scholarly journals Mechanisms and Mediators of Pain in Chronic Inflammatory Arthritis

2021 ◽  
Author(s):  
Marco Di Carlo ◽  
Gianluca Smerilli ◽  
Fausto Salaffi
Keyword(s):  
Inflammatory Pain ◽  
Inflammatory Arthritis ◽  
Operational Definition ◽  
Immunosuppressive Drugs ◽  
Therapeutic Strategies ◽  
Future Research ◽  
Common Symptom ◽  
Joint Diseases ◽  
Chronic Inflammatory Arthritis ◽  
Inflammatory Joint Diseases

Abstract Purpose of the review Pain in chronic inflammatory joint diseases is a common symptom reported by patients. Pain becomes of absolute clinical relevance especially when it becomes chronic, i.e., when it persists beyond normal healing times. As an operational definition, pain is defined chronic when it lasts for more than 3 months. This article aims to provide a review of the main mechanisms underlying pain in patients with chronic inflammatory joint diseases, discussing in particular their overlap. Recent findings While it may be intuitive how synovial inflammation or enthesitis are responsible for nociceptive pain, in clinical practice, it is common to find patients who continue to complain of symptoms despite optimal control of inflammation. In this kind of patients at the genesis of pain, there may be neuropathic or nociplastic mechanisms. Summary In the context of chronic inflammatory joint diseases, multiple mechanisms generally coexist behind chronic pain. It is the rheumatologist’s task to identify the mechanisms of pain that go beyond the nociceptive mechanisms, to adopt appropriate therapeutic strategies, including avoiding overtreatment of patients with immunosuppressive drugs. In this sense, future research will have to be oriented to search for biomarkers of non-inflammatory pain in patients with chronic inflammatory joint diseases.

scholarly journals EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis

2011 ◽  
Vol 71 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Yvonne van Eijk-Hustings ◽  
Astrid van Tubergen ◽  
Carina Boström ◽  
Elena Braychenko ◽  
Beate Buss ◽  
...  
Keyword(s):  
Inflammatory Arthritis ◽  
Research Agenda ◽  
Psychosocial Support ◽  
Task Force ◽  
Future Research ◽  
Chronic Inflammatory Arthritis ◽  
European League Against Rheumatism ◽  
European League ◽  
Educational Agenda

ObjectivesThe authors aim to develop European League Against Rheumatism recommendations for the role of the nurse in the management of patients with chronic inflammatory arthritis, to identify a research agenda and to determine an educational agenda.MethodsA task force made up of a multidisciplinary expert panel including nurses, rheumatologists, occupational therapist, physiotherapist, psychologist, epidemiologist and patient representatives, representing 14 European countries, carried out the development of the recommendations, following the European League Against Rheumatism standardised operating procedures.The task force met twice. In the first meeting, the aims of the task force were defined, and eight research questions were developed. This was followed by a comprehensive, systematic literature search. In the second meeting, the results from the literature review were presented to the task force that subsequently formulated the recommendations, research agenda and educational agenda.ResultsIn total, 10 recommendations were formulated. Seven recommendations covered the contribution of nurses to care and management: education, satisfaction with care, access to care, disease management, psychosocial support, self-management and efficiency of care. Three recommendations focused on professional support for nurses: availability of guidelines or protocols, access to education and encouragement to undertake extended roles. The strength of the recommendations varied from A to C, dependent on the category of evidence (1A–3), and a high level of agreement was achieved. Additionally, the task force agreed upon 10 topics for future research and an educational agenda.Conclusion10 recommendations for the role of the nurse in the management of chronic inflammatory arthritis were developed using a combination of evidence-based and expert consensus approach.

scholarly journals Importance of the second SARS-CoV-2 vaccination dose for achieving serological response in patients with rheumatoid arthritis and seronegative spondyloarthritis

2021 ◽  
pp. annrheumdis-2021-221347
Author(s):  
Elisabeth Simader ◽  
Selma Tobudic ◽  
Peter Mandl ◽  
Helmuth Haslacher ◽  
Thomas Perkmann ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Messenger Rna ◽  
Inflammatory Arthritis ◽  
Vaccine Dose ◽  
Humoral Response ◽  
Joint Diseases ◽  
Serological Response ◽  
Dmard Therapy ◽  
Inflammatory Joint Diseases ◽  
Seronegative Spondyloarthritis

ObjectivesTo assess the kinetics of humoral response after the first and second dose of messenger RNA (mRNA) vaccines in patients with inflammatory joint diseases compared with healthy controls (HC). To analyse factors influencing the quantity of the immune response.MethodsWe enrolled patients with rheumatoid arthritis (RA) and seronegative spondyloarthritis (SpA), excluding those receiving B-cell depleting therapies and assessed the humoral response to mRNA vaccines after the first and the second dose of the vaccine in terms of seroconversion rate and titre. We compared the results to a HC group and analysed the influence of therapies as well as other characteristics on the humoral response.ResultsSamples from 53 patients with RA, 46 patients with SpA and 169 healthy participants were analysed. Seroconversion rates after the first immunisation were only 54% in patients with inflammatory arthritis compared with 98% in the HC group. However, seroconversion rates were 100% in all groups after second immunisation. Patients developed reduced antibody titres after the first vaccination compared with HC, but there was no difference after the second dose. While disease modifying anti-rheumatic drug (DMARD) monotherapy did not affect antibody levels, seroconversion rates as well as titre levels were reduced in patients receiving a combination of DMARDs compared with HC.ConclusionsPatients with inflammatory joint diseases under DMARD therapy show impaired humoral responses to the first vaccine dose but excellent final responses to vaccination with mRNA vaccines. Therefore, the full course of two immunisations is necessary for efficient vaccination responses in patients with inflammatory arthritis under DMARD therapy.

scholarly journals Oligonucleotide Therapies in the Treatment of Arthritis: A Narrative Review

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 902
Author(s):  
Susanne N. Wijesinghe ◽  
Mark A. Lindsay ◽  
Simon W. Jones
Keyword(s):  
Rheumatoid Arthritis ◽  
Articular Cartilage ◽  
Joint Diseases ◽  
Synovial Joint ◽  
Pharmacological Treatments ◽  
In Vivo Models ◽  
Inflammatory Joint Diseases ◽  
Joint Pathology ◽  
Cellular Pathways

Osteoarthritis (OA) and rheumatoid arthritis (RA) are two of the most common chronic inflammatory joint diseases, for which there remains a great clinical need to develop safer and more efficacious pharmacological treatments. The pathology of both OA and RA involves multiple tissues within the joint, including the synovial joint lining and the bone, as well as the articular cartilage in OA. In this review, we discuss the potential for the development of oligonucleotide therapies for these disorders by examining the evidence that oligonucleotides can modulate the key cellular pathways that drive the pathology of the inflammatory diseased joint pathology, as well as evidence in preclinical in vivo models that oligonucleotides can modify disease progression.

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