Pub Date : 2018-07-05eCollection Date: 2018-01-01DOI: 10.1155/2018/4197537
Ebtihal Kamal, Lamis AbdelGadir Kaddam, Maha Dahawi, Montaser Osman, Mohammed Abdelraman Salih, Alnour Alagib, Amal Saeed
Background: Rheumatoid arthritis (RA) is autoimmune inflammatory disease that attacks the synovium of the joints. Both TNFa and interleukin-1 play crucial roles in the pathogenesis of RA. Gum Arabic (GA) is gummy exudates from Acacia senegal tree. Gum Arabic fermentation by colonic bacteria increases serum butyrate concentrations, so it is considered as prebiotic agent. Gum Arabic (GA) has anti-inflammatory activity through its derivative butyrate. To the best of our knowledge, this is the first study conducted to investigate GA intake on inflammatory markers among RA patients.
Patients and methods: This is clinical trial phase II in which 40 patients were enrolled aged 18 to 70 years. Patients received 30g/day GA for 12 weeks. TNF α, ESR, and complete blood count were measured and DAS-28 was calculated before and after regular GA consumption. Study was approved by the Ethical committee of National Medicines and Poisons Board.
Results: This study showed significant decrease in level of serum TNF α (p value 0.05) [95% CI, 0.65 -16.5], ESR (p value 0.011) [95% CI, 2.6 -18.89], and number of swollen and tender joints in RA patients after 12 weeks of GA intake which reflected as significant decrease in disease severity score DAS 28 P.V:0.00 [95% CI, 1.25 -1.99]. On the other hand, GA had trivial change in blood indices.
Conclusion: Gum Arabic has favorable immune modulator effect on rheumatoid arthritis. It can be utilized in clinical practice as adjuvant therapy.
Trial registration: This trial was registered with ClinicalTrials.gov Identifier: NCT02804581 Registered at 19 June 2016, prospective registration.
{"title":"Gum Arabic Fibers Decreased Inflammatory Markers and Disease Severity Score among Rheumatoid Arthritis Patients, Phase II Trial.","authors":"Ebtihal Kamal, Lamis AbdelGadir Kaddam, Maha Dahawi, Montaser Osman, Mohammed Abdelraman Salih, Alnour Alagib, Amal Saeed","doi":"10.1155/2018/4197537","DOIUrl":"https://doi.org/10.1155/2018/4197537","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is autoimmune inflammatory disease that attacks the synovium of the joints. Both TNF<i>a</i> and interleukin-1 play crucial roles in the pathogenesis of RA. Gum Arabic (GA) is gummy exudates from <i>Acacia senegal</i> tree. Gum Arabic fermentation by colonic bacteria increases serum butyrate concentrations, so it is considered as prebiotic agent. Gum Arabic (GA) has anti-inflammatory activity through its derivative butyrate. To the best of our knowledge, this is the first study conducted to investigate GA intake on inflammatory markers among RA patients.</p><p><strong>Patients and methods: </strong>This is clinical trial phase II in which 40 patients were enrolled aged 18 to 70 years. Patients received 30g/day GA for 12 weeks. TNF <i>α</i>, ESR, and complete blood count were measured and DAS-28 was calculated before and after regular GA consumption. Study was approved by the Ethical committee of National Medicines and Poisons Board.</p><p><strong>Results: </strong>This study showed significant decrease in level of serum TNF <i>α</i> (p value 0.05) [95% CI, 0.65 -16.5], ESR (p value 0.011) [95% CI, 2.6 -18.89], and number of swollen and tender joints in RA patients after 12 weeks of GA intake which reflected as significant decrease in disease severity score DAS 28 P.V:0.00 [95% CI, 1.25 -1.99]. On the other hand, GA had trivial change in blood indices.</p><p><strong>Conclusion: </strong>Gum Arabic has favorable immune modulator effect on rheumatoid arthritis. It can be utilized in clinical practice as adjuvant therapy.</p><p><strong>Trial registration: </strong>This trial was registered with ClinicalTrials.gov Identifier: NCT02804581 Registered at 19 June 2016, prospective registration.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"4197537"},"PeriodicalIF":2.3,"publicationDate":"2018-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/4197537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36397663","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}
Pub Date : 2018-07-02eCollection Date: 2018-01-01DOI: 10.1155/2018/8498651
Mahmoud A Alomari, Omar F Khabour, Khaldoon Alawneh, Rania A Shammaa
The effect of homocysteine on cardiovascular diseases is still equivocal, especially in rheumatoid arthritis patients. In this investigation, the association between homocysteine with blood flow and vascular resistance in rheumatoid arthritis was examined. Serum levels of homocysteine were determined in thirty-one rheumatoid arthritis patients and nineteen apparently healthy subjects using ELISA. Additionally, strain-gauge plethysmography was used to determine both forearm blood flow and vascular function at rest and after occlusion. Forearm occlusion blood flow (patients: 21.9 ± 6.55 versus control: 25.5 ± 6.10ml/100mL/min) was lower (p < 0.05) while occlusion vascular resistance (patients: 4.77 ± 2.08 versus controls 3.05 ± 0.96U) was greater (p < 0.01) in rheumatoid arthritis than in the controls. Level of serum homocysteine was similar (p = 0.803) in rheumatoid arthritis group and healthy group. In addition, level of serum homocysteine was correlated with resting blood flow (r = -0.41; p < 0.02) and resting vascular resistance (r = 0.31, p < 0.05) in the patients group. The study confirms altered vascular function in rheumatoid arthritis. Uniquely, the results show that homocysteine was related to resting, but not postischemia, vascular measures. These relationships indicate that homocysteine might impact the vasculature in rheumatoid arthritis.
