Activity Index In Patients Research Articles

The impact of group cognitive behavioral psychotherapy on disease severity and psychosocial functioning in patients with inflammatory bowel disease: a randomized controlled study.

Patients with inflammatory bowel disease (IBD) often report symptoms of anxiety and depression as well as impaired quality of life (QoL). To date, there are few studies on the effect of psychotherapy on psychological functioning and clinical outcome in patients with IBD. The aim of this prospective, randomized, controlled study was to investigate the effect of a brief psychotherapeutic intervention on psychological distress, QoL, sexual functioning, and inflammation and disease activity indices in patients with IBD. Participants were randomized to receive either group cognitive behavioral therapy or treatment as usual (controls) and were assessed at baseline and after six months using psychometric instruments to assess psychological distress, QoL, and sexual functioning. In addition, laboratory measurements, including levels of C-reactive protein (CRP), cytokines and calprotectin, and calculations of disease activity indices were performed during the two study periods. 80 participants took part in the study. Patients who received psychotherapy reported a significant decrease in anxiety and depression symptoms, a significant improvement in physical functioning, general health, vitality, social functioning and mental health, a decrease in physical pain and a decrease in role limitations caused by emotional problems. CRP levels and the Crohn's disease activity index (CDAI) also decreased significantly at follow-up compared to controls. Group cognitive behavioral therapy is proving to be an important component of holistic care for IBD patients, as it can significantly improve not only patients' psychosocial functioning but also their clinical course by inhibiting inflammation and reducing disease activity.

Comparison of Disease Activity Indices in Patients of Rheumatoid Arthritis

Objective: To find out correlation between disease activity scores of Rheumatoid arthritis (RA), shedding light on significance of each disease activity score. Patients and methods: It is a cross sectional comparative study. The study was carried out at Rheumatology department, Fauji Foundation Hospital Rawalpindi, Pakistan over a period of six months. 240 patients (33 males, 203 females) aged [Formula: see text]18 years diagnosed as RA according to ACR 2010 criteria, were selected. We recorded demographics, details of RA, laboratory value (baseline chemistry, acute phase reactants, and RA serology), comorbidities, DAS 28 ESR, DAS 28 CRP, CDAI, SDAI and RAPID 3 of all the patients. Analysis was performed using Statistical Package for Social Sciences (SPSS) version 23. Pairwise correlation between the disease activity indices was assessed by Spearman’s log-rank analysis. Results: Median age of the study population was 53 years (range 20-87 years). Duration of RA in study population was 8 years (IQR= 4-15). Twenty-two patients (9.6%) had early RA, whereas 208 patients (90.4%) had established RA. ESR was raised in 163 (70.9%) of the RA patients. Methotrexate was the most common disease modifying drug, which was being used by 180(77.9%) patients. All the disease activity scores showed a significant correlation on bivariate spearman’s analysis. Although the strength of the correlation varied. Disease activity by DAS-28 ESR was most strongly correlated with CDAI. Disease activity assessment via RAPID-3 had the highest correlation with CDAI. There was a fair correlation of RAPID-3 with DAS-28 and a weak correlation with SDAI. Disease activity, as assessed by CDAI and SDAI had a moderate correlation with each other. Conclusion: While all disease activity indices demonstrate agreement in clinical use, CDAI and RAPID-3 offer suitable alternatives to DAS28 in resource-limited settings.

Use of the Bath Ankylosing Spondylitis Disease Activity Index in Patients With Psoriatic Arthritis With and Without Axial Disease.

To evaluate whether the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a responsive instrument in psoriatic arthritis (PsA) and whether it differentiates between axial and peripheral disease activity in PsA. Individuals with PsA initiating therapy in a longitudinal cohort study based in the United States were included. Axial PsA (axPsA), most often also associated with peripheral disease, was defined as fulfillment of the Assessment of Spondyloarthritis international Society axial spondyloarthritis classification criteria or presence of axial disease imaging features. Baseline BASDAI, individual BASDAI items, patient global assessment, patient pain, and Routine Assessment of Patient Index Data 3, and score changes following therapy initiation were descriptively reported. Standardized response means (SRMs) were calculated as the mean change divided by the SD of the change. The mean (SD) baseline BASDAI score at the time of therapy initiation was 5.0 (2.2) among those with axPsA (n = 40) and 4.8 (2.0) among those with peripheral-only disease (n = 79). There was no significant difference in patient-reported outcome scores between the groups. The mean change for BASDAI was similar among axial vs peripheral disease (-0.75 vs -0.83). SRMs were similar across axial vs peripheral disease for BASDAI (-0.37 vs -0.44) and the individual BASDAI items. BASDAI has reasonable responsiveness in PsA but does not differentiate between axPsA and peripheral PsA. (ClinicalTrials.gov: NCT03378336).

