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very early arthritis

D van der Heijde, A Deodhar, R Fleischmann, P J Mease, M Rudwaleit, T Nurminen, O Davies BPharm
Objective Early identification of patients unlikely to achieve good long-term disease control with anti-TNF therapy in axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) is important for physicians following treat-to-target recommendations. Here we assess associations between disease activity or clinical response during the first 12 weeks (wks) of treatment and attainment of treatment targets at Wk48 in axSpA and PsA patients receiving certolizumab pegol (CZP). Methods The relationship between disease activity or clinical response during the first 12 wks of treatment, and achievement of Wk48 targets (axSpA: ASDAS-CRP inactive disease or BASDAI <2 with normal CRP; PsA: minDA), was assessed post-hoc using RAPID-axSpA (NCT01087762) and RAPID-PsA (NCT01087788) trial data...
October 1, 2016: Arthritis Care & Research
Pascale Krejbich-Trotot, Essia Belarbi, Miora Ralambondrainy, Chaker El-Kalamouni, Wildriss Viranaicken, Pierre Roques, Philippe Desprès, Gilles Gadea
Alphaviruses such as Chikungunya and Ross River (RRV) viruses are associated with persistent arthritis and arthralgia in humans. Monocytes and macrophages are believed to play an important role in alphaviral arthritides. In this study, we evaluated RRV permissiveness of the human acute leukemia MM6 cell line. Viral growth analysis showed that RRV infection of MM6 cells resulted in a very low virus progeny production with daily output. Using recombinant RRV expressing the reporter gene Renilla luciferase, a weak viral replication level was detected in infected cells at the early stages of infection...
October 2, 2016: Virus Research
Ana Paula Sakamoto, Clovis Artur Silva, Mariana Paes Leme Ferriani, Rosa Maria Rodrigues Pereira, Eloisa Bonfá, Claudia Saad-Magalhães, Eunice Okuda, Simone Appenzeller, Francisco Hugo Gomes, Ana Luiza Garcia Cunha, Mirna Henriques Tomich Salume, Daniela Petry Piotto, Maria Teresa Terreri
Chronic arthritis (CA) is an unusual condition in childhood-onset systemic lupus erythematosus (cSLE) and data in children is very limited. The aim of the study is to assess CA in a large population of cSLE patients, in a multicenter cross-sectional study including 852 cSLE patients followed in ten Pediatric Rheumatology referral services in state of São Paulo, Brazil. CA was observed in 32/852 (3.7 %) cSLE patients mostly in hands and ankles. Chronic monoarthritis was diagnosed in four cSLE patients, oligoarthritis in nine and polyarthritis in 19...
September 14, 2016: Rheumatology International
Carla F Gamarra-Hilburn, Grissel Rios, Luis M Vilá
Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of 3.1 × 10(3)/μL (41% neutrophils, 30% lymphocytes, and 29% monocytes). Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week...
2016: Case Reports in Rheumatology
Peter N Chalmers, Dane H Salazar, Karen Steger-May, Aaron M Chamberlain, Georgia Stobbs-Cucchi, Ken Yamaguchi, Jay D Keener
BACKGROUND: Very little longitudinal information has been available regarding the relationship of cuff tears and arthritis. The purpose of this study was to determine the midterm risk of and risk factors for rotator cuff tear arthropathy progression in a cohort of subjects with an asymptomatic rotator cuff tear. METHODS: Baseline (visit 1), 5-year (visit 2), and most recent follow-up (visit 3) radiographs were reviewed in a cohort of 105 subjects enrolled for longitudinal surveillance of asymptomatic degenerative rotator cuff tears and 33 controls...
November 2016: Journal of Shoulder and Elbow Surgery
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
Ellen Sauar Norli, Gina H Brinkmann, Tore K Kvien, Olav Bjørneboe, Anne J Haugen, Halvor Nygaard, Cathrine Thunem, Elisabeth Lie, Maria D Mjaavatten
OBJECTIVES: To study occurrence of and factors associated with self-limiting arthritis among patients fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis (RA) (2010 RA criteria) in patients with ≤16 weeks׳ duration of joint swelling. METHODS: We applied the 2010 RA criteria in 1118 patients included in a 2-year longitudinal cohort. In all, 256 patients fulfilled the 2010 RA criteria at baseline; outcome was defined as either "self-limiting arthritis" (no DMARD use during follow-up, no swollen joints at last assessment, and no final clinical diagnosis of RA) or "persistent disease...
