Arthritis Patients Research Articles

Prevalence of caries disease in patients with Rheumatoid arthritis: Results of a comparative study

Objectives: This study aims to determine the prevalence of dental caries in rheumatoid arthritis (RA) patients and compare it with controls. Materials and Methods: We conducted a cross-sectional study between two departments of the Ibn Sina University Hospital in Rabat: the Conservative Dentistry Department at the Center for Consultation and Dental Treatment and the Rheumatology B Department at El Ayachi Hospital in Salé.We collected socio-demographic, disease, and oral health data for each patient, assessing caries prevalence using the DMFT index (Decayed, Missing, and Filled teeth ) along with gingival and plaque indices (Löe and Silness) Results: We recruited 61 patients, including 31 patients with rheumatoid arthritis (RA) and 30 control patients. The average age was 47.6 ± 13.1 years, mostly female, with 59.3% postmenopausal. RA patients had a higher number of missing teeth (8.3±7 [0; 19]), moderate to severe gingival inflammation in 64.6% of patients, and significant plaque buildup in 67.7% of cases. Only 38.7% of patients used proper brushing techniques, and 45.2% viewed their condition as a barrier to oral hygiene.The DMFT index in the RA group was 15.5, with an average of 2 [0; 4] filled teeth, compared to 0 [0; 2] in the control group (p=0.05). 67.7% of RA patients had visible plaque deposits, and 64.6% showed moderate to severe gingival inflammation Conclusion: Patients with rheumatoid arthritis exhibited poorer oral health compared to the control group, highlighting the importance of multidisciplinary care, including regular dental consultations and treatment

Therapeutic Dose of Zinc Aspartate and Zinc Citrate Attenuates Disease Activity Indices in Rheumatoid Arthritis.

Zinc aspartate and zinc citrate have been used as zinc supplements in different health conditions. Taking into consideration their anti-inflammatory, immunomodulatory, anti-oxidant and antimicrobial properties, the present study has been designed to analyse the effect of zinc aspartate and zinc citrate treatment at therapeutic dose level on disease severity index, haematological, serological, antimicrobial and radiological markers of rheumatoid arthritis in Wistar rats. Bactericidal potential of the two organic zinc compounds was analysed in vitro in clinically isolated Escherichia coli. Arthritis was induced in male Wistar rats by intradermal injection of an emulsion containing collagen type II and Complete Freund's Adjuvant (CFA) containing 1mgmL-1 Mycobacterium tuberculosis H37Ra. Zinc aspartate and zinc citrate were orally administered after the onset of the disease for 4weeks. Ameliorative effect of zinc aspartate and zinc citrate was evaluated by analysing indices of severity and disease activity markers of rheumatoid arthritis. The liver and kidney function tests were performed to evaluate any possible adverse effect of compounds. Antimicrobial activity of the zinc compounds was assessed in clinically isolated E. coli by MTT assay. Zinc aspartate and zinc citrate equivalent to a therapeutic dose of 50mg/day of elemental zinc attenuated the clinical characteristic of rheumatoid arthritis in the animal model of arthritis, collagen-induced arthritis (CIA). Both zinc salts also exhibited antimicrobial effects against E. coli. The selected dose of zinc aspartate and zinc citrate showed no adverse effects in treated rats. This study highlights the potentiality of zinc compounds as antiarthritic agents and also point to its preventive effects on microbial growth that has been observed in rheumatoid arthritis patients due to their increased sensitivity for bacterial infection.

Risks of malignancies related to disease-modifying antirheumatic drugs in rheumatoid arthritis: a pharmacovigilance analysis using the FAERS database

