopy in the diagnosis and therapy of arthritis. | 1992 Mar 30 | The future of arthroscopy as an intervention in the management of patients with arthritis will depend largely on developments in technology and wider use of the procedure. With the capability of performing office arthroscopy, large-scale clinical studies will help improve both the diagnosis and management of rheumatoid arthritis and osteoarthritis. | |
| 8601050 | Disease-modifying antirheumatic drugs. Potential effects in older patients. | 1995 Dec | Disease-modifying antirheumatic drugs (DMARDs) are frequently used in rheumatoid arthritis. A number of physiological changes occur in the elderly which may modify the use of these medications. The most commonly used DMARDs are antimalarial drugs (particularly hydroxychloroquine), sulfasalazine and methotrexate. The principal mechanism of action of the antimalarials relates to the fact that they change intracellular pH, which downregulates numerous immune functions. Hydroxychloroquine is metabolised to 3 metabolites and has a very low clearance. It is moderately effective in dosages up to 6.4 mg/kg/day. While it is not the most effective of the DMARDs, it is the least toxic. Sulfasalazine is a prodrug which is enzymatically split in the bowel to form sulfapyridine (the principal active metabolite) and 5-aminosalicylic acid. The metabolism of sulfasalazine is complex and, to some extent, genetically determined. The mechanism of action of the drug is not well understood, but involves decreased production of cytokines and decreased proliferative response of lymphocytes. It may slow the rate of bony damage associated with rheumatoid arthritis. Nearly 50% of the patients who are prescribed sulfasalazine continue to receive the drug for up to 4 years. Sulfasalazine is not as well tolerated as hydroxychloroquine. Gastrointestinal toxicity, in particular, seems to be a problem in elderly patients taking this medication. Methotrexate is presently the most popular of the DMARDs for the treatment of rheumatoid arthritis. Methotrexate inhibits dihydrofolate reductase and adenosine release and has a secondary effect on cytokines and polymorphonuclear chemotaxis. It is highly metabolised within cells and remains there for prolonged periods. Up to 70% of patients who are prescribed methotrexate continue treatment for 5 years. Methotrexate treatment is associated with gastrointestinal, hepatic, cutaneous and, possibly, pulmonary adverse effects. The use of azathioprine, penicillamine and gold compounds is briefly reviewed in this article. Elderly patients have an increased incidence of rashes when using penicillamine, relative to young patients. There are no age-related differences in the efficacy and tolerability of azathioprine or gold therapy. The poor absorption and renal toxicity associated with cyclosporin, the new 'salvage' therapy in rheumatoid arthritis, make it generally unsuitable for use in the elderly, except under specialists' supervision. | |
| 8290397 | Postoperative results of rheumatoid arthritis patients on methotrexate at the time of reco | 1993 Nov | We conducted a retrospective chart review examining the frequency of local postoperative infection and poor wound healing of 15 methotrexate-treated rheumatoid arthritis patients undergoing 155 procedures during 39 surgeries. The patients were compared to a group of rheumatoid patients not on methotrexate who underwent similar reconstructive surgery of the hand. The patients taking methotrexate were followed postoperatively for a minimum of 10 weeks, with a mean follow-up time of 1 year, 42 weeks. There were no postoperative complications that would lead to the belief that the administration of methotrexate results in poor wound healing or leaves the patient more susceptible to postoperative infection. Our findings and a review of the literature support a continuation of methotrexate therapy in rheumatoid arthritis patients scheduled for reconstructive surgery of the hand and wrist. | |
| 8834139 | Roentgenographic evaluation of erosive changes in early cases of rheumatoid arthritis: usi | 1995 May | The diagnosis of typical cases of rheumatoid arthritis can be done on clinical grounds but problem arises in equivocal cases and radiological changes suggestive of rheumatoid arthritis help in confirmation or overweight the clinical diagnosis. Radiological changes viz, osteoporosis and soft tissue swelling can be assessed by conventional projections but problem arises in early detection of minute erosive changes of the articular surfaces. These lesions have been very well demonstrated by using magnification radiography and hence may be recommended for early diagnosis of rheumatoid arthritis. | |
| 8340481 | Miller Fisher syndrome mimicking stroke in immunosuppressed patient with rheumatoid arthri | 1993 Jun | A patient with rheumatoid arthritis on immunosuppressive therapy was admitted to hospital with the sudden onset of diplopia and ataxia. Because of the history, a stroke was thought most likely. However, as he progressed a diagnosis of the Miller Fisher syndrome was established. He responded to plasma exchange. This presentation is highly unusual and has not previously been described. In addition, the possibility of immune dysregulation setting the stage for the development of this syndrome is discussed. The role of plasma exchange for this condition is also reviewed. | |
