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Very early rheumatoid arthritis

Ismet H Bajraktari, Blerim Krasniqi, Sylejman Rexhepi, Sadi Bexheti, Elton Bahtiri, Halit Bajraktari, Besim Luri
BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterised by intra-articular and extra-articular manifestations but very rarely with coxitis. AIM: This study aimed to investigate the prevalence of coxitis, clinical changes, and its correlation with the parameters of inflammatory activity. METHODS: A cohort of 951 patients diagnosed with ACR/EULAR (American College of Rheumatology/European League against Rheumatism) 2010 criteria was enrolled in this prospective, observational and analytic research study...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Alberto Lo Gullo, Javier Rodríguez-Carrio, Caterina Oriana Aragona, Giuseppe Dattilo, Concetta Zito, Ana Suárez, Saverio Loddo, Marco Atteritano, Antonino Saitta, Giuseppe Mandraffino
BACKGROUND AND AIMS: Cardiovascular (CV) morbidity is increased in inflammatory joint diseases (IJD), as rheumatoid (RA) and psoriatic arthritis (PsA). Whereas increased prevalence of subclinical atherosclerosis has been reported in these conditions, whether an early myocardial functionality is also impaired remains unknown. The aim of this study was to evaluate the myocardial functionality by speckle-tracking echocardiography (STE) in recent onset RA and PsA patients and its potential associations with the levels of circulating CD34 +  cells, vitamin D, and with disease activity...
March 2, 2018: Atherosclerosis
Emma C de Moel, Veerle F A M Derksen, Gerrie Stoeken, Leendert A Trouw, Holger Bang, Robbert J Goekoop, Irene Speyer, Tom W J Huizinga, Cornelia F Allaart, René E M Toes, Diane van der Woude
BACKGROUND: The autoantibody profile of seropositive rheumatoid arthritis (RA) is very diverse and consists of various isotypes and antibodies to multiple post-translational modifications. It is yet unknown whether this varying breadth of the autoantibody profile is associated with treatment outcomes. Therefore, we investigated whether the composition of the autoantibody profile in RA, as a marker of the underlying immunopathology, influences initial and long-term treatment outcomes. METHODS: In serum from 399 seropositive patients with RA in the IMPROVED study, drawn at baseline and at the moment of drug tapering, we measured IgG, IgM, and IgA isotypes for anti-cyclic citrullinated peptide-2 and anti-carbamylated protein antibodies, IgM and IgA rheumatoid factor, and reactivity against four citrullinated and two acetylated peptides (anti-modified protein antibodies (AMPAs))...
February 26, 2018: Arthritis Research & Therapy
Jingfeng Zhang, Junli Wang, Xiongwei Mao, Zhengang Li
RATIONALE: Synovial cysts are well known in rheumatoid arthritis (RA), and most common in the popliteal fossa. They may produce lots of local symptoms and complaints, which may present initially as an unrelated clinical condition. Few studies have reported multiple extra-articular synovial cysts (MESCs) in the RA patients. Early diagnosis is crucial for patient treatment. PATIENT CONCERNS: A 50-year-old man without any special clinical histories found a soya bean size bump at the left elbow medially, then multiple lumps were found at bilateral elbows and gradually increasing...
February 2018: Medicine (Baltimore)
Willem J J Falkenburg, Helen J von Richthofen, Jana Koers, Cas Weykamp, Marco W J Schreurs, Liesbeth E Bakker-Jonges, Inez-Anne Haagen, Willem F Lems, Dörte Hamann, Dirkjan van Schaardenburg, Theo Rispens
BACKGROUND: Accurate measurements of rheumatoid factors (RFs), autoantibodies binding IgG, are important for diagnosing rheumatoid arthritis (RA) and for predicting disease course. Worldwide, various RF assays are being used that differ in technique and target antigens. We studied whether assay choice leads to clinically important discrepancies in RF status and level. METHODS: RF measurements using four commercial RF assays were compared in 32 RF+ samples. Using enzyme-linked immunosorbent assays (ELISAs), the influence of the target antigen source - human IgG (hIgG) versus rabbit IgG (rIgG) - on measured RF levels was investigated in arthralgia patients and RA patients...
February 10, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Sandra L Goss, Cheri E Klein, Ziyi Jin, Charles S Locke, Ramona C Rodila, Hartmut Kupper, Gerd-Rudiger Burmester, Walid M Awni
PURPOSE: Methotrexate (MTX) and adalimumab are well-recognized treatments of rheumatoid arthritis (RA), the efficacy of which may be driven by intracellular polyglutamates (PGs). The aim of this analysis was to characterize MTX PG concentrations and adalimumab pharmacokinetics in the CONCERTO trial. In addition, the relationships between MTX dose/pharmacokinetics, adalimumab pharmacokinetics, and efficacy were evaluated. METHODS: CONCERTO was a double-blind, parallel-arm study in patients with early RA randomized to adalimumab 40 mg SC every other week plus blinded MTX 2...