Comparative study of the synovial levels of RANKL and OPG in rheumatoid arthritis, spondyloarthritis and osteoarthritis

IntroductionIn chronic arthropathies, there are several mechanisms of joint destruction. In recent years, studies have reported the implication of receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) in the process of activation and differentiation of osteoclasts, a key cell in the development of bone erosion. The RANKL/OPG ratio is increased in the serum of patients with malignant diseases and lytic bone disease, as well as rheumatoid arthritis (RA). The objective of this study was to measure and compare the concentrations of OPG and RANKL in the synovial fluid (SF) of patients with rheumatoid arthritis, spondyloarthritis (SpA) and osteoarthritis (OA).MethodsThis was an observational and cross-sectional study with 83 patients, 33 with RA, 32 with SpA and 18 with OA, followed up regularly in the outpatient clinics of the Rheumatology Department of the Clinics Hospital of the Ribeirão Preto Medical School-USP. All patients were assessed for indications for arthrocentesis by the attending physicians at the time of SF collection and were evaluated for demographic variables and medication use. Disease activity was assessed in individuals with RA and SpA. The quantification of SF OPG and RANKL levels was performed by ELISA, and the correlations of the results with clinical, laboratory and radiological parameters were assessed.ResultsWe found no statistically significant difference in the RANKL and OPG levels among the groups. Patients with RA showed a positive correlation between the SF cell count and RANKL level (r = 0.59; p < 0.05) and the RANKL/OPG ratio (r = 0.55; p < 0.05). Patients with OA showed a strong correlation between C-reactive protein (CRP) and the RANKL/OPG ratio (r = 0.82; p < 0.05). There was no correlation between the OPG and RANKL levels and markers of inflammatory activity or the disease activity index in patients with RA or SpA.ConclusionWithin this patient cohort, the RANKL/OPG ratio was correlated with the SF cell count in patients with RA and with serum CRP in patients with OA, which may suggest a relationship with active inflammation and more destructive joint disease.

Associations of Neutrophil/lymphocyte ratio with disease activity indices in patients with ankylosing spondylitis

Background: Axial spondyloarthritis (axSpA) is a painful, inflammatory condition of the spine that usually manifests in young individuals with chronic back pain (less than 45 years of age). It may also be accompanied by extra-articular or periarticular (enthesitis, dactylitis) symptoms (uveitis, psoriasis, inflammatory bowel disease). AxSpA encompasses both ankylosing spondylitis (AS) with radiographic evidence of sacroiliitis and axSpA without radiographic evidence of sacroiliitis. Objective: to assess neutrophil/lymphocyte ratio (NLR) among AS patients and to evaluate its relation to disease activity. Methodology: The present investigation included thirty AS patients and thirty healthy controls. Disease Bath Ankylosing Spondylitis Disease Activity indicators were utilized to assess the disease activity of AS (BASDAI). Analyses were conducted on the relationship between NLR and disease activity. Results: There was a significant positive correlation between NLR and Duration of the disease (r=0.421, P=0.020), ESR (r=0.433, P=0.014), CRP (r=0.700, P< 0.001), BASDAI (r=0.433, P=0.017). There was an insignificant correlation between NLR and age. NLR had increased considerably among AS patients compared to controls (P-value <0.05). NLR can significantly predict AS disease activity (P-value <0.001, at cut off value ≥2.03 with 90% sensitivity, 88.89 % specificity, 94.7% PPV and 80% NPV). Conclusion: In conjunction with acute phase reactants, NLR might be a valuable marker for indicating inflammation.