ObjectivesOver the years when disease-modifying antirheumatic drugs (DMARDs) have been used in rheumatoid arthritis patients, reports of malignancies have emerged. This study aims to investigate the association between malignancies and DMARDs by using data extracted from the Food and Drug Administration Adverse Event Reporting System (FAERS).MethodsFAERS data (January 2019 to December 2023) were reviewed. For each drug-event pair, the disproportionality analysis was conducted to evaluate the risk of malignancy. Multivariate logistic regression was implemented to mitigate potential biases. Moreover, the time to onset of malignancy was also evaluated.ResultsWe conducted a detailed search for rheumatoid arthritis indications and identified a total of 17,412 adverse event reports associated with malignancies, with selective DMARDs designated as the role code “primary suspect”. At the preferred term level, there were 198 positive signals, among which the lower limit of the 95% confidence interval for the information component is 3.55 for squamous cell carcinoma of the skin, 2.39 for breast cancer, and 2.27 for lymphoproliferative disorder. In comparison to other DMARDs, targeted synthetic DMARDs were associated with a broader range of malignancies at both preferred term and Standardized MedDRA Queries levels. The number of adverse events reported in female patients is approximately 2–3 times higher than men, and the median age across the population was approximately 62 years. In terms of onset time, the conventional synthetic DMRADs exhibited a relatively longer median time, ranging from 3.58 to 7.08 years, while the targeted synthetic DMARDs demonstrated a shorter median time of 0.83–1.67 years.ConclusionOur study uncovers varying degrees of malignancy risks related to DMARDs, with a significantly higher risk observed in targeted synthetic DMARDs. Additionally, novel malignancy signals, not documented in product labels, have been detected. In the future, further research will be necessary to validate our findings.

Rheumatoid arthritis and COVID-19 outcomes: a systematic review and Meta-analysis.

This study aimed to conduct a comprehensive systematic literature review and meta-analysis to assess the risk and outcomes of coronavirus disease 2019 (COVID-19) in patients with rheumatoid arthritis. A systematic search was performed across four electronic databases. The quality of the studies was assessed using the Newcastle‒Ottawa quality assessment scale and the Joanna Briggs Institute critical appraisal checklist. Statistical analyses were conducted using STATA 14 software. A total of 62 studies were included in the analysis. First, the meta-analysis revealed the following prevalence rates among rheumatoid arthritis patients: COVID-19, 11%; severe COVID-19, 18%; COVID-19-related hospitalization, 29%; admission to the intensive care unit (ICU) due to COVID-19, 10%; and death from COVID-19, 8%. Second, rheumatoid arthritis was associated with an increased risk of COVID-19 infection (OR 1.045(0.969-1.122), p = 0.006), COVID-19-related hospitalization (OR 1.319(1.055-1.584), p = 0.006), admission to the ICU due to COVID-19 (OR 1.498(1.145-1.850), p = 0.002), and death from COVID-19 (OR 1.377(1.168-1.587), p = 0.001). Third, no statistically significant association was found between rheumatoid arthritis and severe COVID-19 (OR 1.354(1.002-1.706), p = 0.135). Rheumatoid arthritis patients have a significantly greater risk of COVID-19 infection, hospitalization, ICU admission, and death than individuals without rheumatoid arthritis. However, rheumatoid arthritis did not show a significant association with the risk of severe COVID-19. These findings underscore the need for tailored management strategies and vigilant monitoring of COVID-19 outcomes in rheumatoid arthritis patients. The study has been registered on PROSPERO [ https://www.crd.york.ac.uk/PROSPERO/ ], and the registration number is CRD42024528119.

Effect of traditional Chinese Yijinjing exercise on hand dysfunction in rheumatoid arthritis patients: a randomized controlled trial

IntroductionRheumatoid arthritis (RA) patients often experience significant hand dysfunction. Yijinjing, a traditional Chinese exercise, has been recognized for its benefits to mind–body health. This study aimed to evaluate the efficacy and safety of Yijinjing in improving hand dysfunction among individuals with RA.MethodsThis research was conducted as a single-center, outcome-blinded, randomized controlled trial. A total of 66 eligible RA participants were randomly assigned in a 1:1 ratio to either the Yijinjing exercise group (YJJG) with sessions conducted three times per week over a 12-week period or the control group (CG), which maintained ordinary activities. Various outcomes were assessed, including the Michigan Hand Outcomes Questionnaire (MHQ), handgrip strength, active range of motion (AROM), RA disease activity, the Health Assessment Questionnaire Disability Index (HAQ-DI), levels of anxiety and depression, and wrist ultrasound, all of which were collected at baseline and the week 12.ResultsAt the end of the 12 weeks, the YJJG demonstrated significant improvements in MHQ scores compared to the CG (p < 0.05), alongside enhancements in handgrip strength and AROM, specifically in wrist extension, radial deviation, and metacarpophalangeal flexion (p < 0.05). Wrist ultrasound scores did not exhibit a significant increase in the YJJG, meaning no inflammation aggravation (p > 0.05). Additionally, morning stiffness duration, Disease Activity Score 28-ESR (DAS28-ESR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels showed significant improvement in the YJJG (p < 0.05). Both groups reported enhancements in quality of life, as well as reductions in anxiety and depression scores, with the YJJG displaying greater improvements overall (p < 0.05). Importantly, no adverse events or significant abnormalities in vital signs were observed in either group.ConclusionYijinjing exercise may effectively enhance hand function, handgrip strength, and flexibility in RA patients with low disease activity. Furthermore, it appears to improve quality of life and reduce anxiety and depression without exacerbating joint inflammation.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT05527158, Identifier NCT05527158.

