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Demographic and Clinical Patterns of Rheumatoid Arthritis in an Emirati Cohort from United Arab Emirates 来自阿拉伯联合酋长国的阿联酋队列的类风湿关节炎的人口统计学和临床模式
IF 2.3 Q3 Medicine Pub Date : 2019-09-25 DOI: 10.1155/2019/3057578
R. Namas, Abhay Joshi, Zarmeena Ali, J. Al Saleh, Mohamed Abuzakouk
This retrospective cohort study aimed to assess the demographic and clinical characteristics of rheumatoid arthritis (RA) in Emirati patients attending Cleveland Clinic Abu Dhabi, a large tertiary center in the Middle East. In this study, 414 Emirati patients with RA were evaluated over a 3-year period from April 2015 to April 2018. All patients fulfilled the 2010 RA ACR/EULAR criteria and were assessed for demographic and clinical characteristics. The estimated RA prevalence rate in our population cohort was 2.72%. Females showed predominance (80%) with a higher body mass index (31.4 ± 6.61, P = 0.0001) compared to males (28.8 ± 6.03, P = 0.0001). The most frequent comorbidity observed was dyslipidemia (43.5%) followed by hypertension (37.9%), diabetes mellitus (34.5%), and gastroesophageal reflux disease (33.1%). Xerophthalmia was the most frequent extra-articular manifestation. Rheumatoid factor and anti-citrullinated peptide were detected in 63.3% and 41.5% patients, respectively, while both were present in 33.3% of patients. Methotrexate, adalimumab, and rituximab were the most frequently prescribed disease modifying agents. In this study, we describe disease features that are unique to United Arab Emirates (UAE) patients and demonstrate that RA has a significant disease burden. Our findings highlight the need for a RA national registry to improve the quality of care of these patients in UAE.
这项回顾性队列研究旨在评估中东大型三级中心阿布扎比克利夫兰诊所的阿联酋患者类风湿性关节炎(RA)的人口统计学和临床特征。在这项研究中,从2015年4月到2018年4月,对414名阿联酋RA患者进行了为期3年的评估。所有患者均符合2010年RA ACR/EULAR标准,并进行人口统计学和临床特征评估。在我们的人群队列中,估计RA患病率为2.72%。女性占主导地位(80%),体重指数较高(31.4 ± 6.61,P=0.0001)与男性(28.8 ± 6.03,P=0.0001)。最常见的合并症是血脂异常(43.5%),其次是高血压(37.9%)、糖尿病(34.5%)和胃食管反流病(33.1%)。干眼症是最常见的关节外表现。类风湿因子和抗瓜氨酸肽分别在63.3%和41.5%的患者中检测到,而两者都存在于33.3%的患者中。甲氨蝶呤、阿达木单抗和利妥昔单抗是最常见的疾病调节剂。在这项研究中,我们描述了阿拉伯联合酋长国(UAE)患者特有的疾病特征,并证明RA具有显著的疾病负担。我们的研究结果强调了建立RA国家登记册的必要性,以提高阿联酋这些患者的护理质量。
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引用次数: 12
Erratum to "Are All Oral COX-2 Selective Inhibitors the Same? A Consideration of Celecoxib, Etoricoxib, and Diclofenac". 所有口服COX-2选择性抑制剂都是一样的吗?塞来昔布、依托昔布和双氯芬酸的考虑”。
IF 2.3 Q3 Medicine Pub Date : 2019-06-02 eCollection Date: 2019-01-01 DOI: 10.1155/2019/8635073
Chris Walker

[This corrects the article DOI: 10.1155/2018/1302835.].

