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rheumatoid arthritis mortality

Francesca Ometto, Ugo Fedeli, Elena Schievano, Costantino Botsios, Leonardo Punzi, Maria Chiara Corti
OBJECTIVES: The aim of our study was to investigate cause-specific mortality in rheumatoid arthritis (RA) subjects living in Italy. METHODS: We identified in the electronic archive of the Veneto Region patients aged 20-89 years who were exempt from co-payment for RA in January 2010, and linked them with the archive of causes of deaths of the period 2010-2015. Causes of death were coded according to the International Classification of Diseases, 10th Edition. Standardised mortality ratios (SMRs) with 95% confidence intervals were computed as the ratios between deaths observed in the cohort, and those expected according to age- and gender-specific regional mortality rates...
March 2, 2018: Clinical and Experimental Rheumatology
Yoshiya Tanaka
Rheumatoid arthritis is a systemic autoimmune disease characterized by inflammation and joint damage that causes significant morbidity and mortality. Rapid and appropriate intervention using disease-modifying anti-rheumatic drugs(DMARDs)is prerequisite to halt joint destruction and long-term functional disabilities. Recent progress in the treatment strategy has brought about paradigm shift for the management of the disease, namely, the combined use of methotrexate, a synthetic DMARD, and a biologic DMARD targeting TNF, IL-6 and T cells has revolutionized treatment of rheumatoid arthritis...
2018: Clinical Calcium
Jessica Widdifield, J Michael Paterson, Anjie Huang, Sasha Bernatsky
OBJECTIVE: To compare mortality rates, underlying causes of death, excess mortality and years of potential life lost (YPLL) among rheumatoid arthritis (RA) patients relative to the general population. METHODS: We studied an inception cohort of 87,114 Ontario RA patients and 348,456 age/sex/area-matched general population comparators over 2000 to 2013. All-cause, cause-specific, and excess mortality rates, mortality rate ratios (MRRs), and YPLL were estimated. RESULTS: A total of 11,778 (14% of) RA patients and 32,472 (9% of) comparators died during 508,385 and 1,769,365 person-years (PY) of follow-up, respectively, for corresponding mortality rates of 232 (95% CI 228, 236) and 184 (95% CI 182, 186) per 10,000 PYs...
March 7, 2018: Arthritis Care & Research
K Krüger
Due to therapeutic advances, rheumatoid arthritis (RA) today has developed into a satisfactorily treatable disease in most cases, with remission being the target of treatment. Early diagnosis with immediate treatment initiation following treat-to-target strategy is the key to a favorable long-term outcome. A guideline-directed treatment algorithm determines the use of conventional synthetic disease-modifying anti-rheumatic drugs (DMARD; e.g., methotrexate), biological DMARD, and targeted oral DMARD (Janus kinase inhibitors)...
March 5, 2018: Der Internist
Masato Habuka, Yoko Wada, Yoichi Kurosawa, Suguru Yamamoto, Yusuke Tani, Riuko Ohashi, Yoichi Ajioka, Masaaki Nakano, Ichiei Narita
BACKGROUND: Visceral disseminated varicella zoster viral (VZV) infection is a rare but severe complication with a high mortality rate in immunosuppressed individuals, and an increased susceptibility to VZV has been reported in kidney transplant recipients who are treated with mycophenolate mofetil (MMF). In Japan, MMF is currently approved for patients with lupus nephritis (LN) and data to indicate its optimal dosage are still insufficient. CASE PRESENTATION: A 46-year-old Japanese woman with rheumatoid arthritis was diagnosed as having systemic lupus erythematosus (SLE) and LN class III (A/C)...
March 5, 2018: BMC Research Notes
Fawad Aslam, Nasim Ahmed Khan
Introduction: Comorbidities influence the prognosis, clinical outcomes, disease activity, and treatment response in rheumatoid arthritis (RA). RA patients have a high-comorbidity burden necessitating their study. Comorbidity indices are used to measure comorbidities and to study their impacts on different outcomes. A large number of such indices are used in clinical research. Some indices have been specifically developed in RA patients. Aim: This review aims to provide an overview of generic and specific comorbidity indices commonly used in RA research...
2018: Frontiers in Medicine
Sizheng Zhao, Eduardo Mysler, Robert J Moots
Etanercept was the first specific anticytokine therapy approved for the treatment of rheumatoid arthritis (RA). Its clinical efficacy and safety has been demonstrated by several clinical trials in early as well as established disease. Etanercept, along with other TNF inhibitors, have revolutionized management of RA and dramatically improved disease activity, function, quality of life and mortality for these patients. It is structurally distinct from other TNF inhibitors and thus has desirable profiles for immunogenicity, drug survival and infection rate...
