DMARD Treatment Research Articles

PReS-FINAL-2019: Tuberculosis infection observed in patients receiving biological DMARDs for treatment of juvenile idiopathic arthritis

The use of immunosuppressant drugs and also biological DMARDs in the treatment of juvenile idiopathic arthritis (JIA) may weaken patient's immunity and raise the risk of serious infections, including tuberculosis (TB).

Lag time between disease onset and first visit to a tertiary rheumatology centre by patients with rheumatoid arthritis

IntroductionRheumatoid arthritis is a chronic disabling disease. Presently there is great emphasis on early diagnosis and treatment to prevent damage and disability. There is however, lack of awareness of urgency to treat amongst lay persons and doctors resulting in treatment delays. We have studied the delay in referral, disease activity and damage at first presentation to our clinic. PatientsThis is a retrospective chart analysis of 357, consecutively seen patients between January 2002 and December 2005. At first visit demographic details, details of prior treatment, disease activity, disability index, clinical and radiological damage were noted in a predesigned form. ResultsThere were 313 females, 44 males. The median age was 50 years and the disease duration was 88 months. The median delay in seeing a rheumatologist was 24 months (1–372). 278 (78%) had received DMARD with 163 (58%) patients taking regular DMARD treatment. Methotrexate monotherapy was the most common DMARD used: 160 (74%) were on <10 mg per week. 143 (40%) had received or were on steroids, 260 (73%) had taken alternate form of treatment. 257 (72%) had evidence of radiological damage. HAQ (325 patients) was <1 in 159 (49%), 1–2 in 134 (41%), and >2 in 32 (10%). DAS-28 (3) (350 patients) was, <2.4 in 14 (4%), 2.4–3.2 in 21 (6%), 3.2–5.1 in 112 (32%), >5.1 in 203 (58%). ConclusionsThere is a long delay in referral to a rheumatologist. Even on treatment, disease is not well controlled. Majority of the patients have high disease activity with significant disability and evidence of joint damage. Special efforts are needed to ensure early institution of therapy with the aim to achieve maximum disease control as early as possible.

AB0109 Regulatory mechanism and importance of thrombospondin-1 (tsp-1) expression in rheumatoid synovial tissues: analysis by immunohistochemistry, in vitro fibroblast-like synovial cell culture and clinical evaluation

BackgroundWe have recently reported that serum immune complex containing thrombospondin-1 (TSP-1) is a novel biomarker in patients with rheumatoid arthritis (RA) (Ref. 1, 2), suggesting an abundant expression of TSP-1...

AB0404 Rheumatoid arthritis: What are the predictors of rheumatologists’ “usual care” management?

BackgroundTreat to target strategy trials have been shown to improve patient outcomes in the research setting. However, a general goal in exploring targeted therapy in rheumatoid arthritis (RA) will continue...

THU0291 Neutrophil apoptosis is not affected by glucocorticoid or DMARD treatment in juvenile-onset systemic lupus erythematosus

BackgroundGlucocorticoids (GCs) and disease-modifying agents (DMARDs) are frequently used in the management of juvenile-onset Systemic Lupus Erythematosus (JSLE). Whilst affecting a range of immune cells including neutrophils, impact of these...

AB1177 Aggressive sacroiliitis in a 4-year-old patient. Successful anti tnf treatment

BackgroundEnthesitis-related arthritis represents 3-11% of all patients with juvenile idiopathic arthritis (JIA). It affects more frequently males over 6 years old. This condition courses with arthritis that in the 90%...

FRI0049 Are there differences between young and older onset early rheumatoid arthritis (RA) and does this impact outcomes? an analysis from the catch cohort.

BackgroundThe population is ageing and the median age of rheumatoid arthritis onset is also increasing. There may be differences in the manifestations of early RA (ERA) onsetting in the elderly...

FRI0115 Non-steroidal anti-inflammatory drug use and the risk of cardiovascular disease in patients with rheumatoid arthritis – is there a risk?

BackgroundSafety data from clinical trials have raised concerns over the cardiovascular (CV) safety of non-steroidal anti-inflammatory drug (NSAID) use in general. Despite the widespread use of NSAIDs in RA patients,...