July 20, 2016: Seminars in Arthritis and Rheumatism
Štefan Blazina, Gašper Markelj, Mojca Zajc Avramovič, Nataša Toplak, Tadej Avčin
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood. The outcome in patients with JIA has markedly improved with the advent of biologic drugs. Although early aggressive therapy with biologics seems to be very effective, this approach leads to overtreatment in patients who would respond to classic disease-modifying anti-rheumatic drugs. Therefore, methotrexate remains first-line long-term therapy for most children with polyarticular JIA. Tumor necrosis factor-α inhibitors have shown tremendous benefit in children with refractory non-systemic JIA...
August 2, 2016: Paediatric Drugs
Makoto Hirao, Kosuke Ebina, Hideki Tsuboi, Takaaki Noguchi, Jun Hashimoto, Hideki Yoshikawa
Control of rheumatoid arthritis (RA) disease activity is an important factor related to the development of hallux valgus (HV) deformity. Furthermore, if valgus hindfoot remains and/or appears after HV surgery, the affected foot is at risk of recurrence of HV deformity. We experienced a case suggesting the possibility that hindfoot valgus deformity appeared after HV surgery because of poor control of RA disease activity, and the HV deformity recurred in the very early period after surgery.
July 18, 2016: Modern Rheumatology
Takenobu Yamamoto, Junko Matsuda, Sumito Dateki, Kazunobu Ouchi, Wataru Fujimoto
Sitosterolemia is a very rare autosomal recessive lipoprotein metabolic disorder caused by homozygous or compound heterozygous mutations in one of the two adenosine triphosphate-binding cassette transporter genes, ABCG5 and ABCG8. Sitosterolemia is clinically characterized by xanthomas and atherosclerosis, arthritis, fever, hemolysis and macrothrombocytopenia even in early childhood. We described a 16-month-old girl, who had numerous yellowish-brown intertriginous xanthomas along the skin creases on the extremities with severe hypercholesterolemia and elevated plant sterol levels...
July 12, 2016: Journal of Dermatology
Irina A Udalova, Alberto Mantovani, Marc Feldmann
Macrophages are very important in the pathogenesis of rheumatoid arthritis (RA). The increase in the number of sublining macrophages in the synovium is an early hallmark of active rheumatic disease, and high numbers of macrophages are a prominent feature of inflammatory lesions. The degree of synovial macrophage infiltration correlates with the degree of joint erosion, and depletion of these macrophages from inflamed tissue has a profound therapeutic benefit. Research has now uncovered an unexpectedly high level of heterogeneity in macrophage origin and function, and has emphasized the role of environmental factors in their functional specialization...
August 2016: Nature Reviews. Rheumatology
Valentina Grossi, Maria Infantino, Mariangela Manfredi, Francesca Meacci, Emanuele Bellio, Valerio Bellio, Francesca Li Gobbi, Simone Ugolini, Stefano Catani, Piercarlo Sarzi-Puttini, Fabiola Atzeni, Maurizio Benucci
BACKGROUND: Inflammatory arthritis (IA) is highly prevalent and so the discovery of new early diagnostic biomarkers is of particular interest. Calprotectin is a very sensitive and potentially a predictive biomarker of drug responsiveness. METHODS: Serum calprotectin levels were determined in 88 patients diagnosed as having rheumatoid arthritis (RA), psoriatic arthritis (PsA) or spondyloarthritis (SA), and 73 healthy subjects. RESULTS: Logistic regression and receiver operating characteristic (ROC) analyses showed that serum calprotectin levels were diagnostically accurate in the IA population...
June 28, 2016: Current Rheumatology Reviews
Maria Hoeltzenbein, Evelin Beck, Richa Rajwanshi, Carina Gøtestam Skorpen, Erhan Berber, Christof Schaefer, Monika Østensen
OBJECTIVES: Analyze the cumulative evidence for pregnancy outcomes after maternal exposure to tocilizumab, an anti-interleukin-6-receptor monoclonal antibody used for the treatment of rheumatoid arthritis and juvenile idiopathic arthritis. At present, published experience on tocilizumab use during pregnancy is very limited. METHODS: We have analyzed all pregnancy-related reports documented in the Roche Global Safety Database until December 31, 2014 (n = 501). RESULTS: After exclusion of ongoing pregnancies, duplicates, and cases retrieved from the literature, 399 women were found to have been exposed to tocilizumab shortly before or during pregnancy, with pregnancy outcomes being reported in 288 pregnancies (72...
October 2016: Seminars in Arthritis and Rheumatism
Stefano Piaserico, Paolo Gisondi, Paolo Amerio, Giuseppe Amoruso, Anna Campanati, Andrea Conti, Clara De Simone, Giulio Gualdi, Claudio Guarneri, Anna Mazzotta, Maria L Musumeci, Damiano Abeni
Psoriatic arthritis (PsA) is a potentially severe inflammatory condition (entheso-arthro-osteopathy), and early diagnosis is important to guide treatment choices in patients with psoriasis. The objective of this study is to further validate the PsA Screening and Evaluation (PASE) questionnaire, and to assess its field performance. Data were collected in 10 Italian centres, and the PASE was administered at baseline, after 3 days and after 3 months. The Skindex-29 was also administered. To determine the best cut-off value to identify patients with PsA we produced receiver operating characteristic (ROC) curves using the rheumatologist's diagnosis as outcome...
