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Clinical Rheumatology

Mirjana Bećarević, Duško Mirković, Svetlana Ignjatović
Although numerous studies investigated the association between homocysteine (Hcy), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP) and apolipoproteins (apos) with thrombosis and/or recurrent pregnancy losses, studies that analyzed the abovementioned parameters and multiple positivity of antiphospholipid antibodies (aPL Abs) in patients with primary antiphospholipid syndrome (PAPS) are lacking. Therefore, the aim of this study was to analyze the presence of various combinations of the abovementioned parameters and their associations with clinical and/or serological features of PAPS...
October 14, 2016: Clinical Rheumatology
Latika Gupta, Shruti Bhattacharya, Vikas Agarwal, Amita Aggarwal
Monocytes of patients with ankylosing spondylitis (AS) have toll-like receptor 4 (TLR4) overexpression on their monocytes. Myeloid-related protein (MRP) 8/14 protein complexes are calcium-binding proteins, which act as endogenous ligands to TLR4. Thus, we studied the levels of MRP8/14 in adult AS patients. MRP8/14 levels were assessed in 99 adult AS patients satisfying Assessments in Ankylosing Spondylitis International Society 2010 criteria and 71 healthy controls by ELISA. Patient disease parameters like patient and physician global assessment, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), swollen and tender joint count, entheseal count by Maastricht enthesitis index, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were also recorded...
October 13, 2016: Clinical Rheumatology
Valderilio Azevedo, Brian Hassett, João Eurico Fonseca, Tatsuya Atsumi, Javier Coindreau, Ira Jacobs, Ehab Mahgoub, Julie O'Brien, Ena Singh, Steven Vicik, Brian Fitzpatrick
The manufacture of biologics is a complex process involving numerous steps. Over time, differences may arise as a result of planned changes to the manufacturing processes of a biologic from the same manufacturer. Comparability is the regulatory process that outlines the scope of an assessment required of an already licensed biologic after a manufacturing process change made by the same manufacturer. The aim of a comparability assessment is to demonstrate that any pre-manufacturing and post-manufacturing changes have no adverse impact on quality, safety, and efficacy of the biologic...
October 12, 2016: Clinical Rheumatology
R Fleischmann, P J Mease, S Schwartzman, L-J Hwang, K Soma, C A Connell, L Takiya, E Bananis
Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). This post hoc analysis investigated the effect of methotrexate (MTX) dose on the efficacy of tofacitinib in patients with RA. ORAL Scan (NCT00847613) was a 2-year, randomized, Phase 3 trial evaluating tofacitinib in MTX-inadequate responder (IR) patients with RA. Patients received tofacitinib 5 or 10 mg twice daily (BID), or placebo, with low (≤12.5 mg/week), moderate (>12.5 to <17.5 mg/week), or high (≥17...
October 12, 2016: Clinical Rheumatology
Carsten Paul Bramlage, Britta Froelich, Manuel Wallbach, Joan Minguet, Clemens Grupp, Cornelia Deutsch, Peter Bramlage, Michael Koziolek, Gerhard Anton Müller
In patients with rheumatic diseases, reliable markers for determining disease activity are scarce. One potential parameter is the level of immunoglobulin free light chains (FLCs), which is known to be elevated in the blood of patients with certain rheumatic diseases. Few studies have quantified FLCs in urine, a convenient source of test sample, in patients with different rheumatic diseases. We carried out a retrospective analysis of patients with rheumatic disease attending the University hospital of Goettingen, Germany...
October 12, 2016: Clinical Rheumatology
Chongru He, Xiaokang He, Wenwen Tong, Wei Zheng, Tianfang Zhang, Jinzhu Zhao, Weidong Xu
Although total hip replacement (THR) has been proven to be effective, the effect of THR on employment in ankylosing spondylitis (AS) in Chinese population is still unknown. We aimed to demonstrate whether or not patients with AS returned to work following THR and factors associated with the work ability after THR. We performed a retrospective study including a total number of 128 AS patients undergoing THR between 2009 and 2013. Presurgery and postsurgery data including disease state, work status, type of job, and time of resuming work were collected...
October 12, 2016: Clinical Rheumatology
Soumya M Reddy, Sheila Crean, Amber L Martin, Meghan D Burns, Jacqueline B Palmer
Anti-tumor necrosis factors (Anti-TNFs) are a class of biologic disease-modifying anti-rheumatic drugs indicated for the treatment of moderate-to-severe psoriatic arthritis (PsA). Refractory patients are commonly managed by switching from one anti-TNF to another. To assess the evidence on the effectiveness of anti-TNF cycling in PsA patients, a systematic review of the literature was conducted. MEDLINE- and Embase-indexed English-language publications were systematically searched from 1995 to 2015 for studies assessing real-world effectiveness outcomes of anti-TNF cycling in PsA patients...
