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https://www.readbyqxmd.com/read/29780139/methotrexate-associated-intravascular-large-b-cell-lymphoma-in-a-patient-with-rheumatoid-arthritis-a-very-rare-case
#1
Masao Hagihara, Toru Mese, Shin Ohara, Jian Hua, Shiro Ide, Morihiro Inoue
we herein report a rare case of methotrexate (MTX)-associated intravascular large B-cell lymphoma (IVLBCL) in a man with rheumatoid arthritis. Two episodes of a fever of unknown origin accompanied by elevated levels of serum lactate dehydrogenase and the soluble interleukin-2 receptor occurred within a year, so the patient was suspected of having an MTX-associated lymphoproliferative disorder. His clinical symptoms resolved after the cessation of MTX. However, after treatment with iguratimod, another disease-modified anti-rheumatic drug, markedly similar symptoms recurred, and random skin biopsies resulted in a diagnosis of IVLBCL...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29776427/rheumatoid-meningitis-developed-in-patient-with-stable-rheumatoid-arthritis-and-myasthenia-gravis-detailed-analysis-of-intracranial-inflammation-using-flow-cytometry
#2
Miki Oono, Yoshimasa Fujita, Nobuaki Uchida, Ukichiro Kawai, Michiyo Fujita-Nakata, Megumi Nakanishi, Mitsuru Sanada, Shigemi Nagayama, Makoto Matsui
BACKGROUND: Rheumatoid meningitis (RM) is a rare disorder that often develops during a remission phase of rheumatoid arthritis (RA). This is the first study to demonstrate differences in regard to immunological disturbance between blood and cerebrospinal fluid (CSF) samples obtained from a patient with RM using flow cytometry. CASE PRESENTATION: A 36-year-old woman with RA and generalized myasthenia gravis (MG) developed RM during a remission phase. Although both RA and MG were stable and well controlled, she noticed fever, headache, and transient sensory disturbance...
May 18, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29771924/obesity-and-response-to-anti-tumor-necrosis-factor-%C3%AE-agents-in-patients-with-select-immune-mediated-inflammatory-diseases-a-systematic-review-and-meta-analysis
#3
Siddharth Singh, Antonio Facciorusso, Abha G Singh, Niels Vande Casteele, Amir Zarrinpar, Larry J Prokop, Eduardo L Grunvald, Jeffrey R Curtis, William J Sandborn
OBJECTIVES: We sought to evaluate the association between obesity and response to anti-tumor necrosis factor-α (TNF) agents, through a systematic review and meta-analysis. METHODS: Through a systematic search through January 24, 2017, we identified randomized controlled trials (RCTs) or observational studies in adults with select immune-mediated inflammatory diseases-inflammatory bowel diseases (IBD), rheumatoid arthritis (RA), spondyloarthropathies (SpA), psoriasis and psoriatic arthritis (PsA)-treated with anti-TNF agents, and reporting outcomes, stratified by body mass index (BMI) categories or weight...
2018: PloS One
https://www.readbyqxmd.com/read/29765444/sequentiality-of-treatment-in-the-rheumatoid-arthritis-drug-programme-in-the-years-2009-2014
#4
Małgorzata Tłustochowicz, Andrzej M Śliwczyński, Melania Brzozowska, Zbigniew Teter, Michał Marczak
Approximately 1% of the population suffers from rheumatoid arthritis (RA) worldwide (0.45% in Poland). The therapy consists of the use of disease-modifying antirheumatic drugs (DMARDs). Biologics are used in the form of the drug programme. Analysis of the NHF database demonstrated the sequence of conversion between drugs and time spent in a single treatment. In 2009, the patients would start the following treatments: adalimumab 5.8%; etanercept 14.4%; infliximab 23.1%; leflunomide 53.6%; rituximab 3%. After the first year 16% of patients changed therapy or abstained, and in the second year this situation affected 65% of patients...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29764965/effect-of-treat-to-target-strategies-aiming-at-remission-of-arterial-stiffness-in-early-rheumatoid-arthritis-a-randomized-controlled-study
#5
Lydia Ho-Pui Tam, Qing Shang, Edmund Kwok-Ming Li, Priscilla Ching-Han Wong, Kitty Yan Kwok, Emily Wai-Lin Kun, Isaac Cheuk-Wan Yim, Violet Ka-Lai Lee, Ronald Man-Lung Yip, Steve Hin-Ting Pang, Virginia Weng-Nga Lao, Queenie Wah-Yan Mak, Isaac Tsz-Ho Cheng, Xerox Sze-Lok Lau, Tena Ka-Yan Li, Tracy Yaner Zhu, Alex Pui-Wai Lee, Lai-Shan Tam
OBJECTIVE: To determine the efficacy of 2 tight control treatment strategies aiming at Simplified Disease Activity Score (SDAI) remission (SDAI ≤ 3.3) compared to 28-joint count Disease Activity Score (DAS28) remission (DAS28 < 2.6) in the prevention of arterial stiffness in patients with early rheumatoid arthritis (RA). METHODS: This was an open-label study in which 120 patients with early RA were randomized to receive 1 year of tight control treatment. Group 1 (n = 60) aimed to achieve SDAI ≤ 3...
