scholarly journals AB0101 THE IMPACT OF TIME SPAN TO ACHIEVE BOOLEAN REMISSION FOR MAINTAINING DISEASE ACTIVITY AFTER ACQUISITION IN RHEUMATOID ARTHRITIS PATIENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1079.1-1079
Author(s):  
I. Yoshii
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Remission Rate ◽  
Mean Value ◽  
Time Span ◽  
Mean Values ◽  
The Mean ◽  
The Relationship

Background:Boolean remission criteria is one most popular and stringent criteria in treating patient with rheumatoid arthritis (RA), because it may guarantees a stable clinical course after attaining remission.Objectives:Impact of time span from initiation to achieving Boolean remission on maintaining disease activity, daily activities, and quality of life after attaining Boolean remission was investigated from daily clinical practice data.Methods:685 patients with RA since August 2010 under the T2T strategy were treated. They were monitored for their TJC, SJC, PGA, EGA, CRP, and disease activity indices such as CDAI, SDAI, DAS28, and Boolean criteria at every visit. HAQ-DI score, pain score using visual analog scale (PS-VAS), and EQ-5D were also monitored, and the quality of life score (QOLS) calculated from EQ-5D was determined at every visit from the time of diagnosis (baseline).Of 685 patients, 465 patients had achieved Boolean remission >1 times, and were consecutively followed up for >3 years. These patients were enrolled in the study. Time span from the first visit to first Boolean remission was calculated. The relationship between the time span and each of background parameters, and the relationship between the time span and each of the mean values of the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at the first Boolean remission and thereafter was evaluated statistically.Patients were subsequently divided into the G ≤ 6 and G > 6 groups based on the achievement of first Boolean remission within two groups: time span G ≤ 6 months and G > 6 months. The two groups were compared with regard to the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at first visit and at the time of first Boolean remission, and the mean values of these parameters after remission were evaluated statistically. Moreover, changes of these parameters and the mean Boolean remission rate after the first remission, and SDAI remission rate at the first Boolean remission to thereafter were compared between the two groups statistically.Results:Out of 465 patients, females comprised 343 (73.7%), and the mean age was 67.8 years (range, from 21–95 years). The mean disease duration at first visit was 6.1 years (range, from 1 months–45 years). The mean follow up length was 88.1 months (range: 36–122 months; median: 85 months) and mean time span from the first visit to the first Boolean remission was 8.1 months. The mean SDAI score, HAQ score, PS-VAS, and the QOLS at first visit were 13.3, 0.467, 33.2, and 0.834, respectively. Among the study parameters, PS-VAS and QOLS were significantly correlated with the time span. For parameters at the first Boolean remission, HAQ-DI score, PS-VAS, and QOLS demonstrated significant correlation with the time span, whereas SDAI, HAQ-DI score, PS-VAS, SHS, and QOLS after the Boolean remission demonstrated significant correlation with the time span.The comparison between the G ≤ 6 and the G > 6 groups revealed that the disease duration, HAQ score, and PS-VAS at baseline in the G > 6 were significantly higher than that in the G ≤ 6 group, and QOLS in the G ≤ 6 group was significantly higher than that in the G > 6 group at baseline. Similarly, the HAQ score and PS-VAS at the first Boolean remission in the G > 6 group were significantly higher than that in the G ≤ 6 group, whereas QOLS in the G ≤ 6 group demonstrated no significant difference compared with that in the G > 6 group.The mean value of the SDAI score after the first Boolean remission in the G > 6 group was significantly higher than that in the G ≤ 6 group. Similarly, the SDAI score, HAQ score, and PS-VAS after the first Boolean remission in the G > 6 group were also significantly higher than those in the G ≤ 6 group, and the mean value of the QOLS in the G ≤ 6 group were significantly higher than that in the G > 6 group. The Boolean remission rate and SDAI remission rate after the first Boolean remission were significantly higher in the G ≤ 6 group than those in the G > 6 group.Conclusion:Attaining Boolean remission ≤ 6 months for RA has significant benefit for more stable disease control, that leads good maintenance of ADL.Disclosure of Interests:None declared

