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Swollen joint

Alberto Cauli, Dafna D Gladman, Alessandro Mathieu, Ignazio Olivieri, Giovanni Porru, Paul P Tak, Claudia Sardu, Raffaele Scarpa, Antonio Marchesoni, William J Taylor, Carlo Salvarani, Joachim Kalden, Ennio Lubrano, Sueli Carneiro, Matteo Piga, Alberto Floris, Francesca Desiati, John A Flynn, Salvatore D'Angelo, Arno W R van Kuijk, Maria Grazia Catanoso, Francesco Caso, Paolo Contu, Ilona Ujfalussy, Philip S Helliwell, Philip J Mease
OBJECTIVE: Physician's global assessment (PGA) of disease activity is a major determinant of therapeutic decision making. This study assesses the reliability of the PGA, measured by means of 0-100 mm visual analog scale (VAS), and the additional use of separate VAS scales for musculoskeletal (PhysMSK) and dermatologic (PhysSk) manifestations in patients with psoriatic arthritis (PsA). METHODS: Sixteen centers from 8 countries enrolled 319 consecutive patients with PsA...
June 15, 2018: Journal of Rheumatology
Xiu-Min Chen, Jia-Qi Wu, Qing-Chun Huang, Jian-Yong Zhang, Jian-Hong Pen, Zhi-Sheng Huang, Yong-Liang Chu, Xiao-Hong He, Mao-Jie Wang, Run-Yue Huang
Biqi capsule is a Traditional Chinese Medicine preparation for treating rheumatoid arthritis (RA), and clinical studies have indicatedthat its effect may be more beneficial than that of Western medicine. The present study aimed to estimate the efficacy and safety of Biqi capsule alone or combined with methotrexate (MTX) compared with MTX alone for treating RA by performing a meta-analysis of randomized controlled trials and controlled clinical trials. A systematic literature search of studies published until March 2017 was performed...
June 2018: Experimental and Therapeutic Medicine
David B Bartlett, Leslie H Willis, Cris A Slentz, Andrew Hoselton, Leslie Kelly, Janet L Huebner, Virginia B Kraus, Jennifer Moss, Michael J Muehlbauer, Guillaume Spielmann, William E Kraus, Janet M Lord, Kim M Huffman
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disease in which adults have significant joint issues leading to poor health. Poor health is compounded by many factors, including exercise avoidance and increased risk of opportunistic infection. Exercise training can improve the health of patients with RA and potentially improve immune function; however, information on the effects of high-intensity interval training (HIIT) in RA is limited. We sought to determine whether 10 weeks of a walking-based HIIT program would be associated with health improvements as measured by disease activity and aerobic fitness...
June 14, 2018: Arthritis Research & Therapy
Atul Deodhar, Alice B Gottlieb, Wolf-Henning Boehncke, Bin Dong, Yuhua Wang, Yanli Zhuang, William Barchuk, Xie L Xu, Elizabeth C Hsia
BACKGROUND: Guselkumab, a human monoclonal antibody that binds to the p19 subunit of interleukin 23, has been approved for the treatment of moderate-to-severe psoriasis. Psoriatic arthritis is a common comorbidity of psoriasis with an umet need for novel treatments. We assessed the efficacy and safety of guselkumab in patients with active psoriatic arthritis. METHODS: We did a randomised, double-blind, placebo-controlled, phase 2a trial at 34 rheumatology and dermatology practices in Canada, Germany, Poland, Romania, Russia, Spain, and the USA...
June 2, 2018: Lancet
Shi-Yun Chen, Peng Zhou, Ye Qin
OBJECTIVE: To study the clinical efficacy and safety of bee-venom acupuncture therapy for rheumatoid arthritis (RA). METHODS: A total of 120 cases of RA patients were randomized into bee-sting acupuncture group (treatment) and western medicine group (control) in accordance with the random number table. The patients of the control group were treated by oral administration of Methotrexate (10 mg, once a week) and Celecoxlb (0.2 g, once a day), and those of the treatment group treated by 5 to 15 bee stings of Ashi -points or acupoints according to different conditions and corporeity, and with the bee-sting retained for about 5 min every time, once every other day...
