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reumatoid arthritis

Marieke M Ter Wee, Veerle Mh Coupé, Debby den Uyl, Birgit S Blomjous, Esmee Kooijmans, Pit Jsm Kerstens, Mike T Nurmohamed, Dirkjan van Schaardenburg, Alexandre E Voskuyl, Maarten Boers, Willem F Lems
Objective: To evaluate if COmbinatie therapie Bij Reumatoïde Artritis (COBRA)-light therapy is cost-effective in treating patients with early rheumatoid arthritis (RA) compared with COBRA therapy. Methods: This economic evaluation was performed next to the open-label, randomised non-inferiority COBRA-light trial in 164 patients with early RA. Non-responders to COBRA or COBRA-light received etanercept (50 mg/week) for 3-6 months. The societal perspective analysis took medical direct, non-medical direct and indirect costs into account...
2017: RMD Open
Massimiliano Leigheb, Michela Bosetti, Antonio De Consoli, Alessia Borroni, Mario Cannas, Federico Grassi
Articular cartilage repair is still a challenge. To date evidence is insufficient to support a treatment over the others. Inflammatory conditions in the joint hamper the application of tissue engineering during chronic joint diseases. Most of the Matrix Autologous Chondrocyte Implantation (MACI) cases reported in literature do not deal with rheumatoid knees and do not have a long clinical-histologic follow-up. We report about a 46-year old woman who suffered of a painful focal Outerbridge 4th degree chondral lesion in the medial femoral condyle of her left rheumatoid knee...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
María Auxiliadora Martín-Martínez, Jose Luis Andreu-Sanchez, Fernando Sanchez-Alonso, Hector Corominas, Jose Javier Perez-Venegas, Jose Andres Roman-Ivorra, Mercedes Alperi, Ricardo Blanco-Alonso, Rafael Caliz, Eugenio Chamizo-Carmona, Jenaro Graña-Gil, Blanca Hernández, Carlos Marras, Ramon Mazzucchelli, Julio Antonio Medina Luezas, Antonio Naranjo-Hernández, Ana Ortiz, Rosa Roselló, Ginés Sanchez-Nievas, Raimon Sanmartí, Paloma Vela-Casasempere
OBJECTIVE: The current guidelines in the treatment of rheumatoid arthritis (RA) include the early diagnosis and early use of disease modifying drugs to achieve remission or low disease activity level, known as "Treat to Target" (T2T). The objective of this study is to develop a composite indicator (CI) to evaluate the quality of care in the management of patients with RA, according to the T2T strategy and other general recommendations concerning the management of these patients. MATERIAL AND METHOD: The phases of the construction of the CI were: 1) selection of quality criteria through expert judgment; 2) prioritization of the criteria, according to relevance and feasibility, applying the Delphi methodology (two rounds) involving 20 experts; 3) design of quality indicators; and 4) calculation of the weighted CI, using the mean value in relevance and feasibility granted by the experts...
August 5, 2017: Reumatología Clinica
Rosario García-Vicuña, María Auxiliadora Martín-Martínez, María Rosa Gonzalez-Crespo, Jesús Tornero-Molina, Antonio Fernández-Nebro, Francisco Javier Blanco-García, Ricardo Blanco-Alonso, Sara Marsal-Barril
To establish a set of recommendations for the management of patients diagnosed with rheumatoid arthritis (RA) who cannot be treated with methotrexate (MTX) due to contraindications, drug toxicity or lack of adherence, and to establish therapeutic strategies more effective and safer in these RA patients. A qualitative analysis of the scientific evidence available to June 2015. The 2-round Delphi technique of consensus was used to collect and establish expert opinion based on the participants' clinical experience when only low quality evidence was available...
May 2017: Reumatología Clinica
Isidoro González-Álvaro, Isabel Castrejón, Ana M Ortiz, Esther Toledano, Santos Castañeda, Alberto García-Vadillo, Loreto Carmona
OBJECTIVE: To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. METHODS: Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis...
