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ID PMID Title PublicationDate abstract
19509330 Unmet needs in rheumatoid arthritis. 2009 Jun Despite recent advances in the treatment of rheumatoid arthritis (RA), including the introduction of biologic therapies and employment of combination disease-modifying antirheumatic drug (DMARD) strategies, remission rates remain suboptimal and patients with RA are still missing a significant number of work days. Early diagnostic criteria are needed to ensure that appropriate treatment is initiated early so as to prevent joint damage. Better prognostic markers are also needed to identify patients with the potential for poor outcomes, in whom more aggressive strategies can be applied at the outset. Because of stringent inclusion criteria and heterogeneous definitions of remission, results seen in clinical trials of RA are not necessarily generalizable to results seen in clinical practice. As a result, existing guidelines may not adequately reflect current practice. In the absence of biomarkers to predict the course of disease, methotrexate remains the standard of care initially for most patients with RA. The ability to predict the course of disease could allow more appropriately targeted therapy and higher rates of remission.
20205662 Pharmacogenetics in treatment of rheumatoid arthritis. 2010 Over the last decades important progress is being made regarding disease modifying anti-rheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis (RA). Nevertheless, a substantial part of the patients fail to achieve a good response and/or experience toxicity, which limits further treatment leading to progression of inflammation and destruction of joints. These high interindividual differences in drug response gave rise to the need for prognostic markers in order to individualize and optimize therapy with these antirheumatic agents. Besides demographic and clinical factors, studies in the research field of pharmacogenetics have reported potential markers associated with clinical response on treatment with methotrexate and TNF inhibitors. However, publicized conflicting results and underlying interpretation difficulties inhibit drawing definitive conclusions. Presently, clinical implementation of pharmacogenetics as an important step for individualizing drug therapy in RA is not feasible yet. Replication and prospective validation in large patient cohorts are required before pharmacogenetics can be used in clinical practice. This review provides the current state of art in genotyping RA patients as a potential guide for clinical decision making.
20354048 Recent advances in rheumatoid arthritis. 2010 Apr Management of rheumatoid arthritis (RA) has radically changed over the last decade. Diagnostic methods have improved with availability of highly specific tests such as antibody to cyclic citrullinated peptide (specificity approximately 96%), and introduction of advanced imaging modalities such as ultrasound and magnetic resonance imaging to facilitate earlier diagnosis. The current aim of management is to achieve remission and prevent joint damage. In order to achieve this goal, inflammation is suppressed as much as possible during the early phase of the disease before onset of joint damage. Aggressive treatments with combinations of disease modifying anti-rheumatic drugs are commenced earlier in the course of disease, and tight control maintained with regular objective monitoring of disease activity. Early use of anti-TNFalpha (tumour necrosis factor alpha) therapy in combination with methotrexate helps to achieve better clinical and radiographic outcomes, which can be maintained for up to 5 years after withdrawal of anti-TNFalpha therapy. Apart from anti-TNFalpha, several other biological treatments are now available, including those that target CD20 on B cells (rituximab), cytokines such as IL1 (anakinra) and IL6 (tocilizumab), and molecules that cause interaction between antigen presenting cells and T cells (abatacept). There is better awareness and understanding of RA associated complications such as cardiovascular disease and osteoporosis. Use of non-steroidal anti-inflammatory drugs is on the decline in light of recent concerns about cardiovascular safety. Evidence is emerging in support of statins and bisphosphonates for improving RA disease activity and preventing erosions, respectively. In the coming years, further improvements in therapeutic strategies are likely with the pace at which research is currently progressing.
20576221 The assessment of disease activity in rheumatoid arthritis. 2010 May Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by progressive damage of diathrodial joints, with variable extra-articular manifestations. Joint damage begins early in the course of the disease as a consequence of the active inflammation, and can lead to progressive and irreversible disability. Successful treatment relies on patients attaining low disease activity or a state of remission, which have become achievable goals since the improved use of methotrexate (MTX) and the introduction of biological agents, especially tumor necrosis factor (TNF) inhibitors. To allow physicians to evaluate the indication and effect of particular therapies, accurate assessment of disease activity is necessary. Disease states in RA can be evaluated by a number of measures. These include signs and symptoms, such as counts of tender and swollen joints; laboratory measures like the acute phase response, which is a direct reflection of the underlying inflammatory activity; and patient-focused variables to measure pain and global assessment of disease activity. Some of these (and additional) measures are used in composite indices to assess disease activity or a disease activity state at any point in time and can inform the physician (and patient) about improvement (or deterioration) in disease activity from or states at a particular level at baseline, to that seen at any specific time point. The accurate assessment of disease is, therefore, an important part of the care of patients with RA. However, it can be complex to perform in the clinical setting, so new and simplified measures have evolved. Next to disease activity, the disease outcome is of utmost importance, in particular disability and quality of life, which are assessed using patient reported questionnaires. Radiographic assessment of structural changes is also an important outcome of RA and mirrors joint damage. The latest developments in the field are discussed and will help to identify patients who can benefit most from today's opportunities of pharmacotherapy, allowing optimization of patient care.
