Active Rheumatoid Arthritis Research Articles

Serum lncRNA ITGB2-AS1 and ICAM-1 as novel biomarkers for rheumatoid arthritis and osteoarthritis diagnosis.

The complete circulating long non-coding RNAs (lncRNAs) signature of rheumatoid arthritis (RA) and osteoarthritis (OA) is still uncovered. The lncRNA integrin subunit beta 2 (ITGB2)-anti-sense RNA 1 (ITGB2-AS1) affects ITGB2 expression; however, there is a gap in knowledge regarding its expression and clinical usefulness in RA and OA. This study investigated the potential of serum ITGB2-AS1 as a novel diagnostic biomarker and its correlation with ITGB2 expression and its ligand intercellular adhesion molecule-1 (ICAM-1), disease activity, and severity in RA and primary knee OA patients. Forty-three RA patients, 35 knee OA patients, and 22 healthy volunteers were included. Compared with healthy controls, serum ITGB2-AS1 expression was upregulated in RA patients but wasn't significantly altered in knee OA patients, whereas serum ICAM-1 protein levels were elevated in both diseases. ITGB2-AS1 showed discriminative potential for RA versus controls (AUC = 0.772), while ICAM-1 displayed diagnostic potential for both RA and knee OA versus controls (AUC = 0.804, 0.914, respectively) in receiver-operating characteristic analysis. In the multivariate analysis, serum ITGB2-AS1 and ICAM-1 were associated with the risk of developing RA, while only ICAM-1 was associated with the risk of developing knee OA. A panel combining ITGB2-AS1 and ICAM-1 showed profound diagnostic power for RA (AUC = 0.9, sensitivity = 86.05%, and specificity = 91.67%). Interestingly, serum ITGB2-AS1 positively correlated with disease activity (DAS28) in RA patients and with ITGB2 mRNA expression in both diseases, while ICAM-1 positively correlated with ITGB2 expression in knee OA patients. Our study portrays serum ITGB2-AS1 as a novel potential diagnostic biomarker of RA that correlates with disease activity. A predictive panel combining ITGB2-AS1 and ICAM-1 could have clinical utility in RA diagnosis. We also spotlight the association of ICAM-1 with knee OA diagnosis. The correlation of serum ITGB2-AS1 with ITGB2 expression in both diseases may be insightful for further mechanistic studies.

Contribution of inflammation markers and quantitative sensory testing (QST) indices of central sensitisation to rheumatoid arthritis pain.

Pain, the primary complaint in rheumatoid arthritis (RA), is multifaceted, and may be driven by inflammatory disease activity and central sensitisation. We aimed to ascertain what proportion of RA pain severity is explained by markers of inflammation and quantitative sensory testing (QST) indices of central sensitisation. This was a cross-sectional analysis of data from individuals with clinically active RA. Pain severity was assessed using numerical rating scales and inflammation via 28-joint Disease Activity Score (DAS28) and Ultrasound (Greyscale, Power Doppler). Pain sensitivity was assessed by 'static' (tibialis anterior or brachioradialis pressure pain detection threshold-PPT-TA/PPT-BR) and 'dynamic' (temporal summation-TS, conditioned pain modulation-CPM) QST. Bivariate associations used Spearman's correlation coefficients, and multivariable linear regression models determined relative contributions to pain severity. In bivariate analyses of N = 96 (age 65 ± 10y, 77% females) people with RA, pain severity was significantly associated with inflammation indices (r = 0.20 to 0.55), and CPM (r=-0.26). In multivariable models that included TS, CPM, age, sex, and body mass index, inflammation indices remained significantly associated with pain severity. Multivariable models explained 22 to 27% of pain variance. Heterogeneity was apparent for associations with pain between subscores for pain now, strongest or average over the past 4-weeks. In individuals with clinically active RA, markers of inflammatory disease activity best explain RA pain with only marginal contributions from QST indices of central sensitisation. Although inflammation plays a key role in the experience of RA pain, the greater proportion of pain severity remains unexplained by DAS28 and ultrasound indices of inflammation.

