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Open Access Rheumatology: Research and Reviews

Rita N Cunha, Renata Aguiar, Filipa Farinha
Gout is currently the most frequent cause of inflammatory arthritis worldwide and is responsible for poor health-related quality of life and loss of work productivity. It is caused by high levels of serum urate, leading to the deposition of monosodium urate crystals in joints and soft tissues. This condition is associated with acute flares and, if untreated or refractory, chronic and potentially destructive arthritis and tophi formation. Pegloticase is a recombinant, pegylated uricase used in the treatment of gout patients who fail conventional urate-lowering therapy...
2018: Open Access Rheumatology: Research and Reviews
Yong Wu, En Lin Goh, Dong Wang, Shaocheng Ma
Osteoarthritis is the most prevalent chronic joint condition worldwide. The principles of osteoarthritis treatment are to alleviate pain and stiffness as well as maintain function, with current consensus guidelines recommending the use of a combination of conservative measures including physical therapy, analgesia, and surgical interventions such as arthroplasty. In recent years, several pharmacological therapies have emerged as potential alternatives. Although a disease-modifying osteoarthritis drug has yet to be identified, promising results have been reported in recent trials especially with serotonin-norepinephrine reuptake inhibitors, IL-1 antagonists, and antibodies to nerve growth factor...
2018: Open Access Rheumatology: Research and Reviews
Daniela Iacono, Elvira Favoino, Alessia Borgia, Serena Fasano, Ilenia Pantano, Virginia D'Abrosca, Giuseppe Picillo, Rosa Daniela Grembiale, Federico Perosa, Gabriele Valentini
Background and objective: Anti-carbamylated protein antibodies (anti-CarP Ab) represent a novel kind of autoantibodies specificity detectable in the sera of patients with rheumatoid arthritis (RA). They have been recently reported to be associated with increased mortality in Spanish patients with RA. The aim of our study was to compare the incidence mortality rates (IMRs) detected in RA patients from a tertiary Italian center with those reported in other European tertiary centers and to evaluate the putative role of anti-CarP Ab in modulating the low IMR detected in our patients...
2018: Open Access Rheumatology: Research and Reviews
Butsabong Lerkvaleekul, Soamarat Vilaiyuk
Macrophage activation syndrome (MAS) is a life-threatening condition, and it is a subset of hemophagocytic lymphohistiocytosis (HLH). The clinical features include a persistent high-grade fever, hepatosplenomegaly, lymphadenopathy, hemorrhagic manifestations, and a sepsis-like condition. From the clinical features, it is usually difficult to differentiate between a true sepsis, disease flare-ups, or MAS. Although the laboratory abnormalities are similar to those of a disseminated intravascular coagulation, which shows pancytopenia, coagulopathy, hypofibrinogenemia, and an elevated d-dimer test, it can also be a late stage of MAS...
2018: Open Access Rheumatology: Research and Reviews
Fatima Jafri, Amanda Sammut
Introduction: Patients undergoing treatment with an anti-tumor necrosis factor-alpha (TNF- α ) agent can, as an adverse event, develop anti-TNF- α -induced lupus (ATIL). Neuropsychiatric symptoms such as depression and suicidal ideations are not commonly seen in patients who develop ATIL. We describe a case of a 56-year-old female who developed ATIL and suicidal ideations while on Adalimumab. Case presentation: A 56-year-old female with rheumatoid arthritis (RA) and no known prior history of systemic lupus erythematosus or depression presented with suicidal ideations, joint pains and a malar rash after a recent change in her Adalimumab dose...
2018: Open Access Rheumatology: Research and Reviews
Walid Fakhouri, Pedro Lopez-Romero, Silvia Antonelli, Serena Losi, Veronica Rogai, Stefano Buda, Diego Sangiorgi, Valentina Perrone, Luca Degli Esposti
Objectives: This study aimed to: 1) describe treatment patterns and drug utilization profile (in terms of therapeutic strategy used, switch, persistence and drug consumption variation) among adult patients affected by rheumatoid arthritis (RA), and 2) estimate the health care resource utilization and its associated direct cost for the management of RA patients. Methods: A retrospective cohort analysis, using administrative databases of six Local Health Units in Italy, was performed...