Association of NF-κB1/IKKε Gene Expression with Disease Activity Indices in Patients with Early Rheumatoid Arthritis

Association of NF-κB1/IKKε Gene Expression with Disease Activity Indices in Patients with Early Rheumatoid Arthritis

Increased muscle activity during sleep and more RBD symptoms in H1N1-(Pandemrix)-vaccinated narcolepsy type 1 patients compared with their non-narcoleptic siblings.

Narcolepsy type 1 (NT1) is characterized by unstable sleep-wake and muscle tonus regulation during sleep. We characterized dream enactment and muscle activity during sleep in a cohort of post-H1N1 NT1 patients and their siblings, and analyzed whether clinical phenotypic characteristics and major risk factors are associated with increased muscle activity. RBD symptoms and polysomnography m. tibialis anterior electromyographical signals [long (0.5-15 s); short (0.1-0.49 s)] were compared between 114 post-H1N1 NT1 patients and 89 non-narcoleptic siblings. Association sub-analyses with RBD symptoms, narcoleptic symptoms, CSF hypocretin-1 levels, and major risk factors [H1N1-(Pandemrix)-vaccination, HLA-DQB1*06:02-positivity] were performed. RBD symptoms, REM and NREM long muscle activity indices and REM short muscle activity index were significantly higher in NT1 patients than siblings (all p < 0.001). Patients with undetectable CSF hypocretin-1 levels (<40 pg/ml) had significantly more NREM periodic long muscle activity than patients with low but detectable levels (40-150 pg/ml) (p = 0.047). In siblings, REM and NREM sleep muscle activity indices were not associated with RBD symptoms, other narcolepsy symptoms, or HLA-DQB1*06:02-positivity. H1N1-(Pandemrix)-vaccination status did not predict muscle activity indices in patients or siblings. Increased REM and NREM muscle activity and more RBD symptoms is characteristic of NT1, and muscle activity severity is predicted by hypocretin deficiency severity but not by H1N1-(Pandemrix)-vaccination status. In the patients' non-narcoleptic siblings, neither RBD symptoms, core narcoleptic symptoms, nor the major NT1 risk factors is associated with muscle activity during sleep, hence not indicative of a phenotypic continuum.

Effects of high tibial osteotomy combined with arthroscopy on local inflammation degree and gait activity index in patients with medial knee osteoarthritis.

To analyze the effects of high tibial osteotomy (HTO) combined with arthroscopy on the degree of inflammation and the gait activity indexes of patients with medial knee osteoarthritis. We collected the records of 112 patients with medial knee osteoarthritis treated in the Department of Orthopedics of our hospital from June 2019 to June 2021. We divided the data into two groups: the control group included those of 54 patients who had received simple HTO and the observation group included those of 58 patients who had undergone HTO combined with arthroscopy. We assessed clinical efficacies, degrees of inflammation and gait activity indexes of the two groups to compare treatment outcomes. The percentage of excellent and good outcomes in the observation group (89.66%) was significantly higher than that in the control group (66.67%; p < 0.05). One year after the operation, the serum and synovial fluid levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and interleukin-17 (IL-17) in the observation group were significantly lower than those in the control group (p < 0.05). Moreover, the double support phase was significantly lower in the observation group than in the control group, while the step length, speed and frequency were significantly higher in the observation group than in the control group (p < 0.05). HTO combined with Arthroscopy in patients with medial knee osteoarthritis improves the curative effect and the degree of inflammation, and it promotes the recovery of gait activity indices.

Association of Hypovitaminosis D with Poor Bone Health in Patients of Rheumatoid Arthritis – A Case–Control Study