Progression of TMJ disorders in patients with rheumatoid arthritis

Relevance. The literature highlights the significant impact of rheumatoid arthritis (RA) on the onset of musculoskeletal dysfunction symptoms in the temporomandibular joint (TMJ). However, the risk factors that influence the clinical manifestations of TMJ disorders in RA patients remain insufficiently explored.Objective: To examine the impact of rheumatoid arthritis on the onset and progression of TMJ disorders.Materials and methods. At the Dental Clinic of the Central Research Institute of Stomatology and Maxillofacial Surgery, 180 patients from St. Petersburg State Clinical Rheumatology Hospital No. 25, diagnosed with rheumatoid arthritis, were examined. Standard clinical assessments and detailed medical history collection were performed.Results. Patients with long-standing RA (over 5 years) were more likely to experience TMJ disorder symptoms, with a relative risk of 1.342 (95% CI) [1.106; 1.628]. No statistically significant correlation was found between RA activity and TMJ disorders. The symptom pattern varied by timing: prior to RA, patients predominantly experienced TMJ clicking and crepitus (66%); during RA onset, pain and restricted jaw movement were more common (80% and 72%, respectively). After RA manifestation, pain became the dominant symptom, though its intensity diminished over time (to 60%).Conclusions. The duration of RA has a notable impact on both the frequency and nature of TMJ disorder symptoms. While RA treatment reduces symptom intensity over time, their frequency remains high.

Olokizumab effect on chronic pain in rheumatoid arthritis: Results of the PROLOGUE observational study.

Evaluate the efficacy and safety ® (olokizumab) in patients with rheumatoid arthritis (RA) in real-world clinical practice, with a targeted assessment of patient report outcomes (PRO) and central sensitization. An open-label observational non-interventional study was conducted, enrolling 183 patients with moderate and severe RA activity. All patients received OKZ 64 mg SC as injections every 4 weeks (Q4W) with methotrexate. The patients' follow-up period was 24 weeks or less. RA activity (DAS28-CRP), pain severity (NRS), patient global assessment (PGA, NRS), functional impairment (NRS), fatigue (FACIT-F), central sensitization (central sensitization inventory, CSI), and symptoms of neuropathic pain (PainDETECT) were evaluated. The study cohort was comprised of 144 patients. And 39 patients were lost to follow-up, refused OKZ treatment, or were not dosed with OKZ for administrative reasons. In 6 months, DAS28-CRP decreased to 3.3 ± 0.9 (p < .001) and statistically significant reductions in pain intensity, PGA, functional impairment, and fatigue were achieved. Pain intensity decreased as early as 2 days after the first OKZ administration (p < .05). The number of patients with CSI >40 in 24 weeks decreased from 71.0% to 21.0% (p < .001), with PainDETECT >18 - from 21.5% to 13.2%. NSAIDs use decreased from 70.8% to 33.8% (р < .001), steroids - from 54.2% to 32.6%. AEs were reported in 14.2% patients, serious events were observed in three patients. OKZ is effective in reducing RA activity and controlling chronic pain related to dysfunction of the nociceptive system.

Application Value of Platelet-to-Lymphocyte Ratio as a Novel Indicator in Rheumatoid Arthritis: A Review Based on Clinical Evidence.

Rheumatoid arthritis (RA) is a chronically progressive autoimmune disease with increasing age-standardized prevalence and incidence of RA worldwide. Its pathological features are persistent synovitis of the joint, accompanied by the release of a large number of inflammatory cytokines and cartilage and bone destruction. RA can lead to progressive joint damage, stiffness and swelling, vascular and bone-related complications, and irreversible disability, which seriously affects patients' life treatment. Early diagnosis and treatment can enhance the quality of life of RA patients. Platelet-to-lymphocyte ratio (PLR), as a common indicator in routine blood tests, has been proposed as an indicator of systemic inflammation in recent years. Its clinical detection is less invasive, economical, rapid and simple, and has been applied to the clinical evaluation of a variety of diseases. Of note, this indicator is important in assessing disease activity in RA, co-diagnosing RA, detecting subclinical complications, and monitoring responses to anti-inflammatory therapy. Therefore, this review summarizes the relationship between PLR and RA and the relevant mechanisms, further advancing the understanding of the clinical value of PLR.

Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial

ObjectiveTreatment strategies of patients with active rheumatoid arthritis (RA) vary within and between countries. While most patients in Germany are treated on an outpatient basis, some are hospitalised (inpatients). In...

Combining patient-reported outcome measures to screen for active disease in rheumatoid arthritis and psoriatic arthritis

ObjectivesTo investigate whether a combination of general health (Visual Analogue Scale (VAS)), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain (VAS/Numerical Rating Scale (NRS)), quality of life (EQ-5D), fatigue (VAS/NRS) and presenteeism...

Effects of Adalimumab-adbm Versus Adalimumab Reference Product on Patient-Reported Outcomes in Rheumatoid Arthritis: Results from VOLTAIRE-RA.

This post hoc analysis of VOLTAIRE-RA compared patient-reported outcomes, including health-related quality of life (HRQoL), in patients with rheumatoid arthritis (RA) before and after treatment with biosimilar adalimumab-adbm or adalimumab reference product. HRQoL was assessed by 36-Item Short Form Survey (SF-36) Physical and Mental Component Summary (PCS and MCS, respectively) and domain scores at baseline and weeks12/24. Results were considered clinically meaningful if improvements were greater than or equal to minimum clinically important differences (MCIDs) of 2.5 for PCS and MCS and 5.0 for domain scores. Comparisons with age- and sex-matched norms and treatment-associated changes in domain scores from baseline were quantified using spydergrams and the health utility SF-6D measure. All comparisons between treatment groups were descriptive in nature. No differences in PCS scores were reported between treatment groups at baseline or weeks12/24. MCS scores slightly favored the reference product group at baseline, and differences in scores at weeks12/24 generally reflected those differences. Improvements in PCS scores greater than or equal to MCID at weeks12/24 were reported by over 65% of patients in both treatment groups, while over 56% experienced improvements in MCS scores greater than or equal to MCID at weeks12/24. Similar proportions receiving reference product and adalimumab-adbm reported scores greater than or equal to US age- and sex-matched normative values at week24: 14-39% versus 15-36%, respectively, compared with baseline (1-17%). In patients with moderate to severely active RA, adalimumab-adbm and adalimumab reference product were both associated with clinically meaningful improvements in SF-36 PCS, MCS, and domain scores that were highly similar at weeks12/24. The high proportion of patients reporting scores greater than or equal to normative values in both treatment groups is notable, as this represents a treatment goal that was difficult to achieve in earlier RA trials. Video abstract available for this article. VOLTAIRE-RA (ClinicalTrials.gov number, NCT02137226; EudraCT number, 2012-002945-40). Video abstract (MP4 29755 KB).

Another Notch in the Belt of Rheumatoid Arthritis.