scholarly journals POS0439 THE INFLUENCE OF ESCALATED PGA SCORE ON DISEASE ACTIVITY, DAILY ACTIVITY, AND QUALITY OF LIFE, AND SOLUTION FOR OPTIMAL PGA LEVEL THAT DESERVES CLINICAL REMISSION IN PATIENT WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 448.2-448
Author(s):  
I. Yoshii
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Daily Activity ◽  
Remission Rate ◽  
Mean Value ◽  
Daily Activities ◽  
Mean Values

Background:Patient’s global assessment (PGA) is one most difficult component as a part of disease activity index for treatment of rheumatoid arthritis (RA), that often causes an obstacle to attaining clinical remission. Moreover, PGA level affects activities in daily living.Objectives:The influence of escalated PGA score on disease activity, daily activity, and quality of life for patient with RA was investigated., and the optimal PGA level for both disease activity and daily activities was investigated from real world data.Methods:A total of 24,075 times of monitoring for RA was performed in the institute. Monitored items included TJC, SJC, PGA, EGA, CRP, and calculated values of DAS28, CDAI, SDAI, composite index of Boolean evaluation (Boolean), pain score with visual analog scale (PS-VAS), Health Assessment Questionnaire Disability Index (HAQ-DI), and quality of life score (QOLS) calculated from Euro-QOL questionnaire with 5th dimensions. Each measured item was calculated as mean value according to the PGA score, which was measured at the same time. The PGA score was classified by one increment from zero to ten. The mean values of DAS28, CDAI, SDAI, remission rate of these indices and Boolean remission rate, and mean values of PS-VAS, HAQ-DI, and QOLS were statistically evaluated.HAQ-DI below 0.5 was determined as remission (HAQ remission). Sensitivity and specificity regarding attaining HAQ remission according to each level of PGA score were calculated, and cutoff index (COI) was determined with receiver operating characteristic (ROC) curve. For PS-VAS, sensitivity and specificity of Boolean remission regarding each level of PS-VAS after classification divided by one increment was calculated, and comparable level (PS-VAS remission) was determined with reference of the curve. ROC was performed according to PGA level, and COI was determined with a same manner.Results:Number of measures counted 10428, 3099, 3110, 2346, 998, 1773, 751, 703, 655, 139, and 73 for each PGA level. PGA level from 3 to 5, and 5 to 10 were put together for number adjusting.Mean DAS28, CDAI, and SDAI demonstrated significant increase as PGA level increased, and remission rate of the all indices including Boolean demonstrated significant decrease as PGA level increases (p<0.01%). Boolean remission rate demonstrated zero percent from two, and CDAI and SDAI remission rate demonstrated zero from five, whereas DAS remission rate showed gradual decrease then zero percent was not shown in any level. Mean value of PS-VAS and HAQ-DI score demonstrated also significant decrease as PGA level increases, and QOLS demonstrated significant decrease as PGA level increases (p<0.01%). Increase of HAQ-DI score and decline of QOLS demonstrated more steep from PGA level 3, whereas no significant difference demonstrated from zero to one.HAQ remission counted 15,703, whereas no HAQ remission counted 8,335. Using ROC, COI of the PGA level was 2.0, whereas sensitivity and specificity were 63.4% and 66.3%, respectively. The estimated PS-VAS remission level was 10mm. Optimal PGA level for PS-VAS remission was set as 1.0, and sensitivity and specificity regarding PS-VAS remission were 87.1% and 71.3%, respectively.Conclusion:Increase of PGA affects daily activities and quality of life. The evident level that increases deterioration risk significantly was supposed to be from 3. Optimal level of PGA score for attaining the PS-VAS remission was 1.0, whereas the optimal PGA level for HAQ-DI remission is 1.0, despite sensitivity and specificity for the HAQ remission were lower than these for the PS-VAS remission.Disclosure of Interests:None declared