[这更正了文章DOI: 10.1155/2018/1302835.]
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引用次数: 1
The Contribution of Drugs and Helicobacter pylori to Gastric Mucosa Changes in Patients with Systemic Lupus Erythematosus and Antiphospholipid Syndrome. 药物及幽门螺杆菌对系统性红斑狼疮及抗磷脂综合征患者胃黏膜变化的影响。
IF 2.3 Q3 Medicine Pub Date : 2019-05-05 eCollection Date: 2019-01-01 DOI: 10.1155/2019/9698086
Tatiana M Reshetnyak, Irina A Doroshkevich, Natalia V Seredavkina, Evgeny L Nasonov, Igor V Maev, Vasiliy I Reshetnyak

Background: The nature and rate of gastric mucosal (GM) damage in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) remain to be among the unsolved problems.

Objective: To define the role of H. pylori and drugs in the development of GM damages in SLE and APS.

Methods: A study was conducted on 85 patients with SLE and APS. All the patients underwent esophagogastroduodenoscopy with targeted biopsy of the mucosa of the gastric body and antrum. The presence of H. pylori in the gastric biopsy specimens was determined using polymerase chain reaction.

Results: Endoscopic examination revealed that the patients with SLE and APS on admission had the following GM changes: antral gastritis (82.4%), erosions (24.7%), hemorrhages (8.2%), and pangastritis (8.2%). SLE and APS patients showed no direct correlation between the found GM damages and the presence of H. pylori. The use of glucocorticoid, low-dose acetylsalicylic acid, nonsteroidal anti-inflammatory drug, and anticoagulant in SLE and APS patients is accompanied by GM damage.

Conclusion: There was no evidence of the role of H. pylori in GM damage in the SLE and APS patients. More frequent detection of H. pylori was observed in anticoagulants or low-dose acetylsalicylic acid users than in glucocorticoids and nonsteroidal anti-inflammatory drugs ones.

背景:系统性红斑狼疮(SLE)和抗磷脂综合征(APS)患者胃粘膜(GM)损伤的性质和发生率仍是尚未解决的问题之一。目的:探讨幽门螺杆菌和药物在SLE和APS患者GM损伤发展中的作用。方法:对85例SLE合并APS患者进行研究。所有患者均行食管胃十二指肠镜检查,并对胃体和胃窦粘膜进行有针对性的活检。采用聚合酶链反应测定胃活检标本中幽门螺杆菌的存在。结果:内镜检查显示,SLE合并APS患者入院时GM变化为:胃窦性胃炎(82.4%)、糜烂(24.7%)、出血(8.2%)、胃脘炎(8.2%)。SLE和APS患者发现的GM损伤与幽门螺杆菌的存在没有直接关系。SLE和APS患者使用糖皮质激素、低剂量乙酰水杨酸、非甾体类抗炎药和抗凝血药时伴有GM损伤。结论:没有证据表明幽门螺杆菌在SLE和APS患者GM损伤中的作用。抗凝血剂或低剂量乙酰水杨酸使用者幽门螺杆菌检出率高于糖皮质激素和非甾体抗炎药使用者。
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引用次数: 7
Simultaneous Adalimumab and Antitubercular Treatment for Latent Tubercular Infection: An Experience from Nepal. 同时阿达木单抗和抗结核治疗潜伏性结核感染:尼泊尔的经验。
IF 2.3 Q3 Medicine Pub Date : 2019-04-01 eCollection Date: 2019-01-01 DOI: 10.1155/2019/2034950
Binit Vaidya, Shweta Nakarmi

Introduction: In Nepal, adalimumab is the most common agent being used, but in a disease activity-based dose tapering to address the economic constraints. Another constraint is the high risk of reactivation of tuberculosis in countries with high burden, especially with the use of tumor necrosis factor blocking agents. Though there are recommendations for screening and treatment of latent tuberculosis infection (LTBI) before using adalimumab, data is not clear regarding the appropriate screening schedule and the timing of initiation of biologic therapy.

Methodology: This retrospective review of prospectively followed cohort of spondyloarthropathy patients aimed to evaluate the efficacy of simultaneous initiation of adalimumab with LTBI treatment. Patients fulfilling either the modified New York criteria for ankylosing spondylitis or Assessment in SpondyloArthritis international Society criteria and who were refractory to oral treatment were screened with Mantoux (≥10mm) and interferon gamma release assay (QuantiFERON) to detected LTBI. Those who tested positive were started on rifampicin/isoniazid combination for 3 months and adalimumab treatment on the same day. The patients were followed up at 2 weeks, 4 weeks, 12 weeks, and then every 3 months for 2 years.