Notch ligands and receptors, including JAG1/2, DLL1/4, and Notch1/3, are enriched on macrophages (MΦs), fibroblast-like synoviocytes (FLS), and/or endothelial cells in rheumatoid arthritis (RA) compared with normal synovial tissues (ST). Power Doppler ultrasound-guided ST studies reveal that the Notch family is highly involved in early active RA, especially during neovascularization. In contrast, the Notch family is not implicated during the erosive stage, evidenced by their lack of correlation with radiographic damage in RA ST. Toll-like receptors and tumor necrosis factor (TNF) are the common inducers of Notch expression in RA MΦs, FLS, and endothelial cells. Among Notch ligands, JAG1 and/or DLL4 are most inducible by inflammatory responses in RA MΦs or endothelial cells and transactivate their receptors on RA FLS. TNF plays a central role on Notch ligands, as anti-TNF good responders display JAG1/2 and DLL1/4 transcriptional downregulation in RA ST myeloid cells. In in vitro studies, TNF increases Notch3 expression in MΦs, which is further amplified by RA FLS addition. Specific disease-modifying antirheumatic drugs reduced JAG1 and Notch3 expression in MΦ and RA FLS cocultures. Organoids containing FLS and endothelial cells have increased expression of JAG1 and Notch3. Nonetheless, Methotrexate, interleukin-6 receptor (IL-6R) antibodies, and B cell blockers are mostly ineffective at decreasing Notch family expression. NF-κB, MAPK, and AKT pathways are involved in Notch signaling, whereas JAK/STATs are not. Although Notch blockade has been effective in RA preclinical studies, its small molecule inhibitors have failed in phase Iand II studies, suggesting that alternative strategies may be required to intercept their function.

Ultrasound 7 score and serum chemerin in rheumatoid arthritis: Relation to disease activity

Background and objectives. Chemerin is an adipokine associated with inflammation. Musculoskeletal ultrasonography is now widely used for detecting and monitoring RA due to its availability, practicality, and cost-effectiveness. The aim of the study is to determine how accurate serum chemerin levels are as a biomarker of active rheumatoid arthritis (RA) disease and to find a link between these levels and ultrasonographic findings. Materials and methods. This case-control study included 44 RA cases and 44 matched-age and sex-healthy controls. Seven joints in the hand and foot were assessed by the German-ultrasound 7 (GUS 7) score through greyscale (GSUS) and power Doppler US (PDUS) in all cases. Disease activity score 28 (DAS28) evaluated RA activity, and serum chemerin levels were measured in cases and controls. Both DAS28-CRP and DAS28-ESR were used in the assessment of the disease. Outcomes. The mean age of patients was 43.48 years versus 39.18 years of controls. 86.4% of patients were females; versus 75% of the control group. 47.7% of the studied patients had moderate disease activity, 31.8% had high disease activity, and 20.5% had low disease activity. There was a statistically significant higher median chemerin serum level among RA cases compared to the control group (898.94 versus 247.81 ng/ml, p &lt;0.001). There was a significant difference in median chemerin between inactive and active patients (352.1 versus 1032.6 ng/ml (p &lt;0.001). The serum chemerin can differentiate between RA patients and controls with a higher sensitivity of 81.8%, a specificity of 88.6%, and an accuracy of 85.2%. There was a statistically significant positive association between chemerin and RA activity (p &lt;0.001). The combination of serum chemerin level and tenosynovitis GSUS score and DAS2-ESR to differentiate between active and inactive RA patients was highly significant with the highest sensitivity of 100%. Conclusions. Chemerin can serve as an advantageous marker for assessing RA activity. The US-7 score is a complementary method used in standard assessment to determine synovial inflammation in RA. The combined use of serum chemerin and the US 7 score could be of high value for detecting disease activity in RA.

Association Between Pharmacotherapy And Circulating Hematological Profile In Rheumatoid Arthritis

Background — Hematological indices are useful predictors and prognostic biomarkers in rheumatoid arthritis (RA). Some antirheumatic drugs (ARD) have a negative effect on circulating blood cells and bone marrow and therefore may bias the interpretation of biomarker value. Objective — Our cross-sectional study aimed to demonstrate the effect of ADR use on peripheral blood indices in RA patients. Methods — This cross-sectional study was conducted on 103 adult RA patients and 21 healthy subjects at Rizgari Teaching Hospital in collaboration with the Department of Clinical Pharmacy and College of Pharmacy, Hawler Medical University, Erbil, Iraq, from January 2020 through December 2022. Patients were treated with methotrexate (MTX), hydroxychloroquine (HCQ), biologics (BL), MTX+HCQ, MTX+BL, and HCQ+BL. RA activity and complete blood count were obtained from patient records. Results — Our results implied that HCQ was associated with significantly lower hemoglobin levels, while MTX+BL was accompanied by significantly lower mean corpuscular volume. The mean platelet volume was significantly higher in all treatment groups than in healthy subjects. Conclusion — We concluded that BL use was statistically significantly associated with changes in hematological indices and ratios in patients with RA. It is important to consider the category of pharmacotherapy when interpreting circulating blood cell indices as predictors or prognostic biomarkers in RA.

