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"early rheumatoid arthritis"

Giovanni Ciancio, Manuela Ferracin, Elena Saccenti, Valentina Bagnari, Ilaria Farina, Federica Furini, Elisa Galuppi, Barbara Zagatti, Francesco Trotta, Massimo Negrini, Marcello Govoni
OBJECTIVES: To evaluate the micro-RNA (miRNA) expression profile in patients with early psoriatic arthritis (PsA) in order to assess the role of miRNAs as potential PsA biomarkers. METHODS: The expression of 723 mature miRNAs in peripheral blood mononuclear cells of early PsA patients in comparison with early-rheumatoid arthritis (ERA) patients and healthy controls (HC) was evaluated using a miRNA microarray. All patients had active disease and were naïve from treatment...
October 7, 2016: Clinical and Experimental Rheumatology
Aidan G O'Keeffe, Daniel M Farewell, Brian D M Tom, Vernon T Farewell
In longitudinal randomised trials and observational studies within a medical context, a composite outcome-which is a function of several individual patient-specific outcomes-may be felt to best represent the outcome of interest. As in other contexts, missing data on patient outcome, due to patient drop-out or for other reasons, may pose a problem. Multiple imputation is a widely used method for handling missing data, but its use for composite outcomes has been seldom discussed. Whilst standard multiple imputation methodology can be used directly for the composite outcome, the distribution of a composite outcome may be of a complicated form and perhaps not amenable to statistical modelling...
2016: Statistics in Biosciences
T Shimizu, M Takahata, H Kimura-Suda, Y Kameda, K Endo, H Hamano, S Hiratsuka, M Ota, D Sato, T Ito, M Todoh, S Tadano, N Iwasaki
: This study showed that autoimmune arthritis induces especially severe osteoporosis in the periarticular region adjacent to inflamed joints, suggesting that arthritis increases the fragility fracture risk near inflamed joints, which is frequently observed in patients with RA. INTRODUCTION: Periarticular osteoporosis near inflamed joints is a hallmark of early rheumatoid arthritis (RA). Here we show that rheumatic inflammation deteriorates the bone quality and bone quantity of periarticular bone, thereby decreasing bone strength and toughness in a mouse model of RA...
October 4, 2016: Osteoporosis International
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
Karine R Luz, Marcelo M Pinheiro, Giovanna S Petterle, Marla F Dos Santos, Artur R C Fernandes, Jamil Natour, Rita N V Furtado
OBJECTIVE: To propose a novel ultrasound scoring system for hand and wrist joints (US10) for evaluation of patients with early rheumatoid arthritis (RA) and to correlate the US10 with clinical, laboratory and functional variables. METHODS: Forty-eight early RA patients underwent clinical and laboratory evaluations as well as blinded ultrasound (US) examinations at baseline, three, six and 12 months. The proposed US10 system involved the assessment of the wrist, second and third metacarpophalangeal and proximal interphalangeal joints...
September 2016: Revista Brasileira de Reumatologia
Sharzad Emamikia, Elizabeth V Arkema, Noémi Györi, Jacqueline Detert, Katerina Chatzidionysiou, Maxime Dougados, Gerd Rüdiger Burmester, Ronald van Vollenhoven
OBJECTIVE: To determine whether an induction-maintenance strategy of combined therapy (methotrexate (MTX)+tumour necrosis factor (TNF) inhibitor (TNFi)) followed by withdrawal of TNFi could yield better long-term results than a strategy with MTX monotherapy, since it is unclear if the benefits from an induction phase with combined therapy are sustained if TNFi is withdrawn. METHODS: We performed a meta-analysis of trials using the initial combination of MTX+TNFi in conventional synthetic disease-modifying antirheumatic drug-naïve patients with early rheumatoid arthritis (RA)...
2016: RMD Open
Lesley-Anne Bissell, Elizabeth M A Hensor, Lukasz Kozera, Sarah L Mackie, Agata N Burska, Jacqueline L Nam, Helen Keen, Edith Villeneuve, Helena Donica, Maya H Buch, Philip G Conaghan, Jacqueline Andrews, Paul Emery, Ann W Morgan
OBJECTIVES: To determine the change in established biomarkers of cardiovascular (CV) risk, namely, total cholesterol/high-density lipoprotein cholesterol ratio (TC/HDL-C), N-terminal pro-brain natriuretic peptide (NT-proBNP) and insulin resistance (IR) in patients with early RA treated with two different treat-to-target strategies. METHODS: Fasting glucose, lipids, insulin and NT-proBNP were measured at baseline, weeks 26 and 78 in 79 DMARD-naïve RA patients, free of CV disease, as part of a double-blind randomized controlled trial of MTX with either infliximab (IFX) or methylprednisolone as induction therapy...