April 25, 2018: Zhen Ci Yan Jiu, Acupuncture Research
Naza Mohammed Ali Mahmood, Saad Abdulrahman Hussain, Hawar Ali Ehsan Kaka Khan
Objective: The present study aimed to evaluate the efficacy and safety of azilsartan (Azil) as "add-on" treatment with methotrexate (MTX) in patients with active rheumatoid arthritis (RA). Methods: This single center, randomized, placebo-controlled, double-blind, pilot study included 64 patients with active RA. Patients received either placebo or Azil in addition to their currently used MTX doses for 90 days. The primary outcomes were DAS-28, SDAI, HAQ-DI, CDAI, EGA, and swollen and tender joints count...
2018: BioMed Research International
Tor Olofsson, Jonas K Söderling, Anders Gülfe, Lars-Erik Kristensen, Johan K Wallman
OBJECTIVE: To study the impact of common, non-composite disease activity measures on sick leave in biologics-treated RA-patients. METHODS: Study visits of biologics-treated RA-patients of working-age (<65y), in the observational South Swedish Arthritis Treatment Group register 2005-2011, were included (5118 visits; 941 patients). We performed association analyses between various non-composite disease activity measures at each visit and number of sick leave days during the month thereafter, retrieved from the Social Insurance Agency...
June 8, 2018: Arthritis Care & Research
Antoni Fellas, Davinder Singh-Grewal, Derek Santos, Andrea Coda
Background: Juvenile idiopathic arthritis (JIA) is the most common form of rheumatic disease in childhood and adolescents, affecting between 16 and 150 per 100,000 young persons below the age of 16. The lower limb is commonly affected in JIA, with joint swelling and tenderness often observed as a result of active synovitis. Objective: The objective of this scoping review is to identify the existence of physical examination (PE) tools to identify and record swollen and tender lower limb joints in children with JIA...
2018: Arthritis
Katie Bechman, Fang En Sin, Fowzia Ibrahim, Sam Norton, Faith Matcham, David Lloyd Scott, Andrew Cope, James Galloway
Background: Tapering of anti-tumour necrosis factor (TNF) therapy appears feasible, safe and effective in selected patients with rheumatoid arthritis (RA). Depression is highly prevalent in RA and may impact on flare incidence through various mechanisms. This study aims to investigate if psychological states predict flare in patients' dose tapering their anti-TNF therapy. Methods: This study is a post-hoc analysis of the Optimizing TNF Tapering in RA trial, a multicentre, randomised, open-label study investigating anti-TNF tapering in RA patients with sustained low disease activity...
2018: RMD Open
Richard Holland, William Tillett, Alexis Ogdie, Ying Y Leung, Dafna D Gladman, Kristina Callis Duffin, Laura C Coates, Philip J Mease, Lihi Eder, Vibeke Strand, Musaab Elmamoun, Pil Højgaard, Jeffrey Chau, Maarten de Wit, Niti Goel, Chris A Lindsay, Oliver FitzGerald, Bev Shea, Dorcas Beaton, Ana-Maria Orbai
The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Core Set working group is in the process of selecting core instruments for PsA clinical trials. During a 2-h workshop and breakout group discussions at the GRAPPA 2017 annual meeting in Amsterdam, the Netherlands, participants discussed the first set of candidate instruments to be taken through the OMERACT Filter 2.1 instrument selection process: 66/68 swollen/tender joint count (66/68JC), Spondyloarthritis Consortium of Canada (SPARCC) enthesitis index, patient's global assessment (GRAPPA and OMERACT formulations), Health Assessment Questionnaire-Disability Index (HAQ-DI), Psoriatic Arthritis Impact of Disease (PsAID) questionnaires 9 and 12, and Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue...
