Parameters Of Rheumatoid Arthritis Research Articles

Corelations between radiological score with clinical and laboratory parameters in rheumatoid arthritis

Corelations between radiological score with clinical and laboratory parameters in rheumatoid arthritis

Correlations between IL6 and the main clinical and biological parameters in rheumatoid arthritis

Correlations between IL6 and the main clinical and biological parameters in rheumatoid arthritis

CHANGES IN CALPROTECTIN LEVEL, ITS RELATIONSHIP TO THE CLINICAL AND LABORATORY PARAMETERS OF DISEASE ACTIVITY AND SIGNIFICANCE FOR PREDICTING THE THERAPEUTIC RESPONSE IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH ETANERCEPT

Objective: to analyze changes of serum calprotectin (CP) concentration, its relationship to the clinical and laboratory parameters of rheumatoid arthritis (RA) activity, and the significance of baseline CP level for predicting therapeutic response in RA patients treated with etanercept (ETC). Subjects and methods. A total of 84 patients with moderate and high RA activity (mean DAS28 6.35±0.92) who had been ineffectively treated with disease-modifying antirheumatic drugs were examined. The patients received ETC 50 mg/week subcutaneously for 34 weeks. To assess RA activity, tender and swollen joint count, pain, patient’s and physician’s assessment of global disease activity on 100-mm visual analogue scale and DAS28 were used. Functional status was evaluated by HAQ and RAPID3. Treatment efficacy was assessed according to the European League against Rheumatism (EULAR) criteria and the American College of Rheumatology (ACR) criteria. Serum concentration of CP was tested before, 12 and 25 weeks after start of therapy. Results and discussion. There was a statistically significant (p < 0.0001) decrease in CP concentrations after 12 weeks of ETC therapy. Later (after 25 weeks) CP level remained essentially unchanged. CP concentration correlated with erythrocyte sedimentation rate, C-reactive protein level, swollen joint count, and DAS28. Baseline CP level was not a predictor for achieving the therapeutic response according to the EULAR and ACR criteria. In a group of patients unresponsive to treatment according to the EULAR criteria, CP levelrose at 25 weeks whereas it fell during clinical improvement. In the patients achieving ACR 50 and 70% response, changes of CP level were significantly better than those in the other patients. Conclusion. ETC therapy caused a considerable reduction of CP level, clinical and laboratory parameters of RA activity. The baseline concentration of CP was not a predictor for achieving the response to ETC treatment.

Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis.

BackgroundGait analysis is increasingly being used to characterise dysfunction of the lower limb and foot in people with inflammatory arthritis (IA). The aim of the systematic review was to evaluate the spatiotemporal, foot and ankle kinematic, kinetic, peak plantar pressure and muscle activity parameters between patients with inflammatory arthritis and healthy controls.MethodsAn electronic literature search was performed on Medline, CINAHL, SportsDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Effect sizes with 95 % confidence intervals (CI) were calculated as the standardised mean difference (SMD). Meta-analysis was conducted if studies were homogenous.ResultsThirty six studies with quality ranging from high to low met the inclusion criteria. The majority of studies reported gait parameters in Rheumatoid arthritis (RA). The gait pattern in RA was characterised by decreased walking speed (SMD 95 % CI −1.57, −2.25 to −0.89), decreased cadence (SMD −0.97, −1.49 to −0.45), decreased stride length (SMD −1.66, −1.84 to −1.49), decreased ankle power (SMD −1.36, −1.70 to −1.02), increased double limb support time (SMD 1.03, 0.84 to 1.22), and peak plantar pressures at the forefoot (SMD 1.11, 0.76 to 1.45). Walking velocity was reduced in psoriatic arthritis and gout with no differences in ankylosing spondylitis. No studies have been conducted in polymyalgia rheumatica, systemic sclerosis or systemic lupus erythematosus.ConclusionsThe review identified the majority of studies reporting gait adaptations in RA, but limited evidence relating to other IA conditions. Poor data reporting, small sample sizes and heterogeneity across IA conditions limit the interpretation of the findings. Future studies may consider a standardised analytical approach to gait analysis that will provide clinicians and researchers with objective evidence of foot function in people with IA.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0596-0) contains supplementary material, which is available to authorized users.

Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta‐analysis

Gait analysis is increasingly being used to characterise dysfunction of the lower limb and foot in people with inflammatory arthritis (IA). The aim of the systematic review was to evaluate the spatiotemporal, foot and ankle kinematic, kinetic, peak plantar pressure and muscle activity parameters between patients with inflammatory arthritis and healthy controls. An electronic literature search was performed on Medline, CINAHL, SportsDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Effect sizes with 95 % confidence intervals (CI) were calculated as the standardised mean difference (SMD). Meta-analysis was conducted if studies were homogenous. Thirty six studies with quality ranging from high to low met the inclusion criteria. The majority of studies reported gait parameters in Rheumatoid arthritis (RA). The gait pattern in RA was characterised by decreased walking speed (SMD 95 % CI −1.57, −2.25 to −0.89), decreased cadence (SMD −0.97, −1.49 to −0.45), decreased stride length (SMD −1.66, −1.84 to −1.49), decreased ankle power (SMD −1.36, −1.70 to −1.02), increased double limb support time (SMD 1.03, 0.84 to 1.22), and peak plantar pressures at the forefoot (SMD 1.11, 0.76 to 1.45). Walking velocity was reduced in psoriatic arthritis and gout with no differences in ankylosing spondylitis. No studies have been conducted in polymyalgia rheumatica, systemic sclerosis or systemic lupus erythematosus. The review identified the majority of studies reporting gait adaptations in RA, but limited evidence relating to other IA conditions. Poor data reporting, small sample sizes and heterogeneity across IA conditions limit the interpretation of the findings. Future studies may consider a standardised analytical approach to gait analysis that will provide clinicians and researchers with objective evidence of foot function in people with IA.

Red cell distribution width is associated with cardiovascular risk and disease parameters in rheumatoid arthritis.

Since red cell distribution width (RDW) has been associated with cardiovascular (CV) disease and inflammation in several conditions, the main aim of this study was to evaluate its prognostic value in RA patients and its potential associations with clinical features. The history of CV events was retrospectively reviewed in 160 RA patients and RDW was recorded at disease onset and 6 and 12 months after diagnosis to calculate the accumulated value [area under the curve (AUC) RDW] and change during the first year (ΔRDW). In addition, RDW was analysed in 110 patients with established disease in relation to clinical features. Increased RDW at diagnosis and AUC RDW were able to predict the occurrence of CV events in RA patients [hazard ratio (HR) 1.247 (95% CI 1.079, 1.441), P = 0.003 and HR 1.038 (95% CI 1.018, 1.059), P = 0.0001, respectively] after adjusting by potential confounding factors. Receiver operating characteristic curve analyses revealed a better power of discrimination for the AUC RDW (P = 3.394 × 10(-5)). In addition, an increase in RDW during the first year was associated with poor CV outcome (P = 0.010). On the other hand, RDW in patients with established RA was significantly associated with disease activity, acute phase reactants and severity. RDW at disease onset may be used as an early marker of CV risk in RA, whereas in patients with established disease it was related to the activity of the disease. These findings suggest that RDW can be considered as a surrogate marker of inflammation and, consequently, CV risk in RA patients.

Periodontal disease in Thai patients with rheumatoid arthritis

To evaluate the prevalence and severity of periodontal disease in patients with rheumatoid arthritis (RA) who attended a rheumatology clinic in a university hospital. All consecutive patients with RA who attended the rheumatology clinic between June 2009 and January 2010 were asked to enroll in this study. All participants answered questionnaires, which included demographic data, medical history, medications used and smoking habits. A full mouth periodontal examination, including gingival index, plaque index, probing pocket depth and clinical attachment level was performed. Only cases that had at least 20 teeth were included in this study. Rheumatoid arthritis parameters, including number of tender and swollen joints, erythrocyte sedimentation rate, the presence of rheumatoid factor (RF), hand radiographs, Disease Activity Index (DAS) and health status using the Thai Health Assessment Questionnaire (HAQ), were determined. The association between RA parameters and periodontal condition was examined. There were 196 participants (87.2% female) with a mean age of 51.7 ± 9.70 years, mean disease duration of 9.62 ± 7.0 years and mean DAS score of 4.64 ± 1.25. Eighty-two per cent were RF-positive. Moderate and severe periodontitis were found in 42% and 57%, respectively. Higher age, male gender, previous or current smoking and high level of plaque score were associated with severe periodontal disease. No differences in RA parameters were found between groups of patients who had moderate and severe periodontitis. We found a high prevalence of periodontitis in Thai patients with RA. However, there was no association between RA parameters and periodontal conditions.