May 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29761420/long-term-radiographic-and-patient-reported-outcomes-in-patients-with-rheumatoid-arthritis-treated-with-tofacitinib-oral-start-and-oral-scan-post-hoc-analyses
#6
Vibeke Strand, Arthur Kavanaugh, Alan J Kivitz, Désirée van der Heijde, Kenneth Kwok, Ermeg Akylbekova, Arif Soonasra, Mark Snyder, Carol Connell, Eustratios Bananis, Josef S Smolen
INTRODUCTION: Here we examine the relationship between achieving different levels of disease activity with tofacitinib (an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis), long-term structural progression, and patient-reported physical function. METHODS: This was a post hoc analysis of two 24-month, phase III randomized controlled trials in methotrexate (MTX)-naïve (ORAL Start [NCT01039688]) or MTX-inadequate responder (IR) patients (ORAL Scan [NCT00847613]) receiving tofacitinib 5 or 10 mg twice daily as either monotherapy or with background MTX...
May 14, 2018: Rheumatology and Therapy
https://www.readbyqxmd.com/read/29760159/inadequate-response-to-treat-to-target-methotrexate-therapy-in-patients-with-new-onset-rheumatoid-arthritis-development-and-validation-of-clinical-predictors
#7
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
https://www.readbyqxmd.com/read/29757670/regulatory-t-cell-dynamics-with-abatacept-treatment-in-rheumatoid-arthritis
#8
Kane Langdon, Nagaraja Haleagrahara
The progressive damage in rheumatoid arthritis (RA) has been linked to an increase in inflammatory Th1/Th17 cells and a decrease in number or function of immunomodulatory regulatory T cells (Tregs). Many therapies that are effective in RA are shown to affect Th1/Th17 cells and/or Tregs. One such therapy, abatacept, utilizes a physiologic immunomodulatory molecule called cytotoxic lymphocyte antigen-4 (CTLA-4) which causes contact-dependent inhibition of inflammatory T-cell activation. Recent advances in CTLA-4 research has uncovered the method by which this occurs physiologically but the actions of the CTLA-4Ig fusion protein are still not fully understood...
May 14, 2018: International Reviews of Immunology
https://www.readbyqxmd.com/read/29745893/cell-therapies-for-refractory-rheumatoid-arthritis
#9
REVIEW
Rui Liu, Pengfei Zhao, Wenfeng Tan, Miaojia Zhang
Rheumatoid arthritis (RA), an autoimmune disease, is characterised by a persistent synovitis in the joints and systemic inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids and disease-modifying antirheumatic drugs (DMARDs) are widely used to treat RA patients. However, a portion of patients still have inadequate response to traditional medications. Recently, cell-based therapies have become the focus, attracting more attention due to their potential for remission induction. Several immune-regulatory cell types, such as haematopoietic stem cells, mesenchymal stem cells and regulatory T cells have been defined as novel targets...
May 8, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29745885/explorative-analyses-of-protein-biomarkers-in-patients-with-early-rheumatoid-arthritis-achieving-sustained-drug-free-remission-after-treatment-with-tocilizumab-or-methotrexate-based-strategies-from-transcriptomics-to-proteomics
#10
Xavier M Teitsma, Johannes W G Jacobs, Arno N Concepcion, Attila Pethö-Schramm, Michelle E A Borm, Jacob M van Laar, Johannes W J Bijlsma, Floris P J G Lafeber
OBJECTIVES: Previously, we identified networks of co-expressed genes related to achieving sustained drug-free remission (sDFR). The aim of the present exploratory analysis was to identify inflammatory proteins associated with achieving sDFR and their enriched biological pathways, and compare these pathways with those found in the previous transcriptomic analyses. METHODS: Serum samples were used from 60 patients who participated in the U-Act-Early trial and were treated-to-target with tocilizumab plus methotrexate, or tocilizumab or methotrexate; 37 achieved sDFR (≥3 months drug-free) and 23 did not (controls)...