19233049 Drug management of early rheumatoid arthritis - 2008. 2009 Feb Modern therapy of rheumatoid arthritis (RA) is based on recognition of the severity of the natural history of disease, with early and aggressive treatment strategies. Methotrexate is the anchor drug, with addition of other disease-modifying anti-rheumatic drugs (DMARDs) in combinations, and biological targeted therapies. The approach emphasizes 'tight control', aiming for remission and low disease activity according to quantitative monitoring. In this chapter, we review selected randomized controlled studies for data concerning early versus delayed therapies. We present a historical perspective for the treatment of early RA using early RA cohorts from Finland as an example. Finally, we discuss principles of contemporary treatment of early RA in 2008.
20146863 Visfatin: a potential therapeutic target for rheumatoid arthritis. 2009 Nov Rheumatoid arthritis (RA) is usually a chronic, systemic inflammatory disorder primarily targeting the synovium and articular cartilage. It is incurable, costly and responds poorly to treatment. Methotrexate alone or in combination with conventional and/or biological disease-modifying antirheumatic drugs (DMARDs) is often used to induce remission of active disease. The effectiveness of treatment is, however, limited and most patients develop chronic disability and require total knee arthroplasty or total hip replacement. Emerging therapies targeting specific cytokines and growth factors in the RA inflammatory cascade offer potent new means of modifying disease activity. Recently, increased concentrations of adipokines, including visfatin, mainly produced by adipocytes in serum and joint synovial fluid, were found in RA patients. Visfatin has important pro-inflammatory and catabolic roles in RA pathogenesis and is now being studied as a potential therapeutic target for RA. Here we discuss the relationship between visfatin and RA and its potential as a therapeutic target for RA.
18957873 Efficacy of biologicals in the treatment of rheumatoid arthritis. a meta-analysis. 2009 Rheumatoid arthritis (RA) is a chronic multisystem disease. A characteristic feature of RA is persistent inflammatory synovitis, usually involving the peripheral joints in a symmetric distribution. The prevalence of RA is approximately 0.8% of the population (range: 0.3-2.1%); women are affected approximately 3 times more often than men. The current therapeutic approach is to start a disease-modifying agent early in the illness to prevent eventual joint damage. Older disease-modifying anti-rheumatic drugs include methotrexate, sulphasalazine and hydroxychloroquine. Newer ones such as leflunomide and cyclosporin are also used. A recent advance in the management of rheumatoid arthritis is the use of biological agents, which block certain key molecules involved in the pathogenesis of the illness. They include tumour-necrosis-factor-alpha-blocking agents such as infliximab, etanercept and adalimumab, the anti-CD-20 agent, rituximab, and CTLA-4 Ig abatacept. The present study was planned with the aim of evaluating the efficacy of such newer biological therapies in refractory RA at various time points. Databases including Medline, Embase and the Cochrane Library were searched for all relevant studies up to January 2007. A total of 26 studies were included in present meta-analysis. The method of DerSimonian and Laird [Control Clin Trials 1986;7:177-188] was used to calculated a pooled odds ratio (OR) for the American College of Rheumatology (ACR) criteria 20, 50 and 70, at 24, 54 and 96 weeks. The overall pooled OR were found to be significantly more than the placebo at all 3 time points for all 3 criteria (ACR 20, 50 70). In conclusion, biologicals as a group are highly effective in the treatment of RA. Biologicals were efficacious both in treatment naïve and methotrexate-refractory patients.