2018: Open Access Rheumatology: Research and Reviews
James R O'Dell, Stanley B Cohen, J Carter Thorne, Joel Kremer
Purpose: The objective of this study was to assess the treatment for patients with rheumatoid arthritis (RA) in the USA. Patients and methods: This study entailed analysis of claims data for patients with RA who initiated treatment with oral methotrexate (MTX) or a biologic in 2009 (n=48,910) or 2012 (n=107,636) and had follow-up for 4 years (2009 cohort) or 2 years (2012 cohort). Results: A biologic was initiated before MTX for 27% of the 2009 cohort and 36% of the 2012 cohort...
2018: Open Access Rheumatology: Research and Reviews
Sara Sabbagh, Tova Ronis, Patience H White
The transition from pediatric to adult health care is often a challenging process due to multiple interwoven complexities, especially for children with chronic medical conditions. Health care transition (HCT) is a process of moving from a pediatric to an adult model of health care with or without a transfer to a new clinician. This paper focuses on what is known about HCT for youth and young adults (Y/YA) with rheumatic diseases within a larger context of HCT recommendations. HCT barriers for youth, families, and providers and current evidence for a structured HCT processes are reviewed...
2018: Open Access Rheumatology: Research and Reviews
Renee F Modica, Kathleen G Lomax, Pamela Batzel, Armelle Cassanas
Purpose: To understand the experience of adolescent systemic juvenile idiopathic arthritis (SJIA) patients and those of their parents based on their social media posts. Methods: English language posts related to SJIA, Still's disease, or juvenile arthritis were collected and analyzed. Results: In total, 71 posts created between 2009 and 2015 on 15 websites were identified in November 2015. Of the 32 unique authors, 17 were SJIA patients aged 13-20 years (40 posts), 7 were mothers of SJIA patients (12 posts), and 8 patients had unspecified forms of juvenile arthritis (19 posts)...
2018: Open Access Rheumatology: Research and Reviews
Sangeeta Sule, Kevin Fontaine
Objective: The objective of this study was to determine the risk of obesity and metabolic syndrome in adults with a history of juvenile arthritis (JA). Methods: Using the National Health and Nutrition Examination Survey (NHANES), we compared the characteristics of respondents with arthritis (JA vs rheumatoid arthritis [RA]) to those of the control group without arthritis. We used logistic regression analyses, controlling for age, race, and gender, to determine the ORs for metabolic syndrome...
2018: Open Access Rheumatology: Research and Reviews
Snezana Tomasevic-Todorovic, Atina Vazic, Abukari Issaka, Fahad Hanna
Background: Both osteoporosis and osteopenia remain worldwide public health concerns. They both lead to bone fractures, which can lead to disability and burden on those who are afflicted. Objectives: To assess and compare fracture risk between these two groups of patients. Patients and methods: Our cross-sectional study included 82 patients (46 with osteoporosis and 36 with osteopenia) with an average age of 63±9.33 years, who received treatment at the Clinic for Medical Rehabilitation, Clinical Center of Vojvodina in Novi Sad, Serbia...
2018: Open Access Rheumatology: Research and Reviews
Hasan Ulusoy, Gurkan Akgol, Arif Gulkesen, Arzu Kaya, Gul Ayden Kal, Dilara Kaman, Turkan Tuncer
Objectives: Heat-shock proteins (HSPs) have gained increased interest for their role in autoimmune disorders. These proteins are targeted by the immune system in various autoimmune diseases. The aim of this study was to assess the serum heat-shock protein-65 antibody (anti-HSP65) levels and their clinical significance in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Patients and methods: A total of 30 patients with RA, 30 patients with AS, and 30 healthy controls were enrolled in this study...
2018: Open Access Rheumatology: Research and Reviews
Ross Leighton, Jane Fitzpatrick, Helen Smith, Daniela Crandall, Carl R Flannery, Thierry Conrozier
Background: Pain and limitations in joint mobility associated with knee osteoarthritis (OA) are clinically challenging to manage, and advanced progression of disease can often lead to total knee arthroplasty. Intra-articular injection of hyaluronic acid (HA), also referred to as viscosupplementation, is a non-surgical treatment approach for OA, the effectiveness of which may depend on the HA composition, and the length of time over which it resides in the joint. One of the available options for such therapies includes NASHA (Durolane HA), a non-animal, biofermentation-derived product, which is manufactured using a process that stabilizes the HA molecules to slow down their rate of degradation and produce a unique formulation with a terminal half-life of ~1 month...