May 8, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29745059/an-economic-evaluation-of-stopping-versus-continuing-tnf-inhibitor-treatment-in-rheumatoid-arthritis-patients-in-remission-or-low-disease-activity-results-from-the-poet-randomized-trial
#11
An Tran-Duy, Marjan Ghiti Moghadam, Martijn A H Oude Voshaar, Harald E Vonkeman, Annelies Boonen, Philip Clarke, Geoff McColl, Peter M Ten Klooster, T R Zijlstra, Willem F Lems, N Riyazi, E N Griep, J M W Hazes, Robert Landewé, Hein J Bernelot Moens, Piet L C M van Riel, Mart A F J van de Laar, T L Jansen
OBJECTIVE: To evaluate, from a societal perspective, the incremental cost-effectiveness of withdrawing tumor necrosis factor inhibitors (TNFis) compared to continuation of these drugs within a one-year randomized trial among patients with rheumatoid arthritis (RA) having longstanding stable disease activity or remission. METHODS: Data were collected from a pragmatic, open label trial. Cost-utility analysis was performed using the non-parametric bootstrapping method and a cost-effectiveness acceptability curve was constructed using the net-monetary benefit (NMB) framework, where a willingness-to-accept threshold (WTA) was defined as the minimal cost saved that a patient accepted for each quality-adjusted life year (QALY) lost...
May 9, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29736302/rheumatoid-arthritis-pathological-mechanisms-and-modern-pharmacologic-therapies
#12
REVIEW
Qiang Guo, Yuxiang Wang, Dan Xu, Johannes Nossent, Nathan J Pavlos, Jiake Xu
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects the lining of the synovial joints and is associated with progressive disability, premature death, and socioeconomic burdens. A better understanding of how the pathological mechanisms drive the deterioration of RA progress in individuals is urgently required in order to develop therapies that will effectively treat patients at each stage of the disease progress. Here we dissect the etiology and pathology at specific stages: (i) triggering, (ii) maturation, (iii) targeting, and (iv) fulminant stage, concomitant with hyperplastic synovium, cartilage damage, bone erosion, and systemic consequences...
2018: Bone Research
https://www.readbyqxmd.com/read/29731463/-diagnosis-and-treatment-of-rheumatoid-arthritis-toward-the-best-practice-best-practice-in-the-use-of-t-cell-co-stimulatory-inhibitor-for-patients-with-rheumatoid-arthritis
#13
Shinsuke Yasuda
CTLA4 abolishes interaction between CD28 on T cells and B7 molecules on antigen presenting cells. CTLA4-Ig, abatacept(ABT)was developed as a drug with multipotent inhibitor against activated T/B cells, monocytes, dendritic cells, macrophages and osteoclast progenitors expressing B7 molecules. In phase Ⅲ RCTs, clinical effects of ABT have been established in MTX-naive, MTX-IR and TNF inhibitor-IR patients with RA. Moreover, in head-to head comparison with representative TNF inhibitors, ABT exerted compatible clinical effect...
2018: Clinical Calcium
https://www.readbyqxmd.com/read/29731461/-diagnosis-and-treatment-of-rheumatoid-arthritis-toward-the-best-practice-the-best-practice-for-tnf-inhibitors
#14
Hideto Kameda
As of February 2018, 5 originator TNF inhibitors(infliximab, etanercept, adalimumab, golimumab and certolizumab pegol)and biosimilar agents of infliximab and etanercept are available for rheumatoid arthritis(RA)in Japan. The effectiveness of TNF inhibitors considerably improves with concomitant methotrexate regardless of their immunogenicity. The Japan College of Rheumatology guideline for TNF inhibitor use in RA has been updated in March 2017 according to recent evidences. During the remission induction phase, maintenance of drug trough level above effective blood concentration is paramount, while the tapering and withdrawal of TNF inhibitors may be considered after achieving sustained remission...
2018: Clinical Calcium
https://www.readbyqxmd.com/read/29730637/comparative-effectiveness-of-tocilizumab-versus-tnf-inhibitors-as-monotherapy-or-in-combination-with-conventional-synthetic-disease-modifying-antirheumatic-drugs-in-patients-with-rheumatoid-arthritis-after-the-use-of-at-least-one-biologic-disease-modifying
#15
Kim Lauper, Dan C Nordström, Karel Pavelka, Maria Victoria Hernández, Tore K Kvien, Eirik Klami Kristianslund, Maria Jose Santos, Žiga Rotar, Florenzo Iannone, Catalin Codreanu, Galina Lukina, Sara L Gale, Khaled Sarsour, Yves Luder, Delphine Sophie Courvoisier, Cem Gabay
OBJECTIVE: To compare the effectiveness of tocilizumab (TCZ) and tumour necrosis factor (TNF) inhibitors (TNFi) as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) after the use of at least one biologic DMARD (bDMARD). METHODS: We included patients with RA having used at least one bDMARD from 10 European registries. We compared drug retention using Kaplan-Meier and Cox models and Clinical Disease Activity Index (CDAI) change over time with mixed-effects models for longitudinal data...