October 12, 2016: Clinical Rheumatology
Tomoko Ito, Naoto Tamura, Sayuri Okuda, Kurisu Tada, Masakazu Matsushita, Ken Yamaji, Kazunori Kato, Yoshinari Takasaki
CD146, a transmembrane glycoprotein member of the immunoglobulin superfamily, acts as an adhesion molecule that helps maintain the cell monolayer. Human endothelial cells expressing CD146 are involved in angiogenesis and inflammation. Recently, we developed a sandwich ELISA for detecting soluble CD146 (sCD146) in human serum specimens. The aim of this study is to determine serum levels of sCD146 in patients with systemic sclerosis (SSc) and to examine the relationship between sCD146 levels and clinical manifestations...
October 11, 2016: Clinical Rheumatology
Rafael Alfonso-Cristancho, Nigel Armstrong, Ramesh Arjunji, Rob Riemsma, Gill Worthy, Rita Ganguly, Jos Kleijnen
Our aim was to establish the comparative effectiveness of rheumatoid arthritis (RA) biologics, using a systematic review and network meta-analysis. The systematic review used randomized controlled trials (RCTs) in adults with RA who failed treatment with conventional disease-modifying agents for rheumatoid disease (cDMARDs). We compared the effectiveness of abatacept, adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, and rituximab to tocilizumab, a recent biologic with a different mechanism of action (anti-IL-6 receptor)...
October 10, 2016: Clinical Rheumatology
Carmen Pizzorni, Alberto Sulli, Vanessa Smith, Barbara Ruaro, Amelia Chiara Trombetta, Maurizio Cutolo, Sabrina Paolino
This study aimed to detect by nailfold videocapillaroscopy (NVC) the presence of age-related capillary morphological patterns in a large cohort of subjects affected by primary Raynaud's phenomenon (PRP). NVC was performed in 877 patients affected by PRP, divided into three age groups: <35, 35-55 and >55 years. The following qualitative parameters were assessed and compared in the three groups of patients: apical dilations, irregular (non-homogeneous) dilations, venous branch dilations, microhaemorrhages, tortuosities and subpapillary venous plexus visibility...
October 8, 2016: Clinical Rheumatology
Mehmet Akif Öztürk, Rıdvan Mercan, Kevser Gök, Ahmet Mesut Onat, Bünyamin Kısacık, Gezmiş Kimyon, Ayşe Balkarlı, Arif Kaya, Veli Çobankara, Mehmet Ali Balcı, ÖmerNuri Pamuk, Gözde Yıldırım Çetin, Mehmet Sayarlıoğlu, Soner Şenel, Mehmet Engin Tezcan, Adem Küçük, Kemal Üreten, Şafak Şahin, Abdurrahman Tufan
Although gout is potentially curable, the management of this disease is often suboptimal. In this study, we investigated the treatment of gout in Turkey and also compared the management approaches to gout in different clinical specialties. Three hundred and nineteen consecutive patients (mean age 58.60 ± 12.8 years; 44 females, 275 males) were included in this multicenter study. A standardized form was generated to collect data about the patient's first admission to health care, the specialty of the doctor first diagnosed the gout, the treatment options for gout including attack management, patient referral, chronic treatment including medical treatment, and life style modifications...
October 8, 2016: Clinical Rheumatology
Georgios Christopoulos, V Christopoulou, J G Routsias, A Babionitakis, C Antoniadis, G Vaiopoulos
Patients with rheumatoid arthritis (RA) from different ethnic groups present elevated levels of antibodies against Proteus mirabilis. This finding implicates P. mirabilis in the development of RA. The aim of this study was to investigate the importance of P. mirabilis in the etiopathogenesis of RA in Greek RA patients. In this study, 63 patients with RA and 38 healthy controls were included. Class-specific antibodies IgM, IgG, and IgA against three human cross-reactive and non-cross-reactive synthetic peptides from P...
October 8, 2016: Clinical Rheumatology
Masachika Hayashi, Toshiaki Kikuchi, Toshinori Takada
No abstract text is available yet for this article.