Menopause Matters: Results of a National Survey of Rheumatoid Arthritis Patients in the UK.

The effects of the menopause have received a lot of attention in the press recently. Anecdotally, patients report changes in their arthritis around the menopause, either onset or aggravation of symptoms. Clearly, there are hormonal influences on arthritis with the female predominance, onset of RA around times of hormonal change and improvement during pregnancy. We were interested in exploring the patient perspective to inform future research and educational needs. A national survey was organised through the National Rheumatoid Arthritis Society (NRAS), using their database of people with RA and online community who self-selected as peri menopausal, menopausal or post-menopausal. A questionnaire was developed by the steering group seeking responses on the effects of the menopause, changes in the arthritis at the time, use of hormone replacement therapy (HRT) and any discussions they had had with their healthcare providers. Free text comments were analysed qualitatively. A total of 779 people responded during September/October 2023. Respondents were 95% Caucasian mainly in their 50s with onset of menopausal symptoms in their 40s. 80% responded that their arthritis was worse during the menopause with 10% being much worse. 47% had taken HRT. Of these, 80% experienced an improvement in their menopausal symptoms and 30% had a moderate or large improvement in their arthritis symptoms. A standout statistic was that 93% of respondents had had no medical discussion about the menopause. For those who did, this was most frequently with the GP in relation to HRT and osteoporosis. 84% of participants felt that the rheumatology team should receive more education and training about the menopause in relation to RA. The qualitative analysis revealed several themes: Discussion about the menopause only occurred if the patient raised it. There was conflicting advice about HRT. There is overlap and confusion of symptoms between RA and the menopause. Participants expressed a perceived link between menopause and onset or deterioration of their arthritis. This study was long overdue. Patients perceive a strong association between the menopause and onset or deterioration of their arthritis, with confusion over what is due to arthritis and what is being caused by the menopause. Patients would like much more discussion about the menopause, but this is not currently happening. They are getting conflicting advice on HRT. Further research is necessary to clarify the impact of the menopause on people with arthritis.

Comparison of treatment of severe rheumatoid arthritis patients with biological agents and JAK-STAT inhibitors. An extension study

IntroductionThis study compared treatment with biologic agents and Janus kinase inhibitors (JAKi) in combination with methotrexate (MTX) for rheumatoid arthritis (RA) in a real-world setting at a large center in Poland. There is a persistent shortage of such studies, and illustrating the switching of medications in search of a suitable way of treatment for a given patient is a crucial step towards future personalized therapy.Aim of the studyThis study is an extension of the initial work published in 2022 in <i>Reumatologia</i>, with the addition of an analysis of patients treated with upadacitinib. The study compared the effectiveness and side effects after treatment of biological disease modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) in combination with MTX.Materials and methodsA total of 130 patients with active severe RA (Disease Activity Score for 28 joints based on the erythrocyte sedimentation rate [DAS28-ESR] value > 5.1) were treated at the Rheumatologic Outpatients Department of the Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland between January 2010 and September 2021. All patients were treated with MTX 25 mg per week. They were divided into two groups: group I (80 patients) treated with biologic agents, and group II (50 patients) treated with JAKi. Assessment of DAS28-ESR and Simplified Disease Activity Index (SDAI) and analy­sis of Boolean criteria for remission were performed. Remission or low disease activity, switching between drugs and adverse events were assessed and compared between studied groups.ResultsPatients treated with tsDMARDs had previously used a higher number of conventional synthetic DMARDs (csDMARDs) and bDMARDs compared to those treated with bDMARDs. However, they achieved lower SDAI and assessment of disease activity using Visual Analogue Scale (VAS) values, and a higher proportion of patients achieved Boolean criteria for remission after treatment.ConclusionsThe results of treatment with JAKi were successful, but the potential side effects indicate that this treatment may not be equally suitable for all RA patients.