Analyses of Human and Rat Clinical Parameters in Rheumatoid Arthritis Raise the Possibility of Use of Crude Aloe vera Gel in Disease Amelioration

Rheumatoid Arthritis (RA) is a chronic inflammatory condition affecting the joints causing swelling, stiffness and pain which finally leads to substantial loss of functioning and mobility in its advanced stages. In the present study we have monitored important serological parameters of fifty RA patients and also have discussed the justification of using rat as a model for human RA researches by comparing their respective serological parameters. We have also evaluated the anti-arthritic roles of raw Aloe vera gel and its effects in rat model where arthritis was induced by using Freund’s Complete Adjuvant (FCA). Three essential conclusive statements were derived from the study. Firstly, the six clinical parameters that we have selected for the study namely, RA factor, CRP, ASO, ESR, ceruloplasmin and serum creatinine were all essential for the differential diagnosis of Rheumatoid Arthritis during its early and later stages, RA factor being the most sensitive of all parameters (92% sensitivity). Secondly, this study has supported the use of the rat as a model for designing therapeutic strategies against RA. Lastly, as evident from our study, Aloe vera extracts can be beneficial for the reduction of inflammatory edema and also for the reduction of ceruloplasmin in RA condition in rat model. However, further investigations are necessary for more refined therapeutic usage of Aloe vera for the treatment of RA in human.

Evaluation of Corneal Parameters with Scheimpflug Imaging in Patients with Rheumatoid Arthritis

Purpose: To evaluate corneal parameters of rheumatoid arthritis (RA) patients by Pentacam-HR.Methods: Seventy RA patients and 100 control subjects were enrolled. All participants underwent Pentacam (Pentacam-HR, Oculus, Germany) evaluation. Both RA and control groups were divided into two subgroups as dry eye (DE) (Schirmer test with topical anesthesia (STA) ≤ 5 mm) and without DE (STA > 5 mm).Results: Pachymetric measurements and the mean corneal volume were significantly lower in RA group (p < 0.001). Disease duration was negatively correlated with pachymetric measurements in RA group. Pachymetric measurements and corneal volume of RA patients with DE were significantly lower than all the other subgroups. Control subgroups with or without DE were similar in pachymetric measurements and corneal volume.Conclusions: The results suggest that RA patients have thinner corneas compared to control subjects that may be affected by disease duration. Furthermore, coexistence of DE and RA seems to aggravate the thinning of cornea as well.

Comparison of the Efficacy &amp; Safety of Minocycline versus Hydroxychloroquine as an Add-On Therapy to Methotrexate in Treatment of Rheumatoid Arthritis

Objective: This study was designed to compare the efficacy and safety of minocycline versus hydroxychloroquine (hcq) as an add on therapy to methotrexate in treatment of rheumatoid arthritis. Methods: This was a prospective open label, randomized, comparative, clinical study conducted in Pt. B. D Sharma, PGIMS, Rohtak. Fifty newly diagnosed rheumatoid arthritis patients were included in the study. These were randomly assigned to one of the following treatment protocols: group one was given oral methotrexate (7.5–25 mg orally in divided doses per week), hydroxychloroquine (200mg b.d) &amp; etoricoxib (400mg o.d). In the other group oral methotrexate (7.5–25 mg orally in divided doses per week), minocycline (100mgb.d) &amp; etoricoxib 400mg o.d) were given. Efficacy and safety assessmentwas done by evaluation of various parameters of rheumatoid arthritis at 2, 6 &amp; 12 wks. Repeated measures ANOVA test was applied for intragroup analysis and independent ‘t’ test was applied for intergroup analysis of various parameters. Results: In minocycline treated group, there was statistically significant improvement in most of the parameters at 12 weeks as compared to hydroxychloroquine (hcq) group except the three parameters i.e grip strength in right hand, erythrocyte sedimentation rate (esr) &amp;health assessment questionnaire (HAQ). These three parameters although also show improvement but the difference was not statistically significant. Regarding the side effects, incidence of side effects was more with hcq group than minocycline group. Conclusion: Minocycline was found to be more efficacious and safer than hydroxychloroquine, as an add on therapy to methotrexate for the treatment of rheumatoid arthritis. © 2011 IGJPS. All rights reserved.