High disease activity influences the presence of vertebral fractures in rheumatoid arthritis.

It is important to assess the risk of vertebral fractures (VFs) in patients with rheumatoid arthritis (RA), as RA is associated with a high risk of VFs. However, the epidemiology and risk of VFs in patients with RA remain inconclusive. The present study therefore clarified the prevalence and associated factors of VFs in patients with RA. We included 107 patients (19 men and 88 women) and retrospectively investigated the number and location of VFs, bone mineral density (BMD), RA disease activity score for 28 joints based on C-reactive protein (DAS28-CRP), and history of medication for RA and osteoporosis. Based on the investigated items, we assessed the prevalence of VFs in patients with RA and the association between the clinical parameters of RA patients and VFs. The average age, disease duration, and DAS28-CRP were 67.9 years old, 14.9 years, and 2.2, respectively. We found that the prevalence of VFs in patients with RA was 30.8%, and 84.8% of patients with VFs and 62.2% of those without VFs had been treated for osteoporosis. We further found that the prevalence of VFs in patients with RA with a history of anti-osteoporotic agent use was 37.8%. In univariate analyses, patients with RA with VFs had significantly higher DAS28-CRP values, a higher rate of corticosteroid use, and lower BMD (p = 0.018, p = 0.004, and p < 0.001, respectively) than those without VFs. A multivariable logistic regression analysis and ordinal logistic analysis revealed that the DAS28-CRP and BMD were independent factors associated with the presence (p = 0.042 and p = 0.011, respectively) and number (p = 0.036 and p = 0.048, respectively) of VFs. The prevalence of VFs was relatively high in patients with RA, regardless of the use of anti-osteoporotic agents. A high disease activity score and low BMD are associated with the presence and number of VFs in patients with RA. Based on these findings, to reduce VFs in RA patients, it is important to tightly control the disease activity of RA in addition to osteoporosis treatment.

Comparative Analysis of Coagulation Activation in Rheumatoid Arthritis Patients Treated With TNF Inhibitors Versus JAK Inhibitors: A Prospective Study.

This study aims to investigate the activation of the coagulation system of RA patients and assess changes during anti-inflammatory treatment with tumor necrosis factor blockers (anti-TNF) and Janus kinase inhibitors (JAKi). Biomarkers for the coagulation system, including D-dimer, fibrinogen, prothrombin time, activated partial thrombin time, prothrombin fragment 1 + 2, thrombin-antithrombin complex (TAT), activated factor IX, antithrombin complex, and von Willebrand factor (vWF), were longitudinally measured in 83 RA patients treated with anti-TNF and 38 RA patients with JAKi. Data were collected at baseline, after 1, 3, and 6 months. The mean age was 57 (±14) years; 76% was female. The mean DAS28-CRP was 3.6 (±1.3) for anti-TNF users and 4.1 (±1.4) for JAKi users at baseline and declined in both groups. Baseline coagulation markers levels were comparable between groups. In anti-TNF users, D-dimer and fibrinogen levels significantly declined (-0.31 mg/L, p = 0.01 and -0.71 g/L, p < 0.001, respectively), whereas TAT significantly increased after 6 months follow-up (1.46 μg/L, p = 0.03) and no effect on vWF (p = 0.98). In JAKi users, vWF declined significantly during the 6 months follow-up (-37.41%, p < 0.001); additionally, there were reductions of D-dimer, fibrinogen, and TAT that did not reach significance (-0.17 mg/L, p = 0.59; -0.49 g/L, p = 0.12; and 0.68 μg/L, p = 0.27, respectively). The prothrombotic tendency in active RA declined during effective treatment with both anti-TNF and JAKi. Altogether, the biomarkers used in this study suggest that an increased VTE risk in the first 6 months due to either treatment with anti-TNF or JAKi is unlikely.