Study of Interleukin 6 in Rheumatoid Arthritis and Anemic Patients in Sudan

Rheumatoid arthritis is considered one of the most common, and particularly attacks the joint causing significant individual and community burden and resulting from immunological abnormalities. It has been found that IL-6 plays a key role in the development of this disease. Overall anemia of chronic disease and iron deficiency anemia are frequent causes of anemia in RA patients. This study to analysis serum IL6 and to detect frequency of anemia/non-anemia and Rheumatoid arthritis (RA) patients and establish relationship between blood parameters and disease activity among Sudanese patients suffering from rheumatoid arthritis and deficiency anemia in Khartoum State. Methods It is a descriptive case-control study that involved 74 patients of both genders of RA, Anemia and non-anemic disease duration was two years. This study was conducted in Khartoum State. Complete Blood Count (CBC) was performed using the Auto Hematology Analyzer. Serum concentrations of IL-6, was measured in all patients and healthy individual using CLIA. The data collection was simple questionnaire and self-interview. Results The frequency of the RA within anemic and non- anemic patients was found higher in females 46(62.16%) than in males 28(37.83%). The overall analysis showed significant changes in most of blood parameters between the age groups. A statistically significant association was found between the WBCs, RBCs and MCH blood parameters with IL6 among RA/anemia's patients with Chi square p-value = 0.001,0.013 and 0.014, respectively. The statistic odd ratio was found 5.828 and 5.703 for WBCs and RBCs. This increase was highly significant among RA-Anemia patients in particular. Conclusion Our study reported the blood parameters isolates which harbored the IL6 and their association with rheumatoid arthritis and Anaemia which possibly cause the disease symptoms. Anemia is an important complication in rheumatoid arthritis (RA) which is associated with physical disability and increased mortality. Among various mechanisms, recent studies suggest the central role of hepcidin and IL-6 for the pathophysiology of Anemia.

Residual symptoms: Unmet needs for rheumatoid arthritis patients who achieved low clinical disease activity

Residual symptoms: Unmet needs for rheumatoid arthritis patients who achieved low clinical disease activity

Sex Differences in Cardiovascular Risk Profiles of Patients with Rheumatoid Arthritis: Results from an Italian Multicentre Cohort

Objective: The effect of sex and gender-related variables on the evaluation of cardiovascular (CV) risk in rheumatoid arthritis patients has been poorly explored. We investigated the differences in CV risk features and scores according to sex in a wide rheumatoid arthritis (RA) cohort. Methods: This is a cross-sectional analysis of a consecutive RA cohort. Disease-specific clinical and serologic variables, traditional CV risk factors and the 10-year CV risk calculated by the SCORE-2, Progetto CUORE and Expanded Risk Score-RA algorithms were compared in males and females. Results: A total of 820 patients (193 men, 627 women) were included. Disease activity was similar between the two sexes. A significantly higher prevalence of traditional CV risk factors and higher mean CV risk scores were detected in male compared to female patients. In the multiple linear regression analysis, a higher HAQ, csDMARD use and ACPA positivity were significantly associated with an increased CV risk in females, while b/tsDMARDs was associated with a lower CV risk in males according to different algorithms. Conclusions: The distribution of traditional CV risk factors and the 10-year risk of CV disease significantly differed in female and male patients despite similar disease activity. Disease-specific variables may contribute differently to CV risk according to sex. The CV screening in RA should also take into account the different distribution of CV risk factors between sexes.

Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis.

To investigate the association between depression and anxiety and the inability to achieve remission in rheumatoid arthritis(RA) and psoriatic arthritis(PsA) patients. In addition, the association between depressive and anxiety symptoms and disease activity components were explored. 400 RA and 367 PsA patients from the tREACH and DEPAR were included, respectively. Patients had a possible depression or anxiety disorder if they scored >7 on the Hospital Anxiety and Depression Scale(HADS). Remission was defined as DAS44<1.6 in RA and DAPSA≤4 in PsA. Mixed models were used to assess the association between depression/anxiety, at any timepoint during 2 years, and remission during 2 years, and to explore which disease activity components are most influenced by depression/anxiety. At baseline, 20% of RA patients had a possible depression and 30% a possible anxiety disorder. In PsA this was 18% and 23%. After adjustment for concurrent anxiety symptoms depression was associated with a lower odds of achieving remission during 2 years of follow-up (OR 0.45(95%CI 0.25-0.80) for RA and OR 0.24(95%CI 0.08-0.71) for PsA). Anxiety was not associated with remission after adjustment for concurrent depression symptoms.The presence of depression/anxiety was associated with higher tender joint count, worse general health, more pain and slightly elevated inflammation markers, but not with more swollen joints in both RA and PsA. The presence of depressive symptoms in RA and PsA patients at baseline or during follow-up was associated with a lower likelihood of achieving remission. Healthcare professionals should, therefore, be aware of symptoms of depression.