In vivoconfocal microscopic evaluation of corneal Langerhans cell density, and distribution and evaluation of dry eye in rheumatoid arthritis

Corneal Langerhans cells (LCs) offer the opportunity to gain insight into the activity of the innate immunity. We examined the density and the distribution of LCs and compared the results with dry-eye parameters in rheumatoid arthritis (RA). Fifty-two RA patients with various degrees of disease activity and 24 healthy subjects were enrolled. Peripheral and central LC number and morphology were assessed with invivo laser confocal microscopy. In addition, ocular surface disease index (OSDI), lid parallel conjunctival folds, Schirmer test, and tear break-up time (TBUT) were evaluated. The prevalence of central and peripheral LC, and the central LC morphology values (LCM) were higher than normal in RA. Within the RA group, LC prevalence and morphology were not affected by disease activity. However, patients on anti-TNF or glucocorticosteroid (GCS) therapy exhibited normal LCM, and normal central and peripheral LC density. OSDI was higher and TBUT was lower than normal in RA. The alteration of LC in RA suggests an active inflammatory process in the cornea, which may reflect an increased activation state of the innate immune system-even in inactive stages of RA and without ocular symptoms. The results also indicate ocular effects of GCS therapy in RA.

Relationship of brachial artery responsiveness parameters to left ventricular diastolic dysfunction in patients with rheumatoid arthritis

Система комплексной поддержки и сопровождения научного журнала Elpub позволяет запустить двуязычный сайт журнала со встроенной системой электронной редакции в соответствии с лучшими издательскими практиками, а так же предусматривает техническую и методическую поддержку со стороны специалистов НЭИКОН.

In vivo confocal microscopic examination of corneal Langerhans cell density, distribution and evaluation of dry eye in rheumatoid arthritis

AbstractPurpose To examine the density and the distribution of corneal Langerhans cells (LCs) and to compare the results with dry‐eye related parameters in rheumatoid arthritis (RA).Methods 52 RA patients (mean age: 58 [49‐66]) with various degree of disease activity and 24 healthy subjects (mean age: 61 [52.5‐67]) were enrolled. Central and peripheral LC number and morphology were assessed with in vivo confocal laser corneal microscopy. In addition, lid parallel conjunctival folds (LIPCOF), tear break up time (TBUT), Schirmer’s‐test (ST), and ocular surface disease index (OSDI) were also evaluated. .Results The prevalence of central and peripheral LCs and the central LC morphology values (LCM) were higher in RA compared to controls (median [interquartile range]: 42.50 [22.95‐93.50] vs 10.00 [0.00‐42.33] cell/mm2, 98.00 [62.00‐154.5] vs 59.50 [45.25‐94.75] cell/mm2, and 2.00 [1.00‐2.00] vs 1.00 [0.25‐1.00], respectively, p&lt;0.05 for all). Within the RA group, LC prevalence and morphology were not affected by disease activity. However, patients on anti‐TNF or corticosteroid therapy exhibited LCM and central and peripheral LC density comparable to controls. TBUT values were lower and OSDI scores were higher in RA than in controls (9.00 [7.00‐12.00] vs 12.00[9.00‐14.00] seconds and 20.00 [10.93‐38.21] vs 9.75 [4.93‐16.28], respectively, p&lt;0.05 for all). ST results were comparable in RA and controls.Conclusion Dendritic cell accumulation and maturation in the corneal center suggest the involvement of the cornea in RA, even in patients in inactive stage and without ocular symptoms.

