Long-standing Rheumatoid Arthritis Research Articles

THU0191 Achieving Comprehensive Disease Control in Long-Standing or Early Rheumatoid Arthritis Patients Treated with Adalimumab Plus Methotrexate Versus Methotrexate Alone

BackgroundEffective treatment of rheumatoid arthritis (RA) patients (pts) aims to suppress inflammation, preserve physical function, and prevent structural damage, which together represent the hallmarks of comprehensive disease control (CDC).1ObjectivesThe present...

AB0380 Endothelial dysfunction in early rheumatoid arthritis

BackgroundEndothelial dysfunction is considered as a link between chronic, systemic inflammatory process in rheumatoid arthritis (RA) and initiation of atherosclerosis process. Microvascular dysfunction may precede the beginning of atherosclerosis and...

FRI0144 Angiogenic t cells depletion in rheumatoid arthritis patients: a putative marker of cardiovascular disease

BackgroundAlthough several studies have reported an increased cardiovascular (CV) risk and endothelial damage in Rheumatoid Arthritis (RA) patients [1, 2], the underlying mechanisms remain unclear. The Angiogenic T cells (Tang)...

FRI0038 Differential in vitro migration of synovial fibroblasts from diseased and healthy joints

BackgroundActivated synovial fibroblasts (SF) are key mediators of inflammation and joint destruction in rheumatoid arthritis (RA), their activated phenotype has been likened to that of cancer associated fibroblasts. Two major...

THU0209 Disease Activity and Structural Damage-Related Differences in Functional Disability in Early and Established Rheumatoid Arthritis

BackgroundA measure of functional impairment, the Health Assessment Questionnaire Disability Index (HAQ), consists of a reversible disease activity-related component (ACT-HAQ) and a joint damage component that increases with time (DAM-HAQ).ObjectivesTo...

AB0423 The threshold of pain in patients affected by rheumatoid arthritis correlates with ESR but not with ultrasound score

BackgroundIn clinical practice, joint synovitis is generally assessed indirectly, by collecting clinical and laboratory data. Ultrasound is a non-expensive, repeteable, non-invasive test and may help the clinician to monitor the...

FRI0099 Obese patients with rheumatoid arthritis have reduced response rates to biologic anti-rheumatic agents: a comparison between european and american ra patients

BackgroundObesity in RA patients has been associated with an increased risk of comorbidity, total joint replacement, pain, disability, high medical costs and impaired quality of life. One study has suggested...

FRI0072 Predictors of response to anti-TNF therapy in ra patients with moderate disease activity compared to those with high disease activity according to DAS28 scores’

BackgroundStudies have found that patients who start anti-TNF therapy with lower DAS28 scores are more likely to achieve disease remission (defined using a DAS28 <2.6). However no studies have previously...

FRI0208 The possibility and predictive factors of maintaining low disease activity and joint structure after discontinuation of infliximab in ra patients: results from 3-year experience of rrr study

BackgroundClinical remission is a goal for every RA patient, especially for patients with early-stage RA. It has also been reported that biologic-free remission could be obtained beyond the achievement of...

AB0467 Cerebral arteritis and vasculogenic recurrent brain necrosis in rheumatoid arthritis

BackgroundVasculitis of the cerebral arterioles and small arteries can lead to local ischaemia and to regressive changes in the brain. This process is more or less widespread and multifocal, depending...

SAT0503 Is There a Benefit in using Morphological and Perfusion-Based MRI Measurements in the Follow-Up of Patients with Rheumatoid Arthritis Treated with Anti-IL-6 Antibody? – a Comparison with Clinical Scores and Serologic Data

BackgroundIn the last years the development of new anti-rheumatic drugs based on the current state of knowledge with respect to pathogenic mechanisms involved in RA and especially in RA-related bone...

THU0063 Does biologic treatment modify the relationship of the variables associated with fatigue in patients with rheumatoid arthritis? The peps study of tocilizumab in real life

BackgroundFatigue is an important domain of health in rheumatoid arthritis (RA), however it seems to be associated with patient-related variables (eg, depression) as much as disease-related variables (eg, disease activity)....

AB0317 Swollen joints- the only predictor of achieving low disease activity in ra with tocilizumab therapy in czech national registry attra

BackgroundTocilizumab (TCZ) was highly effective in numerous RCT. There are much les data from registries, which can bring additional data about efficacy and safety in real clinical practise. Predictive factors...

SAT0398 Diagnostic value of anti mutated citrullinated vimentin in comparison to anti-cyclic citrullinated peptide and anti-viral citrullinated peptide 2 antibodies in rheumatoid arthritis: A multicentric study by firma group

BackgroundIn recent years the diagnostic approach to rheumatoid arthritis (RA) significantly changed. Among new serological assays, an ELISA test detecting antibodies directed against recombinant mutated citrullinated vimentin (anti-MCV), a protein...

THU0008 Serial Analysis of Gene Expression of Synovial Fibroblasts Discriminates Between Resolving and Persistent Inflammatory Arthritis

BackgroundRheumatoid arthritis synovial fibroblasts (RASF) are key mediators of the persistence of inflammation and joint destruction in RA. Their activated phenotype has been likened to that of cancer associated fibroblasts,...