2016: PloS One
Marina Amaral de Ávila Machado, Cristiano Soares de Moura, Felipe Ferré, Sasha Bernatsky, Elham Rahme, Francisco de Assis Acurcio
OBJECTIVE: To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD) and tumor necrosis factor blockers (anti-TNF drugs). METHODS: This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription...
August 22, 2016: Revista de Saúde Pública
Carlos Abud-Mendoza
No abstract text is available yet for this article.
July 2015: Reumatología Clinica
Patrick Verschueren, Diederik De Cock, Luk Corluy, Rik Joos, Christine Langenaken, Veerle Taelman, Frank Raeman, Isabelle Ravelingien, Klaas Vandevyvere, Jan Lenaerts, Elke Geens, Piet Geusens, Johan Vanhoof, Anne Durnez, Jan Remans, Bert Vander Cruyssen, Els Van Essche, An Sileghem, Griet De Brabanter, Johan Joly, Kristien Van der Elst, Sabrina Meyfroidt, Rene Westhovens
INTRODUCTION: Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. METHODS: Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3...
2015: Arthritis Research & Therapy
Linda A Rasch, Lilian H D van Tuyl, Willem F Lems, Maarten Boers
Treatment with initial high-dose prednisolone and a combination of methotrexate (MTX) and sulfasalazine (SSZ) according to the COBRA regimen (Dutch acronym for combinatietherapie bij reumatoide artritis, 'combination therapy for rheumatoid arthritis'), has repeatedly been demonstrated to be very effective in early rheumatoid arthritis (RA). COBRA combination therapy is superior to initial monotherapy of SSZ and MTX, is also associated with a good long-term outcome, is as safe as other treatment regimes, and performs as well as the combination of high-dose MTX and the tumor necrosis factor antagonist infliximab...
2015: Neuroimmunomodulation
Marieke M ter Wee, Debby den Uyl, Maarten Boers, Pit Kerstens, Mike Nurmohamed, Dirkjan van Schaardenburg, Alexandre E Voskuyl, Willem F Lems
BACKGROUND: Recently, we documented the likely non-inferiority of Combinatietherapie Bij Reumatoïde Artritis (COBRA)-light therapy (methotrexate increased to 25 mg/week with initial prednisolone 30 mg/day) compared with the original COBRA therapy (methotrexate 7.5 mg/week, sulfasalazine 2 g/day, with initial prednisolone 60 mg/day) after 26 weeks in patients with early active rheumatoid arthritis (RA). OBJECTIVE: To assess the non-inferiority of COBRA-light versus COBRA after 1 year in terms of disease activity (DAS44), functional outcome (Health Assessment Questionnaire (HAQ)) and radiographic progression (Sharp/van der Heijde score (SHS)), and to assess the effect of adding etanercept...
June 2015: Annals of the Rheumatic Diseases
L Heimans, M van den Broek, S le Cessie, B Siegerink, N Riyazi, K H Han, P J S M Kerstens, T W J Huizinga, W F Lems, C F Allaart
OBJECTIVE: To assess the association between high body mass index (BMI) and treatment response in recent-onset rheumatoid arthritis. METHODS: In the Behandelstrategieën voor Reumatoide Artritis (Treatment Strategies for Rheumatoid Arthritis) study, 508 patients were randomized to initial monotherapy or combination therapy with prednisone or infliximab (IFX). The response to Disease Activity Score (DAS) ≤2.4-steered treatment (first dose and after 1 year) was compared between patients with a BMI <25 kg/m(2) and ≥25 kg/m(2) , using relative risk (RR) regression analyses...
