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rheumatoid arthritis remission

Daniel Aletaha, Manuel Bécède, Josef S Smolen
Disease activity assessment of rheumatoid arthritis has never been trivial. Composite indices like the Disease Activity Score using 28 joint counts 28 (DAS28) and the Clinical Disease Activity Index (CDAI) and the Simplified Disease Activity Index (SDAI) attempted to integrate several core set variables into one readout, which eventually laid the grounds for implementation strategies that targeted disease activity levels, like remission. While CDAI and SDAI were clearly simpler at times when a calculator was needed, this has likely become less relevant in the era of digital records, where core set variables are entered into a computed device after measurement...
September 2016: Clinical and Experimental Rheumatology
Johannes W G Jacobs
The history, issues and result of the development of the computer decision software tool used for the two tight control and treat-to-target CAMERA (Computer Assisted Management in Early Rheumatoid Arthritis) studies are described. The software tool is simple and can be used with various protocolled strategies and visit intervals both in clinical trials and daily practice, because it does not dictate strategy steps and is independent of visit intervals. The tool gives information on whether enough improvement since the last visit is present and whether there is remission or not...
September 2016: Clinical and Experimental Rheumatology
Piet L C M van Riel, Lisanne Renskers
In rheumatoid arthritis (RA), disease activity cannot be measured in all individual patients according to a single variable. The Disease Activity Score (DAS) and the DAS28 have been developed to measure disease activity in RA both in daily clinical practice as well as in clinical trials on a group as well as individual level. The DAS/DAS28 is a continuous measure of RA disease activity that combines information from swollen joints, tender joints, acute phase response and general health. The DAS-based EULAR response criteria were primarily developed to be used in clinical trials...
September 2016: Clinical and Experimental Rheumatology
Mei Jiang, Feifeng Ren, Yaning Zheng, Ruyu Yan, Wenhan Huang, Ning Xia, Lei Luo, Jun Zhou, Lin Tang
OBJECTIVES: To evaluate the efficacy and safety of down-titration (dose reduction/tapering) strategies compared with continuation of biological disease-modifying anti-rheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) who achieved and maintained low disease activity or remission. METHODS: We searched the following electronic database up to March 2016: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and conference proceedings of the American College of Rheumatology (ACR) and European League against Rheumatism (EULAR)...
September 7, 2016: Clinical and Experimental Rheumatology
Julio Ramírez, José Iniciarte-Mundo, Andrea Cuervo, Virginia Ruiz-Esquide, M Victoria Hernández, Raimón Sanmartí, Juan D Cañete
OBJECTIVES: To analyse clinical, serological and sonographic differences between rheumatoid arthritis (RA) and polyarticular psoriatic arthritis (PsA) patients on anti-TNF therapy in clinical remission. METHODS: Angiogenic and proinflammatory cytokine serum levels were determined by multiplex ELISA in patients with RA and PsA in clinical remission (DAS28-ESR<2.6), clinically-active RA patients (DAS28>3.2) and healthy controls. Ultrasound (US) scans were made of both wrists and hands...
October 7, 2016: Clinical and Experimental Rheumatology
Nadia Boubouchairopoulou, Irini Flouri, Alexandros A Drosos, Kyriaki Boki, Loukas Settas, Dimitrios Zisopoulos, Fotini N Skopouli, Ioannis Papadopoulos, Alexios Iliopoulos, John Kyriopoulos, Dimitrios T Boumpas, Konstantinos Athanasakis, Prodromos Sidiropoulos
OBJECTIVES: To assess in daily practice in patients with rheumatoid arthritis (RA) the effect of treatment with first tumour necrosis factor-α inhibitor (TNFi) in quality of life (Qol), disease activity and depict possible baseline predictors for gains in Qol. METHODS: Patients followed prospectively by the Hellenic Registry of Biologic Therapies were analysed. Demographics were recorded at baseline, while RA-related characteristics at baseline and every 6 months...
October 7, 2016: Clinical and Experimental Rheumatology
Takao Koike, Masayoshi Harigai, Naoki Ishiguro, Shigeko Inokuma, Syuji Takei, Tsutomu Takeuchi, Hisashi Yamanaka, Yoshinari Takasaki, Tsuneyo Mimori, Katsutoshi Hiramatsu, Shuichi Komatsu, Yoshiya Tanaka
INTRODUCTION: There is insufficient evidence regarding the appropriate dose of methotrexate (MTX) required to achieve specific treatment goals in patients with rheumatoid arthritis (RA) receiving biologic drugs in Japan. The present study aimed to assess the dose-response effect of MTX in combination with adalimumab (ADA) to achieve low disease activity (LDA) and/or remission at 24 weeks in RA patients. METHODS: This analysis used data of the ADA all-case survey in Japan (n = 7740), and 5494 patients who received ADA and MTX were classified into five groups by weighted average MTX dose (>0-<4, 4-<6, 6-<8, 8-< 10, and ≥10 mg/week)...