Abstract Background: Data on correlation between hypovitaminosis D and disease activity indices in patients with rheumatoid arthritis (RA) are varied. In this context, this prospective, case–control study aimed to evaluate the contribution of hypovitaminosis D toward bone health in patients with RA and correlate it with clinical, functional, and radiological disease activity indices. The study objectives were to assess the occurrence of hypovitaminosis D, to determine baseline bone mineral density (BMD), and to evaluate factors likely to contribute to poor bone health in patients of RA. Results: Hypovitaminosis D was observed in 76% of patients of RA with all of them having poor bone health as evident by statistically significant correlation between low Vitamin D levels and poor BMD. Poor bone health was observed in 80% of patients with femoral measurements, exhibiting greater severity of reduced BMD than lumbar spine values. Bivariate analysis revealed significant correlation of low Vitamin D, parathyroid hormone, Modified Sharp Score (MSS), and steroid intake with poor BMD at both spine and femur neck. Furthermore, binary logistic regression analysis among these four variables showed that only MSS had statistically significant association with osteoporosis, and there was a trend towards significance with poor BMD. Conclusions: This study has observed that RA patients indeed have poor bone health. Consequent osteoporosis has multifactorial etiology, and hypovitaminosis D remains one of the prime contributors, yet underappreciated and consequently undertreated.

Intravoxel incoherent motion diffusion-weighted imaging as a quantitative tool for evaluating disease activity in patients with axial spondyloarthritis

To determine the correlations between four quantitative magnetic resonance imaging (MRI) parameters derived from intravoxel incoherent motion diffusion-weighted images (IVIM DWI) and the semi-quantitative Spondyloarthritis Research Consortium of Canada (SPARCC) score of the sacroiliac joint (SIJ) and five clinical activity indices in patients with axial spondyloarthritis (axSpA). A total of 75 patients with axSpA and complete clinical activity indices and SIJ MRI were enrolled to this prospective study. Univariable and multivariable linear regression analyses were performed to evaluate correlations between MRI parameters and clinical activity indices after controlling for confounders. All data were further analysed using Pearson's correlation coefficients (r). Only pure diffusion coefficient (D) and incoherent perfusion related microcirculation (D∗) were found to be independently positively correlated with several clinical activity indices (all p<0.05). Positive correlations were observed between D and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Patient Global Assessment (PGA), extent of influence of pain, with r of 0.605, 0.402, 0.319, and 0.485 (all p<0.0125). D∗ correlated positively with BASDAI, BASFI, and PGA (r=0.436, 0.356, 0.301, respectively; all p<0.0125). D and D∗ derived from IVIM DWI could be associated with some disease activity indices in patients with axSpA; apparent diffusion coefficient (ADC) and SPARCC scores were not correlated with these indices. IVIM DWI may be a useful tool for the quantitative assessment of disease activity in patients with axSpA.

Evaluation of neutrophyl/lymphocyte ratio, platelet/lymphocyte ratio and mean platelet volume according to the disease activity index in patients of ankylosing spondylitis

Objective: To determine the relationship between neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) and mean platelet volume (MPV) with acute phase reactants in patients with ankylosing spondylitis (AS) and to show the usability of these parameters in the activation periods and follow-up of the disease.&#x0D; Material and Method: The demographic data (age, gender) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of 70 patients who had been followed regularly for at least 1 year and whose diagnosis of AS was definite were recorded. The control group consists of 70 people who do not have any disease. Among the laboratory parameters, neutrophil, platelet, lymphocyte count, C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), NLR, PLR and MPV values were retrospectively checked and recorded.&#x0D; Results: In our study, a statistically significant difference was found between the AS patients and the control group in MPV, NLR and PLR values. In addition, these values were found to be statistically significantly different between the groups with low disease activity and high disease activity in the AS patient group. There was a weak negative correlation between MPV value and BASDAI, ESR and CRP values. There was no statistically significant correlation between NLR value and ESR and CRP. There was no correlation between PLR value and ESR and CRP.&#x0D; Conclusion: As a result of our study, NLR, PLR and MPV values are seen as simple, easy and inexpensive markers that can be used to determine disease activity in AS patients.

Serum Elabela level is related to endoscopic activity index in patients with active ulcerative colitis.