February 2018: Clinical Therapeutics
Josef S Smolen, Annette Szumski, Andrew S Koenig, Thomas V Jones, Lisa Marshall
BACKGROUND: The aim was to analyze characteristics that predict remission induction and subsequent loss of remission in patients with moderately active rheumatoid arthritis (RA) who received full-dose combination etanercept plus methotrexate induction therapy followed by reduced-dose etanercept or etanercept withdrawal. METHODS: Patients with Disease Activity Score based on 28-joint count (DAS28) >3.2 and ≤5.1 received open-label etanercept 50 mg once weekly (QW) plus methotrexate for 36 weeks...
January 16, 2018: Arthritis Research & Therapy
Edyta Brzustewicz, Izabella Henc, Agnieszka Daca, Maria Szarecka, Malgorzata Sochocka-Bykowska, Jacek Witkowski, Ewa Bryl
Introduction: Currently used clinical scale and laboratory markers to monitor patients with early rheumatoid arthritis (RA) seem to be not sufficient. It has been demonstrated that disease- related cytokines may be elevated very early in RA development and cytokines are considered as the biomarkers potentially useful for RA monitoring. Material and methods: The group of patients with undifferentiated arthritis (UA) developing RA (UA→RA) was identified from a total of 121 people with arthralgia...
2017: Central-European Journal of Immunology
Raju Vaishya, Amit Kumar Agarwal, Paras Kumar Banka, Vipul Vijay, Abhishek Vaish
Introduction: Insufficiency fractures (IFs) are a subtype of stress fractures commonly associated with osteoporosis and Vitamin D deficiency. These nontraumatic fractures often occur in the pelvis and spine, but the involvement of other unusual sites is also not very uncommon. Plain radiographs and magnetic resonance imaging scan are the most commonly used imaging modalities for the diagnosis of IF. Case Report: We are presenting a series of five cases of IFs at unusual sites, along with a detailed literature review on this individual...
July 2017: Journal of Orthopaedic Case Reports
Huajun Xu, Yingchun Zhang, Huimei Zhang, Caishan Wang, Pan Mao
BACKGROUND: As an irreversible disease, a treatment delay can negatively affect treatment response in rheumatoid arthritis (RA). Ultrasound and MRI have played an important role in assessing disease progression and response to treatment in RA for many years. The present study was designed to compare the diagnostic efficacy of ultrasound grading and MRI in early RA. METHODS: In this retrospective study, 62 early RA patients within 12 months of symptom onset were included...
October 17, 2017: Journal of Orthopaedic Surgery and Research
Tomohiro Shimizu, Hyo Jin Choi, Ursula Heilmeier, Matthew Tanaka, Andrew J Burghardt, Jingshan Gong, Nattagan Chanchek, Thomas M Link, Jonathan Graf, John B Imboden, Xiaojuan Li
BACKGROUND: Although one study showed minimal progression of erosions in patients with rheumatoid arthritis (RA) one year after TNFα inhibition therapy, no studies have investigated very early bone changes after initiation of anti-TNFα treatment. We investigated the effects of 3-month anti-TNFα treatment on bone erosion progression and bone microarchitecture in RA patients using high-resolution peripheral quantitative computed tomography (HR-pQCT). METHODS: Patients with RA (n = 27) (17 in the anti-TNFα and 10 in the MTX-only group) underwent assessment of disease activity score in 28 joints (DAS-28), radiographs, 3-T magnetic resonance imaging (MRI) and HR-pQCT of metacarpophalangeal and wrist joints at baseline and 3 months...
October 4, 2017: Arthritis Research & Therapy
Mai T T Nguyen, Hanne Lindegaard, Oliver Hendricks, Charlotte Sværke Jørgensen, Bjørn Kantsø, Nina Friis-Møller
OBJECTIVE: To evaluate the initial serological responses to pneumococcal vaccination with the 13-valent protein-conjugated pneumococcal vaccine (PCV13) followed by the 23-valent polysaccharide pneumococcal vaccine (PPV23) among patients with rheumatoid arthritis (RA) treated with biological disease-modifying antirheumatic drugs (bDMARD) according to dosing and intervals between immunizations. METHODS: Investigator-initiated clinical trial. Patients with RA receiving bDMARD were randomized (1:1:1) to immunization with single dose PCV13 followed by PPV23 after 16 or 24 weeks, or double dose PCV13 followed by PPV23 after 16 weeks...
December 2017: Journal of Rheumatology
Irazú Contreras-Yáñez, Guillermo Guaracha-Basañez, Daniel Ruiz-Domínguez, Virginia Pascual-Ramos
BACKGROUND: During the course of rheumatoid arthritis (RA), patients have profound negative effects on their patient-reported-outcomes (PRO); in addition, the impact of sustained remission (SR) on PROs may differ for each particular outcome. The objectives of this study were to identify SR from an inception cohort of RA patients and to examine the impact of SR in an ample spectrum of PROs. METHODS: The study was developed in a well characterized and ongoing cohort of RA patients with recent onset disease recruited from 2004 onwards...