Results: Out of 784 patients diagnosed, 92 were receiving adalimumab. LTBI was detected by positivity of either Mantoux or QuantiFERON in 29.3% patients. None of the patients with LTBI who were started on the 2 drug regime simultaneous with adalimumab developed activation of tuberculosis. However, two patients testing negative for both the tests developed tubercular pleural effusion during treatment.

Conclusions: Our findings indicate that screening for LTBI should be more frequent in patients from high tuberculosis burden countries; treatment of LTBI with rifampicin/isoniazid combination for 3 months is effective in preventing reactivation even when adalimumab is started simultaneously.

在尼泊尔,阿达木单抗是最常用的药物,但在基于疾病活动的剂量逐渐减少,以解决经济限制。另一个制约因素是,在高负担国家,特别是在使用肿瘤坏死因子阻滞剂的情况下,结核病重新激活的风险很高。虽然有建议在使用阿达木单抗之前筛查和治疗潜伏性结核感染(LTBI),但关于适当的筛查计划和开始生物治疗的时间,数据尚不清楚。方法:这项前瞻性随访的脊柱关节病患者队列回顾性研究旨在评估同时开始阿达木单抗与LTBI治疗的疗效。通过Mantoux(≥10mm)和干扰素γ释放法(QuantiFERON)检测LTBI,对符合强直性脊柱炎修改后的纽约标准或国际脊椎关节炎评估协会(Assessment in SpondyloArthritis international Society)标准且难以口服治疗的患者进行筛选。检测呈阳性的患者开始接受利福平/异烟肼联合治疗3个月,并在同一天接受阿达木单抗治疗。随访时间分别为2周、4周、12周,之后每3个月随访一次,随访2年。结果:在诊断的784例患者中,92例接受了阿达木单抗治疗。29.3%的患者通过Mantoux或QuantiFERON阳性检测LTBI。与阿达木单抗同时开始两种药物治疗方案的LTBI患者中,没有一例出现结核病活化。然而,两例两项检查均阴性的患者在治疗期间出现结核性胸腔积液。结论:我们的研究结果表明,在结核病高负担国家的患者中应该更频繁地筛查LTBI;利福平/异烟肼联合治疗LTBI 3个月,即使同时开始使用阿达木单抗,也能有效防止再激活。
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引用次数: 2
Vertebral Fractures among Patients Referred for Bone Densitometry Screening in Dubai Primary Health Care Facilities. 在迪拜初级卫生保健机构进行骨密度测定筛查的患者中椎体骨折。
IF 2.3 Q3 Medicine Pub Date : 2019-03-06 eCollection Date: 2019-01-01 DOI: 10.1155/2019/7974534
Anood Jamal Alshaali, Soha Abd El Aziz Abd El Aal, Amal Mohamad AlJaziri, Tamer Mohamed Farid Abdellatif, Manal Mohammad Omran Taryam, Nahed AbdulKhaleq Monsef

Vertebral fractures are one of the most common fractures associated with low bone mineral density. However two-thirds to three-fourths of patients with vertebral fractures are not clinically recognized. The objective of this study was to determine the prevalence of vertebral fractures in patients referred for bone densitometry and the most common site of fracture. The study was carried out in the osteoporosis clinic in Dubai primary health care center. A total of 120 patients were examined using the dual energy X-ray absorptiometry. Of all the patients, 48.3% were osteoporotic and 40.9% were osteopenic. The overall prevalence of vertebral fracture was 14.2%. The result showed that the prevalence of vertebral fracture was higher in female compared to male (15.7% and 9.7%, respectively). It was found that patients aged 80 and above had the highest prevalence of vertebral fracture (54.5%). Undiagnosed vertebral fractures were common. Therefore, it is crucial to prevent vertebral fracture through early diagnosis and appropriate treatment of osteoporosis.