October 7, 2016: Clinical Rheumatology
María Pilar Cruz-Domínguez, Grettel García-Collinot, Miguel A Saavedra, Gabriela Medina, Rosa Angélica Carranza-Muleiro, Olga Lidia Vera-Lastra, Luis J Jara
Calcinosis is a frequent complication of systemic sclerosis (SSc) that is usually located in extremities but may occur across the board. The aim of our study was to identify and quantify the distribution of calcinosis in a cohort of Mexican patients with SSc and its association with clinical features and autoantibodies. A cohort of patients with SSc (2013 ACR/EULAR criteria), classified in diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) (Le Roy criteria), was studied. For their analysis, patients were allocated into those with and without calcinosis (clinical and/or radiological)...
October 7, 2016: Clinical Rheumatology
Amit Lakhanpal, Ernest Brahn
Biologics as therapeutic interventions for human disease represent both a distinctly modern novelty and an echo of ancient, or at least old, medical practice. The similarity lies in the sense that in both the synthetic effort occurs in living organisms (an extract of a plant, animal tissue, or a cell culture) while the difference is apparent in the bioengineering required in modern methods and the corresponding flexibility to customize the therapeutic product. Although the concept of looking to living systems as a source of medically useful compounds either for research or for actual patient care has never vanished, the development of biochemistry and advances in medicinal chemistry made production by total synthesis the standard for a safe, reliable, and commercial drug production at sufficient scale...
October 6, 2016: Clinical Rheumatology
Z Birsin Özçakar, Suat Fitöz, Adalet Elçin Yıldız, Fatoş Yalçınkaya
There is limited number of publications about the use of non-invasive imaging modalities in the diagnosis of childhood polyarteritis nodosa (cPAN). The aim of this study was to present the clinical and imaging findings of the patients with cPAN who were diagnosed with non-invasive imaging techniques. Files of patients who had been diagnosed as cPAN in our department from 2005 to 2015 were reviewed, retrospectively. Demographic, clinical, laboratory, and imaging findings of the patients were evaluated. Nine patients (8M, 1F; age at disease onset: 12...
October 5, 2016: Clinical Rheumatology
Yuan An, Tian Liu, Dongyi He, Lijun Wu, Juan Li, Yi Liu, Liqi Bi, Bin Zhou, Changsong Lin, Lan He, Xiangyuan Liu, Xiaofeng Li, Niansheng Yang, Zhuoli Zhang, Hui Song, Wei Wei, Jing Liu, Yu Bi, Zhanguo Li
The aims of this study are to characterize the biological disease-modifying antirheumatic drug (bDMARD) usage patterns in real-life and examine the remission rate of rheumatoid arthritis (RA) patients receiving bDMARDs in routine clinical practice in China. Consenting RA patients (≥18 years) from 15 teaching hospitals and receiving marketed bDMARDs were included. In total, 802 patients (81.3 % women, 49.0 ± 13.9 years) were included; 89.5 % were receiving a combination of bDMARDs and conventional synthetic DMARDs (csDMARDS), whereas 10...
October 5, 2016: Clinical Rheumatology
D Windschall, G Horneff
The TNF inhibitors etanercept (ETA) and adalimumab (ADA) are approved for treating patients older than 2 years with polyarticular juvenile idiopathic arthritis (JIA). Because long-term experience of treating children younger than 4 years is limited, we evaluated the efficacy and safety of ETA or ADA in patients aged 2-4 years. This prospective, long-term, observational registry study documented baseline demographics, clinical characteristics, disease activity parameters, and safety of patients treated with ETA or ADA...
October 5, 2016: Clinical Rheumatology
Atul Deodhar, Bojena Bitman, Yue Yang, David H Collier
Patients with rheumatoid arthritis (RA) are at an increased risk of cardiovascular disease (CVD). Treatment with tumor necrosis factor inhibitors improves both joint symptoms associated with RA and also CVD risk. This exploratory analysis of a phase 4 study evaluated changes in metabolic risk factors in patients with RA treated with etanercept. Metabolic analytes were measured at baseline, week 12, and week 24 in patients enrolled in a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of etanercept in moderately active RA...
October 5, 2016: Clinical Rheumatology
Avital Avriel, Stela Fleischer, Michael Friger, Ora Shovman, Gal Neuman, Yehuda Shoenfeld, Mahmoud Abu-Shakra
A significantly high correlation between reduced activity of Annexin A5 by the flow cytometric assay (FCA) and the diagnosis of antiphospholipid syndrome (APS) has been reported. The aim of this study was to assess the clinical and laboratory significance of the Annexin A5 competition assay among patients with systemic lupus erythematosus (SLE). The FCA competition assay was performed on blood samples from 57 consecutive SLE patients. The FCA was performed according to a previously validated method. Forty-seven patients (82...
October 4, 2016: Clinical Rheumatology
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