February 27, 2018: Immunotherapy
Reto Daniel Kurmann, Rekha Mankad
Autoimmune rheumatologic conditions have increased cardiovascular morbidity and mortality compared to the general population. Many of these diseases occur more commonly in women, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis, and Sjogren's. Most of the literature that has identified the link between autoimmune diseases and atherosclerotic cardiovascular disease (ASCVD) has been regarding patients with RA and SLE. The reason for the increased ASCVD is related to both traditional risk factors for atherosclerosis and nontraditional risk factors such as the burden of inflammation...
February 26, 2018: Clinical Cardiology
Lydia Ntari, Maria Sakkou, Panagiotis Chouvardas, Iordanis Mourouzis, Alejandro Prados, Maria C Denis, Niki Karagianni, Constantinos Pantos, George Kollias
OBJECTIVES: Patients with rheumatoid arthritis and spondyloarthritisshow higher mortality rates, mainly caused by cardiac comorbidities. The TghuTNF (Tg197) arthritis model develops tumour necrosis factor (TNF)-driven and mesenchymalsynovial fibroblast (SF)-dependent polyarthritis. Here, we investigate whether this model develops, similarly to human patients, comorbid heart pathology and explore cellular and molecular mechanisms linking arthritis to cardiac comorbidities. METHODS: Histopathological analysis and echocardiographic evaluation of cardiac function were performed in the Tg197 model...
February 23, 2018: Annals of the Rheumatic Diseases
Stergios Soulaidopoulos, Elena Nikiphorou, Theodoros Dimitroulas, George D Kitas
Rheumatoid arthritis (RA) is an autoimmune, inflammatory disorder associated with excess cardiovascular morbidity and mortality. A complex interplay between traditional risk factors (dyslipidemia, insulin resistance, arterial hypertension, obesity, smoking) and chronic inflammation is implicated in the development of premature atherosclerosis and consequently in the higher incidence of cardiovascular events observed in RA patients. Despite the acknowledgment of elevated cardiovascular risk among RA individuals, its management remains suboptimal...
2018: Frontiers in Medicine
Charlotte Hyldgaard, Torkell Ellingsen, Elisabeth Bendstrup
No abstract text is available yet for this article.
February 13, 2018: Lancet Respiratory Medicine
Cristian Caimmi, Cynthia S Crowson, Wendy M Smith, Eric L Matteson, Ashima Makol
OBJECTIVE: Inflammatory ocular disease (IOD) is a rare but severe extraarticular manifestation of rheumatoid arthritis (ExRA) with high mortality. The aim of our study was to examine clinical characteristics of IOD in rheumatoid arthritis (RA) and their effect on disease severity and outcomes in recent years. METHODS: A retrospective cohort of RA patients with IOD evaluated between 1996 and 2013 was assembled and compared to RA comparators without IOD and matched for age, sex, and disease duration...
February 15, 2018: Journal of Rheumatology
Yuhei Ito, Machiko Arita, Shogo Kumagai, Reoto Takei, Maki Noyama, Fumiaki Tokioka, Keisuke Nishimura, Takashi Koyama, Hiromasa Tachibana, Tadashi Ishida
Objectives High-resolution computed tomography (HRCT) parenchymal patterns have been used to predict prognosis in patients with interstitial lung disease (ILD). In idiopathic pulmonary fibrosis, the fibrosis score (i.e., the combined extent of reticulation and honeycombing) has been associated with worse survival. This study aimed to identify HRCT patterns and patient characteristics that can predict poor prognosis in rheumatoid arthritis-related ILD (RA-ILD). Methods We retrospectively analysed 65 patients with newly diagnosed RA-ILD from 2007 to 2016 at Kurashiki Central hospital...
February 15, 2018: Modern Rheumatology
Stephan N Salzmann, Peter B Derman, Lukas P Lampe, Janina Kueper, Ting Jung Pan, Jingyan Yang, Jennifer Shue, Federico P Girardi, Stephen Lyman, Alexander P Hughes
BACKGROUND: The rate of cervical spinal fusion has been increasing significantly. However, there is paucity of literature describing trends based on surgical approach using complete population databases. We investigated the approach-based trends in epidemiology, indications and in-hospital outcomes of cervical spinal fusion. METHODS: New York's Statewide Planning and Research Cooperative System database was queried to identify patients who underwent primary subaxial cervical fusion from 1997-2012...