椎体骨折是与低骨密度相关的最常见骨折之一。然而,三分之二到四分之三的椎体骨折患者没有得到临床确认。本研究的目的是确定骨密度测量患者椎体骨折的患病率和最常见的骨折部位。这项研究是在迪拜初级卫生保健中心骨质疏松症诊所进行的。采用双能x线吸收仪对120例患者进行检查。其中骨质疏松48.3%,骨质减少40.9%。椎体骨折的总发生率为14.2%。结果显示,女性椎体骨折发生率高于男性(分别为15.7%和9.7%)。发现80岁及以上患者椎体骨折发生率最高(54.5%)。未确诊的椎体骨折很常见。因此,骨质疏松症的早期诊断和适当治疗对于预防椎体骨折至关重要。
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引用次数: 3
Medication Adherence and Coping Strategies in Patients with Rheumatoid Arthritis: A Cross-Sectional Study. 类风湿性关节炎患者的药物依从性和应对策略:一项横断面研究。
IF 2.3 Q3 Medicine Pub Date : 2019-03-04 eCollection Date: 2019-01-01 DOI: 10.1155/2019/4709645
Carolin Berner, Ludwig Erlacher, Karl H Fenzl, Thomas E Dorner

Objectives: The aim of this study was to determine if strategies for coping with illnesses, demographic factors, and clinical factors were associated with medication adherence among patients with rheumatoid arthritis (RA).

Methods: This cross-sectional study was conducted at a Viennese rheumatology outpatient clinic on RA patients. Medication adherence was assessed using the Medication Adherence Report Scale. Strategies for coping with illness were assessed using the Freiburg Questionnaire for Coping with Illness.

Results: Half (N=63, 52.5%) of the 120 patients included in the study were considered completely medication adherent. Female sex (odds ratio [OR]: 4.57, 95% confidence interval [CI]: 1.14 - 18.42), older age (54-65 yr vs. <45 yr OR: 9.2, CI:2.0-40.70; >65 yr vs. <45 yr OR 6.93, CI:1,17 - 40.87), middle average income (middle average income vs. lowest income class OR= 0.06, CI= 0.01-0.43), and shorter disease duration (5-10 yr vs. >10 yr OR= 3.53, CI= 1.04-11.95; 1-4 yr vs. >10 yr OR=3.71, CI= 1.02-13.52) were associated with higher medication adherence. Levels of active coping (15.57 vs. 13.47, p=0.01) or diversion and self-encouragement (16.10 vs. 14.37, p=0.04) were significantly higher among adherent as opposed to less adherent participants. However, in multivariate regression models, coping strategies were not significantly associated with adherence.

Conclusions: Age, sex, monthly net income, and disease duration were found to be associated with an increased risk for medication nonadherence among patients with RA. Coping strategies such as active coping, diversion, and self-encouragement were associated with adherence in univariate models, but not when adjusted for demographic and clinical factors.