June 2018: Journal of Rheumatology. Supplement
Cheryl Barnabe, Yufei Zheng, Arto Ohinmaa, Louise Crane, Tyler White, Brenda Hemmelgarn, Gilaad G Kaplan, Liam Martin, Walter P Maksymowych
OBJECTIVE: To examine clinical effectiveness, treatment complications, and healthcare costs for indigenous and non-indigenous Albertans with rheumatoid arthritis (RA) participating in the Alberta Biologics Pharmacosurveillance program. METHODS: Patients initiating biologic therapy in Alberta (2004-2012) were characterized for disease severity and treatment response. Provincial hospitalization separations, physician claims, outpatient department data, and emergency department data were used to estimate treatment complication event rates and healthcare costs...
June 1, 2018: Journal of Rheumatology
Baptiste Louveau, Yann De Rycke, Alexandre Lafourcade, Alain Saraux, Francis Guillemin, Florence Tubach, Bruno Fautrel, David Hajage
Objectives: Several authors have tried to predict the risk of radiographic progression in RA according to baseline characteristics, considering exposure to treatment only as a binary variable (Treated: Yes/No). This study aims to model the risk of 5-year radiographic progression taking into account both baseline characteristics and the cumulative time-varying exposure to corticosteroids or DMARDs. Methods: The study population consisted of 403 patients of the Etude et Suivi des Polyarthrites Indifférenciées Récentes cohort meeting the 1987 ACR or 2010 ACR/EULAR criteria for RA at inclusion and having complete radiographic data at baseline and 5 years...
May 22, 2018: Rheumatology
John C Taylor, Tim Bongartz, Jonathan Massey, Borbala Mifsud, Athina Spiliopoulou, Ian C Scott, Jianmei Wang, Michael Morgan, Darren Plant, Marco Colombo, Peter Orchard, Sarah Twigg, Iain B McInnes, Duncan Porter, Jane E Freeston, Jackie L Nam, Heather J Cordell, John D Isaacs, Jenna L Strathdee, Donna Arnett, Maria J H de Hair, Paul P Tak, Stella Aslibekyan, Ronald F van Vollenhoven, Leonid Padyukov, S Louis Bridges, Costantino Pitzalis, Andrew P Cope, Suzanne M M Verstappen, Paul Emery, Michael R Barnes, Felix Agakov, Paul McKeigue, Taisei Mushiroda, Michiaki Kubo, Richard Weinshilboum, Anne Barton, Ann W Morgan, Jennifer H Barrett
Methotrexate (MTX) monotherapy is a common first treatment for rheumatoid arthritis (RA), but many patients do not respond adequately. In order to identify genetic predictors of response, we have combined data from two consortia to carry out a genome-wide study of response to MTX in 1424 early RA patients of European ancestry. Clinical endpoints were change from baseline to 6 months after starting treatment in swollen 28-joint count, tender 28-joint count, C-reactive protein and the overall 3-component disease activity score (DAS28)...
May 25, 2018: Pharmacogenomics Journal
Pacôme Fosse, Marie-Joelle Kaiser, Gauthier Namur, Dominique de Seny, Michel G Malaise, Roland Hustinx
Background: 18 F-FDG PET/CT has been proposed in the evaluation of the disease activity in rheumatoid arthritis (RA). The goals of this study were to evaluate the reproducibility of the technique, to compare metabolic parameters to clinical, biological and ultrasonographic parameters before and after treatment and to evaluate whether the early metabolic response was related to the outcome. 18 F- FDG PET/CT of the hands, wrists and knees was obtained in 15 patients with anti-TNFα refractory RA, at baseline and 16 weeks after treatment with rituximab...
