scholarly journals Relationship between clinical efficacy and laboratory correlates of inflammatory and immunologic activity in rheumatoid arthritis patients treated with nonsteroidal antiinflammatory drugs

1990 ◽  
Vol 33 (5) ◽  
pp. 623-633 ◽  
Author(s):  
John J. Cush ◽  
Hugo E. Jasin ◽  
Regina Johnson ◽  
Peter E. Lipsky
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Efficacy ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Immunologic Activity

Treatment Options for Rheumatoid Arthritis: Celecoxib, Leflunomide, Etanercept, and Infliximab

2000 ◽  
Vol 34 (6) ◽  
pp. 743-760 ◽  
Author(s):  
Brigitte T Luong ◽  
Barbara S Chong ◽  
Dionne M Lowder
Keyword(s):  
Rheumatoid Arthritis ◽  
English Language ◽  
Data Extraction ◽  
Treatment Options ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Pertinent Data

OBJECTIVE: To review new pharmacologic agents approved for use in the management of rheumatoid arthritis (RA). DATA SOURCES: A MEDLINE search (1966–January 2000) was conducted to identify English-language literature available on the pharmacotherapy of RA, focusing on celecoxib, leflunomide, etanercept, and infliximab. These articles, relevant abstracts, and data provided by the manufacturers were used to collect pertinent data. STUDY SELECTION: All controlled and uncontrolled trials were reviewed. DATA EXTRACTION: Agents were reviewed with regard to mechanism of action, efficacy, drug interactions, pharmacokinetics, dosing, precautions/contraindications, adverse effects, and cost. DATA SYNTHESIS: Traditional pharmacologic treatments for RA have been limited by toxicity, loss of efficacy, or both. Increasing discoveries into the mechanisms of inflammation in RA have led to the development of new agents in hopes of addressing these limitations. With the development of celecoxib, a selective cyclooxygenase-2 inhibitor, the potential exists to minimize the gastrotoxicity associated with nonsteroidal antiinflammatory drugs. Leflunomide has been shown to be equal to or less efficacious than methotrexate, and may be beneficial as a second-line disease-modifying antirheumatic drug (DMARD). The biologic response modifiers, etanercept and infliximab, are alternatives that have shown benefit alone or in combination with methotrexate. However, they should be reserved for patients who fail to respond to DMARD therapy. Further studies should be conducted to evaluate the long-term safety and efficacy of these agents as well as their role in combination therapy. CONCLUSIONS: Celecoxib, leflunomide, etanercept, and infliximab are the newest agents approved for RA. Clinical trials have shown that these agents are beneficial in the treatment of RA; however, long-term safety and efficacy data are lacking.

A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes

2019 ◽  
Vol 47 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Stephanie O. Keeling ◽  
Samantha L. Bowker ◽  
Anamaria Savu ◽  
Padma Kaul
Keyword(s):  
Rheumatoid Arthritis ◽  
Pregnant Women ◽  
Population Level ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Neonatal Outcomes ◽  
Hypertensive Disorder ◽  
Antiinflammatory Drugs ◽  
Hypertensive Disorders ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Objective.The effects of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level have not previously been well compared.Methods.A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of 1 live birth event per woman. We identified 3 groups: (1) no inflammatory arthritis (no IA, n = 308,989), (2) RA (n = 631), and (3) SpA (n = 2461). We compared maternal and neonatal outcomes, comorbid conditions, and medication use among the 3 groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy.Results.Pregnant women with RA were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Nonsteroidal antiinflammatory drugs and corticosteroid use were significantly higher in pregnant women with RA compared to the other groups. Women with RA were significantly more likely to have an SGA baby (OR 1.51, 95% CI 1.21–1.88; p < 0.01), and hypertensive disorder in pregnancy (OR 1.51, 95% CI 1.16–1.97; p < 0.01), compared to women with no IA, while no difference was found between women with SpA and those with no IA.Conclusion.Women with RA have a higher risk of worse maternal and neonatal outcomes, whereas the risk of these events is similar between women with and without SpA.

scholarly journals Nonsteroidal antiinflammatory drugs in rheumatoid arthritis and osteoarthritis. Support for the concept of “responders” and “nonresponders”