19962616 Radiographic measures to assess patients with rheumatoid arthritis: advantages and limitat 2009 Nov Radiographs present several attractive features for the assessment and monitoring of patients with rheumatoid arthritis (RA). Radiographic erosions are the closest to a pathognomonic sign in RA. Radiographs provide a permanent record of permanent damage. Excellent quantitative scoring systems have been developed by Larsen, Sharp, van der Heijde, Genant, Rau, and others. However, quantitative radiographic scoring is used only in research studies and is not included in usual treatment. Furthermore, magnetic resonance imaging and ultrasonography may be more sensitive than radiography in detecting abnormalities. Moreover, treatment of patients with RA should be initiated before evidence of damage. Reports that biologic therapy is superior to methotrexate in preventing radiographic progression are accurate for groups of patients, although methotrexate and other disease-modifying antirheumatic drugs control inflammation in 70% to 80% of patients and most patients present no radiographic progression with methotrexate. Radiographic findings are also much less significant and functional measures are far more significant in the prediction of severe outcomes of RA, including costs and mortality. Whereas prevention of radiographic progression is certainly desirable, it appears that prevention of functional disability is far more important for successful patient outcomes.
21068083 Cardiovascular morbidity and mortality in patients with rheumatoid arthritis: vascular alt 2011 Jan Mortality in patients with rheumatoid arthritis (RA) is higher than in the general population, which is due mainly to premature cardiovascular disease. Traditional cardiovascular risk factors cannot entirely explain the higher level of cardiovascular complications, and there is growing evidence that chronic inflammation is the main culprit. The aims of this review of the literature are to (i) summarize aspects of vascular alterations found in the cardiovascular system of RA patients and to relate them to the clinically relevant cardiovascular morbidity and mortality and (ii) evaluate what these abnormalities and complications might in the end imply for clinical management. A number of abnormalities in the cardiovascular system of RA patients have been identified, on the molecular level, in endothelial function, arterial stiffness, arterial morphology and, finally, in the clinical presentation of cardiovascular disease. Cardiovascular risk assessment should be part of the care of RA patients. While a great deal of data is published demonstrating abnormalities in the cardiovascular system of these patients, it is much less clear what specific interventions should be performed to reduce the incidence of cardiovascular complications. Cardiovascular care should be delivered in accordance with recommendations for the general population. Whether specific drugs (e.g. statins, aspirin) are of particular benefit in RA patients needs further investigation. Control of inflammation appears to be of benefit. Methotrexate and tumor necrosis factor-α blocking agents might reduce the number of cardiovascular events. Leflunomide, cyclosporine, non-steroidal anti-inflammatory drugs and cyclo-oxygenase-2 inhibitors may worsen cardiovascular outcome. The role of glucocorticoids in active RA remains to be determined.
19946022 The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis 2010 Feb OBJECTIVES: Patients with RA have an increased prevalence of cardiovascular disease (CVD). This is due to traditional risk factors and the effects of chronic inflammation. MTX is the first-choice DMARD in RA. We performed a systematic literature review to determine whether MTX affects the risk of CVD in patients with RA. METHODS: We searched Medline, Embase, Cochrane database, database of abstracts of reviews of effects, health technology assessment and Science Citation Index from 1980 to 2008. Conference proceedings (British Society of Rheumatology, ACR and EULAR) were searched from 2005 to 2008. Papers were included if they assessed the relationship between MTX use and CVD in patients with RA. Two reviewers independently assessed each title and abstract for relevance and quality. RESULTS: A total of 2420 abstracts were identified, of which 18 fulfilled the inclusion criteria. Two studies assessed the relationship between MTX use and CVD mortality, one demonstrated a significant reduction in CVD mortality and the second a trend towards reduction. Five studies considered all-cause CVD morbidity. Four demonstrated a significant reduction in CVD morbidity and the fifth a trend towards reduction. MTX use in the year prior to the development of RA decreased the risk of CVD for 3-4 years. Four studies considered myocardial infarction, one demonstrated a decreased risk and three a trend towards decreased risk with MTX use. CONCLUSION: The current evidence suggests that MTX use is associated with a reduced risk of CVD events in patients with RA. This suggests that reducing the inflammation in RA using MTX not only improves disease-specific outcomes but may also reduce collateral damage such as atherosclerosis.
