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rheumatoid arthritis and tb

Vikram Londhey, Meghav M Shah
INTRODUCTION: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been considered very specific for rheumatoid arthritis (RA). Some studies have shown that these antibodies can be positive in infectious diseases like TB, HIV, etc. METHODS: Fifty patients of tuberculosis both pulmonary and extra-pulmonary were enrolled in the study from inpatient and outpatient departments from May 2012 to November 2013. Anti-CCP antibody test was done in all the patient by ELISA...
May 2016: Journal of the Association of Physicians of India
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
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
Marta Olejárová
UNLABELLED: The biological treatment which is the most effective type of therapy for inflammatory rheumatic diseases, has become part of a standard clinical rheumatology practice in recent years. Thousands of patients in the Czech Republic with rheumatoid arthritis, different forms of spondyloarthritides and with psoriatic arthritis are now successfully treated in this way. The following medications are registered in the Czech Republic for the treatment of rheumatic diseases: infliximab, adalimumab, golimumab, certolizumab pegol, etanercept, abatacept, rituximab, tocilizumab and belimumab, newly also secukinumab...
2016: Vnitr̆ní Lékar̆ství
Adriana Lama, Lucía Ferreiro, María E Toubes, Antonio Golpe, Francisco Gude, José M Álvarez-Dobaño, Francisco J González-Barcala, Esther San José, Nuria Rodríguez-Núñez, Carlos Rábade, Carlota Rodríguez-García, Luis Valdés
BACKGROUND: Pseudochylothorax (PCT) (cholesterol pleurisy or chyliform effusion) is a cholesterol-rich pleural effusion (PE) that is commonly associated with chronic inflammatory disorders. Nevertheless, the characteristics of patients with PCT are poorly defined. METHODS: A systematic review was performed across two electronic databases searching for studies reporting clinical findings, PE characteristics, and the most effective treatment of PCT. Case descriptions and retrospective studies were included...
August 2016: Journal of Thoracic Disease
Ennio Lubrano, Fabrizio Cantini, Alessandro Mathieu, Ignazio Olivieri, Carlo Salvarani, Raffaele Scarpa, Antonio Marchesoni
OBJECTIVES: Accurate diagnosis and appropriate management of psoriatic arthritis (PsA) is essential to avoid unnecessary morbidity. Our aim in this study was to evaluate the current approach to the management of PsA among rheumatologists. METHODS: A 16-item online questionnaire, produced using the Delphi method, was submitted to a panel of rheumatologists who anonymously expressed their opinions on a scale from 1 (maximum disagreement) to 5 (maximum agreement). Positive consensus was defined by ≥66% of the respondents scoring an item 3, 4 or 5...
August 31, 2016: Clinical and Experimental Rheumatology
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
Jinoos Yazdany, Mark Robbins, Gabriela Schmajuk, Sonali Desai, Diane Lacaille, Tuhina Neogi, Jasvinder A Singh, Mark Genovese, Rachel Myslinski, Natalie Fisk, Melissa Francisco, Eric Newman
BACKGROUND: Electronic clinical quality measures (eCQMs) rely on computer algorithms to extract data from electronic health records (EHRs). On behalf of the American College of Rheumatology (ACR), we sought to develop and test eCQMs for rheumatoid arthritis (RA). METHODS: Drawing from published ACR guidelines, a working group developed candidate RA process measures and subsequently assessed face validity through an interdisciplinary panel of health care stakeholders...
August 26, 2016: Arthritis Care & Research
Mehdi Vazirian, Shabnam Faridfar, Mahdieh Eftekhari
BACKGROUND: Gharikon is a well-known medicinal mushroom in Iranian traditional medicine and mentioned several times in different kinds of authentic literature. Considering both traditional and modern literature, the aim of this study is to present a review of its biological activities. METHODS: Using online databases (e.g. PubMed, Scopus, and Google Scholar) as well as reviewing traditional medicinal literature (e.g. Makhzan-ul-Adwiah, Al-Qanun fi al-Tibb); we reviewed the published literature on the pharmacological effects of Laricifomes officinalis (the most common species considered as "Gharikon")...