1997 ◽  
Vol 40 (11) ◽  
pp. 1944-1954 ◽  
Author(s):  
Judith S. Walker ◽  
Rachel B. Sheather-Reid ◽  
John J. Carmody ◽  
Richard O. Day ◽  
Janet H. Vial
Keyword(s):  
Rheumatoid Arthritis ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs

scholarly journals Orthopedic Surgery in Rheumatoid Arthritis in the Era of Biologic Therapy

2013 ◽  
Vol 40 (11) ◽  
pp. 1850-1855 ◽  
Author(s):  
Leticia Leon ◽  
Lydia Abasolo ◽  
Loreto Carmona ◽  
Luis Rodriguez-Rodriguez ◽  
Jose Ramon Lamas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Orthopedic Surgery ◽  
Total Joint Replacement ◽  
Sociodemographic Factors ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Biologic Therapies ◽  
Antiinflammatory Drugs ◽  
Related Factors ◽  
Orthopedic Procedure ◽  
Record Review

Objective.To analyze sociodemographic and clinic-related factors associated with the use of orthopedic surgical procedures in rheumatoid arthritis (RA), focusing on the potential role of new biologic therapies.Methods.A retrospective medical record review was performed in a probability sample of 1272 patients with RA from 47 units distributed in 19 Spanish regions. Sociodemographic and clinical features, use of drugs, and arthritis-related joint surgeries were recorded following a standardized protocol.Results.A total of 94 patients (7.4%) underwent any orthopedic surgery during their disease course, with a total of 114 surgeries; 47 (41.2%) of these surgeries were total joint replacement (TJR). The median time to first orthopedic procedure was 7.9 years from the onset of RA symptoms, and the rate of orthopedic surgery (excluding TJR) was 4.5 procedures per 100 person-years from the beginning of RA, while the rate of TJR was 2.25 interventions per 100 person-years. A higher risk of undergoing an orthopedic surgical procedure was associated with taking nonsteroidal antiinflammatory drugs (NSAID) in the previous 2 years, female sex, longterm disease, and the presence of extraarticular complications. The risk factors for undergoing a TJR were being old, having a longterm disease, and taking biologic therapies.Conclusion.In the era of biologics, our national audit found a low percentage of patients who underwent orthopedic surgery, probably reflecting a thorough management of the RA. Sociodemographic factors, longterm RA, extraarticular complications, and NSAID were associated with orthopedic surgery.

scholarly journals Investigation of antiinflammatory compositions and Tantum Verde® in combined treatment of patients with generalized periodontitis

2020 ◽  
Vol 104 (5) ◽  
pp. 22-25
Author(s):  
A. Borysenko ◽  
◽  
A. Kuvayev ◽  
V. Stolar ◽  
K. Myalkovsky ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Clinical Investigation ◽  
Combined Treatment ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Complex Treatment ◽  
Antiinflammatory Drugs ◽  
Periodontal Tissues ◽  
Initial Stage ◽  
Vacuum Test ◽  
Pharmaceutical Composition

Objectives. Periodontal disease is the most widespread human diseases. The problem of rational treatment of generalized periodontitis is actual. In the complex treatment of patients with generalized periodontitis widely used antiinflammatory medicaments. Among them is well-known nonsteroidal antiinflammatory drugs (NSAID) Tantum Verde® (benzydamine hydrochloride). Investigation of antiinflammatory activity of drug compositions based on medicinal plants and preparation Tantum Verde® was made. Aim. The determination of the clinical efficacy of the proposed pharmaceutical compositions and well-known drug Tantum Verde® in the initial stage of complex treatment of generalized periodontitis. Materials and methods. Clinical investigation was conducted in two groups of patients. The first consisted of 30 patients with generalized periodontitis, the second – 30 similar patients, who underwent dental implants. Mtdicamental treatment was carried out using a pharmaceutical composition of the proposed solution and rinse Tantum Verde®. For this purpose, the patients of both groups were divided into two groups: the first used pharmacological composition, the second – Tantum Verde® rinsing solution. Patients were conducted a comprehensive examenation of periodontal tissue before treatment and after treatment. To evaluate the clinical efficacy of treatment used Schiller-Pisarev test (1962), the index of PMA by C. Parma (1961), hygienic index by Fedorov-Volodkina (1978), the vacuum test by Kulazhenko (1961). Results. As a result of the investigation it was found that the usage of the proposed pharmaceutical composition in the complex therapy of patients with generalized periodontitis can effectively inhibit the dystrophic-inflammatory process in periodontal tissues. This confirms by the decline in the index PMA, increase the time of formation of hematoma during the vacuum tests on Kulazhenko, improving oral hygiene. Conclusions. Application of the proposed pharmaceutical composition increases the effectiveness of treatment of patients with generalized periodontitis.