19633796 [Methylenetetrahydrofolate reductase polymorphisms in methotrexate treatment of rheumatoid 2009 Apr Methotrexate is still a mainstay of rheumatoid arthritis treatment, but a significant variability in drug response is observed among patients. It has been proposed that C677T and A1298C polymorphisms of methylenetetrahydrofolate reductase (MTHFR), an enzyme involved in the folate pathway, could be related to its efficacy and toxicity. Many studies have investigated the predictive value of such polymorphisms for Methotrexate outcome, though with discordant results. Our experience on 79 patients did not find any significant association between genotype and drug response and the review of the literature did not provide sufficient evidences to support the use of MTHFR genetic screening in clinical practice.
20436076 Predictors of clinical response and radiographic progression in patients with rheumatoid a 2010 Jul OBJECTIVE: To determine through a systematic literature search the predictors of clinical response and radiographic progression in adult patients with rheumatoid arthritis (RA) treated with methotrexate (MTX) monotherapy. METHODS: A systematic literature search using Medline, Embase, and the Cochrane Central Register of Controlled Trials, in May 2008, and review of abstracts of the annual congresses of the American College of Rheumatology (2006-2007) and the European League Against Rheumatism (2002-2007) was performed, as part of a national initiative to develop guidelines for the use of MTX in RA. RESULTS: Nine studies fulfilled the criteria set for this literature search. Male sex, low disease activity measured by composite scores (DAS or SDAI), and nonutilization of prior DMARD were predictive of good clinical response to MTX. Patients with early RA who are rheumatoid factor-positive and smokers tend to have lower response. However, this last association has not been found for patients with established disease. High disease activity before introduction of MTX monotherapy and higher activity during followup at 3 months is a predictor of more severe radiographic progression. CONCLUSION: Among factors found to be predictive of clinical and radiographic outcomes of patients with RA treated with MTX, no factor was found to have a high predictive value. Variability in efficacy measures and statistical tests made it difficult to compare results. Followup of disease activity after 3 to 6 months of treatment seems to be a better and more useful predictor than baseline patient characteristics.
21044428 How does methotrexate suppress inflammation? 2010 Sep Methotrexate remains the most widely used agent for the treatment of rheumatoid arthritis and other chronic inflammatory diseases. Although introduced as a chemotherapeutic agent for the treatment of malignancies, it is clear that, in the doses used, the mechanism of action in the suppression of inflammation differs from simply suppression of purine and pyrimidine metabolism, resulting in inhibition of proliferation. Here we review the proposed mechanisms of action of methotrexate.
20084988 Socio-demographic and clinical aspects of rheumatoid arthritis. 2009 May OBJECTIVE: To determine the socio-demographic profiles and some clinical aspects of patients with rheumatoid arthritis (RA). DESIGN: Prospective, cross-sectional study. SETTING: Ambulatory out- patient clinics of Kenyatta National Hospital (KNH), a public national and referral hospital. SUBJECTS: Out of 180 patients interviewed and examined, 60 met American College of Rheumatology (ACR) diagnostic criteria of RA. RESULTS: Of the 60 patients recruited 52 (87%) were females with male: female ratio of 1: 6.5. The mean age of patients was 41.38(+/- 16.8) years. There were two peaks of age of occurrence, 20-29 and 40-49 years. In 75% of the study patients, one or more of metacarpophalangeal joints of the hand were involved in the disease. Other frequently involved sites were--wrists, elbows, knees, ankles and glenohumeral joints of shoulders in a symmetrical manner. Serum rheumatoid factor was positive in 78.9% while rheumatoid nodules were present in 13.3% of the study patients. A large majority of patients (88%) had active disease with 18% having mild disease, 38% moderate activity and 32% having severe disease. Only 12% of patients had disease in remission. Forty six point seven per cent (46.7%) of the study patients were on at least one Disease Modifying anti Rheumatic Drugs (DMARD) from a selection of methotrexate, sulphasalazine, hydroxychloroquine and leflunamide. The most frequent drug combination was methotrexate plus prednisolone at 30% of the study population; while 66.7% were on oral prednisolone with 25% of the study patients taking only Non-Steroidal anti Inflammatory Drugs (NSAIDS). CONCLUSION: A large majority of ambulatory patients with RA had active disease. Most of them were sub-optimally treated, especially the use of DMARDS. About two thirds were on oral steroids. Sub-optimal therapy in relatively young patients, peak 20-29 and 40-49 years is likely to impact negatively on their disease control and quality of life.