August 23, 2016: Acta Dermato-venereologica
Joseph Dias, Stephen Brealey, Surabhi Choudhary, Liz Cook, Matthew Costa, Caroline Fairhurst, Catherine Hewitt, Stephen Hodgson, Laura Jefferson, Kanagaratnam Jeyapalan, Ada Keding, Paul Leighton, Amar Rangan, Gerry Richardson, Claire Rothery, Nicholas Taub, John Thompson, David Torgerson
BACKGROUND: A scaphoid fracture is the most common type of carpal fracture affecting young active people. The optimal management of this fracture is uncertain. When treated with a cast, 88 to 90 % of these fractures unite; however, for the remaining 10-12 % the non-union almost invariably leads to arthritis. The alternative is surgery to fix the scaphoid with a screw at the outset. METHODS/DESIGN: We will conduct a randomised controlled trial (RCT) of 438 adult patients with a "clear" and "bicortical" scaphoid waist fracture on plain radiographs to evaluate the clinical effectiveness and cost-effectiveness of plaster cast treatment (with fixation of those that fail to unite) versus early surgical fixation...
2016: BMC Musculoskeletal Disorders
Vijay Kumar Jha, Ravindra Kumar, Abhijeet Kunwar, Ankur Singh, Mahendra Kumar, Mohan Kumar, Rajniti Prasad
Multicentric reticulohistiocytosis (MRH) is a rare histiocytic proliferative disorder of uncertain etiology, characterized by mucocutaneous papulonodular lesions and progressive, symmetric erosive arthritis. MRH can coexist with various autoimmune disorders, tuberculosis, and malignancy. It usually occurs in the elderly and is very rare in children. This is probably the first case in which disease manifestation appeared in infancy in the form of skin lesions. The patient had recurrent ulceration of cutaneous lesions, which is unusual in MRH...
June 2016: Pediatrics
G Gallo, F Brock, U Kerkmann, B Kola, T W J Huizinga
OBJECTIVE: To evaluate the impact of methotrexate (MTX) dosage on clinical, functional and quality of life outcomes in patients with rheumatoid arthritis (RA) from two previous etanercept (ETN) trials after 24 months of treatment. METHODS: Patients with active RA in the ETN+MTX combination treatment arms of the Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes (TEMPO) and COmbination of Methotrexate and ETanercept in Active Early Rheumatoid Arthritis (COMET) studies were pooled in this post hoc analysis and stratified by MTX dosage at 24 months, having MTX monotherapy groups as control: low dose, <10...
2016: RMD Open
Ilaria Petrucci, Sara Samoni, Mario Meola
Secondary nephropathies can be associated with disreactive immunological disorders or with a non-inflammatory glomerular damage. In systemic lupus erythematosus (SLE), scleroderma and rheumatoid arthritis as in other connective tissue diseases, kidney volume and cortex echogenicity are the parameters that best correlate with clinical severity of the disease, even if the morphological aspect is generally non-specific. Doppler studies in SLE document the correlation between resistance indexes (RIs) values and renal function...
2016: Contributions to Nephrology
S Popelka, A Sosna, P Vavřík, D Jahoda, V Barták, I Landor
UNLABELLED: PURPOSE OF THE STUDY Total joint replacement is one of the options in surgical treatment of advanced ankle arthritis. It allows the ankle to remain mobile but, unfortunately, it does not provide the same longevity as total knee or hip replacements. Therefore, decisions concerning the kind of treatment are very individual and depend on the clinical status and opinion of each patient. MATERIAL AND METHODS A total of 132 total ankle replacements were carried out in the period from 2004 to 2015...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Shelley M Oliver, J Chris Coetzee, Lawrence J Nilsson, Kathryn M Samuelson, Rebecca M Stone, Jacquelyn E Fritz, M Russell Giveans
BACKGROUND: This study presents patient-reported outcomes and patient satisfaction data for the largest series of US patients undergoing modern fixed-bearing total ankle arthroplasty (TAA). METHODS: We retrospectively reviewed the records of 300 consecutive patients who underwent 321 modern, fixed-bearing TAAs at a single institution. Veterans Rand 12-Item Health Survey (VR-12), Ankle Osteoarthritis Scale (AOS), and the American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot score were collected preoperatively and at subsequent follow-up appointments...
September 2016: Foot & Ankle International
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