Anti-pentraxin 3 antibodies and residual disease activity in rheumatoid arthritis.

This study quantified anti-PTX3 antibodies in the serum of seropositive and seronegative rheumatoid arthritis (RA) patients, examining their associations with disease activity and patient-reported outcomes (PROMs). In this cross-sectional study, RA patients diagnosed per ACR/EULAR 2010 criteria were recruited. Seronegative RA was defined as ACPA < 7 kU/l. Data on demographics, clinical characteristics, medications, and PROMs were collected. Serum anti-PTX3 antibodies were measured using an in-house ELISA method. Comparative analyses were conducted with historical controls having psoriatic arthritis (PsA) and fibromyalgia (FM). The cohort included 83 RA patients (42 seropositive, 41 seronegative). Seropositive patients had lower anti-PTX3 antibody levels than PsA (p= 0.001) and FM (p= 0.004) controls. Seronegative patients had higher levels than seropositive ones (p= 0.032). Anti-PTX3 antibodies correlated with CDAI (r = 0.255), PtGA (r = 0.257), VAS-GH (r=-0.235), VAS-pain (r = 0.233), and HAQ (r = 0.311), but not with joint counts, inflammatory markers, or physician's global assessment. The PtGA association remained significant when adjusted for BMI, SJC28, ESR, and prednisone dosage (β = 0.206, p= 0.042). Patients with near-controlled RA (SJC28 ≤ 2, PtGA > 2) had higher anti-PTX3 levels than those with controlled disease (SJC28 ≤ 2, PtGA ≤ 2; p= 0.048). Tocilizumab or abatacept-treated patients had lower levels compared with those on TNFi or JAKi. Elevated anti-PTX3 antibodies in RA indicate residual active disease despite controlled inflammation. They may serve as a biomarker for true active disease, especially in seronegative RA patients who might be undertreated.

The effect of active rheumatoid arthritis on hearing impairment.

To assess hearing loss in rheumatoid arthritis (RA) patients, and to explore its association with disease attributes and activity. The cross-sectional case-control study was conducted from June to December 2022 at Al-Imamein Al- Kadhimein Hospital, Medical City, Baghdad, Iraq, and comprised rheumatoid arthritis patients and healthy controls of either gender aged 18-45 years. Data was collected using electronic instruments and a physical examination, including pure tone audiometry and tympanogram. Data was analysed using SPSS 24. Of the 90 subjects, 60(66.7%) were patients; 45(75%) female and 15(25%) males with mean age 32.9 1±7.21 years and mean body mass index 27.14±8.58kg/m2. There were 30(33.3%) controls; 18(60%) female and 12(40%) males with mean age 30.25±5.51 years and mean body mass index 26.92±6.66kg/m2. The control group had thresholds below 25dB for all frequencies in both ears, which were notably lower than those of the RA patients (p=0.005). The left ear showed significant variation at 2000Hz and 4000Hz, while the right ear showed substantial differences at all frequencies except 1000Hz. The risk of hearing loss was found to be increased in rheumatoid arthritis patients, and it seemed to be related to illness duration.

Efficacy and safety of filgotinib in patients with moderately active rheumatoid arthritis and an inadequate response to methotrexate.