August 2013: Arthritis Care & Research
Fulvia Ceccarelli, Carlo Perricone, Francesco Trotta, Giovanna Cuomo, Raffaele Pellerito, Gianfilippo Bagnato, Fausto Salaffi, Roberto Caporali, Maurizio Cutolo, Mauro Galeazzi, Ugo Fiocco, Giovanni Lapadula, Stefano Bombardieri, Girolamo Bianchi, Roberto Gorla, Anna Rita Giardina, Gaia Gallo, Angela Maria Giardino, Guido Valesini
OBJECTIVES: To provide a survey of disease activity in patients treated with standard care in Italian clinical practice. METHODS: This was an observational prospective cohort study in patients with early, aggressive rheumatoid arthritis (RA; duration ≤2 years but ≥6 weeks; DAS28 >3.2) naïve to anti-tumour necrosis factor (TNF) therapy who were treated with disease-modifying anti-rheumatic drugs (DMARDs) and/or biologics according to standard practice at 15 Italian ARPA (Artrite Reumatoide Precoce Aggressiva) centres...
May 2013: Clinical and Experimental Rheumatology
Ana Filipa Mourão, João Eurico Fonseca, Helena Canhão, Maria José Santos, Alexandra Bernardo, Ana Cordeiro, Ana Rita Cravo, Ana Ribeiro, Ana Teixeira, Anabela Barcelos, Armando Malcata, Augusto Faustino, Cátia Duarte, Célia Ribeiro, Dolores Nour, Domingos Araújo, Elsa Sousa, Eva Mariz, Filipa Ramos, Filipe Vinagre, Francisco Simões Ventura, Graça Sequeira, Helena Santos, Jaime Cunha Branco, J A Gomes, J A Silva, João Ramos, Jorge Espírito Santo, José António Costa, J A Silva, José Saraiva Ribeiro, Luís Inês, Luís Miranda, Luzia Sampaio, Maria Lúcia Costa, Mário Rodrigues, Maria Carmo Afonso, Maria Inês Cunha, Maria João Saavedra, Mário Viana Queiroz, Maura Couto, Miguel Bernardes, Mónica Bogas, Patrícia Pinto, Paula Valente, Paulo Coelho, Pedro Abreu, Sara Cortes, Sofia Pimenta, Sofia Ramiro, Ricardo Figueira, Teresa Nóvoa
The authors review the practical aspects of biological therapy use for rheumatoid arthritis patients, commenting safety issues before and after treatment initiation and the best treatment strategies to optimize efficacy.
October 2011: Acta Reumatológica Portuguesa
Antonio Serrano Hernández
The immune response foreign antigens require a perfect coordination of cells that participate in its different phases. The objective of the response is the rapid destruction of the microorganisms with a minimum repercussion on self-cells and tissues. The regulation of this process is carried out fundamentally by T lymphocytes. There are two main types of coordinator cells: helper cells, what organize the initial immune response, and regulatory cells, what avoid immune attack against self and once the infection is controlled, disassemble the response...
April 2009: Reumatología Clinica
Daniel Xibillé-Friedmann, Victor Mondragón-Flores, César Horcasitas de la Rosa
INTRODUCTION: Rheumatoid arthritis (RA), an important cause of disability, affects 1% of the population. Early diagnosis and referral to a rheumatologist are positive prognostic factor but diagnosis in many cases is in the hands of primary care physicians (PCP). OBJECTIVE: To determine the criteria used by PCP for diagnosis of RA and referral of these patients to a rheumatologist; to evaluate how many cases can be classified as RA according to the ACR. METHODS: Retrospective study of 530 patients referred by PCP and seen as outpatients at a rheumatology clinic in 2002...
September 2006: Reumatología Clinica
M D Ruiz-Montesinos, B Hernández-Cruz, R Ariza-Ariza, L Carmona, J Ballina, F Navarro-Sarabia et al.
OBJECTIVE: To assess the annual costs of rheumatoid arthritis (RA) patients attended at rheumatology units in Spanish public hospitals. METHODS: A longitudinal, prospective, multicenter, observational, 1-year study was performed in the rheumatology units of randomly selected Spanish public hospitals. Randomly selected RA patients were included. The patients made four visits (at baseline and every 4 months). Resource use and costs were collected from patient diaries and structured questionnaires...