In ulcerative colitis patients, Elabela levels and the relation of Elabela with laboratory parameters is unknown. The purpose of this study was to investigate the serum Elabela levels in UC patients and its relationship with other clinical and laboratory findings. Forty-three patients with UC and 40 healthy controls (group I) similar in age and gender were included in the study. Routine patient history, physical examination, and laboratory tests were followed by analysis of serum Elabela levels. Endoscopic activity index (EAI) of patients with UC was calculated. There were two groups of patients: those in remission (group II) and with active disease (group III). Groups I, II, and III had 40, 22, and 21 participants, respectively. Serum Elabela levels were found to be 3.32 ± 1.25ng/mL in group I, 3.38 ± 0.88ng/mL in group II, and 5.48 ± 1.61ng/mL in group III. Comparing the serum Elabela levels, a statistically significant difference was found between three groups (p < 0.001). Serum Elabela level showed a significant and positive correlation with EAI, leukocyte count, and hs-CRP, while a negative correlation was found with hemoglobin levels in univariate analysis (p < 0.001, for each). In linear regression analysis, these parameters were found to be associated with EAI and hs-CRP (p = 0.049, β = 0.337, and p = 0.015, β = 0.396, respectively). Elabela concentrations in patients with active UC was significantly higher and was associated with EAI and hs-CRP. Blood Elabela concentrations can be useful in the diagnosis and follow-up of patients with active UC.

P170 Correlation between health-related quality of life and smartphone-based self-assessment of activity index in patients with ulcerative colitis

Abstract Background E-health platform can facilitate remote monitoring of ulcerative colitis (UC) patients. A recent study shows that patient-administered simple clinical colitis activity index (SCCAI) via online correlated well with physician-assessed SCCAI. We evaluated the correlation between the self-administered SCCAI through smartphone and health-related quality-of-life assessment. Methods Clinical disease activity was assessed by the SCCAI and health-related quality of life by the disease-specific, self-administered Inflammatory Bowel Disease Questionnaire (IBDQ). Patients were followed-up over six months. At months 3 and 6, patients completed SCCAI through access to the web-based system (PROscore system) via link sent by text message to the smartphone at the outside of the hospital; within 48 h, patients subsequently completed the questionnaire of IBDQ in the clinic and attending gastroenterologist (blinded to patients’ scores) assessed the in-clinic SCCAI (reference). SCCAI scores were categorized into remission or active disease. Results A total of 157 patients (median age: 41 years; 62% male) contributed with 310 pairs of questionnaires. SCCAI scores by patients inversely correlated well with IBDQ (Pearson’s ρ =0.39). Moreover, linear regression revealed that this correlation persists irrespective of patient age, gender, disease extent, and education status. Correlation of SCCAI scores by patients and physicians was good (Spearman’s ρ =0.36), with 66% agreement for remission or active disease. The negative predictive value for the active disease was 84.3%; the positive predictive value was 41.2.0%. Conclusion In patients with UC, self-administered SCCAI via smartphone showed a good correlation with physician assessed disease activity and the patient’s quality of life. This validated e-health platform may be useful in remote monitoring of UC patients.

Evaluation of the modified Crohn's disease activity index in patients with Crohn disease with enterostomy: A single-center observational study.

Although the Crohn's Disease Activity Index (CDAI) is often used to evaluate the disease activity in Crohn's disease (CD), the number of liquid or soft stools cannot be precisely evaluated, and thus accurate scores cannot be calculated, in patients with enterostomy. Therefore, we created the modified CDAI (mCDAI), without the defecation frequency item from the CDAI, and examined its usefulness.Study participants comprised 9 patients with CD with enterostomy and 20 patients with CD without enterostomy. Correlations between the mCDAI and serum albumin (Alb) levels or C-reactive protein (CRP) levels were examined using regression analysis. Additionally, regression analyses were conducted in patients with CD without enterostomy to determine the Alb and CRP levels corresponding to the CDAI at its cutoff value for remission status (150). The obtained values were applied to the mCDAI regression equations to determine the equivalent mCDAI cutoff value.mCDAI and Alb levels were significantly negatively correlated (P < .0001). The mCDAI had a significant positive correlation with the CRP level and erythrocyte sedimentation rate (P = .0061 and P = .0133, respectively). From the regression analysis of patients with CD without enterostomy, the Alb and CRP levels equivalent to a CDAI of 150 were 3.85 g/dL and 0.62 mg/dL, respectively. When applying these values to the mCDAI regression formulas, the values of 113.8 and 115.2, respectively, were obtained. Thus, the cutoff value of the mCDAI indicating disease activity was estimated as 115.The mCDAI fully reflects the nutritional status and inflammatory response, and is convenient and useful for assessing disease activity over time, in patients with CD with enterostomy. A mCDAI score ≥ 115 indicates disease activity.