Association between hydroxychloroquine use and risk of diabetes mellitus in systemic lupus erythematosus and rheumatoid arthritis: a UK Biobank-based study

Context/ObjectivesHydroxychoroquine has hypoglycemic effects and may reduce the risk of diabetes mellitus (DM). We determined the association between hydroxychoroquine use and the incidence of DM in a population-based cohort of pations with Rheumatic diseaseMethodsA prospective cohort study among 502392 Potentially eligible participants in the context of UK Biobank, recruitment to the database began between 2006 and 2010. Patients diagnosed with diabetes and fasting glucose greater than or equal to 7 mmol/L at baseline (n=619) were excluded and patients diagnosed with either RA or SLE at baseline (n=6793) were followed up until 2022. Diagnosis was recorded using the International Classification of Diseases, tenth edition (ICD-10) code. The mean follow-up was 13.78 years and the primary outcome was newly recorded type 2 diabetes mellitus (T2DM), with the time of onset of diabetes as the follow-up endpoint date.ResultsDuring a median follow-up period of 13.78 (12.93, 14.49) years, diabetes developed in 537 participants, with an incidence of 7.9%. New diabetes cases not taking hydroxychloroquine and taking hydroxychloroquine was 504 (8.03%) and 33 (6.36%), respectively. In univariate models, the hazard ratio for diabetes was 0.89 (95% confidence interval, 0.81-0.98, P=0.014) for hydroxychloroquine users compared with those not taking hydroxychloroquine. After adjusting for age, sex, race, education level, and BMI the hazard ratio for incident diabetes among hydroxychloroquine users was 0.88 (95% confidence interval, 0.80-0.97, P=0.008). In complete multivariate model hazard ratio for hydroxychloroquine was 0.87 (95% confidence interval, 0.79- 0.96, P=0.005).ConclusionHydroxychloroquine was associated with decreased risk of DM among rheumatoid arthritis patients, our data taken together with correlational studies, warrant further investigation of the potential preventive effect of hydroxychloroquine against T2DM.

Role of serum and urinary orsomucoid protein A in psoriatic arthritis patients and their relation to disease activity.

Role of serum and urinary orsomucoid protein A in psoriatic arthritis patients and their relation to disease activity.

Effects of green tea based oral health strategies on disease activity in rheumatoid arthritis

AimIn this study, we aimed to evaluate oral health strategies in rheumatoid arthritis (RA) patients with periodontitis.MethodsWe enrolled 110 RA patients with periodontitis who were diagnosed in a Grade A tertiary hospital into an oral health strategies program. The control and test groups comprised 55 cases each. The management effect was evaluated by self-care ability, oral health-related quality of life, RA-related clinical indicators, and the DAS28 score. The control group received routine nursing, whereas the test group was in a self-health management program for 3 months.ResultsAfter the intervention, compared to the control group, the test group showed better self-care ability, oral health-related quality of life score, RA-related clinical indicators, and DAS28 score (P &amp;lt; 0.05).ConclusionOur oral health strategies program slowed down the progression of the disease and can be popularized in patients.

Weight-adjusted waist index associated with bone mineral density in rheumatoid arthritis patients: a cross-sectional study.

The research examined the association between weight-adjusted waist index (WWI) and bone mineral density (BMD) in individuals with rheumatoid arthritis, considering the impact of obesity on bone health. The association between WWI and BMD was examined utilizing weighted linear regression and smoothed curve fitting with data from NHANES 2005-2010, 2013-2014, and 2017-2018. Subgroup analysis verified the stability of the results. The study included a cohort of 983 rheumatoid arthritis patients. A significant negative correlation was found between WWI and BMD at the total femur, femoral neck, and lumbar spine (β = -0.03, 95% CI (-0.04, -0.02), p < 0.001; β = -0.02, 95% CI (-0.04, -0.01), p = 0.001; β = -0.04, 95% CI (-0.06, -0.02), p < 0.001). This negative association was not significantly influenced by factors like age, gender, race, education, PIR, diabetes, hypertension, sleep disorders, alcohol consumption, or smoking status (p > 0.05 for interaction). The findings indicate a negative correlation between WWI and BMD in the rheumatoid arthritis population. Key Points •A negative correlation was found between WWI and BMD at the total femur, femoral neck, and lumbar spine in the rheumatoid arthritis population.