scholarly journals AB0102 EVALUATOR’S GLOBAL ASSESSMENT REFLECTS DISEASE ACTIVITY BUT NOT LINEARLY CORRELATES WITH DAILY ACTIVITY OR QUALITY OF LIFE COMPARED TO PATIENT’ GLOBAL ASSESSMENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1079.2-1079
Author(s):  
I. Yoshii
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Daily Activity ◽  
Global Assessment ◽  
Remission Rate ◽  
Objective Assessment ◽  
Mean Value ◽  
Mean Values ◽  
Significant Difference

Background:Evaluator’s global assessment (EGA) is the one component of indexed disease activity evaluation assessed by the rheumatologist for treatment of rheumatoid arthritis (RA). It does not included in the Boolean remission criteria nor 28-joints disease activity score (DAS28), however it is widely recognized among rheumatologist as an only comprehensive and objective assessment parameter.Objectives:The aim of this study is to evaluate how EGA correlates with other components and the influence of EGA on disease activity and daily activity, and quality of life.Methods:A total of 24,075 times of monitoring out of 683 RA patients who were followed up for more than three consecutive years was performed. Contents of monitoring included tenderness joint count (TJC), swollen joint count (SJC), patient’s global assessment (PGA), EGA, C-reactive protein (CRP), and calculated values of DAS28, SDAI, composite index of Boolean evaluation, pain score with visual analog scale (PS-VAS), Health Assessment Questionnaire Disability Index (HAQ-DI), and quality of life score (QOLS) calculated from Euro-QOL questionnaire with 5th dimensions. Each measurement was classified with the EGA score divided by one increment from zero to ten. Mean values of DAS28, CDAI, SDAI, remission rate of these indices and Boolean remission rate, and mean values of PS-VAS, HAQ-DI, and QOLS were statistically evaluated. Results were compared to the results that was analyzed in according to the PGA score substituted with the EGA score.Moreover, EGA at the time of Boolean remission of the patients who achieved Boolean remission at least once during treating were picked up. Patients were classified according to the EGA level with 0.5 increment from zero. Mean value of TJC, SJC, PGA, EGA, SDAI, Boolean remission rate, HAQ-DI, and PS-VAS after attaining Boolean remission were compared statistically.Results:Number of measures counted 15424, 2001, 3688, 1731, 664, 293, 144, 88, 29, 2, and 11 for each level of EGA. The EGA score tended to concentrate more in zero to two in comparing to the PGA score. Mean DAS28, CDAI, and SDAI demonstrated significant increase as the EGA level increased, and remission rate of the all indices including Boolean demonstrated significant decrease as the EGA level increases (p<0.01%). CDAI, SDAI, and Boolean remission rate demonstrated zero percent from two. Mean value of PS-VAS and HAQ-DI score demonstrated also significant decrease as the EGA level increases, and QOLS demonstrated significant decrease as the EGA level increases (p<0.01%). However, these tendency showed more irregular compared to that analyzed with the PGA score. Correlation coefficients with regarding to the EGA score was always less than that with regarding to the PGA score.In the patients who achieved Boolean remission, EGA levels were divided with 294 with zero (G-0) and 118 with 0.5 (G-.5), whereas 71 could not achieve Boolean remission. Average TJC (p<0.05), SJC (p<0.001), EGA (p<0.001), CRP (p<0.05), and SDAI (p<0.01) level in the G-0 group demonstrated significant less than in the G-.5 group, whereas PGA, Boolean remission rate, HAQ-DI, and PS-VAS demonstrated no significant difference in between the two groups.Conclusion:It is more reliable to estimate daily activity and quality of life from the PGA score than to estimate from the EGA score. EGA correlates with SJC and CRP more strongly than with TJC and CRP. EGA does not reflect HAQ-DI and PS-VAS.Disclosure of Interests:None declared

scholarly journals Serum Adenosine Deaminase Level is High But Not Related with Disease Activity Parameters in Patients with Rheumatoid Arthritis