{"title":"Possible Modulation of Vascular Function Measures in Rheumatoid Arthritis by Homocysteine.","authors":"Mahmoud A Alomari, Omar F Khabour, Khaldoon Alawneh, Rania A Shammaa","doi":"10.1155/2018/8498651","DOIUrl":"https://doi.org/10.1155/2018/8498651","url":null,"abstract":"<p><p>The effect of homocysteine on cardiovascular diseases is still equivocal, especially in rheumatoid arthritis patients. In this investigation, the association between homocysteine with blood flow and vascular resistance in rheumatoid arthritis was examined. Serum levels of homocysteine were determined in thirty-one rheumatoid arthritis patients and nineteen apparently healthy subjects using ELISA. Additionally, strain-gauge plethysmography was used to determine both forearm blood flow and vascular function at rest and after occlusion. Forearm occlusion blood flow (patients: 21.9 ± 6.55 versus control: 25.5 ± 6.10ml/100mL/min) was lower (p < 0.05) while occlusion vascular resistance (patients: 4.77 ± 2.08 versus controls 3.05 ± 0.96U) was greater (p < 0.01) in rheumatoid arthritis than in the controls. Level of serum homocysteine was similar (p = 0.803) in rheumatoid arthritis group and healthy group. In addition, level of serum homocysteine was correlated with resting blood flow (r = -0.41; p < 0.02) and resting vascular resistance (r = 0.31, p < 0.05) in the patients group. The study confirms altered vascular function in rheumatoid arthritis. Uniquely, the results show that homocysteine was related to resting, but not postischemia, vascular measures. These relationships indicate that homocysteine might impact the vasculature in rheumatoid arthritis.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"8498651"},"PeriodicalIF":2.3,"publicationDate":"2018-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/8498651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36352375","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}
Pub Date : 2018-06-19eCollection Date: 2018-01-01DOI: 10.1155/2018/3839872
A Majjad, Y Errahali, H Toufik, J H Djossou, M A Ghassem, J Kasouati, A El Maghraoui
Introduction: A variety of musculoskeletal disorders (MS) have been associated with diabetes mellitus (DM). This study aimed at assessing the prevalence and associated factors of MS disorders in Moroccan diabetic patients.
Methods: A cross-sectional study enrolled consecutive patients with DM. We recorded demographic features of patients and characteristics of DM. MS disorders and vascular complications were assessed by clinical examinations and investigations. Associated factors of MS disorders were assessed by univariate and multivariate analyses.
Result: 376 subjects were included; 84.6% had type 2 DM. The participants' median age was 54 years [45-62]; 41% had one or more vascular complications. 34.4% had one or more MS disorders. Osteoarthritis was present in 19.4% of patients. Hand disorders were seen in 14.4%. Shoulder capsulitis was present in 12.5%. Long duration of diabetes and dyslipidemia were associated with increased prevalence of hand abnormalities (P = 0.017; P = 0.019, respectively). Age and dyslipidemia were associated with shoulder capsulitis (P = 0.019; P = 0.047, respectively). Female gender, overweight, and nephropathy were associated with increased odds of osteoarthritis (P = 0.009, P = 0.004, and P = 0.032, respectively).