2018: Open Access Rheumatology: Research and Reviews
Josefina Marin, María Laura Acosta Felquer, Enrique R Soriano
Certolizumab pegol (CZP) is a pegylated humanized tumor necrosis factor-α inhibitor (TNFi) approved for the treatment of ankylosing spondylitis (AS) in the USA and for AS and non-radiographic axial spondyloarthritis (nr-axSpA) in Europe and in some Latin American countries. CZP lacks Fc region, preventing complement fixation and cytotoxicity mediated by antibody; CZP does not actively cross the placenta, unlike other TNFi. RAPID-axSpA study is a Phase III trial conducted in patients with AS and nr-axSpA as double blind and placebo controlled to week 24, dose blind to week 48 and open label to week 204...
2018: Open Access Rheumatology: Research and Reviews
Bruno Bordoni, Fabiola Marelli, Bruno Morabito, Francesca Cavallaro, David Lintonbon
Fibromyalgia (FM) syndrome is a chronic condition causing pain, affecting approximately 0.5%-6% of the developed countries' population, and on average, 2% of the worldwide population. Despite the large amount of scientific literature available, the FM etiology is still uncertain. The diagnosis is based on the clinical presentation and the severity of the symptomatology. Several studies pointed out pathological alterations within the central nervous system, suggesting that FM could originate from a central sensitization of the pain processing centers...
2018: Open Access Rheumatology: Research and Reviews
Cristina F Rabelo, Talita Siara Almeida Baptista, Laura Esteves Petersen, Moisés Evandro Bauer, Mauro Waldemar Keiserman, Henrique Luiz Staub
Introduction: Ankylosing spondylitis (AS) is a chronic disease featuring axial changes, peripheral arthritis and systemic involvement. Proinflammatory cytokines are probably involved in AS pathogenesis. The relationship of circulating cytokines with instruments of AS evaluation is an open field of research. Objective: The aim of this study was to compare serum levels of cytokines in AS patients and healthy controls, and search for correlations of cytokines with indexes of disease activity and quality of life...
2018: Open Access Rheumatology: Research and Reviews
Peter A Fischer, Ronald J Rapoport
Introduction: Although synthetic and biologic disease-modifying antirheumatic drugs are available, many patients with rheumatoid arthritis have a difficult-to-control disease and need other treatment options. Repository corticotropin injection (RCI) may alleviate symptoms and exacerbations in patients with refractory disease. Methods: Nine patients with refractory rheumatoid arthritis were included in this study. Patients were maintained on their baseline therapies with a minimum of 7...
2018: Open Access Rheumatology: Research and Reviews
Fernando Kemta Lekpa, Xavier Chevalier
Relapsing polychondritis is a severe systemic immune-mediated disease characterized by an episodic and progressive inflammatory condition with progressive destruction of cartilaginous structures. This disease has for nearly a century kept secrets not yet explained. The real incidence and prevalence of this rare disease are unknown. The multiple clinical presentations and episodic nature of relapsing polychondritis cause a significant diagnosis delay. No guidelines for the management of patients with relapsing polychondritis have been validated to date...
2018: Open Access Rheumatology: Research and Reviews
Rbab Taha, Hadeel El-Haddad, Abdulqader Almuallim, Fatma Alshaiki, Elaf Obaid, Hani Almoallim
Rituximab (RTX) is established for the treatment of rheumatoid arthritis. This systematic review of the literature since 2006 summarizes evidence for the use of RTX in the treatment of additional rheumatological diseases: antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV), hepatitis C virus-related cryoglobulinemic vasculitis, Henoch-Schönlein purpura, ankylosing spondylitis, and Raynaud's phenomenon. Data from randomized controlled trials are available only for AAV, confirming efficacy for remission induction, including in disease resistant to conventional treatment, and maintenance of remission...
2017: Open Access Rheumatology: Research and Reviews
Alexandra Legge, Chris Blanchard, John G Hanly
Objective: Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are at increased risk of cardiovascular disease (CVD). As sedentary behavior and lack of physical activity are known cardiovascular risk factors, we compared habitual activity between SLE patients, RA patients, and healthy control participants. Patients and methods: For this cross-sectional study, RA and SLE patients were recruited from rheumatology clinics at an academic medical center from April 2013 to December 2014...
2017: Open Access Rheumatology: Research and Reviews
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