Short-chain methotrexate polyglutamate MTXPG2 as outcome parameter in rheumatoid arthritis

Background Due to its positive benefit-risk-ratio, methotrexate (MTX) is a first-line therapy in the treatment of rheumatoid arthritis (RA). Although MTX is very effective, the large interpatient variability in drug response is a major drawback in clinical practice. Erythrocyte methotrexate polyglutamates (MTXPG1–7) — intracellular storage products of methotrexate — are supposed to correlate with clinical efficacy. In particular, long-chain polyglutamates (MTXPG4–5) are strongly retained in the cells and are therefore discussed to be potential markers for clinical response in rheumatoid arthritis. We hypothesized that concentrations of methotrexate polyglutamates could correlate with clinical response parameters in rheumatoid arthritis.

Aberrant IgG galactosylation precedes disease onset, correlates with disease activity, and is prevalent in autoantibodies in rheumatoid arthritis.

To examine the association between aberrant IgG galactosylation and disease parameters in rheumatoid arthritis (RA). Analysis of N-glycan in serum samples from multiple cohorts was performed. The IgG N-glycan content and the timing of N-glycan aberrancy relative to disease onset were compared in healthy subjects and in patients with RA. Correlations between aberrant galactosylation and disease activity were assessed in the RA cohorts. The impact of disease activity, sex, age, anti-cyclic citrullinated peptide (anti-CCP) antibody titer, disease duration, and C-reactive protein level on aberrant galactosylation was determined using multivariate analysis. The N-glycan content was also compared between epitope affinity-purified autoantibodies and the remaining IgG repertoire in RA patients. Our results confirm the aberrant galactosylation of IgG in RA patients as compared with healthy controls (mean +/- SD 1.36 +/- 0.43 versus 1.01 +/- 0.23; P < 0.0001). We observed a significant correlation between levels of aberrant IgG galactosylation and disease activity (Spearman's rho = 0.37, P < 0.0001). This correlation was higher in women (Spearman's rho = 0.60, P < 0.0001) than in men (Spearman's rho = 0.16, P = 0.10). Further, aberrant IgG galactosylation substantially predated the onset of arthritis and the diagnosis of RA (3.5 years) and resided selectively in the anticitrullinated antigen fraction. Our findings identify aberrant IgG galactosylation as a dysregulated component of the humoral immune response in RA that begins prior to disease onset, associates with disease activity in a sex-specific manner, and resides preferentially in autoantibodies.

Interrelationship between the immunological and steroid hormone parameters in rheumatoid arthritis.

In the present work the correlation between the immunological parameters and plasma androgen hormone levels in rheumatoid arthritis (RA) was examined. Female patients were divided in groups according to their age and immunologic state. Plasma dehydroepiandrosterone (D), D sulphate (DS), and testosterone (T) levels were determined by radioimmunological methods. The values were related first to those of normal controls. The T and DS levels were significantly decreased in all patient groups examined, the D level was low only in "Rf+ active" state aged 18 to 45 years. Furthermore, it was examined whether the decreased hormone levels were in relationship either with the autoantibody (Rf) formation or with the activity of the disease. According to the observations the T levels were influenced neither by the autoantibody formation nor by the activity of the disease. The DS and D levels appeared to correlate both with the autoantibody formation and the activity of the disease, particularly in young patients, being significantly low in the "Rf+ active" state. From these we concluded that the condition of the immune system has an influence on the sex hormone and/or adrenal androgen function.

Influence of rituximab–CHOP therapy on clinical course and autoimmune parameters in rheumatoid arthritis associated with diffuse large B cell non-Hodgkin lymphoma

Influence of rituximab–CHOP therapy on clinical course and autoimmune parameters in rheumatoid arthritis associated with diffuse large B cell non-Hodgkin lymphoma

Lack of association of the CD14/C–159T polymorphism with susceptibility and serological activity parameters of rheumatoid arthritis