目的:本研究的目的是确定应对疾病的策略、人口统计学因素和临床因素是否与类风湿关节炎(RA)患者的药物依从性有关。方法:本横断面研究在维也纳风湿病门诊对类风湿性关节炎患者进行。使用药物依从性报告量表评估药物依从性。采用弗莱堡疾病应对问卷对疾病应对策略进行评估。结果:纳入研究的120例患者中有一半(N= 63,52.5%)被认为是完全服药的。女性(优势比[OR]: 4.57, 95%可信区间[CI]: 1.14 - 18.42),年龄较大(54-65岁vs. 65岁vs. 10岁OR= 3.53, CI= 1.04-11.95;1-4年vs >10年OR=3.71, CI= 1.02-13.52)与较高的药物依从性相关。积极应对水平(15.57 vs. 13.47, p=0.01)或转移和自我鼓励水平(16.10 vs. 14.37, p=0.04)在坚持者中显著高于不坚持者。然而,在多元回归模型中,应对策略与依从性无显著相关。结论:年龄、性别、月净收入和疾病持续时间与RA患者药物不依从风险增加相关。在单变量模型中,积极应对、转移和自我鼓励等应对策略与依从性相关,但在调整人口统计学和临床因素后则不相关。
{"title":"Medication Adherence and Coping Strategies in Patients with Rheumatoid Arthritis: A Cross-Sectional Study.","authors":"Carolin Berner,&nbsp;Ludwig Erlacher,&nbsp;Karl H Fenzl,&nbsp;Thomas E Dorner","doi":"10.1155/2019/4709645","DOIUrl":"https://doi.org/10.1155/2019/4709645","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to determine if strategies for coping with illnesses, demographic factors, and clinical factors were associated with medication adherence among patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>This cross-sectional study was conducted at a Viennese rheumatology outpatient clinic on RA patients. Medication adherence was assessed using the Medication Adherence Report Scale. Strategies for coping with illness were assessed using the Freiburg Questionnaire for Coping with Illness.</p><p><strong>Results: </strong>Half (N=63, 52.5%) of the 120 patients included in the study were considered completely medication adherent. Female sex (odds ratio [OR]: 4.57, 95% confidence interval [CI]: 1.14 - 18.42), older age (54-65 yr vs. <45 yr OR: 9.2, CI:2.0-40.70; >65 yr vs. <45 yr OR 6.93, CI:1,17 - 40.87), middle average income (middle average income vs. lowest income class OR= 0.06, CI= 0.01-0.43), and shorter disease duration (5-10 yr vs. >10 yr OR= 3.53, CI= 1.04-11.95; 1-4 yr vs. >10 yr OR=3.71, CI= 1.02-13.52) were associated with higher medication adherence. Levels of active coping (15.57 vs. 13.47, p=0.01) or diversion and self-encouragement (16.10 vs. 14.37, p=0.04) were significantly higher among adherent as opposed to less adherent participants. However, in multivariate regression models, coping strategies were not significantly associated with adherence.</p><p><strong>Conclusions: </strong>Age, sex, monthly net income, and disease duration were found to be associated with an increased risk for medication nonadherence among patients with RA. Coping strategies such as active coping, diversion, and self-encouragement were associated with adherence in univariate models, but not when adjusted for demographic and clinical factors.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/4709645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37123092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 22
Impact of a Student-Led Rheumatology Interest Group on Medical Student Interest in Rheumatology. 学生主导的风湿病学兴趣小组对医学生对风湿病学兴趣的影响。
IF 2.3 Q3 Medicine Pub Date : 2019-02-24 eCollection Date: 2019-01-01 DOI: 10.1155/2019/4892707
Sonia Silinsky Krupnikova, Timothy Brady, Michael Sheppard, N Andrew LaCombe, Derek Jones, Victoria K Shanmugam

Objectives: This observational study was designed to evaluate the impact of a student-led Rheumatology Interest Group on medical student interest in rheumatology.

Methods: The mean numbers of student-rheumatology interactions per six months were assessed for elective enrollment, abstract submissions, and manuscripts, in the pre- and postinterest group period.

Results: Enrollment in the rheumatology elective increased from 2.0 ± 0.36 per six months in the preintervention period to 6.2 ± 1.24 per six months in the postintervention period (p=0.0064). Abstract submissions increased from 0.5 ± 0.34 to 5.86 ± 1.49 (p=0.0077), and manuscript submissions from 0.16 ± 0.16 to 1.57 ± 0.37 (p=0.074).

Conclusion: The Rheumatology Interest Group significantly increased medical student engagement in rheumatology.