February 10, 2018: World Neurosurgery
Joseph Jacob, Jin Woo Song, Hee-Young Yoon, Gary Cross, Joseph Barnett, Wen Ling Woo, Fern Adams, Maria Kokosi, Anand Devaraj, Elisabetta Renzoni, Toby M Maher, Dong Soon Kim, Athol U Wells
AIMS: Autoimmune conditions such as rheumatoid arthritis-related interstitial lung disease (RA-ILD) have been linked to the existence of emphysema in never-smokers. We aimed to quantify emphysema prevalence in RA-ILD never-smokers and investigate whether combined pulmonary fibrosis and emphysema (CPFE) results in a worsened prognosis independent of baseline disease extent. METHODS: RA-ILD patients presenting to the Royal Brompton Hospital (n=90) and Asan Medical Center (n=155) had CT's evaluated for a definite usual interstitial pneumonia (UIP) pattern, and visual extents of emphysema and ILD...
January 31, 2018: EBioMedicine
A S Renjith, Vishal Marwaha, N Aggarwal, Varghese Koshy, V K Singal, K V S Hari Kumar
Background: Rheumatoid arthritis (RA) is a polyarticular disorder with many extra-articular features. Cardiovascular disorders, including heart failure (HF), are the leading causes of mortality in RA patients. We studied the prevalence of left ventricular dysfunction (LVD) in patients with RA. Materials and Methods: In this cross-sectional study, we evaluated 100 consecutive patients with RA (aged >18 years and duration >1 year) for the presence of LVD. We excluded patients with known cardiac and systemic disorders that may contribute to LVD...
July 2017: Journal of Family Medicine and Primary Care
Aprajita Jagpal, Jeffrey R Curtis
Gastrointestinal (GI) perforations are rare events in rheumatoid arthritis (RA) patients, but cause significant morbidity and mortality. Several studies indicate that RA patients may be at higher risk of GI perforation. Traditional RA treatments such as glucocorticoids and non-steroidal anti-inflammatory drugs increase the risk of perforation. In the past two decades, a new class of therapeutic agents called biologics has been added to the RA treatment armamentarium. Biologics are effective in controlling disease activity and are generally well tolerated; however, reports of GI perforations in association with biologics have arisen...
February 1, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Gabriela Medina, Olga Vera-Lastra, Ana Lilia Peralta-Amaro, María Pilar Jiménez-Arellano, Miguel Angel Saavedra, María Pilar Cruz-Domínguez, Luis J Jara
Metabolic syndrome (MetS) is a cluster of metabolic and cardiovascular (CV) risk factors including obesity and visceral adiposity, insulin resistance, dyslipidemia and hypertension contributing to CV mortality. The interface between the metabolic and immune systems has been of great interest recently. These interactions are regulated through genetics, nutritional status, and the intestinal microbiome. Alterations in the immune-metabolic cross-talk contribute to the development of autoimmune diseases. Adipokines exert a variety of metabolic activities contributing to the ethiopathogenesis of MetS and are involved in the regulation of both inflammatory processes and autoimmunity occurring in rheumatic diseases...
January 27, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Ntobeko A B Ntusi, Jane M Francis, Freedom Gumedze, Paul M Matthews, Paul B Wordsworth, Stefan Neubauer, Theodoros D Karamitsos
BACKGROUND: Rheumatoid arthritis (RA) is a multi-system, autoimmune disorder and confers one of the strongest risks for cardiovascular disease (CVD) morbidity and mortality. OBJECTIVE: To assess myocardial function and vascular stiffness in RA patients with and without cardiovascular risk factors (CVRFs) using cardiovascular magnetic resonance (CMR). METHODS: 23 RA patients with no CVRFs (17 female, mean age 52±13 years), 46 RA patients with CVRFs (32 female, mean age 53± 12), 50 normal controls (32 female, mean age 50±11 years), and 13 controls with CVRFs (7 female, mean age 55±7 years), underwent CMR at 1...
January 21, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Santos Castaneda, Carlos Gonzalez-Juanatey, Miguel A Gonzalez-Gay
BACKGROUND: The term inflammatory joint disease (IJD) includes a group of chronic conditions, particularly rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA), with predominant joint involvement and increased risk of cardiovascular (CV) complications and premature mortality. OBJECTIVE: The study aims to review of the most relevant CV manifestations from clinical point of view associated with IJD. METHODS: To update the current knowledge on CV manifestations in patients with IJD, we review the most relevant literature studies published in English (PubMed database) from January 2007 to February 2017...
January 22, 2018: Current Pharmaceutical Design
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