June 2016: Rheumatol Ther
Satoko Hayashi, Katsuya Suzuki, Keiko Yoshimoto, Masaru Takeshita, Takahiko Kurasawa, Kunihiro Yamaoka, Tsutomu Takeuchi
INTRODUCTION: Early prognostic factors for the clinical response in patients with rheumatoid arthritis (RA) after 1 year of treatment with infliximab (IFX) as part of routine clinical practice were investigated. METHODS: Thirty-five patients with RA with an inadequate response to methotrexate were enrolled and administered IFX (3-9 mg/kg, every 4-8 weeks). Serum trough levels of IFX and levels of 9 cytokines were measured at baseline and at 3, 6 months, and 1 year...
June 2016: Rheumatol Ther
A J Ruiz-Padilla, J I Gamez-Nava, A M Saldaña-Cruz, J D Murillo-Vazquez, M L Vazquez-Villegas, S A Zavaleta-Muñiz, B T Martín-Márquez, J M Ponce-Guarneros, N A Rodriguez Jimenez, A Flores-Chavez, F Sandoval-Garcia, J C Vasquez-Jimenez, E G Cardona-Muñoz, S E Totsuka-Sutto, L Gonzalez-Lopez
Objective. To evaluate the association of -174G/C IL-6 polymorphism with failure in therapeutic response to methotrexate (MTX) or leflunomide (LEF). This prospective, observational cohort included 96 Mexican-Mestizo patients with moderate or severe rheumatoid arthritis (RA), initiating MTX or LEF, genotyped for IL-6 -174G/C polymorphism by PCR-RFLP. Therapeutic response was strictly defined: only if patients achieved remission or low disease activity (DAS-28 < 3.2). Results. Patients with MTX or LEF had significant decrement in DAS-28 (p < 0...
2016: BioMed Research International
Anais Gardette, Sébastien Ottaviani, Jérémie Sellam, Francis Berenbaum, Frédéric Lioté, Bruno Fautrel, Elisabeth Palazzo, Alain Meyer, Jean Sibilia, Philippe Dieudé
BACKGROUND: Previous studies suggested that obesity could negatively affect the response to anti-tumor necrosis factor α (TNFα) agents in rheumatoid arthritis (RA). However, data are lacking on whether obesity affects the response to abatacept (ABA). We aimed to determine whether body mass index (BMI) affects the response to ABA in RA. PATIENTS AND METHODS: In this multicenter retrospective study, we included RA patients who received ABA. BMI was calculated at the initiation of treatment...
October 13, 2016: European Journal of Clinical Investigation
Andrea Picchianti Diamanti, Milica Markovic, Giuseppe Argento, Simonetta Giovagnoli, Alberto Ricci, Bruno Laganà, Raffaele D'Amelio
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that can present different extrarticular manifestations involving heart, lungs and kidneys. In recent years there has been a growing awareness of the central role played by the lungs in the onset and progression of RA. In particular interstitial lung disease (ILD) is a common pulmonary manifestation that may be related to the inflammatory process itself, infectious complications and to the treatments used. Management of patients with ILD/RA is still a challenge for clinicians, both synthetic [mainly methotrexate (MTX), leflunomide] and biologic immunosuppressors [mainly anti-tumor necrosis factor (TNF)α] have in fact been related to the onset or worsening of lung diseases with conflicting data...
October 12, 2016: Therapeutic Advances in Respiratory Disease
Bridget Hodkinson, Kingsley Ross Magomero, Mohammed Tikly
BACKGROUND: In resource-constrained settings where biologic agents are not widely available, there are limited therapeutic options for patients with rheumatoid arthritis (RA) refractory to other synthetic disease modifying antirheumatic (DMARD) therapies. The aim of this study is to evaluate the effectiveness and safety of leflunomide (LEF) with methotrexate (MTX) in refractory RA. METHODS: A retrospective record review of adult RA patients treated with LEF/MTX...
October 2016: Therapeutic Advances in Musculoskeletal Disease
Yuan An, Tian Liu, Dongyi He, Lijun Wu, Juan Li, Yi Liu, Liqi Bi, Bin Zhou, Changsong Lin, Lan He, Xiangyuan Liu, Xiaofeng Li, Niansheng Yang, Zhuoli Zhang, Hui Song, Wei Wei, Jing Liu, Yu Bi, Zhanguo Li
The aims of this study are to characterize the biological disease-modifying antirheumatic drug (bDMARD) usage patterns in real-life and examine the remission rate of rheumatoid arthritis (RA) patients receiving bDMARDs in routine clinical practice in China. Consenting RA patients (≥18 years) from 15 teaching hospitals and receiving marketed bDMARDs were included. In total, 802 patients (81.3 % women, 49.0 ± 13.9 years) were included; 89.5 % were receiving a combination of bDMARDs and conventional synthetic DMARDs (csDMARDS), whereas 10...