May 2016: Iranian Journal of Medical Sciences
Mihail Alexandru Badea, Corneliu Florin Buicu, Anca Ileana Sin, Ovidiu Simion Cotoi, Iudita Maria Badea, Andreea Luciana Chiotoroiu, Silviu Horia Morariu
Granulomatous inflammations are a particular type of chronic septic or aseptic inflammation, in which infectious or non-infectious agents are difficult to eliminate by the immune system. These are type IV hypersensitivity reactions mediated by pre-sensitized T-lymphocytes cells CD4+ and CD8+ lymphocytes. Disorders included in this category are: tuberculosis, leprosy, syphilis, sarcoidosis, type I diabetes, multiple sclerosis, Crohn's disease and rheumatoid arthritis. At cutaneous level, this pattern of granulomatous reaction is characterized by a chronic inflammation with formation of granulomas consisting of a variable number of histiocytes, multinucleated giant cells and lymphocytes...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Sarvajeet Pal, Sarath Chandra Mouli Veeravalli, Siddharth Kumar Das, Vineeta Shobha, Ramakrishna Rao Uppuluri, B G Dharmanand, Milind Nadkar, Elizabeth Hsia, Kaiyin Fei, Ruji Yao, Ahmed Khalifa
AIM: To conduct a subgroup analysis of GO-MORE trial Part 1, comparing efficacy and safety of add-on subcutaneous golimumab therapy in rheumatoid arthritis (RA) patients enrolled from and outside India. METHODS: GO-MORE was an open-label, multicenter, prospective trial of add-on golimumab in biologic-naïve RA patients, having active disease despite being on conventional DMARD regimen(s). Part 1 of the study was chosen as the focus of this subgroup analysis because a substantial number of Indian patients (106) were enrolled compared to no Indian patients in Part 2...
July 26, 2016: International Journal of Rheumatic Diseases
Marta Gómez-Mariscal, Andrea Oleñik, Pablo Arriba-Palomero, Mónica García-Cosio, Francisco J Muñoz-Negrete
PURPOSE: To report an uncommon case of Kikuchi-Fujimoto disease-associated-uveitis. METHODS: A 31-year-old Caucasian woman with cervical lymphadenitis and Kikuchi-Fujimoto disease recently confirmed by biopsy, complained about unilateral blurry vision. Differential diagnoses, including non-Hodgkin lymphoma, tuberculosis, sarcoidosis, Behçet disease, rheumatoid arthritis, and juvenile idiopathic arthritis was performed. We undertook a review of other similar cases found in the literature...
July 15, 2016: Ocular Immunology and Inflammation
Tsai-Ling Liao, Chin-Fu Lin, Yi-Ming Chen, Hung-Jen Liu, Der-Yuan Chen
Increasing evidence indicates that the risk of nontuberculous mycobacteria (NTM) disease is elevated in patients with rheumatoid arthritis (RA). However, the risk factors and outcomes for NTM disease among RA patients remain unclear. We conducted a case-control study and estimated odds ratios (ORs) for RA patients with NTM disease according to comorbidities and anti-rheumatic medications by using conditional logistic regression. Prior tuberculosis history (adjusted OR (aOR) =5.58, p < 0.001), hypertension (aOR = 2...
2016: Scientific Reports
Laura E Savolainen, Anu Kantele, Aija Knuuttila, Liana Pusa, Riitta Karttunen, Heikki Valleala, Tamara Tuuminen
New biomarkers are needed for discriminating active tuberculosis (TB) from latent TB infection (LTBI), especially in vulnerable groups representing the major diagnostic challenge. This pilot study was carried out to explore the diagnostic potential of selected genes, IFN-γ, IL-17, IL-4, and FoxP3, associated with TB immunity and immunopathology. IFN-γ, IL-17, IL-4, and FoxP3 mRNA expression levels were measured by quantitative reverse transcription PCR (RT-qPCR) from antigen-stimulated peripheral blood mononuclear cells of patients with active TB (n = 25); patients with miscellaneous inflammatory disorders and concomitant LTBI (n = 20), rheumatoid arthritis (RA) being the most predominant in the group (n = 11); and in healthy Bacillus Calmette-Guérin (BCG) vaccinees (n = 8)...