December 2005: Reumatología Clinica
M D Ruiz-Montesinos, B Hernández-Cruz, R Ariza-Ariza, L Carmona, J Ballina, F Navarro-Sarabia et al.
OBJECTIVE: To determine resource use over a 1-year period in patients with rheumatoid arthritis (RA) attended in rheumatology units in hospitals within the Spanish public health system. PATIENTS AND METHODS: An observational, longitudinal, prospective, multicenter, 1-year study was performed in randomly selected rheumatology units in hospitals of the Spanish public health system. Patients with RA were randomly selected in each hospital. Four visits (at baseline and every 4 months) were conducted by a rheumatologist not routinely involved in the care of the patient...
October 2005: Reumatología Clinica
D Gaudio, A Galassi, P Poppa, C Cattaneo
In Italy many hundreds of victims of both armies who fought WWI still attend to be recovered and, if possible, identified and given back to their relatives. This study has as its objective to carry out a correct recovery, anthropological analysis and possible identification of these soldiers. Our plan has been elaborated so that it may involve various experts of different disciplines (archeologists, historians, antropologists, but also genetists and entomologists). So far, in this research project, 35 recovered skeletons have been studied...
2009: Medicina Nei Secoli
João Eurico Fonseca, Helena Canhão, Paulo Reis, Maria José Santos, Jaime Branco, Alberto Quintal, Armando Malcata, Domingos Araújo, Francisco Ventura, Guilherme Figueiredo, José Canas da Silva, José Vaz Patto, Mário Viana de Queiroz, Rui André Santos, Adriano José Neto, Alves de de Matos, Ana Rodrigues, Ana Filipa Mourão, Ana Sofia Ribeiro, Ana Rita Cravo, Anabela Barcelos, Anabela Cardoso, António Vilar, Arecili Braña, Augusto Faustino, Candida Silva, Fátima Godinho, Inês Cunha, José António Costa, José António Melo Gomes, José António Araújo Pinto, J A Pereira da Silva, Luís Cunha Miranda, Luís Inês, Luís Maurício Santos, Margarida Cruz, Maria João Salvador, Maria Júlia Ferreira, Maria Rial, Miguel Bernardes, Mónica Bogas, Paula Araújo, Pedro Machado, Patrícia Pinto, Rui Gomes de Melo, Sara Cortes, Sérgio Alcino, Susana Capela
The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of rheumatoid arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment should be considered in RA patients with a disease activity score 28 (DAS 28) superior to 3.2 despite treatment with 20mg/week of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 6 months of other conventional disease modifying drug or combination therapy...
January 2010: Acta Reumatológica Portuguesa
João Eurico Fonseca, J A Canas Silva, Helena Canhão, Maria José Santos, Anabela Barcelos, Luis Inês, Maria Lucia Costa, Mário Rodrigues, Alexandra Bernardo, Ana Cordeiro, Ana Rita Cravo, Ana Ribeiro, Ana Teixeira, Armando Malcata, Augusto Faustino, Célia Ribeiro, Dolores Nour, Domingos Araújo, Elsa Sousa, Eva Mariz, Filipa Ramos, Filipe Vinagre, Francisco Simões Ventura, Graça Sequeira, Helena Santos, Jaime Cunha Branco, João Ramos, Jorge Espírito Santo, José António Costa, J A Pereira da Silva, Luis Miranda, Luzia Sampaio, Maria Carmo Afonso, Maria João Saavedra, Maria Inês Cunha, Mário Viana Queiroz, Maura Couto, Patrícia Pinto, Paula Valente, Pedro Abreu, Ricardo Ornelas Figueira, Sofia Ramiro, Teresa Nóvoa, Miguel Bernardes
No abstract text is available yet for this article.
April 2009: Acta Reumatológica Portuguesa
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