Conclusion: MS disorders are frequent in this population and associated with various factors. HbA1c level does not appear to be associated with development of MS disorders.
{"title":"Musculoskeletal Disorders in Patients with Diabetes Mellitus: A Cross-Sectional Study.","authors":"A Majjad, Y Errahali, H Toufik, J H Djossou, M A Ghassem, J Kasouati, A El Maghraoui","doi":"10.1155/2018/3839872","DOIUrl":"https://doi.org/10.1155/2018/3839872","url":null,"abstract":"<p><strong>Introduction: </strong>A variety of musculoskeletal disorders (MS) have been associated with diabetes mellitus (DM). This study aimed at assessing the prevalence and associated factors of MS disorders in Moroccan diabetic patients.</p><p><strong>Methods: </strong>A cross-sectional study enrolled consecutive patients with DM. We recorded demographic features of patients and characteristics of DM. MS disorders and vascular complications were assessed by clinical examinations and investigations. Associated factors of MS disorders were assessed by univariate and multivariate analyses.</p><p><strong>Result: </strong>376 subjects were included; 84.6% had type 2 DM. The participants' median age was 54 years [45-62]; 41% had one or more vascular complications. 34.4% had one or more MS disorders. Osteoarthritis was present in 19.4% of patients. Hand disorders were seen in 14.4%. Shoulder capsulitis was present in 12.5%. Long duration of diabetes and dyslipidemia were associated with increased prevalence of hand abnormalities (<i>P</i> = 0.017; <i>P</i> = 0.019, respectively). Age and dyslipidemia were associated with shoulder capsulitis (<i>P</i> = 0.019; <i>P</i> = 0.047, respectively). Female gender, overweight, and nephropathy were associated with increased odds of osteoarthritis (<i>P</i> = 0.009, <i>P</i> = 0.004, and <i>P</i> = 0.032, respectively).</p><p><strong>Conclusion: </strong>MS disorders are frequent in this population and associated with various factors. HbA1c level does not appear to be associated with development of MS disorders.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"3839872"},"PeriodicalIF":2.3,"publicationDate":"2018-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/3839872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36321236","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}
Pub Date : 2018-06-11eCollection Date: 2018-01-01DOI: 10.1155/2018/9152480
Cecilia Lourdudoss, Laurent Arnaud, Alicja Wolk, Ronald F van Vollenhoven, Daniela Di Giuseppe
Objective: To investigate long-term dietary changes after rheumatoid arthritis (RA) diagnosis in Swedish women, compared to women without RA.
Methods: This study included 21,602 women from the Swedish Mammography Cohort (SMC), who completed dietary questionnaires in 1997 and 2009. Between 1997 and 2009, 191 women were diagnosed with RA. Dietary changes after RA diagnosis were analyzed based on intake of 82 food items. Statistical analysis included linear mixed models.
Results: Women with RA, compared to women without RA, had significantly lower intake (mean servings per week) of animal products such as black pudding, egg, kidney, and liver paste (2.94±2.73 versus 2.45±1.82, p=0.010) and dairy products (35.14±20.02 versus 28.42±16.10, p=0.040) in 1997 and of cereals and grains (31.01±15.54 versus 28.00±14.98, p=0.009) in 2009. However, multivariable adjusted changes in dietary intake from 1997 to 2009 did not show any significant difference in intake. Nevertheless, women without RA increased their intake of whole wheat bread, wheat/oat bran, and rice more than women with RA.
Conclusion: Women who had been diagnosed with RA had similar dietary patterns over time as the general population; these women did not remarkably change their diet over time due to their disease. Dietary recommendations for RA patients are needed.