Collagen triple helix repeat-containing 1 protein: an emerging biomarker and its influence on the clinical and sonographic disease severity in Egyptian medicated female rheumatoid arthritis patients

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of synovial joints, with a multifactorial etiology. Collagen triple helix repeat-containing 1 protein (CTHRC1) is a biomarker produced by fibroblast-like synoviocytes, which was shown to be highly expressed in RA patients. The study aimed to measure serum CTHRC1 level in female RA patients currently on medical treatment and its influence on the clinical and sonographic severity of the disease.ResultsThe patients’ mean age was 43.39 ± 8.55 years and median RA disease duration of 5.5 (0.33–20) years. RA patients showed significantly higher serum CTHRC1 level [89.71 ng/ml (53.95–353.45)] in comparison to controls [87.38 ng/ml (44.47–110.3)] (U = 430, P = 0.014). Furthermore, higher serum CTHRC1 levels were recorded in seropositive versus seronegative patients (U = 76, P = 0.022) and in RA patients with severe disease activity compared to those with lower disease activity (H = 9.79, P = 0.007). Furthermore, serum CTHRC1 levels were lower in RA patients receiving biological therapy compared to those receiving conventional therapy; however, this difference did not reach statistical significance.Significant positive correlations were found between CTHRC1 and disease activity, acute-phase reactants, serological markers, functional assessment, fatigue, and erosions detected by ultrasound, while a significant negative correlation was recorded between CTHRC1 and duration of biologic intake (rs = − 0.45, P = 0.036). Furthermore, on multivariate linear regression analysis, serum CTHRC1 was the only significant predictor for higher disease activity (P = 0.028, B = 0.009, 95% CI 0.001 to 0.017).ConclusionRA patients showed higher CTHRC1 serum levels compared to healthy controls, especially those with seropositivity and highly active disease. Furthermore, it was positively associated with poor patient functional outcome, fatigability, and erosive findings by ultrasound, thus suggesting that serum CTHRC1 can be a good predictor for high RA disease activity and possibly severity. Moreover, biological therapy could influence serum CTHRC1 levels in these patients.

Adherence to the 2019 ESC/EAS guidelines for dyslipidaemia management in a large rheumatoid arthritis cohort: Data from the CORDIS Study Group of the Italian Society of Rheumatology

Background/aimLipid-lowering therapy prescription is low in rheumatoid arthritis (RA) patients, often not achieving lipid threshold target despite treatment. However, evidence derives from small, monocentric cohorts. We assessed adherence to lipid-lowering treatment for primary cardiovascular (CV) prevention in a RA cohort according to international guidelines. MethodsA cross-sectional analysis of an Italian RA cohort was performed. Disease-related features and traditional CV risk factors were collected. The 10-year CV risk was estimated by Systematic COronary Risk Evaluation 2 (SCORE-2) algorithm. The primary preventive dyslipidaemia strategy was assessed according to 2019 European Society of Cardiology/European Atherosclerosis Society guidelines. Results1.133 RA patients (78.2% female, aged 60.6±10.2 years) free from CV events were included. According to SCORE-2, 42.9% of patients were at moderate risk (1–5-%), 33.3% at high risk (5–10%) and 23.7% at very high risk (>10%). In the whole cohort, 12.9% of patients with <5%, 23.6% with 5–10% and 32.3% with >10% risk were on statin, respectively (p<0.001). According to 2019 ESC/EAS guidelines, 51.5% of patients had LDL-c at target. Among patients with LDL-c not at target, 76% were not on lipid-lowering treatment. At multivariate analysis, patients with higher CV risk had significantly lower probability of LDL-c at target. ConclusionIn a wide Italian RA cohort, more than 50% of patients had high or very high CV risk. In these, lipid-lowering treatment prescription is suboptimal leading to not achievement of LDL-c target. Physicians should improve lipid screening and primary prevention therapy to reduce CV risk and improve CV comorbidity in RA patients.

Which accessible clinical features and laboratory findings might predict methotrexate success in children with juvenile idiopathic arthritis in Bosnia and Herzegovina?