2014 ◽  
Vol 8 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Gülseren Demir ◽  
Pınar Borman ◽  
Figen Ayhan ◽  
Tuba Özgün ◽  
Ferda Kaygısız ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Adenosine Deaminase ◽  
Disease Duration ◽  
Control Group ◽  
Mean Values ◽  
Reactive Protein ◽  
Control Subjects ◽  
Rheumatology Unit ◽  
The Mean

Serum adenosine deaminase (ADA) has been previously proposed to predict disease activity in patients with rheumatoid arthritis (RA). The aim of this study was to investigate the level of serum ADA, and the relationship between ADA and disease activity markers, in a group of patients with RA.A hundred and 10 patients with a diagnosis of RA were recruited from outpatient clinic of Rheumatology Unit. Demographic properties comprising age, gender, disease duration and drugs were recorded. Disease activity based on disease activity score (DAS)28-erythrocyte sedimentation rate (ESR) and DAS28- C reactive protein (CRP,) ESR, CRP levels, as well as pain by visual analog scale and rheumatoid factor (RF) were recorded. Serum ADA levels (IU/L) were determined in all RA patients and in 55 age and sex similar healthy control subjects.Ninety-six female and 14 male RA patients with a mean age of 54.32±11.51, and with a mean disease duration of 11.5±9.13 years were included to the study. The control group comprised of 48 female and 7 male healthy subjects. 35.5% of the patients were on methotrexate (MTX) and 64.5% of patients were on combined DMARDs or combined MTX and anti-TNF therapies. The mean serum ADA level was statistically higher in RA patients than in control subjects (27.01±10.6 IU/Lvs21.8 ±9.9 IU/L). The mean values of ESR (23.2±14.8 mm/h), CRP (1.71±1.11mg/dL), pain by VAS (37.2±27.1), DAS28-ESR (2.72±0.77), DAS28 CRP (1.37±0.5) were not correlated with ADA levels (p>0.05).Our results have shown that serum ADA levels are higher in RA patients than in controls but were not related with any of the disease activity markers. We conclude that ADA in the serum may not be a reliable biochemical marker to predict disease activity in patients with RA.

scholarly journals Rheumatoid arthritis in real clinical practice. Results of the «Computer Terminals of Self-Assessment for Patients with Rheumatic Diseases» («TERMINAL-I») project

2019 ◽  
Vol 13 (2) ◽  
pp. 25-30 ◽  
Author(s):  
V. N. Amirdzhanova ◽  
E. Yu. Pogozheva ◽  
A. E. Karateev ◽  
R. R. Samigullina ◽  
O. B. Nesmeyanova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Disease Activity ◽  
Functional Status ◽  
Disease Duration ◽  
The Mean ◽  
Real Clinical Practice