Twenty-four-week clinical results of adalimumab therapy in Japanese patients with rheumatoid arthritis: retrospective analysis for the best use of adalimumab in daily practice

Objective We evaluated patient drug adherence to and efficacy and safety of adalimumab (ADA) based on data collected from approximately 200 patients to retrospectively examine the best use of ADA in Japanese patients with longstanding rheumatoid arthritis (RA) managed in daily practice.Methods For explorative comparisons, patients were stratified by prior use or no use of biologics (Bio-naïve vs. Bio-switch) and concomitant use (+) or no use (−) of methotrexate (MTX) into four subgroups. The primary efficacy endpoint was extent of improvement in the Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR) from baseline to 24 weeks assessed as European League Against Rheumatism (EULAR) good response. Secondary endpoints included ADA treatment continuation as represented by Kaplan–Meier survival curves and percentages of patients achieving remission as defined by DAS28-ESR <2.6.Results Overall, mean DAS28-ESR significantly decreased from 5.6 ± 1.2 at baseline to 4.1 ± 1.7 at week 24 (p < 0.0001), and >30 % of patients achieved EULAR good response. Subgroup analyses indicated that patients in the Bio-naïve and MTX (+) subgroup showed the highest EULAR good response rate of 37.3 % at week 24. The three most commonly reported adverse events (AEs) were skin allergies such as injection-site reactions, infections, and respiratory disorders such as interstitial lung lesions and organizing pneumonia.Conclusion In conclusion, ADA therapy resulted in significant clinical response in established Japanese patients with RA treated in daily practice. It also demonstrated generally good safety and tolerability. It was suggested that the best use of ADA may be in biologically naïve patients with concomitant administration of MTX.

Radio-lunate arthrodesis in rheumatoid arthritis: outcome and techniques

The wrist is one of the most affected joints in rheumatoid arthritis. The purpose of this retrospective study was to assess clinical, functional and radiographic results of radio-lunate arthrodesis. Two different operation and fixation techniques are compared and detailed outcome after this intervention is presented. Twenty-seven patients with long-standing rheumatoid arthritis were operated on, either by stabilisation of the arthrodesis with Shapiro staples (n=14) or by Herbert screw (n=13) and followed for a mean of 5.4years. Radio-lunate arthrodesis resulted in high overall and subjective satisfaction concerning function, grip and return to work. Grip strength was 35kPa for the dominant and 26kPa for the non-dominant hand. No revision, pseudoarthrosis or hardware failure was observed; only two conservatively treated wound healing problems were reported. The procedure resulted in a mean flexion of 26° and a mean extension of 24°; a clear improvement was also seen in activities of daily life. No difference between both groups was observed for pain, complication rate or functional outcome. Due to high patient satisfaction and functional outcome, radio-lunate wrist arthrodesis can be recommended independent of fixation method.

A 67‐Year‐Old Woman Receiving Tumor Necrosis Factor α Inhibitor Therapy Presenting With Neurologic Dysfunction

A 67‐Year‐Old Woman Receiving Tumor Necrosis Factor α Inhibitor Therapy Presenting With Neurologic Dysfunction

Ultrasonographic Assessment of Enthesitis in HLA-B27 Positive Patients with Rheumatoid Arthritis, a Matched Case-Only Study

IntroductionHLA-B27 has a modifier effect on the phenotype of multiple diseases, both associated and non-associated with it. Among these effects, an increased frequency of clinical enthesitis in patients with Rheumatoid Arthritis (RA) has been reported but never explored again. We aimed to replicate this study with a sensitive and quantitative assessment of enthesitis by using standardized ultrasonography (US).MethodsThe Madrid Sonography Enthesitis Index (MASEI) was applied to the US assessment of 41 HLA-B27 positive and 41 matched HLA-B27 negative patients with longstanding RA. Clinical characteristics including explorations aimed to evaluate spondyloarthrtitis and laboratory tests were also done.ResultsA significant degree of abnormalities in the entheses of the patients with RA were found, but the MASEI values, and each of its components including the Doppler signal, were similar in HLA-B27 positive and negative patients. An increase of the MASEI scores with age was identified. Differences in two clinical features were found: a lower prevalence of rheumatoid factor and a more common story of low back pain in the HLA-B27 positive patients than in the negative. The latter was accompanied by radiographic sacroiliitis in two HLA-B27 positive patients. No other differences were detected.ConclusionWe have found that HLA-B27 positive patients with RA do not have more enthesitis as assessed with US than the patients lacking this HLA allele. However, HLA-B27 could be shaping the RA phenotype towards RF seronegativity and axial involvement.

Vertebral Artery Dissection in Rheumatoid Arthritis with Cervical Spine Disease

A 59-year-old woman with long-standing active rheumatoid arthritis presented with posterior circulation ischemic stroke after vertebral dissection. She had severe multilevel degenerative changes of her cervical spine. She did not have classic stroke risk factors nor evidence of atherosclerotic disease or other systemic diseases. The most likely mechanism appears to be injury of the artery wall by an osteophyte, causing dissection that resulted in thrombosis and subsequent embolic strokes.