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;/strong&amp;gt; To determine whether demographic data, clinical features, and laboratory variables at disease onset can predict the response to methotrexate in juvenile idiopathic arthritis (JIA) patients.&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;/strong&amp;gt; A cohort of 143 newly diagnosed JIA patients initially treated with methotrexate was enrolled in this study. Demographic, clinical, and laboratory parameters were analysed using univariate and multivariate logistic regression to identify predictors of response to methotrexate. The variables included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelets, IgA, IgG, the number of active joints and age at disease onset. Treatment response was assessed at six months, with patients classified as responders (those who achieved clinically inactive disease according to the American College of Rheumatology - ACR criteria) or non-responders.&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;/strong&amp;gt; Poor response to methotrexate was associated with the number of active joints (p=0.0001; OR=2.7), baseline levels of CRP (p=0.044; OR=1.138), IgA (p =0.004; OR=2.159), and platelet count (p=0.01; OR=1.05). IgG level (P=0.236) did not correlate with the treatment response.&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;/strong&amp;gt; We identified widely available and clinically acceptable biomarkers that can be utilized as predictive indicators of response to methotrexate in JIA patients.&amp;lt;/p&amp;gt;

Associations of frailty with RA-ILD and poor control of disease activity in patients with rheumatoid arthritis: a multi-center retrospective observational study

BackgroundThis study aimed to investigate factors associated with frailty in rheumatoid arthritis (RA) patients. MethodsA total of 656 RA patients were evaluated using data from an observational study in 2022. Among these patients, 152 with frailty were assigned to the frailty group, and 504 without frailty were assigned to the non-frailty group. Patient characteristics were compared between the two groups by univariate analysis, and factors associated with frailty were assessed by logistic regression analysis. Patient characteristics were also compared between patients with RA-associated interstitial lung disease (RA-ILD) (n=102) and those without RA-ILD (n =554). ResultsThe frailty group was older (mean: 73.6 vs. 66.8 years) and had a higher DAS28-ESR (3.67 vs. 2.66), a higher HAQ-DI (1.13 vs. 0.32), and a higher rate of RA-ILD (25.0 vs. 12.7%) than the non-frailty group. Age (OR: 1.03, 95% CI: 1.01-1.05), HAQ-DI (3.22, 2.28-4.56), DAS28-ESR (1.44, 1.19-1.75), and RA-ILD (2.21, 1.24-3.94) were associated with frailty. RA patients with RA-ILD were older (73.3 vs. 67.5 years) and had a higher DAS28-ESR (3.30 vs. 2.80), a higher HAQ-DI (1.19 vs. 0.32), a higher proportion of frail patients (37.3 vs. 20.6%), lower MTX use (26.5 vs. 62.9%), and higher steroid use (44.1 vs. 26.8%) than those without RA-ILD. ConclusionsMaintaining reasonable control of disease activity is necessary for RA patients, including those with RA-ILD, to recover from frailty.

Gait asymmetry persists following unilateral and bilateral total ankle arthroplasty.

Total ankle arthroplasty (TAA) improves gait symmetry in patients with unilateral end-stage ankle arthritis but has not been studied in patients undergoing bilateral TAA (B-TAA), and few studies compare TAA patients to control subjects. The purpose of this study was to compare gait symmetry in U-TAA and B-TAA patients and healthy controls. Using prospective databases, 19 unilateral and 19 bilateral ankle arthritis patients undergoing TAA were matched to 19 control subjects by age, sex, and BMI. The Normalized Symmetry Index (NSI) was determined for joint mechanics and ground reaction forces (GRF) during walking trials at a single visit for controls and preoperatively and 1 to 2 years postoperatively for TAA patients. Data was analyzed using linear mixed-effects models to determine differences among time points and cohorts at a significance of α = 0.05. Following surgery, B-TAA and U-TAA experienced improved peak plantarflexion moment symmetry (p = 0.017) but remained less symmetric than controls. B-TAA patients had more symmetry than U-TAA patients during peak weight acceptance GRF (p = 0.002), while U-TAA patients had greater peak dorsiflexion symmetry than B-TAA patients. TAA patients demonstrated more asymmetry compared to control subjects for all outcome measures. There was no significant impact of TAA on gait symmetry for GRF or peak ankle angles, and neither U-TAA nor B-TAA was consistently associated with higher gait symmetry. These results indicate that TAA improves symmetry during peak plantarflexion moment, and that significant gait asymmetry persists for B-TAA and U-TAA patients compared to healthy participants.