{"title":"Long-Term Dietary Changes after Diagnosis of Rheumatoid Arthritis in Swedish Women: Data from a Population-Based Cohort.","authors":"Cecilia Lourdudoss, Laurent Arnaud, Alicja Wolk, Ronald F van Vollenhoven, Daniela Di Giuseppe","doi":"10.1155/2018/9152480","DOIUrl":"https://doi.org/10.1155/2018/9152480","url":null,"abstract":"<p><strong>Objective: </strong>To investigate long-term dietary changes after rheumatoid arthritis (RA) diagnosis in Swedish women, compared to women without RA.</p><p><strong>Methods: </strong>This study included 21,602 women from the Swedish Mammography Cohort (SMC), who completed dietary questionnaires in 1997 and 2009. Between 1997 and 2009, 191 women were diagnosed with RA. Dietary changes after RA diagnosis were analyzed based on intake of 82 food items. Statistical analysis included linear mixed models.</p><p><strong>Results: </strong>Women with RA, compared to women without RA, had significantly lower intake (mean servings per week) of animal products such as black pudding, egg, kidney, and liver paste (2.94±2.73 versus 2.45±1.82, p=0.010) and dairy products (35.14±20.02 versus 28.42±16.10, p=0.040) in 1997 and of cereals and grains (31.01±15.54 versus 28.00±14.98, p=0.009) in 2009. However, multivariable adjusted changes in dietary intake from 1997 to 2009 did not show any significant difference in intake. Nevertheless, women without RA increased their intake of whole wheat bread, wheat/oat bran, and rice more than women with RA.</p><p><strong>Conclusion: </strong>Women who had been diagnosed with RA had similar dietary patterns over time as the general population; these women did not remarkably change their diet over time due to their disease. Dietary recommendations for RA patients are needed.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"9152480"},"PeriodicalIF":2.3,"publicationDate":"2018-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/9152480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36299166","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}
Pub Date : 2018-05-13eCollection Date: 2018-01-01DOI: 10.1155/2018/5217461
Ahmad AlEnizi, Khaled AlSaeid, Adel Alawadhi, Eiman Hasan, Entesar H Husain, Ahmad AlFadhli, Aqeel Ghanem, Fatemah Abutiban, Yaser Ali, Adeeba Al-Herz, Khuloud Mohammed, Waleed Alkandari, Ali Aldei, Hebah Alhajeri, Ahmad Dehrab, Sawsan Hayat
People with IRD are at increased risk of infection, and in 2011 EULAR made general recommendations for vaccination in these patients. Global and European perspectives are important, but they cannot accurately reflect the individual situations of patients in different countries and regions. Based on our clinical experience and opinions, we have sought to tailor the original EULAR recommendations to include advice for vaccination with new agents approved in the intervening years-including the new class of targeted synthetic disease-modifying antirheumatic drugs. We have also considered the specific demographic needs of patients in local populations in the Gulf region. The resulting 16 recommendations are grouped into four main categories covering general vaccination guidelines and best-practice for all patients with IRD, followed by a set of recommended vaccines against specific pathogens. The last two categories include recommendations for certain patient subgroups with defined risks and for patients who wish to travel.
{"title":"Kuwait Recommendations on Vaccine Use in People with Inflammatory Rheumatic Diseases.","authors":"Ahmad AlEnizi, Khaled AlSaeid, Adel Alawadhi, Eiman Hasan, Entesar H Husain, Ahmad AlFadhli, Aqeel Ghanem, Fatemah Abutiban, Yaser Ali, Adeeba Al-Herz, Khuloud Mohammed, Waleed Alkandari, Ali Aldei, Hebah Alhajeri, Ahmad Dehrab, Sawsan Hayat","doi":"10.1155/2018/5217461","DOIUrl":"10.1155/2018/5217461","url":null,"abstract":"<p><p>People with IRD are at increased risk of infection, and in 2011 EULAR made general recommendations for vaccination in these patients. Global and European perspectives are important, but they cannot accurately reflect the individual situations of patients in different countries and regions. Based on our clinical experience and opinions, we have sought to tailor the original EULAR recommendations to include advice for vaccination with new agents approved in the intervening years-including the new class of targeted synthetic disease-modifying antirheumatic drugs. We have also considered the specific demographic needs of patients in local populations in the Gulf region. The resulting 16 recommendations are grouped into four main categories covering general vaccination guidelines and best-practice for all patients with IRD, followed by a set of recommended vaccines against specific pathogens. The last two categories include recommendations for certain patient subgroups with defined risks and for patients who wish to travel.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"5217461"},"PeriodicalIF":2.3,"publicationDate":"2018-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5971308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36188923","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}
Pub Date : 2018-04-23eCollection Date: 2018-01-01DOI: 10.1155/2018/3798124
Han Eol Jeong, Sung-Mok Jung, Sung-Il Cho
Rheumatoid arthritis (RA) and allergic diseases are result of a poor functioning immune system, giving dominance to either T-helper 1 (Th1) or T-helper 2 (Th2) diseases, respectively. Studies have stated that there seems to be a relationship present between the immune response subsets. This study was designed to examine the association between RA and respiratory allergic diseases in Korean adults. The study utilized the KNHANES 2013-2015 data and excluded individuals diagnosed with RA before being diagnosed with allergic diseases, using age at clinical diagnosis. Total of 253 RA patients were matched 1 : 1 with non-RA patients by a propensity score, using sex and age as matched variables. Multivariate conditional logistic regression analyses were used to evaluate for association between RA and respiratory allergic diseases in the matched 506 participants. RA was associated with an increased risk of prevalence of respiratory allergic diseases with an OR of 1.51 (95% CI, 1.31-1.75), adjusted for socioeconomic demographic variables. The adjusted OR for prevalence of RA among participants with prevalence of asthma and allergic rhinitis was as follows: 3.12 (95% CI, 2.77-3.51) and 1.39 (95% CI, 1.16-1.67). Participants with prevalence of asthma in particular had an increased risk of developing prevalence of RA. Based on our findings, Th1 and Th2 diseases may indeed coexist, and one pathway may stimulate or contribute towards the onset of the other.