September 16, 2016: Rheumatology
Yasser El Miedany, Maha El Gaafary, Sally Youssef, Sami Bahlas, Samah Almedany, Ihab Ahmed, Deborah Palmer
OBJECTIVE: To assess the use of electronic patient-reported outcome measures (ePROM) in standard clinical practice for early rheumatoid arthritis (RA) management, the ePROM ability to enhance clinical care, and how computing technology can improve the patients' adherence to therapy. METHODS: In a double-blinded randomized-controlled study, 211 patients with early RA diagnosed according to American College of Rheumatology/European League Against Rheumatism criteria completed a PROM in paper format at their first clinic visit...
September 15, 2016: Journal of Rheumatology
Adrian Levitsky, Marius C Wick, Timo Möttönen, Marjatta Leirisalo-Repo, Leena Laasonen, Markku Korpela, Ronald F van Vollenhoven, Vappu Rantalaiho
OBJECTIVES: Predicted versus observed radiographic progression in early rheumatoid arthritis (POPeRA) was applied to demonstrate how various treatment modalities affect and potentially minimise radiographic progression over time. METHODS: The POPeRA method utilises the baseline radiographic score and patient-reported symptom duration to predict radiographic outcomes. It was applied at baseline, 2, and 5 years to patients with eRA from the randomised Finnish RA Combination trial (FIN-RACo) (n=144) and New Finnish RA Combination Therapy (NEO-RACo) (n=90) trials...
August 31, 2016: Clinical and Experimental Rheumatology
O Zengin, M E Onder, A Kalem, M Bilici, I H Türkbeyler, Z A Ozturk, B Kisacik, A M Onat
BACKGROUND: Rheumatoid arthritis (RA) is the most common chronic inflammatory disorder and is associated with progressive destruction of synovial joints and physical disability. Therapies with known benefits include disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, as well as more recent biologic agents, such as tumor necrosis factor inhibitors (anti-TNF therapy). METHOD: This was a retrospective study, which included 205 RA and 112 early RA (ERA) patients from the Rheumatology Clinic at Gaziantep University School of Medicine Research Center as well as 104 healthy controls...
September 7, 2016: Zeitschrift Für Rheumatologie
Pascal H P de Jong, Johanna M Hazes, Leander R Buisman, Pieternella J Barendregt, Derkjen van Zeben, Peter A van der Lubbe, Andreas H Gerards, Mike H de Jager, Peter B J de Sonnaville, Bernard A Grillet, Jolanda J Luime, Angelique E A M Weel
OBJECTIVE: To evaluate direct and indirect costs per quality adjusted life year (QALY) for different initial treatment strategies in very early RA. METHODS: The 1-year data of the treatment in the Rotterdam Early Arthritis Cohort trial were used. Patients with a high probability (>70%) according to their likelihood of progressing to persistent arthritis, based on the prediction model of Visser, were randomized into one of following initial treatment strategies: (A) initial triple DMARD therapy (iTDT) with glucocorticoids (GCs) intramuscular (n = 91); (B) iTDT with an oral GC tapering scheme (n = 93); and (C) initial MTX monotherapy (iMM) with GCs similar to B (n = 97)...
August 30, 2016: Rheumatology
Isabela Siloşi, Mihail Virgil Boldeanu, Manole Cojocaru, Viorel Biciuşcă, Vlad Pădureanu, Maria Bogdan, Ramona Georgiana Badea, Carmen Avramescu, Ileana Octavia Petrescu, Florin Petrescu, Cristian A Siloşi
Aims. In the present study, we aimed to assess the concentrations of IL-13 and IL-17 in serum of patients with early rheumatoid arthritis (eRA), the investigation of correlation between the concentrations of these cytokines and disease activity score, and the concentration of some autoantibodies and the evaluation of the utility of IL-13 and -17 concentration measurements as markers of disease activity. Materials and Methods. Serum samples were collected from 30 patients and from 28 controls and analysed parameters...
2016: Journal of Immunology Research
Bruno Stuhlmüller, Karsten Mans, Neeraj Tandon, Marc O Bonin, Biljana Smiljanovic, Till A Sörensen, Pascal Schendel, Peter Martus, Joachim Listing, Jacqueline Detert, Marina Backhaus, Thomas Neumann, Robert J Winchester, Gerd-R Burmester, Thomas Häupl
Effective drug selection is the current challenge in rheumatoid arthritis (RA). Treatment failure may follow different pathomechanisms and therefore require investigation of molecularly defined subgroups. In this exploratory study, whole blood transcriptomes of 68 treatment-naïve early RA patients were analyzed before initiating MTX. Subgroups were defined by serologic and genetic markers. Response related signatures were interpreted using reference transcriptomes of various cell types, cytokine stimulated conditions and bone marrow precursors...
October 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Mohammed A Omair, Edward Keystone, Vivian Bykerk, Daming Lin, Juan Xiong, Ye Sun, Gilles Boire, J Carter Thorne, Janet Pope, Carol Hitchon, Boulos Haraoui, Diane Tin, Pooneh S Akhavan
OBJECTIVES: To compare the EULAR and SDAI50 response measures (RMs) and their impact on future response to treatment in patients with early rheumatoid arthritis (ERA). METHODS: Biologic naïve ERA patients from the Canadian early ArThritis CoHort (CATCH) with complete data at baseline, 3 and 6 months were evaluated. Kappa statistics were used to evaluate the agreement between the EULAR (moderate or good response) and SDAI50 RMs. The RMs at 3 months were also compared for their ability to predict low disease activity state (LDAS) or remission (REM) at 6 months...