Objective: to describe the portrait of a patient with rheumatoid arthritis (RA) in real clinical practice, to assess disease activity from the point of view of a physician and a patient, functional status, quality of life (QOL), and the efficiency of the therapy performed.Patients and methods. The investigation enrolled 976 RA patients from a cohort of patients in the TERMINAL-I multicenter study, who, when visiting a rheumatologist, independently assessed the disease activity and QOL using a computer system (the «Computer Terminals of SelfAssessment for Patients with Rheumatic Diseases» project). The mean age of the patients was 52.30±13.3 years; women accounted for 85%; the median disease duration 8.0 [4.0; 14.0] years. Baseline clinical parameters and pharmacotherapy were evaluated for 6 months. The disease activity was determined by the DAS28 and RAPID-3 indices; functional status and quality of life were evaluated by the HAQ and the EQ-5D, respectively.Results. 83% of the RA patients were positive for rheumatoid factor and 60% were for anti-cyclic citrullinated peptide antibodies. There was a preponderance of patients with high (40.5%) and moderate (46.8%) RA activity; 6.9% were observed to have a low activity; 5.8% had clinical remission. The mean values of DAS28 and RAPID-3 were 4.7±1.3 and 13.7±3.6, respectively. Only 14.3% of patients had a good functional status that was comparable with the population-based control (HAQ≤0.5). The remaining patients were found to have a substantial decrease in joint functional parameters (median HAQ 1.88 [1.0; 2.5]) and EQ-5D QOL (0.60 [0.60; 0.74). Prosthetic joints were present in 7.4% of patients. At visit 1 to a rheumatologist, the therapy was changed in 15% of patients. During 6-month follow-up, conventional disease-modifying anti-rheumatic drugs were taken by almost all (91.2%) patients. Of them, 70.9% of the patients were treated with methotrexate (MTX): 77.0% received the latter at a dose of 15 mg/week and 23.0% had it at a dose of >15 mg (17.5 to 40 mg/week). Glucocorticoids could be stopped in 20.5% of the patients within six months. Tumor necrosis factor-α inhibitors and anti-B-cell therapy were used in 6.6 and 16.2% of patients, respectively. At 6-month follow-up (Visit 2), 54% of patients achieved a 20% clinical improvement in the ACR criteria. At the same time, the DAS28 scores decreased substantially from 4.5±1.2 to 3.8±1.1 (p = 0.0001). There was a minimal functional improvement in the HAQ index in 64% of patients and a better EQ-D QOL scores in 16%.Conclusion. The majority of RA patients who came to the rheumatologists showed high to moderate disease activity. This was due to long disease duration, inadequate MTX dose, and insufficient patient monitoring in real clinical practice. Introduction of a computer system for selfassessment of their health status by RA patients in an outpatient setting could improve the interaction of physicians, nurses, and patients, better monitor disease activity, and enhance therapeutic efficiency. 

scholarly journals AB0217 IMPACT OF THE BODY-MASS-INDEX ON DISEASE ACTIVITY, FUNCTIONAL ABILITY AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1409.2-1409
Author(s):  
L. Medjedovic ◽  
J. Mrdja ◽  
P. Ostojic
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Ability ◽  
Mean Value ◽  
Normal Weight ◽  
Obese Patients ◽  
Mean Values ◽  
Index Measure

Objectives:This study aims to assess differences in disease activity, functional ability and quality of life among underweight, normal weight, overweigth and obese patients with rheumatoid arthritis (RA).Methods:715 patients with RA (609 women and 106 men) were included in this study. According to their Body-Mass-Index, all patients were divided into four subgroups: underweight (BMI <18,5), normal weight (BMI between 18,5 and 24,9), overweight (BMI between 25,0 and 29,9) and obesitas (BMI ≥ 30,0). Mean values of DAS28, CDAI and SDAI (measures of disease activity), HAQ-disability index (measure of functional ability) and RAQoL index (measure of qualitiy of life) were compared among four subgroups of patients.Results:28 (3,9%) RA patients were underweight, 310 (43,4%) had normal weight, 268 (37,5%) were overweight, whilst 109 (15,2%) patients were obese. Among these subgroups, no difference in mean age, disease duration, percentage of seropositive patients, and patients treated with glucocorticoids, csDMARDs or biologics, was noticed. There were no statistically significant differences in mean values of DAS28, CDAI und SDAI in four subgroups of patients. However, mean value of the HAQ disability index was significantly higher (p<0.05) in underweight (1.32) and obese patients (1.27), compared to normal (0.87) and overweigth patients (1.08). The mean value of the RAQoL-Index was also somewhat higher in underweight and obese patients (8.8 and 8.1, respectively) than patients who are overweight or have normal weigth (7.0 and 6.5, respectively), but the difference was not statistically significant.Conclusion:Underweight and obese RA patients have worse physical function than normal and overweight patients. However, worse disability can not be explained by higher disease activity.Disclosure of Interests:None declared

scholarly journals Influence of balneophysical therapy on activity, functional capacity, and quality of life in patients with rheumatoid arthritis