19643759 Disparities in rheumatoid arthritis disease activity according to gross domestic product i 2009 Nov OBJECTIVE: To analyse associations between the clinical status of patients with rheumatoid arthritis (RA) and the gross domestic product (GDP) of their resident country. METHODS: The Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) cohort includes clinical and questionnaire data from 6004 patients who were seen in usual care at 70 rheumatology clinics in 25 countries as of April 2008, including 18 European countries. Demographic variables, clinical characteristics, RA disease activity measures, including the disease activity score in 28 joints (DAS28), and treatment-related variables were analysed according to GDP per capita, including 14 "high GDP" countries with GDP per capita greater than US$24,000 and 11 "low GDP" countries with GDP per capita less than US$11,000. RESULTS: Disease activity DAS28 ranged between 3.1 and 6.0 among the 25 countries and was significantly associated with GDP (r = -0.78, 95% CI -0.56 to -0.90, r(2) = 61%). Disease activity levels differed substantially between "high GDP" and "low GDP" countries at much greater levels than according to whether patients were currently taking or not taking methotrexate, prednisone and/or biological agents. CONCLUSIONS: The clinical status of patients with RA was correlated significantly with GDP among 25 mostly European countries according to all disease measures, associated only modestly with the current use of antirheumatic medications. The burden of arthritis appears substantially greater in "low GDP" than in "high GDP" countries. These findings may alert healthcare professionals and designers of health policy towards improving the clinical status of patients with RA in all countries.
20471892 Assessment of liver fibrosis by transient elastography in rheumatoid arthritis patients tr 2010 Dec OBJECTIVE: This study was designed to assess the degree of liver fibrosis with transient elastography and noninvasive biochemical methods in rheumatoid arthritis patients treated with methotrexate. METHODS: We reviewed the medical records of rheumatoid arthritis patients who were administered methotrexate for more than 3 years. Transient elastography was performed and serological markers of liver fibrosis were evaluated by prospectively and was compared with the result of healthy control group. A correlation of the cumulative dose of methotrexate with the elastography value (kPa) or the level of serological markers was assessed. Two subgroups of patients were compared; patients who received a cumulative dose of methotrexate of less than 4000 mg (group 1) and more than 4000 mg (group 2). A total of 177 consecutive rheumatoid arthritis patients were evaluated. RESULTS: The mean cumulative dose of methotrexate was 3988 ± 1566 mg with doses ranging from 652.5 to 10,415 mg. The mean elastography value of all patients was 4.01 ± 0.77 kPa. The kilopascal values and levels of biochemical markers did not correlate with the cumulative dose of methotrexate, but did correlate with the AST to ALT ratio, AST to platelet ratio index, haptoglobin level. Mean kilopascal values were not statistically different for group 1 and group 2 patients. For rheumatoid arthritis patients treated with a high cumulative dose of methotrexate, significant liver fibrosis is rare and is not accurately detected in patients with liver enzyme abnormalities. CONCLUSION: Taking into account the risk and benefit of a liver biopsy, transient elastography can be recommended as an additional diagnostic option.
20112843 Dyslipidaemia in rheumatoid arthritis in a tertiary care centre in Eastern India--a non-ra 2009 Jul Dyslipidaemia in rheumatoid arthritis, is associated with accelerated atherosclerosis. A nonrandomised trial was conducted to find out the proportion of rheumatoid arthritis patients suffering from dyslipidaemia and change in lipid levels after an intervention with antirheumatic drugs in a tertiary care centre in Eastern India from April 2006 to July 2008. The trial was done on 161 diagnosed patients of rheumatoid arthritis (fulfilling the American College of Rheumatology criteria) on lipid levels. Lipids estimations were done enzymatically by semi-autoanalyser and dyslipidaemia was defined by taking the cut-off value of National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) guidelines. Patients with other comorbid illness and on statins were excluded. Disease activity score 28 (DAS-28) was also employed for evaluating disease activity. Patients were followed up to 10 -12 weeks for repeat lipid level estimation. Using the high cut-off values of NCEP-ATP III, 39.1% of the patients showed dyslipidaemia in initial visit. Low high density lipoprotein cholesterol (HDL-C) was the commonest abnormality seen in 37.2%. In the follow-up study after getting disease modifying antirheumatic drugs (methotrexate, sulfasalazine, hydroxychloroquine) therapy, 19.9% patients had dyslipidaemia again and there were increase in total cholesterol, low density lipoprotein cholesterol, HDL-C but triglyceride was reduced. Low HDL-C again became the commonest (17.9%) and rise in HDL-C level was statistically significant. DAS-28 showed a good reduction and significant negative correlation with HDL-C. Lipid abnormalities, common in Indian patients with rheumatoid arthritis, are also observed in Eastern India. Low HDL-C being the commonest abnormality. Disease activity in rheumatoid arthritis is inversely related to the lipid levels.