Clinical trials restricted to moderately active RA are limited. Filgotinib is approved for treating moderate to severe active RA. This post hoc analysis assessed efficacy and safety of filgotinib in moderately active RA. In FINCH 1, patients with active moderate to severe RA and inadequate response to methotrexate received filgotinib 200 mg or 100 mg (FIL200/FIL100) once daily, adalimumab 40 mg every 2 weeks, or placebo, all with methotrexate (n = 1,755). This subgroup analysis was conducted in patients with a moderate baseline Disease Activity Score in 28 joints using C-reactive protein (DAS28-CRP; >3.2 to ≤ 5.1; n = 425 [24.2%]). A higher proportion of patients achieved DAS28-CRP <2.6, Clinical Disease Activity Index (CDAI) remission (≤2.8), low disease activity (LDA) (DAS28-CRP ≤3.2 or CDAI ≤10), and American College of Rheumatology (ACR20/50/70) responses with FIL200 and FIL100 vs placebo at Weeks 12 and 24. Week 12 ACR20 response rates (primary end point) were 77.9%, 67.8%, and 43.8%, respectively. ∼75% of patients achieved DAS28-CRP LDA by week 24 with either filgotinib dose. FIL200 and FIL100 elicited greater improvements in patient-reported outcomes than placebo. The efficacy of filgotinib, maintained through week 52, was comparable to that of adalimumab. Frequency of adverse events (AEs) was similar with filgotinib and adalimumab. Infections were the most common AEs; incidence rates were 40-53% in active treatment groups. In this subpopulation with moderately active RA, the efficacy and safety of filgotinib were similar to those in the overall FINCH 1 population (patients with active moderate to severe RA). NCT02889796.

Exploring Rheumatoid Arthritis: Unraveling Signaling Pathways, Advancing Management, and Charting Future Perspectives

Rheumatoid arthritis (RA) is a chronic autoimmune disorder in which inflammation occurs in the synovial joint and synovial membrane, and in severe condition, it leads to erosion of cartilage and bone. The etiology of RA is still indescribable; generally, RA is a multifactorial disease, wherein complex interactions between patients and different factors such as environmental, genetic, and epigenetic factors determine the overall risk of disease. RA is classified based on the stage of disease. Treatment for RA is still a challenge for doctors and researchers. Effective treatment for RA can be achieved by decreasing disease activity or reduction of RA to other patients using currently available treatment options. This article gives a comprehensive perspective of data regarding different signaling pathways involved in RA development, factors affecting RA, stages of RA, and other treatments of RA. This article also suggests future research perspectives that would be helpful for the development of RA treatment (medicine) with more efficacy, safety profiles, and lower financial costs.

Thermal Characteristics of the Small Joints of the Hands Between Patients with Rheumatoid Arthritis and Healthy Controls.

Objectives: This study aimed to investigate the thermal characteristics of the small joints of the hands between patients with Rheumatoid arthritis and healthy controls. Patients and Methods: Fifty-two patients with Rheumatoid arthritis and twenty-six healthy controls were included in the study. Joint tenderness was evaluated using Ritchie Articular index. Joint tenderness was scored from 0 to 3. Thermal data was collected from the hand regions of individuals. A FLIR T450sc microbolometer infrared thermal camera with 320x240 resolution was used for the thermography of individuals. Bilaterally proximal interphalangeal joints (1-5) and metacarpophalangeal joints (1-5) were evaluated. The mean temperature was compared between patients and healthy controls Results: The mean temperature values of the joints in the patients with a Rheumatoid arthritis RAI score of 0, 1, 2,3 were 32.43 ± 1.59°C; 32.71 ± 1.36°C; 33.12 ± 1.23°C; 33.60 ± 0.99 respectively. The mean temperature was 31.14 ± 1.51°C in healthy controls. The mean temperature values of the joints in the Rheumatoid arthritis patients with RAI score of 0 was higher compared to healthy controls (p&lt;0.05). Patients with a Ritchie sensitivity score of 1 had a higher mean temperature compared to patients with score of 0 (p&lt;0.05). In Rheumatoid arthritis patients, the joints with a RAI score of 1 had higher mean temperature values than the joints with RAI score of 0 (p&lt;0.05). The mean temperature values of the joints with RAI score of 2 were also higher than the joints with RAI score of 1 (p&lt;0.05). Conclusion: Thermal imaging may be an objective tool for diagnosis and assessing disease activity in Rheumatoid arthritis.