{"title":"Association between Rheumatoid Arthritis and Respiratory Allergic Diseases in Korean Adults: A Propensity Score Matched Case-Control Study.","authors":"Han Eol Jeong, Sung-Mok Jung, Sung-Il Cho","doi":"10.1155/2018/3798124","DOIUrl":"https://doi.org/10.1155/2018/3798124","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) and allergic diseases are result of a poor functioning immune system, giving dominance to either T-helper 1 (Th1) or T-helper 2 (Th2) diseases, respectively. Studies have stated that there seems to be a relationship present between the immune response subsets. This study was designed to examine the association between RA and respiratory allergic diseases in Korean adults. The study utilized the KNHANES 2013-2015 data and excluded individuals diagnosed with RA before being diagnosed with allergic diseases, using age at clinical diagnosis. Total of 253 RA patients were matched 1 : 1 with non-RA patients by a propensity score, using sex and age as matched variables. Multivariate conditional logistic regression analyses were used to evaluate for association between RA and respiratory allergic diseases in the matched 506 participants. RA was associated with an increased risk of prevalence of respiratory allergic diseases with an OR of 1.51 (95% CI, 1.31-1.75), adjusted for socioeconomic demographic variables. The adjusted OR for prevalence of RA among participants with prevalence of asthma and allergic rhinitis was as follows: 3.12 (95% CI, 2.77-3.51) and 1.39 (95% CI, 1.16-1.67). Participants with prevalence of asthma in particular had an increased risk of developing prevalence of RA. Based on our findings, Th1 and Th2 diseases may indeed coexist, and one pathway may stimulate or contribute towards the onset of the other.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"3798124"},"PeriodicalIF":2.3,"publicationDate":"2018-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/3798124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36178483","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}
Pub Date : 2018-04-12eCollection Date: 2018-01-01DOI: 10.1155/2018/8721753
Paul Bird, Charles Peterfy, Peter Countryman, Hedley Griffiths, Rina Barrett, Peter Youssef, Fredrick Joshua, Stephen Hall
Aim: Examine the efficacy of once-weekly subcutaneous tocilizumab (SC-TCZ) on joint damage at 24 weeks based on radiography of the hands and feet and magnetic resonance imaging (MRI) of the hand in subjects with moderate to severe rheumatoid arthritis (RA).
Methods: In this Australian open-label, multicentre, prospective, single-arm study, subjects received 162 mg SC-TCZ weekly. Primary endpoint was change in radiographic Genant-modified Total Sharp Score (TSS) between baseline and Week 24. Secondary endpoints included change from baseline to Week 24 in RA MRI scoring (RAMRIS) of erosions, synovitis, and osteitis and Cartilage Loss Score (CARLOS) in the dominant hand and disease activity score 28 (DAS28).
Results: 52 subjects were enrolled (80% female, mean (SD) age 57 (12) years). Radiography showed mild but not significant progression of joint damage (mean (SD) change in TSS 0.46 (1.29)). Synovitis reduced significantly on MRI; however, osteitis, erosion, and cartilage loss did not change significantly. DAS28 improved significantly by Week 24; 78% of subjects achieved DAS28 remission. SC-TCZ was generally well tolerated.
Conclusion: Synovitis and DAS28 decreased significantly; however, no significant change in osteitis or joint damage was observed at Week 24.
Trial registration: This trial is registered with Clinicaltrials.gov registration number NCT01951170 (ML28703).
