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https://www.readbyqxmd.com/read/28089501/effectiveness-of-conventional-disease-modifying-antirheumatic-drugs-in-psoriatic-arthritis-a-systematic-review
#1
Jesús Maese, Petra Díaz Del Campo, Daniel Seoane-Mato, Mercedes Guerra, Juan D Cañete
BACKGROUND: Due to the clinical heterogeneity of psoriatic arthritis (PsA), recommendations have been developed by international groups to guide therapeutic decisions of the rheumatologist. The objective of the current systematic review (RS) was to evaluate the evidence of efficacy of disease-modifying antirheumatic drugs (DMARDs) in PsA. METHODS: Literature search in Medline, EMBASE, Cochrane Library, from 2008 to 2014. We included RS, randomized clinical trials and observational studies, in patients with PsA and an evaluation of efficiency of conventional DMARDs (methotrexate, sulfasalazine, leflunomide), according to the following outcomes: peripheral and axial symptoms; peripheral radiological damage; enthesitis according to power Doppler ultrasound or magnetic resonance imaging (enthesitis count before and after therapy); dactylitis; uveitis...
January 12, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28079512/long-term-treatment-response-in-rheumatoid-arthritis-patients-starting-adalimumab-or-etanercept-with-or-without-concomitant-methotrexate
#2
Merel J l'Ami, Eva L Kneepkens, Michael T Nurmohamed, Charlotte L M Krieckaert, Ingrid M Visman, Gert-Jan Wolbink
OBJECTIVES: To observe long-term clinical response and drug survival in a prospective two-year cohort study in rheumatoid arthritis (RA) patients starting adalimumab or etanercept treatment, with or without methotrexate (MTX), after failure of conventional DMARD therapy, including MTX. METHODS: Disease activity score of 28 joints (DAS28) and Health Assessment Questionnaire (HAQ) were collected of 873 consecutive RA patients, treated with adalimumab or etanercept, prospectively at baseline, 4, 16, 28, 40, 52, 78 and 104 weeks of biological therapy...
January 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28065486/biologic-disease-modifying-antirheumatic-drug-attributes-in-the-first-lines-of-treatment-of-rheumatoid-arthritis-2015-acordar-project
#3
Santiago Muñoz-Fernández, María Sagrario Bustabad Reyes, Jaime Calvo Alén, Manuel Castaño Sánchez, Eugenio Chamizo Carmona, Héctor Corominas, Nagore Fernández-Llanio Comella, María Cristina Hidalgo Calleja, José Javier Pérez Venegas, José Manuel Rodríguez Heredia, Susana María Romero Yuste, Virginia Ruiz-Esquide Torino
OBJECTIVE: To date, between 17% and 35% of patients with rheumatoid arthritis (RA) do not respond as expected to the initial biological therapy. The objective of this project is to recognize and weigh the attributes of biologic DMARD (bDMARD) to identify the most appropriate for each case, in the first lines of treatment of RA (after inadequate response to at least one synthetic DMARD or previous bDMARD). METHODS: To recognize the possible attributes that could define the bDMARD, we performed a systematic search of the literature that recognized the possible attributes involving general aspects, pharmacology, efficacy, safety, management, and cost...
January 3, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28058499/-rheumatoid-arthritis
#4
REVIEW
D Aletaha, A Kerschbaumer
Therapy reduction in rheumatoid arthritis (RA) is still a challenge for physicians as well as for patients. Effective therapy with subsequent achievement of low disease activity or even remission is achievable for numerous patients using currently available treatment options. Therapy discontinuation has therefore become a hot topic and the risk of exacerbation of well-controlled RA must be weighed against the medical and economic benefits of reducing or even discontinuing therapy. This article gives a review of data regarding tapering of therapy in RA, focusing on conventional disease-modifying antirheumatic drug (DMARD) monotherapy, reduction of conventional therapy under continuing therapy with biologics and discontinuation of biologics...