目的:本观察性研究旨在评估学生主导的风湿病学兴趣小组对医学生对风湿病学兴趣的影响。方法:在兴趣小组前后,评估每六个月学生与风湿病学相互作用的平均数量,包括选修入学、摘要提交和手稿。结果:参加风湿病选修课的人数从干预前的每6个月2.0±0.36人增加到干预后的每6个月6.2±1.24人(p=0.0064)。摘要投稿从0.5±0.34增加到5.86±1.49 (p=0.0077),论文投稿从0.16±0.16增加到1.57±0.37 (p=0.074)。结论:风湿病学兴趣小组显著提高了医学生对风湿病学的参与度。
{"title":"Impact of a Student-Led Rheumatology Interest Group on Medical Student Interest in Rheumatology.","authors":"Sonia Silinsky Krupnikova,&nbsp;Timothy Brady,&nbsp;Michael Sheppard,&nbsp;N Andrew LaCombe,&nbsp;Derek Jones,&nbsp;Victoria K Shanmugam","doi":"10.1155/2019/4892707","DOIUrl":"https://doi.org/10.1155/2019/4892707","url":null,"abstract":"<p><strong>Objectives: </strong>This observational study was designed to evaluate the impact of a student-led Rheumatology Interest Group on medical student interest in rheumatology.</p><p><strong>Methods: </strong>The mean numbers of student-rheumatology interactions per six months were assessed for elective enrollment, abstract submissions, and manuscripts, in the pre- and postinterest group period.</p><p><strong>Results: </strong>Enrollment in the rheumatology elective increased from 2.0 ± 0.36 per six months in the preintervention period to 6.2 ± 1.24 per six months in the postintervention period (p=0.0064). Abstract submissions increased from 0.5 ± 0.34 to 5.86 ± 1.49 (p=0.0077), and manuscript submissions from 0.16 ± 0.16 to 1.57 ± 0.37 (p=0.074).</p><p><strong>Conclusion: </strong>The Rheumatology Interest Group significantly increased medical student engagement in rheumatology.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2019-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/4892707","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37096283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Effects of the Cathepsin K Inhibitor ONO-5334 and Concomitant Use of ONO-5334 with Methotrexate on Collagen-Induced Arthritis in Cynomolgus Monkeys. 组织蛋白酶K抑制剂ONO-5334及ONO-5334与甲氨蝶呤合用对食蟹猴胶原性关节炎的影响
IF 2.3 Q3 Medicine Pub Date : 2019-02-17 eCollection Date: 2019-01-01 DOI: 10.1155/2019/5710340
Hiroyuki Yamada, Hiroshi Mori, Yasutomo Nakanishi, Satoshi Nishikawa, Yasuaki Hashimoto, Yasuo Ochi, Makoto Tanaka, Kazuhito Kawabata

We examined whether the cathepsin K inhibitor, ONO-5334, administered alone or in combination with methotrexate (MTX), could ameliorate joint destruction evoked by collagen-induced arthritis (CIA) in female cynomolgus monkeys. CIA was induced by immunizing with bovine type II collagen. ONO-5334 (30 mg/kg/day) was orally administered once daily and MTX (10 mg/body/day) twice weekly for 9 weeks. X-ray (evaluation of joint destruction) and swelling (inflammatory) scores of proximal interphalangeal (PIP), distal interphalangeal (DIP), and metacarpophalangeal (MP) joints were evaluated. Urinary concentrations of C-terminal telopeptide of type I collagen (CTX-I) and type II collagen (CTX-II) were measured. Arthritis, accompanied by bone and cartilage destruction, was successfully induced in this collagen-induced arthritis monkey model. ONO-5334 showed no suppressive effect on joint swelling, while the joint swelling scores in the MTX and combination (ONO-5334 + MTX) groups were less than 50% compared with the control group. ONO-5334 decreased X-ray score by a mean of 64% (p<0.05 vs the control group), and MTX also decreased in X-ray score by a mean of 46% but with no statistical significance. Combination of ONO-5334 and MTX further decreased the X-ray score by 28% over MTX group (74% reduction vs the control group, p<0.01). Maximum increase in CTX-I (10-fold) and CTX-II (7-fold) compared to baseline was observed at 7 and 3 weeks after the first sensitization, respectively. After treatment with ONO-5334 alone or in combination with MTX, concentrations were maintained near baseline for both markers. In conclusion, ONO-5334 prevented joint destruction but not joint inflammation in this monkey CIA model. Concomitant use of ONO-5334 with MTX reduced architectural joint destruction compared to MTX alone; therefore, ONO-5334 may help to prevent joint destruction in combination with MTX for the treatment of rheumatoid arthritis.