目的:通过对中度至重度类风湿性关节炎(RA)患者的手脚x线片和手部磁共振成像(MRI),研究每周一次皮下tocilizumab (SC-TCZ)治疗24周关节损伤的疗效。方法:在这项澳大利亚开放标签、多中心、前瞻性单臂研究中,受试者每周接受162mg SC-TCZ。主要终点是放射学Genant-modified Total Sharp Score (TSS)在基线和第24周之间的变化。次要终点包括从基线到第24周RAMRI评分(RAMRIS)的变化,主要手的侵蚀,滑膜炎和骨炎,软骨损失评分(CARLOS)和疾病活动评分28 (DAS28)。结果:纳入52例受试者(80%为女性,平均(SD)年龄57(12)岁)。x线摄影显示关节损伤进展轻微但不明显(TSS平均(SD)变化0.46(1.29))。MRI上滑膜炎明显减轻;然而,骨炎、糜烂和软骨丢失没有明显变化。DAS28在第24周显著改善;78%的受试者达到DAS28缓解。SC-TCZ总体耐受良好。结论:滑膜炎、DAS28明显降低;然而,在第24周没有观察到骨炎或关节损伤的显著变化。试验注册:本试验在Clinicaltrials.gov注册,注册号为NCT01951170 (ML28703)。
{"title":"AC-CUTE: An Open-Label Study to Evaluate Progression of Structural Joint Damage and Inflammation in Subjects with Moderate to Severe Rheumatoid Arthritis.","authors":"Paul Bird, Charles Peterfy, Peter Countryman, Hedley Griffiths, Rina Barrett, Peter Youssef, Fredrick Joshua, Stephen Hall","doi":"10.1155/2018/8721753","DOIUrl":"https://doi.org/10.1155/2018/8721753","url":null,"abstract":"<p><strong>Aim: </strong>Examine the efficacy of once-weekly subcutaneous tocilizumab (SC-TCZ) on joint damage at 24 weeks based on radiography of the hands and feet and magnetic resonance imaging (MRI) of the hand in subjects with moderate to severe rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>In this Australian open-label, multicentre, prospective, single-arm study, subjects received 162 mg SC-TCZ weekly. Primary endpoint was change in radiographic Genant-modified Total Sharp Score (TSS) between baseline and Week 24. Secondary endpoints included change from baseline to Week 24 in RA MRI scoring (RAMRIS) of erosions, synovitis, and osteitis and Cartilage Loss Score (CARLOS) in the dominant hand and disease activity score 28 (DAS28).</p><p><strong>Results: </strong>52 subjects were enrolled (80% female, mean (SD) age 57 (12) years). Radiography showed mild but not significant progression of joint damage (mean (SD) change in TSS 0.46 (1.29)). Synovitis reduced significantly on MRI; however, osteitis, erosion, and cartilage loss did not change significantly. DAS28 improved significantly by Week 24; 78% of subjects achieved DAS28 remission. SC-TCZ was generally well tolerated.</p><p><strong>Conclusion: </strong>Synovitis and DAS28 decreased significantly; however, no significant change in osteitis or joint damage was observed at Week 24.</p><p><strong>Trial registration: </strong>This trial is registered with Clinicaltrials.gov registration number NCT01951170 (ML28703).</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"8721753"},"PeriodicalIF":2.3,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/8721753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36178485","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}
Pub Date : 2018-04-10eCollection Date: 2018-01-01DOI: 10.1155/2018/6052326
Mohammed Hammoudeh, Ahmed Al-Momani, Husam Sarakbi, Prem Chandra, Samer Hammoudeh
Objective: The purpose of this pilot study was to assess the prevalence of oral manifestations among systemic lupus erythematosus (SLE) patients in Qatar, in order to warrant future studies that would investigate each one of these manifestations with detail and further scrutiny.
Methods: Study procedures took place between November 2014 and April 2016. All patients visiting the outpatient rheumatology clinics at Hamad General Hospital, Doha, Qatar, were asked to join. The American College of Rheumatology (ACR) 1997 criteria of SLE were used. The patients were examined initially by a rheumatologist and were later scheduled for an appointment with a dentist at the same institution. A total of 77 patients were recruited for the study.
Results: Prevalence rates for the different oral manifestations ranged from 2.4% for soft palate ulcers, cheilitis, and oral candida to 88.1% for the presence of cavitation. Gingivitis, periodontal disease, cavities, and missing teeth were observed in more than 50% of the sample. The prevalence of periodontal disease and missing teeth was higher among those with an SLE duration > 8 years. On the contrary, the prevalence of gingivitis and cavities was higher among those with an SLE duration ≤ 8 years.