AB0384 Determination of multi-drug resistance activity in the lymphocytes of patients with systemic lupus erythematosus. results of 87 patients from a hungarian single center

BackgroundSystemic lupus erythematosus (SLE) is a prototypic autoimmune disease, where the treatment includes corticosteroids, DMARD-s and newly developed biological agents, but we often face drug resistance and thus inefficiency. One...

OP0089 Disease Severity in Patients with Inflammatory Arthritis who Persistently, Intermittently, or Never Achieve Remission

BackgroundThe prognosis for patients with inflammatory polyarthritis (IP) varies and it is difficult to identify at onset which patients will ever achieve remission.ObjectivesTo examine the disease characteristics at i) baseline...

THU0526 Joint Distribution and Outcome in 331 Patients with Monoarthritis of Less Than 16 Weeks Duration: A Longitudinal Multicenter Cohort Study in Eastern Norway

BackgroundCohort studies are essential to provide better understanding of the prognosis of acute monoarthritis, but few studies have focused on this issue.ObjectivesTo describe the joint distribution in a cohort of...

SAT0081 Clinical predictors of response to methotrexate treatment in DMARD naÏve patients with early rheumatoid arthritis: Results from a longitudinal observational study

BackgroundMethotrexate (MTX) is the most widely prescribed DMARD and at present the first line treatment for rheumatoid arthritis (RA). Knowledge about predictors of response to MTX is of potential clinical...

SAT0261 Which Conventional DMARD to Select in the Treatment of Psoriatic Arthritis (PSA)? Data From Nor-Dmard on 1351 Treatment Courses with Methotrexate (MTX), Sulfasalazine (SSZ) And Leflunomide (LEF)

BackgroundMTX is probably the most commonly used DMARD to treat PsA wordwide and a recommended treatment for patients with active disease (1). In a recent publication of a negative placebo-controlled...

OP0211 APOE genotypes are associated with reduced joint damage and increased lipid levels in patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a disease characterised by joint inflammation, in addition RA patients often suffer from dyslipidemia and cardiovascular disease (CVD). Apolipoprotein E (APOE) genotypes are associated with lipid...

OP0161 Use of TNF Inhibitors is Associated with a Reduced Risk of Diabetes in RA Patients

BackgroundInflammation may contribute to diabetes risk, and some studies indicate that certain DMARDs might be associated with a reduced risk of diabetes. Most studies in RA have not included confirmed...

OP0051 Joint damage progression in established rheumatoid arthritis: Common and strongly associated with seropositivity

BackgroundDuring the last decade, rheumatoid arthritis (RA) research has mainly focused on early disease, as it has become apparent that early and aggressive treatment can change the long-term outcome of...

FRI0074 Stringent therapies improve both radiographic and clinical outcome in early-stage ra patients from japanese population: longitudinal study from nagasaki early arthritis cohort

BackgroundPrognosis of RA patients nowadays are supposed to become better by treat-to-target (T2T) strategy. Osteitis determined by magnetic resonance imaging (MRI) is known as a predictor toward radiographic progression.ObjectivesWe have...

AB0293 Changes in glucocorticoid treatment in the first year of biological therapy in RA patients

BackgroundGlucocorticoids (GC) are very commonly used in the rheumatoid arthritis (RA) treatment; however their potential risks warrants a rational use. 1,2ObjectivesEvaluate the impact of biological therapies on GC use in...

SAT0550 Remaining Pain in Early RA Patients Treated with Methotrexate – Results from the Eira Cohort and the Swedish Rheumatology Quality Register

BackgroundAlthough treatment with methotrexate is efficient in decreasing inflammation and joint destruction in RA, several patients report remaining pain at follow-up, and the potential discrepancy between decrease in inflammation and...

AB0268 Vitamin D receptor polymorphisms in early inflammatory arthritis are associated with clinical outcomes and IGM responses to common pathogens but not baseline disease activity

BackgroundVitamin D (VitD) exerts immunoregulatory activities of potential importance to rheumatoid arthritis and acts by binding to nuclear vitamin D receptors (VitDr) and regulating gene expression. VitDr single nucleotide polymorphisms...