September 2, 2017: BMC Musculoskeletal Disorders
Alice M Walsh, Mihir D Wechalekar, Yanxia Guo, Xuefeng Yin, Helen Weedon, Susanna M Proudman, Malcolm D Smith, Sunil Nagpal
OBJECTIVES: This study sought to investigate the genome-wide transcriptional effects of a combination of disease modifying anti-rheumatic drugs (tDMARD; methotrexate, sulfasalazine and hydroxychloroquine) in synovial tissues obtained from early rheumatoid arthritis (RA) patients. While combination DMARD strategies have been investigated for clinical efficacy, very little data exists on the potential molecular mechanism of action. We hypothesized that tDMARD would impact multiple biological pathways, but the specific pathways were unknown...
2017: PloS One
Gina Hetland Brinkmann, Ellen S Norli, Pernille Bøyesen, Désirée van der Heijde, Lars Grøvle, Anne J Haugen, Halvor Nygaard, Olav Bjørneboe, Cathrine Thunem, Tore K Kvien, Maria D Mjaavatten, Elisabeth Lie
OBJECTIVE: To determine how the European League Against Rheumatism (EULAR) definition of erosive disease (erosion criterion) contributes to the number of patients classified as rheumatoid arthritis (RA) according to the 2010 American College of Rheumatology/EULAR RA classification criteria (2010 RA criteria) in an early arthritis cohort. METHODS: Patients from the observational study Norwegian Very Early Arthritis Clinic with joint swelling ≤16 weeks, a clinical diagnosis of RA or undifferentiated arthritis, and radiographs of hands and feet were included...
November 2017: Annals of the Rheumatic Diseases
Davide Orlandi, Salvatore Gitto, Silvia Perugin Bernardi, Angelo Corazza, Luca De Flaviis, Enzo Silvestri, Marco Amedeo Cimmino, Luca Maria Sconfienza
We compared the diagnostic performance of an advanced power Doppler technique (superb microvascular imaging [SMI]) with that of power Doppler Imaging (PDI) and B-mode ultrasound (US) in patients with early rheumatoid arthritis (RA) and RA under treatment with rituximab. Thirty patients (21 women aged 45 ± 11 y) affected by RA with remission to moderate disease activity were examined. Both hand joints were evaluated using US, PDI and SMI. Two radiologists reviewed all video clips and evaluated synovial vascularity intensity using a semi-quantitative scoring system...
June 16, 2017: Ultrasound in Medicine & Biology
Kazuo Kubota, Hiroyuki Yamashita, Akio Mimori
FDG is a tracer for visualizing glucose metabolism. PET/CT using FDG is widely used for the diagnosis of cancer, because glycolysis is elevated in cancer cells. Similarly, active inflammatory tissue also exhibits elevated glucose metabolism because of glycolysis in activated macrophages and proliferating fibroblasts. Elevated FDG uptake by active inflammatory tissues, such as those affected by arthritis, vasculitis, lymphadenitis, and chondritis, has enabled the diagnosis of inflammatory diseases using FDG-PET/CT...
July 2017: Seminars in Nuclear Medicine
Ji Eun Lee, In Je Kim, Min Sun Cho, Jisoo Lee
Rheumatoid vasculitis is a rare, but most serious extra-articular complications of long-standing, seropositive rheumatoid arthritis (RA). Vasculitis of hepatic artery is an extremely rare but severe manifestation of rheumatoid vasculitis. A 72-year-old woman who presented with polyarthralgia for 2 months was diagnosed with early RA. Since she had manifestations of livedo reticularis, and liver dysfunction which was atypical for RA patients, a percutaneous needle liver biopsy was performed revealing arteritis of a medium-sized hepatic artery...
July 2017: Journal of Korean Medical Science
David Werner, David Simon, Matthias Englbrecht, Fabian Stemmler, Christoph Simon, Andreas Berlin, Judith Haschka, Nina Renner, Thomas Buder, Klaus Engelke, Axel J Hueber, Jürgen Rech, Georg Schett, Arnd Kleyer
OBJECTIVE: To characterize the specific structural properties of the erosion-prone bare area of the human joint, and to search for early microstructural changes in this region during rheumatoid arthritis (RA). METHODS: In the initial part of the study, human cadaveric hand joints were examined for exact localization of the bare area of the metacarpal heads, followed by detection of cortical micro-channels (CoMiCs) in this region by high-resolution peripheral quantitative computed tomography (HR-pQCT) and, after anatomic dissection, validation of the presence of CoMiCs by micro-computed tomography (micro-CT)...
August 2017: Arthritis & Rheumatology
Xinqiang Song, Qingsong Lin
Rheumatoid arthritis is an autoimmune disease that affects several organs and tissues, predominantly the synovial joints. The pathogenesis of this disease is not completely understood, which maybe involved in the genomic variations, gene expression, protein translation and post-translational modifications. These system variations in genomics, transcriptomics and proteomics are dynamic in nature and their crosstalk is overwhelmingly complex, thus analyzing them separately may not be very informative. However, various '-omics' techniques developed in recent years have opened up new possibilities for clarifying disease pathways and thereby facilitating early diagnosis and specific therapies...
August 2017: Rheumatology International
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