Vitamin D is not useful as a biomarker for disease activity in rheumatoid arthritis

ObjectiveTo determine whether there is an association between serum vitamin D levels and the Disease Activity Index in patients with rheumatoid arthritis (RA). MethodAn analytical, retrospective, cross-sectional study was performed at the Hospital Luis Vernaza (HLV) and Center for Rheumatology and Rehabilitation (CERER). We included 18 to 75-year-old patients with a diagnosis of RA according to the 2010 classification criteria, and with a 25-hydroxyvitamin D (25 [OH] D) test within the last 3 months. The activity of the disease was assessed with the 28-joint Disease Activity Score (DAS 28) and C-reactive protein (CRP) as an acute-phase reactant. Spearman's rank correlation coefficient was used to establish association between the variables. ResultsA total of 100 RA patients were studied. The mean vitamin D levels were 32.9 ± 11.5 ng/mL. In all, 45% showed insufficient 25 (OH) D and 55% had normal levels; no deficient vitamin D values were found. According to the DAS28-CRP, patients with low, moderate and high activity had an average vitamin D level of 30.4 ± 10.7, 31.9 ± 10.7, and 31.8 ± 12.1 ng/mL, respectively. There were no significant correlations between the disease activity and the serum vitamin D level (P = .60). ConclusionIn our group of RA patients, there was no statistically significant correlation between the levels of vitamin D and the activity of the disease, nor were other determining variables associated with vitamin D levels

VIOLATION OF MICROBIAL AND ENDOGENOUS METABOLISM IN CELIAC DISEASE

Aim: to investigate a fecal microbiota composition and to identify candidate biomarkers of celiac disease (CD) by serum metabolomics analysis. Methods: the quantitative real-time polymerase chain reaction was used for fecal microbiota assessment. Serum metabolomic assays were conducted using the GC–MS. Results: serum of CD patients showed significant increases in stearic acid, 2-HIVA, succinate, fumarate and benzoate compared to HC. A decrease in the level of eicosadiene and an increase in AA in blood were determined. The ratio of AA to EDA was statistically significant (4.84 vs. 3.28, p=0.033). The elongase activity index in patients with celiac disease tended to increase (p=0.067). The colon microbiome in CD was characterized by decreasing in the level of butyrate-producing Faecalibacterium prausnitzii (F.p.) and Bifidobacterium spp.. Significant negative correlations were observed; between the levels of Bifidobacterium spp. and F.p. and the concentration of succinic acid (rs=–0.343 [p=0.026] and rs=–0.430 [p=0.005], respectively); the F.p. and the fumaric acid (r=–0.429, p=0.005); the benzoic acid and the amount of Bifidobacterium spp. (r=–0.341, p=0.025). Conclusion: significant changes in serum levels of microbial and endogenous metabolites, reflecting some metabolic pathways disturbances were observed in CD. Metabolites and metabolomic index reflecting the balance between pro-inflammatory and anti-inflammatory components, may be considered as candidate biomarkers of chronic inflammation and metabolic dysbiosis in CD. An increased B. fragilis/F.p. ratio can serve as available biomarker for intestinal pro-inflammatory dysbiosis in CD.

Clinical efficacy and safety of rituximab in lupus nephritis.

BackgroundLong-term treatment programs with low toxicity represent a therapeutic challenge in lupus nephritis (LN). Although a therapeutic benefit of rituximab (RTX) has been reported in LN patients who have failed conventional treatment, the results are controversial. We aimed to assess the clinical efficacy and safety of RTX as a new immunosuppressive medicine in the treatment of LN with a meta-analysis.MethodsBased on predetermined criteria, PubMed, Embase, and Cochrane Library were used to identify the eligible studies. Cochrane Review Manager version 5.3 was applied to pool the data extracted from individual investigations and provide summary effect estimates.ResultsTwenty-four studies with 940 patients were analyzed. In case series trials with specific LN assessment, the complete remission (CR) rate at 12 months was 35.9% (95% CI: 24.2%–49.5%), and total remission (TR: CR plus partial remission) was 73.4% (95% CI: 66.0%–79.7%). In controlled trials, RTX was associated with a higher probability of TR (OR =2.02, 95% CI: 1.23–3.32, P<0.01). The CR in the RTX group was higher than that in the control group, although there was no significant difference between the two groups (OR =1.98, 95% CI: 0.90–4.39, P>0.05). Additionally, RTX treatment significantly decreased proteinuria (mean difference: −2.79, 95% CI: −3.95 to −1.62, P<0.01) as well as the renal activity index in patients with LN (mean difference: −3.46, 95% CI: −4.43 to −2.50, P<0.01). In controlled trials, the relative risks of the adverse events of infection and infusion reaction were not notably different between the two groups.ConclusionRTX is a promising therapy for the treatment of LN due to significant clinical efficacy and a favorable safety profile. In future studies, larger study populations and longer-term time points may identify additional important patient-centered outcomes.