January 5, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28053390/effectiveness-of-arthroscopic-elbow-synovectomy-in-rheumatoid-arthritis-patients-long-term-follow-up-of-clinical-and-functional-outcomes
#5
Vivek Shankar, Pankaj Sharma, Ravi Mittal, Samarth Mittal, Uma Kumar, Shivanand Gamanagatti
OBJECTIVE: To determine the long-term clinical and functional results of arthroscopic elbow synovectomy in rheumatoid arthritis patients with refractory elbow synovitis in terms of improvement in pain, function, and active range of motion (AROM) or arc of motion. METHOD: Fifteen rheumatoid elbows in 13 patients, not responding to DMARD therapy and with radiological changes not more than Larsen grade 3 were taken, who underwent arthroscopic elbow synovectomy. The main outcome measured in forms of Mayo Elbow Performance Scale (MEPS) score, measurement of pain using a Visual Analogue Scale (VAS), radiological angles of elbow, disease activity score (DAS-28), arc of motions (AOM) and complications, which were assessed at follow-up periods of 6 months, 24 months, and 30 months...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28028155/abatacept-reduces-disease-activity-and-ultrasound-power-doppler-in-acpa-negative-undifferentiated-arthritis-a-proof-of-concept-clinical-and-imaging-study
#6
Maya H Buch, Elizabeth M A Hensor, Chadi Rakieh, Jane E Freeston, Edward Middleton, Sarah Horton, Sudipto Das, Charles Peterfy, Ai Lyn Tan, Richard J Wakefield, Paul Emery
OBJECTIVES: No proven treatment exists for ACPA-negative undifferentiated arthritis (UA). The aim of this study was to evaluate whether abatacept is effective in treating poor prognosis, ACPA-negative UA, including its effect on power Doppler on US (PDUS). METHODS: A proof-of-concept, open-label, prospective study of 20 patients with DMARD-naïve, ACPA-negative UA (⩾2 joint synovitis) and PDUS ⩾ 1 with clinical and 20-joint US (grey scale/PDUS) assessments at baseline, 6, 12, 18 and 24 months...
January 2017: Rheumatology
https://www.readbyqxmd.com/read/28013211/effect-of-anti-tnf-and-conventional-synthetic-disease-modifying-anti-rheumatic-drug-treatment-on-work-disability-and-clinical-outcome-in-a-multicentre-observational-cohort-study-of-psoriatic-arthritis
#7
William Tillett, Gavin Shaddick, Amelia Jobling, Ayman Askari, Annie Cooper, Paul Creamer, Gavin Clunie, Philip S Helliwell, Jana James, Lesley Kay, Eleanor Korendowych, Suzanne Lane, Jonathon Packham, Ragai Shaban, Matthew L Thomas, Lyn Williamson, Neil McHugh
OBJECTIVE: To determine the effect of medical treatment on work disability in patients with active PsA in a real-world setting. METHODS: Four hundred patients with active PsA commencing or switching to anti-TNF or conventional synthetic DMARD (csDMARD) were recruited to a multicentre UK prospective observational cohort study. Work disability was measured using the work productivity and activity-specific health problem instrument and peripheral joint activity was measured with the disease activity in PsA composite measure...
December 24, 2016: Rheumatology
https://www.readbyqxmd.com/read/28011918/hepatitis-b-virus-reactivation-in-rheumatoid-arthritis-patients-undergoing-biologics-treatment
#8
Ming-Han Chen, Ming-Huang Chen, Chun-Yu Liu, Chang-Youh Tsai, De-Feng Huang, Hsiao-Yi Lin, Mei-Hsuan Lee, Yi-Hsiang Huang
BACKGROUND: Immunosuppressants can induce hepatitis B virus(HBV) reactivation, however, informative data regarding the risk of different immunosuppressive regimens including biologics on HBV reactivation(HBVr) among patients with rheumatoid arthritis(RA) is unsettled. METHODS: Among 2334 RA patients who had available HBsAg data, 123 patients positive for hepatitis B surface antigen(HBsAg) without receiving anti-HBV prophylaxis were enrolled. These patients undergoing varied mono- or combination immunosuppressive therapy, including 36 receiving biological disease-modifying antirheumatic drugs(bDMARDs)...
December 23, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27992958/impaired-akt-phosphorylation-in-monocytes-of-patients-with-rheumatoid-arthritis
#9
Krista Kuuliala, Antti Kuuliala, Mari Hämäläinen, Riitta Koivuniemi, Hannu Kautiainen, Eeva Moilanen, Heikki Repo, Marjatta Leirisalo-Repo
It has been proposed that the Akt kinase pathway provides a regulatory mechanism to limit the inflammatory response. We examined the activation of Akt upon LPS challenge in monocytes of patients with rheumatoid arthritis (RA), and correlated it with disease activity. Twelve subjects with recent-onset, DMARD-naïve RA, thirteen patients with chronic, DMARD therapy -nonresponding RA and 27 healthy volunteers provided whole blood samples for phosphospecific flow cytometric measurement of unstimulated and LPS-stimulated Akt phosphorylation at serine 473 in monocytes, determined in relative fluorescence units (RFU)...