| 8356248 | What is the natural history of rheumatoid arthritis? | 1993 Feb | Analyses of the natural history of RA, recognizing that all patients receive therapies, indicate the following: 1. Classification criteria for RA identify individuals with (at least) three different types of pathogenetic processes and long-term outcomes; most patients seen in clinical settings have progressive disease. 2. Results of therapies documented to be efficacious in clinical trials are not applicable to the long-term course of RA, in part due to patient selection and the short-time frame of observation in clinical trials; most therapies for RA are not effective in most patients over long periods. 3. Over periods of 10 years or longer, most patients with RA experience radiographic progression and severe functional declines, and work disability is seen in 60% of patients after 10 years of disease. 4. Mortality rates are increased in patients with RA, although RA is generally not listed on death certificates. 5. Individual patients with RA who are at risk for early mortality may be identified through clinical markers, including many involved joints, comorbid cardiovascular disease, and poor functional status according to questionnaires and physical measures. 6. Patient behaviors and lifestyles identified through formal educational level as a marker appear of great importance in the prevalence, morbidity, and mortality of RA. | |
| 7901898 | Toxicity of sulphasalazine in rheumatoid arthritis. Possible protective effect of rheumato | 1993 | Adverse reactions to sulphasalazine were seen in 35 of 100 patients with rheumatoid arthritis. Gastrointestinal side effects, skin reactions and increases of serum liver enzymes were most frequently noted. Serious or fatal adverse reactions were not observed. The frequency of toxicity to sulphasalazine was significantly lower among patients treated concurrently with small doses of oral corticosteroids, and also among cases seropositive for rheumatoid factors. Of the 14 seropositive patients also treated with corticosteroids, none developed side effects to sulphasalazine. | |
| 8952180 | Plasma reactive nitrogen intermediate levels in patients with clinically active rheumatoid | 1996 Oct | We studied reactive nitrogen intermediate levels in 31 patients with active rheumatoid arthritis (RA) taking indomethacin and 20 healthy controls using nitrite and citrulline levels, measured by spectrophotometry, as markers. Twenty patients with RA were followed up after 4 and 8 wk of treatment with additional therapy in the form of methotrexate. Mean nitrite levels in 31 patients were 0.94 +/- 0.41 mumol/ml and 20 controls it was 1.18 +/- 0.99. After treatment with methotrexate for 4 and 8 wk the levels were 0.9 +/- 0.45 and 1.25 +/- 1.15 mumol/ml, respectively. Mean citrulline levels in all patients was 1.68 +/- 0.11 and controls was 1.39 +/- 0.6 mumol/ml. Following therapy with methotrexate for 4 and 8 wk the levels were 1.40 +/- 0.49 and 1.40 +/- 0.51 mumol/ml, respectively. It is possible that serum levels of these products may not reflect alterations in the synovial fluid levels. Alternatively, whatever lowering may have been achieved by the anti-inflammatory effect of the therapy may have been countered by drug derived free radicals. | |
| 1455371 | [A comparative evaluation of combined immunocorrective therapy in rheumatoid arthritis wit | 1992 | Thirty-two patients with rheumatoid arthritis were included in the trial. Each of them was assigned to one of the 4 groups comparable by the main features. Each group entered 8 patients. Group 1 patients underwent hemosorption weekly for 3 weeks. After the second procedure cyclophosphamide was added at a single IV dose 1000 mg. After the third procedure the treatment was continued with methotrexate (7.5 mg, weekly). Group 2 began the treatment with methotrexate (7.5 mg, weekly). Group 3 received cyclophosphamide 200 mg IV twice a week 6 times and then 200 mg weekly orally till a total dose of 2 g. Group 4 received azathioprine in a daily dose 100 mg. The treatment with nonsteroidal antirheumatic drugs and corticosteroids was continued unchanged. After 6 months we did not see significant differences between the 4 groups. | |
| 7945478 | Unique clinical and psychological correlates of fibromyalgia tender points and joint tende | 1994 Oct | OBJECTIVE: We investigated the relationship of fibromyalgia (FM) tender points to other manifestations of rheumatoid arthritis (RA). METHODS: Sixty-seven RA patients completed questionnaires at study entry and described symptoms, emotionally significant events, and mood every evening for 75 days. Joint and tender point examinations were conducted every 2 weeks. RESULTS: Controlling for joint tenderness, the tender point count correlated with the degree of daily stress. Depression was not significantly related when daily stress was controlled for. CONCLUSION: We conclude that FM tender point counts correlate uniquely with RA patients' reports of daily stress. | |
| 1737238 | Vertebral osteoporosis in rheumatoid arthritis patients: effect of low dose prednisone the | 1992 Feb | The effect of low dose prednisone therapy on spinal bone mass is controversial. We measured lumbar trabecular and cortical bone mineral density (BMD) in 74 rheumatoid arthritis (RA) patients by dual energy quantitative computerized tomography in a cross-sectional study. The presence of vertebral deformities was evaluated on a lateral spine radiograph. Patients who had never been treated with corticosteroids (n = 44) were compared with patients on long-term low dose (less than or equal to 10 mg/day) prednisone therapy (n = 30). After correction for confounding variables the lumbar BMD was highly significantly influenced by prednisone therapy in postmenopausal patients (estimated influence -31.2% on trabecular BMD and -37.2% on cortical BMD). Vertebral deformities were also significantly more frequent in prednisone treated postmenopausal patients. No negative effect of prednisone treatment could be demonstrated in male patients. In contradiction to previous reports we conclude that long-term prednisone therapy may be associated with development of spinal osteoporosis in postmenopausal RA patients, even when low doses are used. |