The Effect of the Presence of Fibromyalgia on Common Clinical Disease Activity Indices in Patients with Psoriatic Arthritis: A Cross-sectional Study.

The Effect of the Presence of Fibromyalgia on Common Clinical Disease Activity Indices in Patients with Psoriatic Arthritis: A Cross-sectional Study.

Vitamin A supplementation decreases disease activity index in patients with ulcerative colitis: A randomized controlled clinical trial

IntroductionConsidering the link between vitamin A deficiency and disease activity in ulcerative colitis (UC) and also the association between dietary intake of vitamin A and gastrointestinal symptoms in these patients, this study aimed to investigate the effect of vitamin A supplementation on disease activity in patients with UC. MethodIn the present double-blind randomized controlled clinical trial, one hundred and fifty patients with Mayo score of 6–12 were randomly assigned to receive 25,000 IU/day vitamin A supplements or placebo for two months. The disease activity was calculated by the Mayo clinic score. Within groups and between groups comparisons were performed using paired sample t-test and one-way ANCOVA respectively. For measuring the treatment effect, the response ratio and number needed to treat (NNT) was calculated for the rate of clinical response and mucosal healing. ResultsOne hundred and forty three patients completed the study. After two months of supplementation, significant decreases in Mayo clinic score (p < 0.001) and subscores (p < 0.001) was observed in the intervention group. There were significant differences between the two groups regarding Mayo clinic score and subscores after adjusting for age, sex, BMI, disease duration and baseline values (P < 0.05). Moreover, there were significant differences between two groups regarding clinical response ratio (P < 0.001) and mucosal healing ratio (P < 0.001). The NNT [95%CI] values for the clinical response was 3 [2–40] and for the mucosal healing was 5 [2.90–10.4]. ConclusionAlthough according to the results, daily dose of 25,000 IU vitamin A had positive clinical and endoscopic effects, considering the limitations, further studies with longer duration and larger sample size and considering dietary intake are needed to confirm these preliminary results.

Vitamin D is not useful as a biomarker for disease activity in rheumatoid arthritis.

To determine whether there is an association between serum vitamin D levels and the Disease Activity Index in patients with rheumatoid arthritis (RA). An analytical, retrospective, cross-sectional study was performed at the Hospital Luis Vernaza and Center for Rheumatology and Rehabilitation. We included 18 to 75-year-old patients with a diagnosis of RA according to the 2010 classification criteria, and with a 25-hydroxyvitamin D (25 [OH] D) test within the last 3 months. The activity of the disease was assessed with the 28-joint Disease Activity Score (DAS28) and C-reactive protein (CRP) as an acute-phase reactant. Spearman's rank correlation coefficient was used to establish association between the variables. A total of 100 RA patients were studied. The mean vitamin D levels were 32.9 ± 11.5 ng/mL. In all, 45% showed insufficient 25 (OH) D and 55% had normal levels; no deficient vitamin D values were found. According to the DAS28-CRP, patients with low, moderate and high activity had an average vitamin D level of 30.4 ± 10.7, 31.9 ± 10.7, and 31.8 ± 12.1 ng/mL, respectively. There were no significant correlations between the disease activity and the serum vitamin D level (P=.60). In our group of RA patients, there was no statistically significant correlation between the levels of vitamin D and the activity of the disease, nor were other determining variables associated with vitamin D levels.