2018: European journal of hybrid imaging
Imad Ghozlani, Aziza Mounach, Mirieme Ghazi, Anass Kherrab, Radouane Niamane
BACKGROUND Acquired hemophilia A (AH) is a rare hemorrhagic diathesis, characterized by the presence of autoantibodies directed against the pro-coagulant activity of factor VIII. It is associated with rheumatoid arthritis (RA) in 4% to 8% of cases and its prognosis remains severe. CASE REPORT A 66-year-old patient has been followed up for 20 years for deforming and severe RA, which was in low-disease activity. However, the patient presented a polyarticular flare involving the metacarpophalangeal and the proximal interphalangeal joints, the left elbow, and the right knee, which was warm and swollen...
May 21, 2018: American Journal of Case Reports
Bjorn Gudbjornsson, Arni Jon Geirsson, Niels Steen Krogh
Objective: To explore differences in response to a low dosage regimen of infliximab with an escalating dosage in comparison to a standard dosage of etanercept and adalimumab in patients with psoriatic arthritis (PsA). Methods: Biologically naïve PsA patients who were beginning anti-TNF-α therapy were selected from the ICEBIO registry. Demographics and clinical differences were compared in four treatment groups: infliximab <4 mg/kg; infliximab >4 mg/kg; etanercept or adalimumab at baseline and on follow-up (6 and 12 months, last visit)...
2018: Psoriasis: targets and therapy
Xavier M Teitsma, Johannes W G Jacobs, Paco M J Welsing, Pascal H P de Jong, Johanna M W Hazes, Angelique E A M Weel, Attila Pethö-Schramm, Michelle E A Borm, Jacob M van Laar, Floris P J G Lafeber, Johannes W J Bijlsma
OBJECTIVE: To identify and validate clinical baseline predictors associated with inadequate response (IR) to methotrexate (MTX) therapy in newly diagnosed patients with rheumatoid arthritis (RA). METHODS: In U-Act-Early, 108 disease-modifying antirheumatic drug (DMARD)-naive patients with RA were randomised to initiate MTX therapy and treated to target until sustained remission (disease activity score assessing 28 joints (DAS28) <2.6 with four or less swollen joints for ≥24 weeks) was achieved...
May 14, 2018: Annals of the Rheumatic Diseases
Connor Boyle, Thomas Howard, David Griffith, Jonathan Cowie
A previously healthy 18-year-old woman presented with an acutely painful, swollen right ankle joint, with similar symptoms subsequently developing in the right hip and right wrist. Microbiological samples from the ankle aspirate grew Neisseria meningitidis She had had no preceding clinical symptoms of meningitis or previous contact with a patient with meningitis. She was treated with intravenous antibiotics and surgical drainage.On follow-up, her symptoms had resolved, inflammatory markers had returned to normal and she has no long-term sequelae of septic arthritis...
May 8, 2018: BMJ Case Reports
Farideh Shishehbor, Mahnaz Rezaeyan Safar, Elham Rajaei, Mohammad Hosein Haghighizadeh
OBJECTIVE: This study evaluated the effect of cinnamon on disease activity, serum levels of some inflammatory markers, and cardiovascular risk factors in women with rheumatoid arthritis (RA). METHODS: In this randomized double-blind clinical trial, 36 women with RA were randomly divided to 2 groups, receiving 4 capsules of either 500 mg cinnamon powder or placebo daily for 8 weeks. Fasting blood sugar (FBS), lipid profile, liver enzymes, serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), erythrocyte sedimentation rate (ESR), blood pressure, and clinical symptoms were determined at baseline and end of the week 8...
May 3, 2018: Journal of the American College of Nutrition
Emil Rydell, Kristina Forslind, Jan-Åke Nilsson, Lennart T H Jacobsson, Carl Turesson
BACKGROUND: Identification of risk factors for rapid joint destruction in early rheumatoid arthritis (RA) can be helpful for optimizing treatment, and improving our understanding of destructive arthritis and its mechanisms. The objective of this study was to investigate the relationship between early RA patient characteristics and subsequent rapid radiographic progression (RRP). METHODS: An inception cohort of patients with early RA (symptom duration < 12 months), recruited during 1995-2005 from a defined area (Malmö, Sweden), was investigated...
May 2, 2018: Arthritis Research & Therapy
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