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Adey A Berhanu, Svetlana Krasnokutsky, Robert T Keenan, Michael H Pillinger
INTRODUCTION: Pegloticase is a highly effective therapy for patients with refractory and/or tophaceous gout, but has a high discontinuation rate (30-50%) due to development of anti-drug antibodies causing loss of efficacy and risk of infusion reactions. OBJECTIVE: To describe the use of azathioprine or other immunosuppressive therapies as a pegloticase adjunct to prevent pegloticase immunogenicity when treating gout. METHODS: Case report of azathioprine use in a patient receiving pegloticase therapy for refractory tophaceous gout, and review of the literature for the impact of immunosuppressive agents on development of anti-drug antibodies...
September 20, 2016: Seminars in Arthritis and Rheumatism
Joel M Kremer
The Corrona US national registry collects data concerning patient status from both the rheumatologist and patient at routine clinical encounters. Corrona has functioning disease registries in rheumatoid arthritis, psoriatic arthritis, spondyloarthropathies, psoriasis and inflammatory bowel disease. Corrona merges data concerning long-term effectiveness and safety, as well as comparative and cost effectiveness of agents to treat these autoimmune diseases.
September 2016: Clinical and Experimental Rheumatology
Joachim Sieper, Tim Holbrook, Christopher M Black, Robert Wood, Xiaohan Hu, Sumesh Kachroo
OBJECTIVES: To assess the impact of non-radiographic axial spondyloarthritis (nr-axSpA) on patients and society based on real-world evidence from the Adelphi nr-axSpA Disease Specific Programme, a cross-sectional survey of rheumatologists and their patients in Germany, France, Spain, Italy and the UK. METHODS: Physicians completed patient record forms for the next two patients consulting with nr-axSpA (diagnosis at the physician's judgement); patients were invited to complete a patient self-completion form...
August 31, 2016: Clinical and Experimental Rheumatology
Bindu Madhavi Mudduluru, Shalin Shah, Steven Shamah, Arun Swaminath
Tumor necrosis factor alpha (TNF alpha) antagonists are biologic agents used in the management of inflammatory conditions such as rheumatoid arthritis, seronegative spondyloarthropathies and inflammatory bowel disease. These agents have been recently shown to cause a syndrome called anti-TNF induced lupus (ATIL), a rare condition which has similar clinical manifestations to idiopathic systemic lupus erythematosus (SLE). Given that extra-intestinal manifestations of inflammatory bowel disease include arthritis, it can be difficult to separate arthritis due to underlying disease from drug-induced arthritis...
October 17, 2016: Postgraduate Medicine
Steven Schaub, Hartley M Sirkis, Jonathan Kay
Multifocal osteomyelitis and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome constitute a spectrum of disease that includes inflammatory bone lesions and dermatologic findings. Radiographic features resemble those of the spondyloarthropathies with anterior chest wall involvement. Early radiographic findings are osteodestructive with lytic lesions. Bone scintigraphy of the sternoclavicular region classically yields a 'bull's head' pattern of radionuclide uptake. Magnetic resonance imaging (MRI) can demonstrate corner lesions of vertebral bodies...
November 2016: Rheumatic Diseases Clinics of North America
Jamileh Moghimi, Ali Asghar Rezaei, Raheb Ghorbani, Mohammad Reza Razavi, Daryoush Pahlevan
In the current study, the overall prevalence and the main underlying etiologies of inflammatory low back pain (ILBP) were determined, and the effectiveness of treatment with sulfasalazine was investigated in patients with inflammatory versus mechanical low back pain (LBP). In a prospective study conducted from July 2013 until August 2015, 1,779 consecutive patients within the age range of 18-50 years with a primary complaint of LBP referring to the rheumatology clinics were included. The patients were classified into two distinct groups: those suffering from ILBP (n=118) and those having mechanical LBP (n=1,661)...
2016: Drug Design, Development and Therapy
David B Guiliano, Helen North, Eleni Panayoitou, Elaine C Campbell, Kirsty McHugh, Fiona G M Cooke, Marine Silvestre, Paul Bowness, Simon J Powis, Antony N Antoniou
Objective - HLA-B27 is associated with the inflammatory spondyloarthropathies (SpAs). Of significance, subtypes HLA-B*27:06 and HLA-B*27:09 are not associated with the SpAs. These subtypes primarily differ from the HLA-B*27:05 disease associated allele at residues 114 and 116 of the heavy chain, part of the F pocket of the antigen-binding groove. Dimerisation of HLA-B27 during assembly has been implicated in disease onset. This study investigated the factors influencing differences in dimerisation between disease associated and non-associated HLA-B27 alleles...