October 5, 2016: Clinical Rheumatology
Brigitte Michelsen, Eirik Klami Kristianslund, Hilde Berner Hammer, Karen Minde Fagerli, Elisabeth Lie, Ada Wierød, Synøve Kalstad, Erik Rødevand, Frode Krøll, Glenn Haugeberg, Tore K Kvien
OBJECTIVE: To investigate the predictive value of discordance between (1) tender and swollen joint count and (2) patient's and evaluator's global assessment on remission in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: From the prospective, multicentre Norwegian-Disease-Modifying Antirheumatic Drug study, we included patients with RA and PsA starting first-time tumour necrosis factor inhibitors and DMARD-naïve patients starting methotrexate between 2000 and 2012...
October 4, 2016: Annals of the Rheumatic Diseases
Nicole P C Konijn, Lilian H D van Tuyl, Maarten Boers, Debby den Uyl, Marieke M Ter Wee, Pit Kerstens, Alexandre E Voskuyl, Dirkjan van Schaardenburg, Michael T Nurmohamed, Willem F Lems
OBJECTIVE: To investigate whether remission at single and consecutive visits predicts good outcome in early rheumatoid arthritis (RA). METHODS: The presence of remission according to ACR/EULAR and other criteria (Boolean clinical, CDAI, DAS, DAS28, RAPID3) was assessed in early RA patients during the first year of the COBRA-light trial. Likelihood ratios were used to assess whether meeting the remission criteria at single visits (13, 26, 39 or 52 weeks) and consecutive visits (13 + 26, 26 + 39 or 39 + 52 weeks) predicted good outcome in the second year (52-104 weeks)...
October 1, 2016: Arthritis Care & Research
Michael E Mack, Elizabeth Hsia, Daniel Aletaha
OBJECTIVE: The American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) have defined remission using Boolean- or index-based criteria (i.e., the Simplified Disease Activity Index [SDAI] ≤3.3). The Clinical Disease Activity Index (CDAI) ≤2.8) also was included in our comparison of remission definitions to inform endpoint choice for future rheumatoid arthritis (RA) clinical trials. METHODS: We performed post-hoc analyses on clinical remission rates using data from infliximab (ASPIRE/ATTRACT) and golimumab (GO-FORWARD) trials...
October 1, 2016: Arthritis & Rheumatology
Maxime Dougados, Désirée van der Heijde, Ying-Chou Chen, Maria Greenwald, Edit Drescher, Jiajun Liu, Scott Beattie, Sarah Witt, Inmaculada de la Torre, Carol Gaich, Terence Rooney, Douglas Schlichting, Stephanie de Bono, Paul Emery
BACKGROUND: Baricitinib is an oral, reversible, selective Janus kinase 1 and 2 inhibitor. METHODS: In this phase III, double-blind 24-week study, 684 biologic disease-modifying antirheumatic drug (DMARD)-naïve patients with rheumatoid arthritis and inadequate response or intolerance to ≥1 conventional synthetic DMARDs were randomly assigned 1:1:1 to placebo or baricitinib (2 or 4 mg) once daily, stratified by region and the presence of joint erosions. Endpoint measures included American College of Rheumatology 20% response (ACR20, primary endpoint), Disease Activity Score (DAS28) and Simplified Disease Activity Index (SDAI) score ≤3...
September 29, 2016: Annals of the Rheumatic Diseases
T W Kragstrup
The treatment of rheumatoid arthritis (RA) and spondyloarthritis (SpA) was transformed a little over a decade ago by the introduction of agents neutralizing the pro-inflammatory cytokine tumour necrosis factor (TNF)-α. Nevertheless, some patients do not achieve remission and the inhibition of the normal immune system with current drugs increases the risk of infection. The interleukin (IL)-20 receptor (IL-20R) axis is pivotal for tissue homeostasis. By contrast, this axis does not seem to directly activate cells of the immune system...
August 2016: Scandinavian Journal of Rheumatology
Paola Conigliaro, Maria Sole Chimenti, Paola Triggianese, Eleonora Ballanti, Flavia Sunzini, Iaria Duca, Roberto Perricone
OBJECTIVES: This retrospective study used various indices to evaluate remission and low disease activity in 'real life' patients with rheumatoid arthritis (RA), given antitumour necrosis factor (anti-TNF) as a first-line treatment; changes in concomitant steroid and conventional synthetic disease-modifying antirheumatic drug (csDMARD) treatment were also assessed. METHODS: Remission and low disease activity were analysed in patients with RA treated with anti-TNF using the 28-joint Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI)...
September 2016: Journal of International Medical Research
S Krabbe, R Bolce, C H Brahe, U M Døhn, B J Ejbjerg, M L Hetland, E H Sasso, D Chernoff, M S Hansen, L S Knudsen, A Hansen, O R Madsen, M Hasselquist, J Møller, M Østergaard
OBJECTIVES: To investigate the multi-biomarker disease activity (MBDA) score by comparison with imaging findings in an investigator-initiated rheumatoid arthritis (RA) trial (HURRAH trial, NCT00696059). METHOD: Fifty-two patients with established RA initiated adalimumab treatment and had magnetic resonance imaging (MRI), ultrasonography (US), computed tomography (CT), and radiography performed at weeks 0, 26, and 52. Serum samples were analysed using MBDA score assays and associations between clinical measures, MBDA score, and imaging findings were investigated...
September 28, 2016: Scandinavian Journal of Rheumatology
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