我们研究了组织蛋白酶K抑制剂ONO-5334单独或与甲氨蝶呤(MTX)联合使用是否可以改善雌性食蟹猴胶原诱导关节炎(CIA)引起的关节破坏。用牛ⅱ型胶原免疫诱导CIA。ONO-5334 (30 mg/kg/天)每日口服一次,MTX (10 mg/体/天)每周两次,共9周。评估近端指间关节(PIP)、远端指间关节(DIP)和掌指关节(MP)的x线(关节破坏评估)和肿胀(炎症)评分。测定尿中I型胶原(CTX-I)和II型胶原(CTX-II) c末端末端肽的浓度。在这种胶原诱导的关节炎猴子模型中,成功地诱导了伴有骨和软骨破坏的关节炎。ONO-5334对关节肿胀无抑制作用,而与对照组相比,MTX和联合用药(ONO-5334 + MTX)组关节肿胀评分均小于50%。ONO-5334使x线评分平均降低64% (p
{"title":"Effects of the Cathepsin K Inhibitor ONO-5334 and Concomitant Use of ONO-5334 with Methotrexate on Collagen-Induced Arthritis in Cynomolgus Monkeys.","authors":"Hiroyuki Yamada,&nbsp;Hiroshi Mori,&nbsp;Yasutomo Nakanishi,&nbsp;Satoshi Nishikawa,&nbsp;Yasuaki Hashimoto,&nbsp;Yasuo Ochi,&nbsp;Makoto Tanaka,&nbsp;Kazuhito Kawabata","doi":"10.1155/2019/5710340","DOIUrl":"https://doi.org/10.1155/2019/5710340","url":null,"abstract":"<p><p>We examined whether the cathepsin K inhibitor, ONO-5334, administered alone or in combination with methotrexate (MTX), could ameliorate joint destruction evoked by collagen-induced arthritis (CIA) in female cynomolgus monkeys. CIA was induced by immunizing with bovine type II collagen. ONO-5334 (30 mg/kg/day) was orally administered once daily and MTX (10 mg/body/day) twice weekly for 9 weeks. X-ray (evaluation of joint destruction) and swelling (inflammatory) scores of proximal interphalangeal (PIP), distal interphalangeal (DIP), and metacarpophalangeal (MP) joints were evaluated. Urinary concentrations of C-terminal telopeptide of type I collagen (CTX-I) and type II collagen (CTX-II) were measured. Arthritis, accompanied by bone and cartilage destruction, was successfully induced in this collagen-induced arthritis monkey model. ONO-5334 showed no suppressive effect on joint swelling, while the joint swelling scores in the MTX and combination (ONO-5334 + MTX) groups were less than 50% compared with the control group. ONO-5334 decreased X-ray score by a mean of 64% (p<0.05 vs the control group), and MTX also decreased in X-ray score by a mean of 46% but with no statistical significance. Combination of ONO-5334 and MTX further decreased the X-ray score by 28% over MTX group (74% reduction vs the control group, p<0.01). Maximum increase in CTX-I (10-fold) and CTX-II (7-fold) compared to baseline was observed at 7 and 3 weeks after the first sensitization, respectively. After treatment with ONO-5334 alone or in combination with MTX, concentrations were maintained near baseline for both markers. In conclusion, ONO-5334 prevented joint destruction but not joint inflammation in this monkey CIA model. Concomitant use of ONO-5334 with MTX reduced architectural joint destruction compared to MTX alone; therefore, ONO-5334 may help to prevent joint destruction in combination with MTX for the treatment of rheumatoid arthritis.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2019-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5710340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37084989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Febuxostat and Cardiovascular Events: A Systematic Review and Meta-Analysis. 非布索坦与心血管事件:系统回顾与元分析
IF 2.3 Q3 Medicine Pub Date : 2019-02-03 eCollection Date: 2019-01-01 DOI: 10.1155/2019/1076189
John A Cuenca, Javier Balda, Ana Palacio, Larry Young, Michael H Pillinger, Leonardo Tamariz

Background: Febuxostat is approved in the United States for the management of hyperuricemia in patients with gout. In November 2017 the FDA released a warning alert on a possible link between febuxostat and cardiovascular disease (CVD) reported in a single clinical trial.