October 9, 2016: Arthritis & Rheumatology
Stephen J Balevic, C Egla Rabinovich
Uveitis refers to the presence of intraocular inflammation, and as a strict definition compromises the iris and ciliary body anteriorly and the choroid posteriorly (the uvea). Untreated, uveitis can lead to visual loss or blindness. The etiology of uveitis can include both infectious and noninfectious (usually immune-mediated) causes, the latter of which are often mediated predominantly by Th1 CD4(+) T-cells that secrete proinflammatory cytokines. Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine involved in the pathogenesis of uveitis, which at high concentrations can cause excess inflammation and tissue damage...
2016: Drug Design, Development and Therapy
Francisco Airton Castro Rocha
Father Cicero Romao Batista is probably the most famous Ceará character of all time. An important protagonist of the Cariri region, situated in the south of Ceara State, in the late nineteenth century and the first third of the twentieth century, Father Cicero had great political and religious activity, as well as other less well-known achievements, for instance, his ecological teachings that led him to be awarded the title of "Patron of Forests", besides an enormous effort and personal sacrifice for the improvement of the conditions of human life...
September 2016: Revista Brasileira de Reumatologia
Claudia Fabiani, Antonio Vitale, Giuseppe Lopalco, Florenzo Iannone, Bruno Frediani, Luca Cantarini
The purpose of the present review was to provide a comprehensive picture of the efficacy of the different tumor necrosis factor (TNF)-α inhibiting agents in the treatment of acute anterior uveitis (AAU), the most common extra-articular manifestation of ankylosing spondylitis (AS). AS related, AAU may lead to severe visual impairment, due to frequent flare recurrences, anterior, and posterior segment complications and traditional treatment side effects. Considerably higher levels of tumor necrosis factor (TNF) have been assessed in the aqueous humor and inflamed joints of patients with AS...
November 2016: Clinical Rheumatology
Kalliopi Klavdianou, Stamatis-Nick Liossis, Lazaros Sakkas, Dimitrios Daoussis
BACKGROUND: Dickkopf-1 (Dkk-1) is a soluble inhibitor of the canonical Wnt pathway, which plays critical roles in embryonic development. Evidence suggests that this molecule regulates several aspects of both bone biology and fibrosis. OBJECTIVES: To provide an overview of our current knowledge of the role of Dkk-1 in joint remodeling and fibrosis. METHODS: We performed an electronic search (Medline) using the following key words: Dickkopf-1 (or Dkk-1), new bone formation, joint remodeling, ankylosing spondylitis, systemic sclerosis (or scleroderma), and fibrosis, supplemented by a manual search of references from retrieved articles...
August 23, 2016: Seminars in Arthritis and Rheumatism
Zhen-Guo Huang, Xiao-Liang Chen, Kai-Ning Shi, Ran Yan, He Chen, Min-Xing Yang, Bao-Xiang Gao, Queenie Chan, Guo-Chun Wang
OBJECTIVES: To investigate the feasibility and accuracy of T2-weighted spectral presaturation inversion recovery combined with fluid attenuated inversion recovery (T2W SPIR-FLAIR) in the diagnosis of hip synovitis in patients with spondyloarthropathy (SpA). METHODS: Ten volunteers underwent a T2W SPIR and four T2W SPIR-FLAIR sequence scans with different inversion time (TI) to determine the optimum TI that could effectively suppress the intra-articular fluid signals...
September 23, 2016: British Journal of Radiology
Ozgul Yigit, Meltem Erol, Ozlem Bostan Gayret, Isıl Ustun, Selami Ulas
INTRODUCTION: Tuberculosis remains a major public health problem in developing countries. Diagnosing extrapulmonary tuberculosis can be difficult, as it requires a higher index of suspicion than primary tuberculosis. Extrapulmonary tuberculosis may mimic malignancies and many other diseases, so it should be included in the differential diagnosis. Here, we present a case of extrapulmonary tuberculosis associated with Pott's disease and hip arthritis in a patient who recovered after 12 months of antituberculosis therapy...