August 26, 2016: Arthritis Care & Research
Anna O'Connor, Carter Thorne, Hyeon Kang, Diane Tin, Janet E Pope
BACKGROUND: Methotrexate (MTX) is standard treatment for RA. Absorption is better in subcutaneous MTX (scMTX), which may impact speed of onset. In RA, earlier time to remission improves long-term results. Our objectives were to determine rapidity of response of subcutaneous methotrexate in early rheumatoid arthritis. METHODS: The change in several disease activity measures (including DAS28) from 0 to 6 weeks (early period) and 6 to 12 weeks (late period) was compared...
2016: BMC Musculoskeletal Disorders
Espen A Haavardsholm, Anna-Birgitte Aga, Inge Christoffer Olsen, Siri Lillegraven, Hilde B Hammer, Till Uhlig, Hallvard Fremstad, Tor Magne Madland, Åse Stavland Lexberg, Hilde Haukeland, Erik Rødevand, Christian Høili, Hilde Stray, Anne Noraas, Inger Johanne Widding Hansen, Gunnstein Bakland, Lena Bugge Nordberg, Désirée van der Heijde, Tore K Kvien
OBJECTIVE:  To determine whether a treatment strategy based on structured ultrasound assessment would lead to improved outcomes in rheumatoid arthritis, compared with a conventional strategy. DESIGN:  Multicentre, open label, two arm, parallel group, randomised controlled strategy trial. SETTING:  Ten rheumatology departments and one specialist centre in Norway, from September 2010 to September 2015. PARTICIPANTS:  238 patients were recruited between September 2010 and April 2013, of which 230 (141 (61%) female) received the allocated intervention and were analysed for the primary outcome...
2016: BMJ: British Medical Journal
Laura A Kuusalo, Kari T Puolakka, Hannu Kautiainen, Eeva M Alasaarela, Pekka J Hannonen, Heikki A Julkunen, Oili A Kaipiainen-Seppänen, Markku M Korpela, Timo T Möttönen, Leena H Paimela, Ritva L Peltomaa, Timo K Yli-Kerttula, Marjatta Leirisalo-Repo, Vappu M Rantalaiho
OBJECTIVES: To study the effects of neglecting intra-articular glucocorticoid injections (IAGCIs) into swollen joints in early rheumatoid arthritis (RA). METHODS: Ninety-nine patients with early, DMARD naive RA were treated, aiming at remission, with methotrexate, sulfasalazine, hydroxychloroquine, low-dose oral prednisolone and, when needed, IAGCIs for 2 years, and randomised to receive infliximab or placebo from weeks 4 to 26. During each of the 15 study visits, patients were scored retrospectively 0...
August 2, 2016: Clinical and Experimental Rheumatology
Francisco Espinoza, Sylvie Fabre, Yves-Marie Pers
Recent guidelines on rheumatoid arthritis (RA) point to the importance of achieving remission as soon as possible during the course of the disease. The appropriate use of antirheumatic drugs is critical, particularly in early RA patients, before 24 weeks, since this is a 'window of opportunity' for treatment to modify disease progression. A treat-to-target strategy added to an aggressive therapeutic approach increases the chance of early remission, particularly in early RA patients. We conducted an overview of current therapeutic strategies leading to remission in early RA patients...
August 2016: Therapeutic Advances in Musculoskeletal Disease
Wei Zhang, Nick Bansback, Huiying Sun, Ronald Pedersen, Sameer Kotak, Aslam H Anis
OBJECTIVE: To assess changes in work productivity in patients who have achieved response using etanercept (ETN) 50 mg+methotrexate (MTX) (phase I) are randomised to ETN 25 mg+MTX versus MTX versus placebo (phase II) and then withdrawn from treatment (phase III). METHODS: Patients included in the analysis were in employment entering phase II of the PRIZE trial and had one or more follow-ups. Phase II was a 39-week, randomised and double-blind comparison of the 3 dose-reduction treatments...
2016: RMD Open
Glen S Hazlewood, Claire Bombardier, George Tomlinson, Carter Thorne, Vivian P Bykerk, Andrew Thompson, Diane Tin, Deborah A Marshall
OBJECTIVE: To quantify the preferences of patients with early RA (ERA) with the benefits and harms of DMARDs. METHODS: We assessed patients' preferences using a discrete-choice experiment, an experimentally designed survey to measure trade-offs. Consecutive adult patients with ERA (<2 years since diagnosis) were presented 13 different sets of three treatment options described by eight attributes (clinical outcomes, risks and dosing regimens) and asked to choose one...
July 31, 2016: Rheumatology
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