December 19, 2016: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/27992656/meta-regression-of-a-dose-response-relationship-of-methotrexate-in-mono-and-combination-therapy-in-dmard-naive-early-rheumatoid-arthritis-patients
#10
S A Bergstra, C F Allaart, T Stijnen, Rbm Landewé
OBJECTIVE: To investigate a possible short term dose-response relationship of initial treatment with methotrexate in monotherapy and combination therapy in recent onset rheumatoid arthritis (RA) patients. METHODS: A systematic literature search was performed on trials and cohorts including early, Disease Modifying Antirheumatic Drugs (DMARD) naive RA patients, treated with methotrexate, with data on clinical results within 6 months from treatment start. Cohen's effect sizes were calculated for the HAQ, ESR/CRP and/or DAS/DAS28 in 4 treatment groups: methotrexate monotherapy, or methotrexate in combination with synthetic (cs)DMARDs, biologic (b)DMARDs or glucocorticoids...
December 19, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27974098/use-of-biologic-agents-in-idiopathic-inflammatory-myopathies-in-sweden-a-descriptive-study-of-real-life-treatment
#11
John Svensson, Marie Holmqvist, Anna Tjärnlund, Maryam Dastmalchi, Balsam Hanna, Sara Magnusson Bucher, Ingrid E Lundberg
OBJECTIVES: Biologic treatment has revolutionised treatment in rheumatology in the last decades. Patients with idiopathic inflammatory myopathies (IIM) have so far only been treated with biologics off-label, with little published follow-up on those who are treated and how they are treated. We therefore set out to characterise the Swedish IIM patients who have been treated with biologics. METHODS: By linking Swedish registers we identified 95 patients with IIM who were treated with biologics between 2000 and 2011...
December 9, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27943573/circulating-cell-free-dna-a-marker-to-predict-the-therapeutic-response-for-biological-dmards-in-rheumatoid-arthritis
#12
Teppei Hashimoto, Kohsuke Yoshida, Naonori Hashimoto, Ayako Nakai, Kenta Kaneshiro, Kohjin Suzuki, Yoshiko Kawasaki, Nao Shibanuma, Akira Hashiramoto
AIM: To evaluate the correlation between circulating cell-free DNA (ccfDNA) in plasma and clinical disease activities in patients with rheumatoid arthritis (RA). METHOD: The study group included 30 patients with RA who started biological disease-modifying anti-rheumatic drugs (DMARDs) therapy. The concentration of ccfDNA in plasma was measured by quantitative real-time polymerase chain reaction at baseline to 24 weeks in every 4-week period from 30 patients and 21 healthy individuals...
December 10, 2016: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/27917631/-15-years-experience-with-biological-therapy-of-inflammatory-rheumatic-diseases-in-czech-national-register-attra
#13
Karel Pavelka, Liliana Šedová, Karel Hejduk, Ladislav Dušek
The publication is summarizing application of biological DMARDs in autoimmune inflammatory rheumatic diseases.Up to now conventional therapy, which for example in rheumatoid arthritis was application of methotrexate (MTx) in combination with glucocorticoids, was effective, but the remission as a target was achieved in small proportion of patients and also there was little effect on structural progression of diseases. Biological therapy was great advance because response was achieved in ¾ patients who failed MTx...
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27910962/baricitinib-jak-inhibition-for-rheumatoid-arthritis
#14
J Gras
Rheumatoid arthritis (RA), a chronic autoimmune inflammatory disease characterized by inflammation and joint destruction, is associated with pain, progressive disability, systemic comorbidities and early death. Conventional disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs (bDMARDs) have been able to achieve remission or a very low disease activity status for RA. Nevertheless, since many patients do not reach a sufficient response with DMARDs or present with unacceptable side effects, new therapies are needed...