May 5, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29720221/deleterious-role-of-hepatitis-b-virus-infection-in-therapeutic-response-among-patients-with-rheumatoid-arthritis-in-a-clinical-practice-setting-a-case-control-study
#16
Yu-Lan Chen, Jian-Zi Lin, Ying-Qian Mo, Jian-Da Ma, Qian-Hua Li, Xiao-Ying Wang, Ze-Hong Yang, Tao Yan, Dong-Hui Zheng, Lie Dai
BACKGROUND: Previous studies have revealed that hepatitis B virus (HBV) infection may be associated with rheumatoid arthritis (RA), while there are no further clinical studies regarding the role of HBV infection in RA progression during disease-modifying anti-rheumatic drug (DMARD) therapy. Here, we aimed to explore the influence of HBV infection on radiographic and clinical outcomes among patients with RA in a clinical practice setting. METHODS: Thirty-two consecutive patients with RA (Disease Activity Score 28-joint assessment based on C-reactive protein (DAS28-CRP) ≥2...
May 2, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29718008/correlation-between-lung-and-joint-involvement-in-patients-with-rheumatoid-arthritis-and-interstitial-lung-disease-a-cross-sectional-study
#17
Francisco Paulin, Juan Francisco Mercado, Martín Eduardo Fernández, Fabián Matías Caro, María Laura Alberti, Leandro Alberto Fassola
Background: Rheumatoid arthritis (RA) can affect the lungs in different manners, with interstitial lung disease (ILD) as the most serious manifestation. Although lung and joint compromise could be thought to evolve in parallel, there are data suggesting the opposite. In this study, we evaluated the relationship between lung and joint involvement in RA ILD. Methods: An observational cross-sectional study of RA ILD patients evaluated from January 2015 to February 2017...
2018: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/29717035/predictors-of-flare-following-etanercept-withdrawal-in-patients-with-rheumatoid-factor-negative-juvenile-idiopathic-arthritis-who-reached-remission-while-taking-medication
#18
Angela Aquilani, Denise Pires Marafon, Emiliano Marasco, Rebecca Nicolai, Virginia Messia, Francesca Perfetti, Silvia Magni-Manzoni, Fabrizio De Benedetti
OBJECTIVE: To evaluate the rate of flare after etanercept (ETN) withdrawal in patients with juvenile idiopathic arthritis (JIA) who attained clinical remission while taking medication, and to identify predictors of flare. METHODS: Patients were included with oligo- (oJIA) and rheumatoid factor-negative polyarticular JIA (pJIA) who received a first course of ETN for at least 18 months, maintained clinically inactive disease (CID) for at least 6 months during treatment, and were followed for 12 months after ETN withdrawal...
May 1, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29713865/-getting-older-with-rheumatoid-arthritis-is-there-a-burnout-of-the-disease
#19
REVIEW
J Bauhammer, C Fiehn
Rheumatoid arthritis (RA) is a chronic inflammatory disease. Synovitis is the main pathology and can lead to a progressive destruction of the joints. It is often said that RA "burns out", implying that the inflammation decreases spontaneously in the long term, mostly severe course of RA and reaches a stage with a stable absence of joint inflammation, even without treatment. To test this concept we analyzed the published evidence. Data of historic long-term inception cohorts of patients who have never been treated with antirheumatic drugs and patients who received conventional disease-modifying antirheumatic drugs (DMARD), show that the disease stays active with sustained radiological progression in the majority of patients...
April 30, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29712616/what-is-the-added-value-of-ultrasound-joint-examination-for-monitoring-synovitis-in-rheumatoid-arthritis-and-can-it-be-used-to-guide-treatment-decisions-a-systematic-review-and-cost-effectiveness-analysis
#20
Emma Simpson, Emma Hock, Matt Stevenson, Ruth Wong, Naila Dracup, Allan Wailoo, Philip Conaghan, Cristina Estrach, Christopher Edwards, Richard Wakefield
BACKGROUND: Synovitis (inflamed joint synovial lining) in rheumatoid arthritis (RA) can be assessed by clinical examination (CE) or ultrasound (US). OBJECTIVE: To investigate the added value of US, compared with CE alone, in RA synovitis in terms of clinical effectiveness and cost-effectiveness. DATA SOURCES: Electronic databases including MEDLINE, EMBASE and the Cochrane databases were searched from inception to October 2015. REVIEW METHODS: A systematic review sought RA studies that compared additional US with CE...
April 2018: Health Technology Assessment: HTA
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