Conclusion: This study found high rates of gingivitis, periodontal disease, cavities, and missing teeth among SLE patients in Qatar. It is recommended that healthcare providers of such patients monitor the presence of any oral manifestations in order to arrange for early treatment and prevention efforts. Future prospective longitudinal studies with adequate sample size and power are needed in order to ascertain any causation factors or common etiology pathways.
{"title":"Oral Manifestations of Systemic Lupus Erythematosus Patients in Qatar: A Pilot Study.","authors":"Mohammed Hammoudeh, Ahmed Al-Momani, Husam Sarakbi, Prem Chandra, Samer Hammoudeh","doi":"10.1155/2018/6052326","DOIUrl":"https://doi.org/10.1155/2018/6052326","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this pilot study was to assess the prevalence of oral manifestations among systemic lupus erythematosus (SLE) patients in Qatar, in order to warrant future studies that would investigate each one of these manifestations with detail and further scrutiny.</p><p><strong>Methods: </strong>Study procedures took place between November 2014 and April 2016. All patients visiting the outpatient rheumatology clinics at Hamad General Hospital, Doha, Qatar, were asked to join. The American College of Rheumatology (ACR) 1997 criteria of SLE were used. The patients were examined initially by a rheumatologist and were later scheduled for an appointment with a dentist at the same institution. A total of 77 patients were recruited for the study.</p><p><strong>Results: </strong>Prevalence rates for the different oral manifestations ranged from 2.4% for soft palate ulcers, cheilitis, and oral candida to 88.1% for the presence of cavitation. Gingivitis, periodontal disease, cavities, and missing teeth were observed in more than 50% of the sample. The prevalence of periodontal disease and missing teeth was higher among those with an SLE duration > 8 years. On the contrary, the prevalence of gingivitis and cavities was higher among those with an SLE duration ≤ 8 years.</p><p><strong>Conclusion: </strong>This study found high rates of gingivitis, periodontal disease, cavities, and missing teeth among SLE patients in Qatar. It is recommended that healthcare providers of such patients monitor the presence of any oral manifestations in order to arrange for early treatment and prevention efforts. Future prospective longitudinal studies with adequate sample size and power are needed in order to ascertain any causation factors or common etiology pathways.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"6052326"},"PeriodicalIF":2.3,"publicationDate":"2018-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/6052326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36178484","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}
Pub Date : 2018-02-15eCollection Date: 2018-01-01DOI: 10.1155/2018/1847894
Javier Rueda-Gotor, Fernanda Genre, Alfonso Corrales, Ricardo Blanco, Patricia Fuentevilla, Virginia Portilla, Rosa Expósito, Cristina Mata Arnaiz, Trinitario Pina, Carlos González-Juanatey, Luis Rodriguez-Rodriguez, Miguel A González-Gay
Objective: To determine if the use of the relative risk (RR) chart score may help to identify young ankylosing spondylitis (AS) patients at high risk of cardiovascular (CV) disease.
Methods: 73 AS patients younger than 50 years were assessed. CV risk was calculated according to the total cholesterol systematic coronary risk evaluation (TC-SCORE) and the RR chart score. C-reactive protein (CRP) value at disease diagnosis and carotid ultrasound data were also analyzed.
Results: Twenty (27.4%) patients exhibited carotid plaques being classified into the category of very high CV risk. None of them was found to have a high/very high TC-SCORE. CRP > 3 mg/L at disease diagnosis was associated with the presence of carotid plaques (odds ratio 5.66, p = 0.03). Whereas only 5 (14.2%) of the 35 patients with RR = 1 had carotid plaques, 15 (39.5%) of 38 with RR > 1 showed plaques. A model that included the performance of carotid US in patients with RR > 1 who had CRP > 3 mg/L allowed us to identify 60% of very high risk patients, with a specificity of 77.4%.
Conclusions: RR chart score assessment may help to identify young AS patients at high risk of CV disease.