Role of Diet in Influencing DAS28 Score in Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a chronic inflammatory condition that significantly impacts quality of life. Emerging evidence suggests that dietary modifications can influence disease activity and mental health in RA patients.Objective: To investigate the effect of dietary patterns on disease activity, depression, and anxiety in patients with RA.Methods: A cross-sectional study was conducted among 150 RA patients. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ), while disease activity was measured using the Disease Activity Score in 28 joints (DAS28). Depression and anxiety were evaluated using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. Multiple linear regression analyses were used to explore the relationship between diet and outcomes, controlling for age, gender, ESR, and CRP levels.Results: Higher FFQ scores were significantly associated with lower DAS28 (β = -0.42, p = 0.002), depression (β = -0.55, p = 0.008), and anxiety (β = -0.60, p = 0.003) scores. Age, ESR, and CRP also significantly predicted outcomes (p &lt; 0.05).Conclusion: Dietary patterns significantly influenced disease activity and mental health in RA patients. Integrating dietary counseling into RA management may improve clinical and psychological outcomes.

Increased predictive value of optical spectral transmission in early rheumatoid arthritis through use of patient-adjusted cut-off scores

ObjectivesThe aims of this study were to suggest patient-adjusted optical spectral transmission (OST) cut-off values for the first time and to develop clinical models that predict the probability of an early rheumatoid arthritis (RA) diagnosis based on OST findings and the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria as a reference standard.MethodsOST examinations were performed in newly diagnosed RA patients and healthy controls by the HandScan device. Moreover, RA patients underwent a full clinical [tender/swollen joint counts (TJC/SJC), disease activity score-28 (DAS28)] and laboratory evaluation. OST confounding factors were examined via logistic multivariate regression analyses and patient-adjusted OST-cut-offs were subsequently determined. Furthermore, statistical models to calculate the probability of an RA diagnosis, based on the measured OST values and the presence of OST influencing factors, were developed. Finally, correlations of OST with RA activity parameters were assessed.Results1.584 joints of 72 early RA patients were examined via OST and compared to 2.200 joints of 100 healthy controls and 1.166 joints of 53 patients with non-inflammatory arthralgia (NIA), respectively. Overall OST diagnostic performance was excellent in the whole cohort between RA- and healthy control-group [Area-Under-the-Curve (AUC): 0.810 (95%CI: 0.746–0.873); p < 0.0001], and further improved in RA-patients with ≥ 1 swollen wrist/finger joint(s) [AUC: 0.841 (95%CI: 0.773–0.908); p < 0.0001]. Comparison between RA patients and patients with non-inflammatory arthralgia showed similar results by an AUC of 0.788 (95%-CI: 0.709–0.867; p < 0.0001), and further improved in RA patients with ≥ 1 swollen wrist/finger joint(s) [AUC: 0.822 (95%CI: 0.74–0.90); p < 0.0001]. For the assessment of an adjusted RA diagnosis probability, two gender-specific statistical models were developed, based on OST values and patient age. OST cut-off values of 11.2 and 18.21 were calculated for female and male patients with active disease (sensitivity 93% and 67%; specificity 71.2% and 90%), respectively. Among RA patients, OST was associated moderately/significantly with DAS28 (r = 0.42,p < 0.001) and swollen joint count (rho = 0.355,p = 0.002).ConclusionThe development of patient-adjusted OST cut-off values and the suggested statistical models significantly enhance OST’s diagnostic performance, supporting its utility in differentiating between RA and non-inflammatory conditions. Future research should include a broader spectrum of arthritis types to validate OST’s comprehensive diagnostic utility also across various inflammatory arthritides.Trial registrationDRKS00016752 (German Registry of Clinical Trials)