2009 ◽  
Vol 137 (3-4) ◽  
pp. 171-174 ◽  
Author(s):  
Sonja Stojanovic ◽  
Aleksandar Dimic ◽  
Bojana Stamenkovic ◽  
Aleksandra Stankovic ◽  
Jovan Nedovic
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Capacity ◽  
Mean Value ◽  
Disease Modifying Antirheumatic Drugs ◽  
Das 28 ◽  
Before And After ◽  
The Mean

Introduction It has been well known that balneophysical therapy has a therapeutic effect on clinical and biological parameters of disease activity in the patients with rheumatoid arthritis (RA). Objective. To determine the influence of balneophysical therapy on functional capacity, activity and quality of life of the patients with RA primarily treated with some of disease modifying antirheumatic drugs. Methods. The study enrolled 73 patients with RA treated with some of disease modifying antirheumatic drugs (Methotrexate in 85% of patients). During hospitalization at the Clinical Rheumatologic Department of the Institute 'Niska Banja', the patients were treated, beside the medicamentous therapy, by hydrotherapy (oligomineral, homeothermic, low radioactive water), mineral peloid therapy, electrotherapy and kinesiotherapy. Before and after balneotherapy, the patients filled in the Health Assessment Questionnaire (HAQ) and the Quality of Life Rheumatoid Arthritis (QOL-RA) scale. The Disease Activity Score (DAS) 28 was used to measure the disease activity before and after balneotherapy. A possible value of HAQ was from 0 to 3, and QOL-RA from 0 to 10. Results. The mean value of the duration of balneophysical therapy was 14.7?4.8 days. We found significant improvement of functional capacity in the patients with RA. The average HAQ score before balneotherapy was 1.07?0.61, and 0.86?0.55 after balneotherapy, which was statistically significantly lower (p<0.05). DAS 28 after balneotherapy was also statistically significantly lower than DAS 28 before balneotherapy: the mean value of DAS 28 before therapy was 6.30?0.81 and after therapy 5.48?0.75 (p<0.001). The quality of life significantly improved after balneophysical therapy: the mean value of QOL-RA scale before therapy was 5.38?1.62 and after therapy 7.35?1.81 (p<0.05). Conclusion. Balneophysical therapy, when properly dosed, is an effective, adjuvant therapy in the patients with RA of mild disease activity. Balneophysical therapy has a positive influence on disease activity, functional capacity and quality of life in the patients with rheumatoid arthritis.

scholarly journals Articular Eminence Inclination, Height, and Condyle Morphology on Cone Beam Computed Tomography

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Dilhan İlgüy ◽  
Mehmet İlgüy ◽  
Erdoğan Fişekçioğlu ◽  
Semanur Dölekoğlu ◽  
Nilüfer Ersan
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Mean Value ◽  
Cone Beam ◽  
Articular Eminence ◽  
Age And Gender ◽  
Mean Values ◽  
The Mean ◽  
And Gender ◽  
The Relationship

Aim. The aim of the present study was to examine the relationship between articular eminence inclination, height, and thickness of the roof of the glenoid fossa (RGF) according to age and gender and to assess condyle morphology including incidental findings of osseous characteristics associated with osteoarthritis (OA) of the temporomandibular joint (TMJ) using cone beam computed tomography (CBCT).Materials and Methods. CBCT images of 105 patients were evaluated retrospectively. For articular eminence inclination and height, axial views on which the condylar processes were seen with their widest mediolateral extent being used as a reference view for secondary reconstruction. Condyle morphology was categorized both in the sagittal and coronal plane.Results. The mean values of eminence inclination and height of males were higher than those of females (P<0.05). There were significant differences in the RGF thickness in relation to sagittal condyle morphology. Among the group of OA, the mean value of the RGF thickness for “OA-osteophyte” group was the highest (1.59 mm), whereas the lowest RGF values were seen in the “OA-flattening.”Conclusion. The sagittal osteoarthritic changes may have an effect on RGF thickness by mechanical stimulation and changed stress distribution. Gender has a significant effect on eminence height (Eh) and inclination.