The Serum Level of Agalactosyl IgG in Rheumatoid Arthritis Patients Treated with Methotrexate

1996 ◽  
Vol 9 (1) ◽  
pp. 19-22
Author(s):  
J. K. Lacki ◽  
U. Mackiewicz ◽  
S. Mackiewicz ◽  
W. Muller
Keyword(s):  
Rheumatoid Arthritis ◽  
Serum Level ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Healthy Controls ◽  
Disease Course ◽  
Antiinflammatory Drugs ◽  
Significant Difference ◽  
One Year ◽  
Agalactosyl Igg

To verify the hypothesis that methotrexate may affect the serum level of agalactosyl IgG (IgG[0]) we followed the changes in IgG galactosylation patterns in a cohort of rheumatoid arthritis patients treated with either methotrexate (MTX) or nonsteroidal antiinflammatory drugs (NSAID). The average values of IgG[0] in RA patients at the beginning of the observation were significantly higher as compared to healthy controls (0.45 ± 0.39 vs. −0.03 ± 0.09, p<0.05). The findings of IgG[0] after one-year follow-up were also higher as compared to healthy controls (0.38 ± 0.39 vs. −0.03 ± 0.09, p<0.05). We did not notice any statistically significant difference in IgG[0] between MTX and NSAID treated patients at the beginning of the study (0.49 ± 0.42 vs. 0.42 ± 0.38, NS). However, during one-year MTX treatment IgG[0] significantly dropped (0.49 ± 0.42 vs. 0.25 ± 0.24, p<0.01). We did not establish any fluctuation in IgG[0] in the group of patients treated with NSAID (0.42 ± 0.38 vs. 0.46 ± 0.45, NS). The data thus far obtained suggest that IgG[0] may serve as an indicator for the disease course in patients with RA. Secondly, the clinical improvement and IgG[0] decrease after methotrexate implies, that the immunoregulatory abnormality in RA may be susceptible to correction by immunotherapy.

Ibuprofen-Induced Aseptic Meningitis in Rheumatoid Arthritis

1997 ◽  
Vol 31 (9) ◽  
pp. 1009-1011 ◽  
Author(s):  
Amy C Horn ◽  
Steven W Jarrett
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Aseptic Meningitis ◽  
Lupus Erythematosus ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Systemic Lupus ◽  
Antiinflammatory Drugs ◽  
Stiff Neck ◽  
Laboratory Findings ◽  
Increased Risk

Objective To report a case of aseptic meningitis related to ibuprofen ingestion. Case Summary We discuss the case of a 56-year-old white man with a history of rheumatoid arthritis and hypertension who became confused, nauseated, and began to vomit within 2 hours of the ingestion of ibuprofen. A diagnosis of ibuprofen-induced aseptic meningitis was made based on the patient's physical and laboratory findings, the quick onset and resolution of symptoms, and his medical history. Discussion Ibuprofen-induced aseptic meningitis has been most frequently reported in patients with systemic lupus erythematosus. However, there have been reports of this reaction in patients with other underlying disease states. Various nonsteroidal antiinflammatory drugs have been reported to cause this reaction, but ibuprofen is the most common offending agent. A drug-related cause should be considered in any patient who presents with typical meningitis symptoms, such as fever, headache, and stiff neck, that occur within hours of ingesting a drug. Conclusions Although persons with systemic lupus erythematosus appear to have an increased risk for this type of reaction, the development of signs and symptoms in other patients warrants the consideration of nonsteroidal antiinflammatory drugs as the cause of aseptic meningitis.

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