July 2016: Iranian Red Crescent Medical Journal
Sylke Schneider-Burrus, Ellen Witte-Haendel, Demetrios Christou, Benedetta Rigoni, Robert Sabat, Gerd Diederichs
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease, causing fistulating sinuses in the intertriginous skin of axillary, genitofemoral and perianal sites. OBJECTIVE: As other chronic inflammatory diseases, e.g. psoriasis, are frequently associated with spondyloarthropathies (SpA), the goal of this study was to quantify the prevalence of back pain and SpA in HS patients. METHODS: A prospective questionnaire survey in 100 HS patients and a retrospective evaluation of pelvic magnetic resonance imaging (MRI) scans in 46 HS patients were conducted...
September 21, 2016: Dermatology: International Journal for Clinical and Investigative Dermatology
Adel Mahmoud, Dalia Fayez, Mervat Mammdouh Abou Gabal, Sherin Mohamed Hosny Hamza, Takwa Badr
INTRODUCTION: Fusion of joints as well as intervertebral spaces by the formation of bony spurs appearing as syndesmophytes and osteophytes are the hallmark of spondyloarthropathies which accounts for disability. The aim of this study was to assess the serum level of bone morphogenetic protein (BMP)-7 in ankylosing spondylitis and its relationship with disease activity and the radiographic damage. METHODS: This longitudinal case control study was conducted in Ain Shams University Hospitals (Egypt)...
July 2016: Electronic Physician
Ramez R Hanna, Nicholas Kolanko, Carlos Torres
History A 70-year-old woman presented to a peripheral hospital with signs and symptoms of acute chronic obstructive pulmonary disease (COPD) exacerbation. The patient also reported acute on chronic onset of thoracolumbar back pain over a period of 24 hours. She denied any history of recent trauma or intravenous drug use. She did not have any long-term indwelling catheters. The patient's medical history was also complicated by stage 4 renal failure from long-standing type II diabetes, hypertension, iron deficiency anemia, aortic stenosis, and prior bariatric surgery...
October 2016: Radiology
Sheila L Arvikar, Jameson T Crowley, Katherine B Sulka, Allen C Steere
OBJECTIVE: To describe systemic autoimmune joint diseases following Lyme disease and to compare their clinical features with Lyme arthritis. METHODS: Records of all adult patients referred to our Lyme arthritis clinic over a 13-year period in whom we diagnosed a systemic autoimmune joint disease following Lyme disease were reviewed. For comparison, records of patients enrolled in our Lyme arthritis (LA) cohort over the most recent 2-year period were analyzed. IgG antibodies to Borrelia burgdorferi and to 3 Lyme disease-associated autoantigens were measured...
September 16, 2016: Arthritis & Rheumatology
Somsiri Sukavatcharin, Ornsirin Kijdaoroong, Kaevalin Lekhanont, Sakda Arj-Ong Vallipakorn
PURPOSE: To study the etiology and pattern of uveitis in a tertiary ophthalmology center in Thailand. METHODS: A cross-sectional study was conducted on uveitis patients presenting to a uveitis clinic at Ramathibodi Hospital, Thailand, between February 2014 and January 2015. RESULTS: A total of 758 uveitis patients were enrolled into this study. The most common identified cause was herpetic uveitis (17.2%), followed by Vogt-Koyanagi-Harada disease (13...
September 7, 2016: Ocular Immunology and Inflammation
Qiang Wang, Zhenzhen Wen, Qian Cao
Infliximab is a promising drug with good outcomes demonstrated for diseases such as inflammatory bowel disease (IBD), rheumatoid arthritis (RA) and spondyloarthropathy (SpA). However, treatment with this drug may increase the risk of tuberculosis infection. The aim of the present study was to investigate infliximab-associated tuberculosis infection. Literature searches in PubMed, MEDLINE and EMBASE databases were performed. Randomized controlled trials with >95% of the patients >18 years-old were included...
September 2016: Experimental and Therapeutic Medicine
Akshay S Thomas, Phoebe Lin
PURPOSE OF REVIEW: Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) are numerous and can often involve the eye. This review highlights the ocular complications associated with IBD including the critical role the ophthalmologist can play in the diagnosis of IBD, the pathogenesis of IBD, its ocular complications, and the treatment of ocular inflammation associated with IBD. RECENT FINDINGS: Polygenic and environmental influences, as well as gut microbial dysbiosis, have been implicated in the pathogenesis of IBD...
November 2016: Current Opinion in Ophthalmology
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