Objective: To conduct a systematic review and meta-analysis and assess the risk of major adverse cardiovascular events (MACE) in patients receiving febuxostat compared to a control group.

Methods: We searched the MEDLINE and EMBASE database for studies published up until March 2018. We included randomized clinical trials (RCTs) that compared febuxostat to control groups including placebo and allopurinol. We calculated the pooled relative risk (RR) of MACE and cardiovascular disease (CVD) mortality with the corresponding 95% confidence intervals (CI).

Results: Our search yielded 374 potentially relevant studies. Among the 25 RCTs included in the systematic review, 10 qualified for the meta-analysis. Among the 14,402 subjects included, the median age was 54 years (IQR 52-67) and 90% were male (IQR 82-96); 8602 received febuxostat, 5118 allopurinol, and 643 placebo. The pooled RR of MACE for febuxostat was 0.9; 95% CI 0.6-1.5 (p= 0.96) compared to the control. The RR of CV-related death for febuxostat was 1.29; 95% CI 1.01-1.66 (p=0.03).

Conclusions: Compared with other SU-lowering treatments, febuxostat does not increase or decrease the risk of cardiovascular disease but may increase the risk of CVD death. More RCTs measuring cardiovascular safety as a primary outcome are needed to adequately evaluate the risk of CVD with febuxostat.

背景:非布索坦在美国获批用于治疗痛风患者的高尿酸血症。2017年11月,美国食品药品管理局发布了一项关于非布索坦与心血管疾病(CVD)之间可能存在联系的警告提示:进行系统回顾和荟萃分析,评估与对照组相比,接受非布司他治疗的患者发生主要不良心血管事件(MACE)的风险:我们检索了MEDLINE和EMBASE数据库中截至2018年3月发表的研究。我们纳入了将非布司他与包括安慰剂和别嘌醇在内的对照组进行比较的随机临床试验(RCT)。我们计算了MACE和心血管疾病(CVD)死亡率的汇总相对风险(RR)及相应的95%置信区间(CI):我们的搜索结果显示有 374 项潜在的相关研究。在纳入系统综述的 25 项 RCT 中,有 10 项符合荟萃分析的条件。在纳入的 14402 例受试者中,中位年龄为 54 岁(IQR 52-67),90% 为男性(IQR 82-96);8602 例接受非布索坦治疗,5118 例接受别嘌醇治疗,643 例接受安慰剂治疗。与对照组相比,非布索坦的MACE总RR为0.9;95% CI为0.6-1.5(P= 0.96)。非布索坦的心血管相关死亡RR为1.29;95% CI为1.01-1.66(P=0.03):与其他降 SU 治疗相比,非布索坦不会增加或降低心血管疾病风险,但可能会增加心血管疾病死亡风险。要充分评估非布司他的心血管疾病风险,还需要更多将心血管安全性作为主要研究结果的研究试验。
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引用次数: 0
Comment on "Long-Term Dietary Changes after Diagnosis of Rheumatoid Arthritis in Swedish Women: Data from a Population-Based Cohort". 评论“瑞典女性类风湿性关节炎诊断后的长期饮食改变:来自人群队列的数据”。
IF 2.3 Q3 Medicine Pub Date : 2019-01-02 eCollection Date: 2019-01-01 DOI: 10.1155/2019/1939686
Velammal Petchiappan, Preethi Priyadarshini, V N Nagaprabu
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引用次数: 0
期刊
International Journal of Rheumatology
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