scholarly journals Synovial Tissue Sublining CD68 Expression Is a Biomarker of Therapeutic Response in Rheumatoid Arthritis Clinical Trials: Consistency Across Centers

2009 ◽  
Vol 36 (8) ◽  
pp. 1800-1802 ◽  
Author(s):  
BARRY BRESNIHAN ◽  
ELIZA PONTIFEX ◽  
ROGIER M. THURLINGS ◽  
MARJOLEIN VINKENOOG ◽  
HANI EL-GABALAWY ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Early Stage ◽  
Medical Center ◽  
Biological Effects ◽  
Pearson Correlation ◽  
University Hospital ◽  
Mean Values ◽  
The Mean

Objective.To determine whether the correlation between the mean change in disease activity and the mean change in synovial sublining (sl) CD68 expression could be demonstrated across different academic centers.Methods.Synovial biopsies obtained at arthroscopy from patients with rheumatoid arthritis before and 160 days after rituximab therapy were selected and coded. Paired sections were processed independently at Amsterdam Medical Center (AMC) and at St. Vincent’s University Hospital (SVUH), Dublin. Digital image analysis (DIA) was employed at both centers to quantify sublining CD68 expression.Results.After analysis of CD68sl expression at centers in 2 different countries, high levels of intracenter and intercenter agreement were observed. For the pooled sections stained at AMC, the correlation between 2 investigators was R = 0.942, p = 0.000, and for sections stained at SVUH, R = 0.899, p = 0.001. Similarly, the intracenter correlations for ΔCD68sl expression after treatment were R = 0.998, p = 0.000, for sections stained at AMC and R = 0.880, p = 0.000, for sections stained at SVUH. The intercenter correlation for the pooled scores of sections stained at AMC was R = 0.85, p = 0.000, and for the sections stained at SVUH, R = 0.62, p = 0.001. The consistent correlation between ΔDAS (Disease Activity Score) and ΔCD68sl expression across different studies (Pearson correlation = 0.895, p < 0.001) was confirmed. The standardized response mean values for ΔCD68sl, calculated from analyses at both AMC and SVUH, were consistently 0.5 or greater, indicating a moderate to high potential to detect change.Conclusion.The correlation between mean ΔDAS and mean ΔCD68sl expression was confirmed across 2 centers. Examination of serial biopsy samples can be used reliably to screen for interesting biological effects at the site of inflammation at an early stage of drug development.

Demodex folliculorum in patients with rheumatoid arthritis

2007 ◽  
Vol 52 (1) ◽  
Author(s):  
Ihsan Ciftci ◽  
Umit Dundar ◽  
Zafer Cetinkaya ◽  
Mustafa Kulac ◽  
Nilay Kiyildi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Disease Duration ◽  
Demodex Folliculorum ◽  
Das 28 ◽  
Immunosuppressed Patients ◽  
The Mean ◽  
Demodex Mites ◽  
Assessment Of Disease Activity

AbstractThe objective of this study was to investigate the incidence and density of Demodex folliculorum in the patients with rheumatoid arthritis (RA). Forty-one patients with RA and twenty-seven age and sex matched healthy controls were enrolled in this study. Disease Activity Score (DAS 28) was used for the assessment of disease activity. Out of 41 patients, 33 were females and 8 males. The mean disease duration was 10.9 ± 8.2 years. The mean DAS 28 was 3.8 ± 1.2. No statistically significant differences in the incidence and density of Demodex mites were found between patients with RA and controls. Although immunosuppression is thought to be a risk factor for the D. folliculorum infestation no such correlations could be found in the 41 immunosuppressed patients with RA, therefore, further studies with larger groups are needed.

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