19938416 [Rheumatoid arthritis (updated Current Care guideline)]. 2009 Anti-citrulline antibodies are highly specific to rheumatoid arthritis (RA) and are thus helpful in differential diagnosis. Early and aggressive disease modifying anti-rheumatic drug (DMARD) therapy is essential for a positive treatment result in cases of RA. Remission during the 1st year of treatment predicts permanent remission, milder joint damage and better functional ability. It is recommended that patients with an unsatisfactory response to DMARDs, including methotrexate and a combination of DMARDs, should be treated primarily with TNF blockers, and non-responders with rituximab or abatacept. RA is an independent risk factor for cardiovascular diseases. The assessment of cardiovascular risk must not be forgotten in daily practice.
19348392 [The diurnal variability of blood pressure in patients with hypertension and rheumatoid ar 2009 Feb BACKGROUND: The patients with rheumatoid arthritis have high prevalence of hypertension and increased risk of cardiovascular morbidity and mortality. OBJECTIVE: To determine the level of clinical blood pressure (BP) and 24h ambulatory BP in patients with rheumatoid arthritis and hypertension. Analyze the diurnal variability of BP depending on chronic treatment with prednisone, nonsteroidal anti-inflammatory drugs and methotrexate. GROUP OF PATIENTS: 60 patients with clinically stable rheumatoid arthritis and treated or newly diagnosed hypertension. 15 male and 45 female, mean age 58 +/- 11.3 years. RESULTS: Mean clinical systolic BP 139.0 +/- 14.7 mm Hg, diastolic BP 85.7 +/- 6.5 mm Hg and heart rate 74.9 +/- 7.3 beat.min(-1). Mean 24h systolic BP 127.7 +/- 12.6 mm Hg, diastolic BP 77.7 +/- 7.4 mm Hg and heart rate 73.9 +/- 8.7 beat.min(-1). Mean clinical pulse pressure 54.7 +/- 15.6 mm Hg, mean 24h pulse pressure 50.1 +/- 11.6 mm Hg. In the whole group of patients the number of systolic dippers was 28 (47%), nondippers 17 (28%), excesive dippers 11 (18%) and risers 4 (7%), diastolic dippers 27 (45%), nondippers 9 (15%), excesive dippers 22 (37%) and risers 2 (3%). The patients treated with prednisone and nonsteroidal anti-inflammatory drugs were nondippers in 34% both for systolic BP, in 19% and 20% respectively for diastolic BP. They were excessive dippers for systolic BP in 22% and 20% respectively, for diastolic BP in 37% and 38% respectively. In the course of the treatment with methotrexate were 22% patients nondippers for systolic BP and 8% for diastolic BP, 28% was excessive dippers for systolic BP, 47% for diastolic BP. CONCLUSION: Patients with rheumatoid arthritis and hypertension have a slightly increased pulse pressure (55 mm Hg for clinical BP and 50 mm Hg for 24h ambulatory BP) in comparison to arbitrary limits in generally population. Patients treated with prednison and nonsteroidal anti-inflammatory drugs were more often nondippers (34%) in systolic BP than hypertensive control. The patients treated with methotrexate (47%), prednisone (37%) and nonsteroidal anti-inflammatory drugs (38%) were more often excessive dippers in diastolic BP than hypertensive control.
19578278 Therapeutic and preventive effects of methotrexate on zymosan-induced arthritis in SKG mic 2009 Jun The purpose of this study was to investigate the pathology of zymosan-induced arthritis in the SKG mouse model of rheumatoid arthritis in humans, and to validate this model as a reliable drug screening system. To achieve this purpose, methotrexate (1 or 10 mg/kg, once daily) or vehicle only was administered intraperitoneally to SKG mice with zymosan-induced arthritis. Histologically, this arthritis was characterized by the presence of granulation tissue rich in granulocytes. Methotrexate suppressed the development of arthritis in ankle and wrist joints in both clinical and histological studies. These results indicated that methotrexate has not only prophylactic, but also therapeutic effects on zymosan-induced arthritis developed in SKG mice and may thus be a promising control agent for drug research in the SKG mouse model of rheumatoid arthritis.