Objective: CD14, the monocyte receptor for lipopolysaccharides (LPS), is an important mediator of inflammatory processes. As the T–159C exchange in the promotor of the CD14 gene was reported to lead to enhanced CD14 expression, this could be a new susceptibility gene for rheumatoid arthritis (RA). We investigated whether this single nucleotide polymorphism (SNP) serves as a risk factor for disease development or has any influence on serological activity parameters of RA or soluble CD14 (sCD14) levels.Patients and methods: A total of 130 patients with RA, diagnosed according to the revised American College of Rheumatology (ACR) criteria, and 130 healthy subjects, all Caucasians, were genotyped using polymerase chain reaction (PCR). Genotype frequencies were compared by χ2 analysis.Results: Forty (31%) patients vs. 39 (30%) controls were genotyped CC; 71 (55%) vs. 67 (52%) were heterozygous, and 19 (15%) vs. 24 (19%) showed the TT genotype (p = 0.7). Accordingly, the allele frequency was equally distributed (p = 0.8). There was also no significant difference in genotype distribution between subgroups of patients categorized according to serological activity parameters and sCD14 levels.Conclusion: We found no association between the CD14/C–159T polymorphism and increased risk for the development of RA or serological disease activity parameters or sCD14 levels.

Menopausal syndrome in female patients with rheumatoid arthritis

This study was performed to assess the relationship between joint symptoms in rheumatoid arthritis (RA) and symptoms in menopausal syndrome. Detailed analyses of the clinical course, laboratory data, joint symptoms, and symptoms of menopausal syndrome were performed for five patients with stage I and monocyclic-type RA. The age when joint symptoms first appeared coincided with the age of menopause in all patients, and the mean age was 51.0 years. The mean period from menopause to this study was 5.4 years. All patients showed more than six menopausal syndrome symptoms. Two patients were confirmed gynecologically to have definite menopausal syndrome, and accordingly hormone replacement therapy (HRT) was given. In one patient, the polyarthralgia disappeared after she received HRT. All the American College of Rheumatology (ACR) criteria, with the exception of subcutaneous nodules, can be explained as symptoms related to estrogen deficiency in menopausal syndrome because estrogen regulates the production of inflammatory cytokines such as IL-1, IL-6, and TNFα, and these cytokines are produced in greater abundance in conditions of estrogen deficiency. Estrogen deficiency at the menopause influences joint symptoms and inflammatory parameters in rheumatoid arthritis. Estrogen deficiency in menopausal syndrome may induce joint symptoms resembling RA.

Abstract 40-59

Summary40. Expression of TNF-converting enzyme in inflammatory demyelination of the peripheral nervous system41. Posttraumatic stress disorder and HPA functioning: Hypocortisolism and increased glucocorticoid sensitivity of PBMC in Bosnian war victims42. Effects of adrenaline infusion on immune parameters in rheumatoid arthritis (RA) patients and healthy controls (HC)43. Stiff man-syndrome, a neuropsychiatric disorder with autoimmunity against GABAergic neurones. Part II: GAD autoantibodies impair GABAergic functions within the motor cortex44. Body weight and the plasma levels of leptin and endogenous immune modulators during treatment with carbamazepine45. Changes of tryptophan and kynurenine in the postpartum period46. Mu opioid receptor expression in immune cells is induced by IL-4 and TNF47. Genetic investigations based on immunological findings in schizophrenia48. TNF polymorphism G308A may protect from cytomegalovirus infection in schizophrenia49. Differential effects of psychological stress on IL-6 and IL-1ra responses in women and men from the Whitehall II cohort50. Sleep enhances the human antibody response to hepatitis A vaccination51. Cytokines – immunological link between Major Depressive Disorder (MDD) and alcohol abuse?52. Time-dependant endocrine dysfunction and impact on well-being after radiation therapy of primary brain tumours and the influence of hormone substitution – a longitudinal study53. Nervous immunity: Neurotransmitters, through their specific receptors, dictate T cell functions, in a direct, powerful and contextual manner54. Control of the release of leptin, tumor necrosis factor α and nitric oxide by the central nervous system55. Stiff man-syndrome, a neuropsychiatric disorder with autoimmunity against GABAergic neurones. Part I: Clinical, psychological and immunological characteristics56. Norepinephrine from synovial tyrosine hydroxylase-positive cells is a strong indicator of synovial inflammation in rheumatoid arthritis57. Neurotrophin-4: Evidence for a proinflammatory role in allergic asthma?58. Selective attack of MHC class I-induced neuritis by cytotoxic T lymphocytes59. Early life stress affects the emotional and neuroendocrine development of rat offspring in dependence on the innate level of anxiety