Relationship between psychological factors and arthralgia in patients with rheumatoid arthritis

Various factors were assessed in terms of their contribution to arthralgia in a rheumatoid arthritis patient. Eighty-two outpatients (62 women and 20 men) with rheumatoid arthritis (RA) were examined with respect to the subjective degree of arthralgia, age, disease duration, dysfunction, steroid dose, steroid period, depression, anxiety, extroversion, neurotic disorder, and number of caretakers. The results were explained on the basis of stepwise regression analysis and psychological and clinical data. We analyzed results of a correlation coefficient test on the mutual relationship between variables. Stepwise regression analysis was performed to assess factors of arthralgia in terms of "depression," "mean activity," "morning stiffness," and "steroid dose." Depression is a factor of arthralgia as shown in this study, but it is clear that other factors are also involved. Anxiety was a factor distinct from the activity of RA. The factor contributing most to arthralgia was found to be depression, whereas anxiety had no effect. Received: January 31, 2001 / Accepted: August 3, 2001     

A comprehensive review of rituximab therapy in rheumatoid arthritis patients

Clinical Rheumatology - Rituximab (RTX) is an approved treatment for rheumatoid arthritis (RA) patients that do not respond adequately to disease-modifying antirheumatic drugs. However, different...     

Relationship between frailty and methotrexate discontinuation due to adverse events in rheumatoid arthritis patients

Clinical Rheumatology - Methotrexate (MTX) is an anchor drug in the treatment of rheumatoid arthritis (RA). Frailty is the intermediate condition between being healthy and disabled, and can lead to...     

Limited proliferative response to type II collagen in rheumatoid arthritis

In order to define the potential importance of type II collagen in the activation of rheumatoid arthritis (RA) synovial fluid (SF) lymphocytes, we examined the proliferative response of matched peripheral blood and SF lymphocytes to type II collagen. The mean proliferative response to the collagen was somewhat greater (p less than 0.05) with SF, compared to peripheral blood lymphocytes. However, the magnitude of this response was relatively weak as determined by stimulation indices, and it did not approach that observed with peripheral blood lymphocytes in response to tetanus toxoid. Sixty-seven percent of peripheral bloods and 50% of SF demonstrated positive responses to the control antigen, tetanus toxoid. In contrast, only 6 and 28%, respectively, were positive in response to type II collagen. The addition of exogenous interleukin 2 augmented responses to the tetanus toxoid, however, no such enhancement with type II collagen was noted in our patients. Our collagen was arthritogenic in experimental animals. These observations do not support the existence of T cell specificity toward type II collagen as a common mechanism for the expansion of synovial lymphocytes in RA.     

干扰素-γ基因多态性与干扰素治疗慢性乙肝患者持久应答的关系

目的探讨干扰素-γ(IFN-γ)启动子基因874位点的单核苷酸多态性(SNP)与IFNα-2b治疗慢性乙肝(CHB)持久应答的关系。方法选择CHB患者106例,应用PCR-SSP技术分析宿主的IFN-γ启动子基因874位点的SNP,患者给予IFNα-2b治疗1年,随访1年,比较SNP与IFNα-2b疗程结束时完全应答、停药后随访1年完全应答(持久应答)的关系。结果在标准疗程结束时,完全应答的患者中三种基因型的分布无统计学差异(χ2=3.594 9,P=0.165 7)。而在持久应答患者中三种基因型的分布有统计学差异,TT基因型患者的持久应答率高于其他两种基因型患者(χ2=6.639 8,P=0.036 1)。结论 CHB患者对IFNα-2b治疗的持久应答与IFN-γ基因型有一定关联性,尤其与TT基因型关联更大。     

Consensus statement on the use of rituximab in patients with rheumatoid arthritis

A large number of experts experienced in the treatment of rheumatoid arthritis were involved in formulating a consensus statement on the use of B cell-targeted treatment with rituximab in patients with rheumatoid arthritis. The statement was supported by data from randomised controlled clinical trials and the substantial literature on oncology. The statement underwent three rounds of discussions until its ultimate formulation. It should guide clinicians in the use of this newly approved biological agent in treating patients with rheumatoid arthritis.     

Relationship between arterial dysfunction and extra-articular features in patients with rheumatoid arthritis

Systemic inflammation may be a common process that underpins both atherosclerosis and extra-articular features (ExRA) of rheumatoid arthritis (RA). We evaluated the relationship between ExRA and arterial dysfunction in 114 consecutive patients with RA (82% women) without overt arterial disease aged 40–65?years. A trained research nurse undertook ‘SphygmoCor’ pulse wave analysis (PWA) using radial applanation tonometry to measure the extent (augmentation index, AIX%) and timing (reflected wave transit time, RWT, msec) of aortic wave reflection. Assessment included fasting blood sample, patient questionnaire and medical record review. Mean differences were adjusted for age, sex, mean blood pressure, smoking pack-years, fasting cholesterol, Stanford HAQ score and erythrocyte sedimentation rate. Mean age was 54 (SD 7) and median RA duration 10 (IQR 4–17) years. There was a trend for arterial dysfunction (higher AIX%; lower RWT) to increase as the number of ExRA features rose, but no difference in AIX% (?0.5, 95%CI ?2.8 to 1.8, P?=?0.65) or RWT (0.3?ms, 95%CI ?3.6 to 4.2, P?=?0.86) between ‘any ExRA’ and ‘no ExRA’. Arterial dysfunction was not associated with the presence of rheumatoid nodules, Sjogren’s syndrome or carpal tunnel syndrome. Our study was too small to determine whether severe (‘Malmo’) ExRA (vasculitis, pericarditis, episcleritis) was truly associated with a higher AIX% (3.8, 95%CI ?2.3 to 9.9, P?=?0.22) and lower RWT (?5.5?ms 95%CI ?13.1 to 2.1, P?=?0.16). While arterial dysfunction may be associated with the number of ExRA features and severe ExRA, it does not appear to be associated with other ExRA features.