October 2016: Drugs of Today
https://www.readbyqxmd.com/read/27894399/effect-of-iguratimod-and-methotrexate-on-rankl-and-opg-expression-in-serum-and-il-1%C3%AE-induced-fibroblast-like-synoviocytes-from-patients-with-rheumatoid-arthritis
#15
X T Wang, P Li, T S Xu, R Ding, X Zhang, L Q Bi
The receptor activator of nuclear factor κB ligand (RANKL)/receptor activator of nuclear factor κB (RANK)/osteoprotegerin (OPG) system plays a key role in rheumatoid arthritis (RA)-associated bone erosion. The upregulation of the RANKL/OPG ratio promotes bone erosion. The objective of this study is to explore the effects of iguratimod, a small-molecule disease-modifying antirheumatic drug (DMARD), alone or in combination with methotrexate (MTX), on RANKL and OPG expression in RA. We performed an enzyme-linked immunosorbent assay (ELISA) to investigate the modulatory effects of iguratimod, MTX, or their combination on serum RANKL and OPG levels of patients with RA before and after treatment for 12 and 24 weeks...
October 31, 2016: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/27886796/adult-onset-still-s-disease-advances-in-the-treatment
#16
REVIEW
Santos Castañeda, Ricardo Blanco, Miguel A González-Gay
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder mainly characterized by persistent high spiking fevers, evanescent rash, and joint involvement. The pathogenesis of AOSD is only partially known, but pro-inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, IL-6, IL-18, and IFN-γ seem to play a major role in this disorder. AOSD is at the crossroad of auto-inflammatory syndromes and autoimmune diseases. It is diagnosed by exclusion to determine the presence of high serum ferritin levels, which is usually >1000 μg/L...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27882832/geographic-variation-in-the-quality-and-cost-of-care-for-patients-with-rheumatoid-arthritis
#17
Jason Shafrin, Arijit Ganguli, Yuri Sanchez Gonzalez, Jin Joo Shim, Seth A Seabury
BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best treated with comparatively expensive treatments, such as rheumatoid arthritis (RA), there could be tension between these aims. In this study, we measured geographic variation in quality, access, and cost for patients with RA, a disease with effective but costly specialty treatments. OBJECTIVE: To assess the geographic differences in the quality, access, and cost of care for patients with RA...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27878345/low-vaccination-rates-among-patients-with-rheumatoid-arthritis-in-a-german-outpatient-clinic
#18
Marco Krasselt, Jean-Philipp Ivanov, Christoph Baerwald, Olga Seifert
Patients with rheumatoid arthritis (RA) are at an increased risk of acquiring infections due to two reasons: the disease itself and the immunosuppressive therapy. Vaccinations against preventable diseases are therefore of utmost importance for these group of patients. To estimate vaccination frequencies among patients with rheumatoid arthritis, we studied patients in a survey and calculated vaccination rates based on their vaccination documents. Patients have been recruited from our outpatient clinic during one of their routine visits...
November 22, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27866179/tripterygium-glycosides-for-treating-late-onset-rheumatoid-arthritis-a-systematic-review-and-meta-analysis
#19
Xiao Xu, Quan Jin Li, Sha Xia, Miao Miao Wang, Wei Ji
Context • Older- or late-onset rheumatoid arthritis (LORA) is defined as rheumatoid arthritis (RA) with an onset of symptoms at age 60 y or older, which includes a specific clinical course and features. To date, a specific therapeutic treatment for LORA is still a dilemma in modern medicine. Objective • The study aimed to assess the effectiveness and safety of Tripterygium glycosides for treating LORA. Design • Seven databases were searched from their inceptions until June 2015. The research team included randomized, controlled trials (RCTs) in which Tripterygium glycosides were employed, either alone or as an adjuvant treatment with disease-modifying antirheumatic drugs (DMARDs), in patients with LORA...
November 2016: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/27856658/new-targets-in-psoriatic-arthritis
#20
REVIEW
Juergen Braun
PsA is an immune-mediated chronic inflammatory disease that affects both skin and joints; it is a heterogeneous disease characterized by synovitis, enthesitis, dactylitis and spondylitis. The impact on patients and the burden of disease are substantial. For assessment of the disease, patient-reported outcomes are increasingly important. Conventional therapy consists of NSAIDs, local and systemic CSs, and synthetic and biological DMARDs. While MTX, LEF, SSZ and CYC are the synthetic drugs mainly used, TNF-α blocking agents have represented the majority of biologics used in the last decade (infliximab, etanercept, adalimumab, certolizumab and golimumab)...
December 2016: Rheumatology
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