2016: Frontiers in Immunology
B Hodkinson, N Osman, S Botha-Scheepers
We report the case of a 47-year-old female patient with rheumatoid arthritis and HIV infection presenting with a 3-week history of a painful swollen knee, increased serum inflammatory markers, and a low CD4 lymphocyte count. The diagnosis of TB arthritis was made by synovial fluid culture, GeneXpert/PCR, and confirmed by histopathology of a synovial biopsy. A mini literature review suggests that although HIV infection is associated with extrapulmonary TB, osteoarticular TB is a relatively unusual presentation in an HIV positive patient...
2016: Case Reports in Rheumatology
Gerd R Burmester, Robert Landewé, Mark C Genovese, Alan W Friedman, Nathan D Pfeifer, Nupun A Varothai, Ana P Lacerda
BACKGROUND: Adalimumab has been used in patients with moderately to severely active rheumatoid arthritis (RA) for over 10 years and has a well-established safety profile across multiple indications. OBJECTIVE: To update adverse events (AEs) of special interest from global adalimumab clinical trials in patients with RA. METHODS: This analysis includes 15 132 patients exposed to adalimumab in global RA clinical trials. AEs of interest included overall infections, laboratory abnormalities and AEs associated with influenza vaccination...
June 23, 2016: Annals of the Rheumatic Diseases
A Petrovici, M J Kaiser, R Louis, D Nguyen Dang
Over recent years, anti-TNFα have been used to treat rheumatoid arthritis. The principal secondary effect of anti-TNFα is tuberculosis infections. Another paradoxical effect, previously less well understood, is the development of sarcoid-like granulomatous reactions. We report the case of a 36 year old woman who had been treated for 9 years with anti-TNF alpha. She developed a pulmonary sarcoid-like gra-nulomatosis, complication that is rare but not exceptional in patients treated with TNF-blockers. Discontinuation of anti TNF usually led to recovery...
March 2016: Revue Médicale de Liège
David Rowell, Louisa G Gordon, Catherine M Olsen, David C Whiteman
OBJECTIVES: The composition of the medical costs incurred by people treated for basal cell and squamous cell carcinomas (hereafter keratinocyte cancers) is not adequately understood. We sought to compare the medical costs of individuals with or without keratinocyte cancers. METHODS: We used national health insurance data to analyze the direct medical costs of 2000 cases and 2000 controls nested within the QSkin prospective cohort study (n = 43,794) conducted in Australia...
2016: SAGE Open Medicine
Fabiola Atzeni, Alberto Batticciotto, Ignazio F Masala, Rossella Talotta, Maurizio Benucci, Piercarlo Sarzi-Puttini
Long-term extension studies and observational drug registers have revealed an increased risk of serious infections in patients treated with anti-tumor necrosis factor agents, particularly infliximab, etanercept and adalimumab. The same may be true for the newer biological drugs rituximab, tocilizumab and abatacept, although this has yet to be confirmed by long-term observational studies. We review the risk of tuberculosis, herpes zoster and other opportunistic infections, and the recommendations for screening for tuberculosis and hepatitis B and C infections in patients with rheumatoid arthritis, with the aim of informing patients and encouraging greater awareness among physicians...
March 2016: Israel Medical Association Journal: IMAJ
Ömer Nuri Pamuk, Umut Kalyoncu, Kenan Aksu, Ahmet Omma, Yavuz Pehlivan, Yonca Çağatay, Orhan Küçükşahin, Salim Dönmez, Gözde Yıldırım Çetin, Rıdvan Mercan, Özün Bayındır, Ayşe Çefle, Fatih Yıldız, Ayşe Balkarlı, Levent Kılıç, Necati Çakır, Bünyamin Kısacık, Mustafa Ferhat Öksüz, Veli Çobankara, Ahmet Mesut Onat, Mehmet Sayarlıoğlu, Mehmet Akif Öztürk, Gülsüm Emel Pamuk, Nurullah Akkoç
In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts...
July 2016: Rheumatology International
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