{"title":"Relative Risk Chart Score for the Assessment of the Cardiovascular Risk in Young Patients with Ankylosing Spondylitis.","authors":"Javier Rueda-Gotor, Fernanda Genre, Alfonso Corrales, Ricardo Blanco, Patricia Fuentevilla, Virginia Portilla, Rosa Expósito, Cristina Mata Arnaiz, Trinitario Pina, Carlos González-Juanatey, Luis Rodriguez-Rodriguez, Miguel A González-Gay","doi":"10.1155/2018/1847894","DOIUrl":"https://doi.org/10.1155/2018/1847894","url":null,"abstract":"<p><strong>Objective: </strong>To determine if the use of the relative risk (RR) chart score may help to identify young ankylosing spondylitis (AS) patients at high risk of cardiovascular (CV) disease.</p><p><strong>Methods: </strong>73 AS patients younger than 50 years were assessed. CV risk was calculated according to the total cholesterol systematic coronary risk evaluation (TC-SCORE) and the RR chart score. C-reactive protein (CRP) value at disease diagnosis and carotid ultrasound data were also analyzed.</p><p><strong>Results: </strong>Twenty (27.4%) patients exhibited carotid plaques being classified into the category of very high CV risk. None of them was found to have a high/very high TC-SCORE. CRP > 3 mg/L at disease diagnosis was associated with the presence of carotid plaques (odds ratio 5.66, <i>p</i> = 0.03). Whereas only 5 (14.2%) of the 35 patients with RR = 1 had carotid plaques, 15 (39.5%) of 38 with RR > 1 showed plaques. A model that included the performance of carotid US in patients with RR > 1 who had CRP > 3 mg/L allowed us to identify 60% of very high risk patients, with a specificity of 77.4%.</p><p><strong>Conclusions: </strong>RR chart score assessment may help to identify young AS patients at high risk of CV disease.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2018 ","pages":"1847894"},"PeriodicalIF":2.3,"publicationDate":"2018-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/1847894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36021867","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}
A. Alonso-Larruga, S. Bustabad, J. A. Navarro-Gonzálvez, B. Rodríguez-Lozano, A. Franco, Y. Barrios
The term undifferentiated connective tissue disease (UCTD) is used to describe undiagnosed patients that do not fulfill classification criteria for definite connective tissue disease (Systemic Lupus, Systemic Sclerosis, Sjögren Syndrome, and Dermatomyositis/Polymyositis). It is important to find serological markers as predictors of the evolution or severity of these diseases. The objective of this retrospective study was to investigate if there was a milder subgroup of UCTD with a special clinical profile consisting only in the presence of anti-Ro52 autoantibodies. Immunological and clinical records of 62 patients attending the hospital during 30 months were studied. Results showed a target population formed by mostly women, aged between 40 and 80 years at the moment of the study, with a registered age of onset between 40 and 60 years. Speckled pattern was the most frequent pattern found by indirect immunofluorescence. Given the obtained results and keeping in mind possible limitations because of sample size, isolated positive anti-Ro52 autoantibodies seem to lead to a benign effect in terms of evolution of the disease. As a future objective, the follow-up of these patients should be necessary to investigate new clinical symptoms, serological markers, or development of a definite connective tissue disease over time.
{"title":"Isolated Ro52 Antibodies as Immunological Marker of a Mild Phenotype of Undifferentiated Connective Tissue Diseases","authors":"A. Alonso-Larruga, S. Bustabad, J. A. Navarro-Gonzálvez, B. Rodríguez-Lozano, A. Franco, Y. Barrios","doi":"10.1155/2017/3076017","DOIUrl":"https://doi.org/10.1155/2017/3076017","url":null,"abstract":"The term undifferentiated connective tissue disease (UCTD) is used to describe undiagnosed patients that do not fulfill classification criteria for definite connective tissue disease (Systemic Lupus, Systemic Sclerosis, Sjögren Syndrome, and Dermatomyositis/Polymyositis). It is important to find serological markers as predictors of the evolution or severity of these diseases. The objective of this retrospective study was to investigate if there was a milder subgroup of UCTD with a special clinical profile consisting only in the presence of anti-Ro52 autoantibodies. Immunological and clinical records of 62 patients attending the hospital during 30 months were studied. Results showed a target population formed by mostly women, aged between 40 and 80 years at the moment of the study, with a registered age of onset between 40 and 60 years. Speckled pattern was the most frequent pattern found by indirect immunofluorescence. Given the obtained results and keeping in mind possible limitations because of sample size, isolated positive anti-Ro52 autoantibodies seem to lead to a benign effect in terms of evolution of the disease. As a future objective, the follow-up of these patients should be necessary to investigate new clinical symptoms, serological markers, or development of a definite connective tissue disease over time.","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2017 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2017-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/3076017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41885128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}