scholarly journals Magnetic resonance imaging assessed inflammation in the wrist is associated with patient-reported physical impairment, global assessment of disease activity and pain in early rheumatoid arthritis: longitudinal results from two randomised controlled trials

2017 ◽  
Vol 76 (10) ◽  
pp. 1707-1715 ◽  
Author(s):  
Daniel Glinatsi ◽  
Joshua F Baker ◽  
Merete L Hetland ◽  
Kim Hørslev-Petersen ◽  
Bo J Ejbjerg ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Randomised Controlled Trials ◽  
Global Assessment ◽  
Physical Impairment ◽  
Controlled Trials ◽  
Resonance Imaging ◽  
Patient Reported ◽  
Randomised Controlled ◽  
Assessment Of Disease Activity

Intranasal dexmedetomidine for sedation in children; a review

2019 ◽  
Vol 30 (6) ◽  
pp. 170-175 ◽  
Author(s):  
J Lewis ◽  
CR Bailey
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Randomised Controlled Trials ◽  
Dose Range ◽  
Optimal Dose ◽  
Controlled Trials ◽  
Venous Cannulation ◽  
Resonance Imaging ◽  
Intranasal Route ◽  
Randomised Controlled

Dexmedetomidine is an α2 adrenoreceptor agonist that may be administered by the intranasal route as a sole sedative agent in children. It is odourless, colourless and tasteless and is formulated in a concentration of 100µg.ml−1. We performed a review of published randomised controlled trials in order to determine the efficacy of intranasal dexmedetomidine for sedation in children. Fourteen trials were eligible for inclusion in the review and contained a total of 1809 patients ranging in age from one month to 14 years. Intranasal dexmedetomidine was administered in a dose range of 1–4µg.kg−1 and was compared with various other sedatives. Dexmedetomidine was administered by either drops or a mucosal atomiser device. The procedures ranged from non-painful examinations such as magnetic resonance imaging scans and transthoracic echocardiography to painful procedures such as dentistry and venous cannulation. Administration of 2µg.kg−1 appears to be the optimal dose.

scholarly journals Short-term changes on MRI predict long-term changes on radiography in rheumatoid arthritis: an analysis by an OMERACT Task Force of pooled data from four randomised controlled trials

2016 ◽  
Vol 76 (6) ◽  
pp. 992-997 ◽  
Author(s):  
Charles Peterfy ◽  
Vibeke Strand ◽  
Lu Tian ◽  
Mikkel Østergaard ◽  
Ying Lu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Damage ◽  
Randomised Controlled Trials ◽  
Task Force ◽  
Joint Damage ◽  
Controlled Trials ◽  
X Rays ◽  
X Ray ◽  
Pooled Data ◽  
Randomised Controlled

ObjectiveIn rheumatoid arthritis (RA), MRI provides earlier detection of structural damage than radiography (X-ray) and more sensitive detection of intra-articular inflammation than clinical examination. This analysis was designed to evaluate the ability of early MRI findings to predict subsequent structural damage by X-ray.MethodsPooled data from four randomised controlled trials (RCTs) involving 1022 RA hands and wrists in early and established RA were analysed. X-rays were scored using van der Heijde-modified or Genant-modified Sharp methods. MRIs were scored using Outcome Measures in Rheumatology (OMERACT) RA MRI Score (RAMRIS). Data were analysed at the patient level using multivariable logistic regression and receiver operating characteristic curve analyses.ResultsProgression of MRI erosion scores at Weeks 12 and 24 predicted progression of X-ray erosions at Weeks 24 and 52, with areas under the curve (AUCs) of 0.64 and 0.74, respectively. 12-week and 24-week changes in MRI osteitis scores were similarly predictive of 24-week and 52-week X-ray erosion progressions; pooled AUCs were 0.78 and 0.77, respectively. MRI changes in synovitis at Weeks 12 and 24 also predicted progression of X-ray joint damage (erosion and joint-space narrowing) at Weeks 24 and 52 (AUCs=0.72 and 0.65, respectively).ConclusionsEarly changes in joint damage and inflammation detected with MRI predict changes in joint damage evident on subsequent X-rays. These findings support the use of MRI as a valid method for monitoring structural damage in short-duration RCTs.

scholarly journals Risk of serious infections during rituximab, abatacept and anakinra treatments for rheumatoid arthritis: meta-analyses of randomised placebo-controlled trials

2008 ◽  
Vol 68 (1) ◽  
pp. 25-32 ◽  
Author(s):  
C Salliot ◽  
M Dougados ◽  
L Gossec
Keyword(s):  
Rheumatoid Arthritis ◽  
Randomised Controlled Trials ◽  
Biological Agents ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Serious Infection ◽  
Serious Infections ◽  
High Doses ◽  
Randomised Controlled ◽  
Meta Analyses

Background:Tumour necrosis factor α blockers in rheumatoid arthritis are known to increase the risk of serious infections defined as life-threatening, requiring hospitalisation or intravenous antibiotics. Recently, new biological agents have become available. Their safety is an important issue.Purpose:To assess if biological agents, ie rituximab, abatacept and anakinra increase the risk of serious infections in patients with rheumatoid arthritis in published randomised controlled trials.Data source:A systematic review of the literature using PUBMED, EMBASE, Cochrane library and abstracts databases (American College of Rheumatology and European League Against Rheumatism annual meetings) was performed up to October 2007. This search was completed with data from the Food and Drug Administration, the European Agency for the Evaluation of Medicinal Products and manufacturers.Data extraction:Three fixed-effect meta-analyses were performed to compare serious infection rates between each biological agent and placebo. Pooled odds ratios (ORs) were calculated, using the Mantel–Haenszel method with a continuity correction.Data synthesis:Twelve randomised controlled trials with data concerning serious infections were analysed (three for rituximab, five for abatacept and four for anakinra). They included 745 patients, 1960 patients, 2062 patients and 2112 patients treated by rituximab, abatacept, anakinra and placebo respectively. The overall pooled ORs did not reveal a statistically significant increased risk of serious infection for abatacept and rituximab; this risk was increased for high doses of anakinra (⩾100 mg daily) versus low dose and placebo (ORs = 9.63 (95% CI, 1.31 to 70.91) and 3.40 (95% CI, 1.11 to 10.46) respectively).Conclusions:These meta-analyses did not reveal a significant increase in the risk of serious infections during rituximab or abatacept treatments in patients with rheumatoid arthritis; however, high doses of anakinra may increase this risk, especially when patients have comorbidity factors. Large studies must be performed to confirm this safety profile in daily practice.

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