scholarly journals Long term progression of joint damage in rheumatoid arthritis.

1986 ◽  
Vol 45 (5) ◽  
pp. 373-378 ◽  
Author(s):  
D L Scott ◽  
B L Coulton ◽  
A J Popert
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Damage

scholarly journals Understanding the Mechanisms of Pain in Rheumatoid Arthritis

2020 ◽  
Author(s):  
Kathryn Biddle ◽  
Nidhi Sofat
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Damage ◽  
Joint Inflammation ◽  
Long Term Follow Up ◽  
Important Symptom ◽  
Ongoing Pain ◽  
Disease Modifying Agents

Pain is a debilitating feature of rheumatoid arthritis (RA) and is often described by patients as their most important symptom. Rheumatoid arthritis pain has traditionally been attributed solely to joint inflammation, however despite the advent of increasingly effective disease modifying agents, patients continue to report pain at long term follow up. The cause for ongoing pain is multifactorial and includes joint damage and pain sensitisation. In this book chapter, we will describe the mechanisms underlying the distinct components of pain which are manifest in rheumatoid arthritis and discuss why a thorough assessment of pain is vital to target treatments appropriately.

scholarly journals Identification of Patients With Early Rheumatoid Arthritis: Challenges and Future Directions

2006 ◽  
Vol 13 (2-4) ◽  
pp. 295-297 ◽  
Author(s):  
Catalina Orozco ◽  
Nancy J. Olsen
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Inflammatory Arthritis ◽  
Gene Expression Analysis ◽  
Adult Population ◽  
Joint Damage ◽  
Early Arthritis ◽  
Future Directions ◽  
Serologic Markers

Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis that affects the adult population. Early diagnosis and treatment are the cornerstones to prevent joint damage and avoid long-term costs and disability. This article reviews the limitations of the currently available tools for the evaluation of patients with early arthritis, including clinical assessment, serologic markers and imaging modalities. It also discusses gene expression analysis, a newer and potentially promising approach to the early diagnosis of RA.

scholarly journals Association between pain phenotype and disease activity in rheumatoid arthritis patients: a non-interventional, longitudinal cohort study

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
P. M. ten Klooster ◽  
N. de Graaf ◽  
H. E. Vonkeman
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Longitudinal Study ◽  
Disease Activity ◽  
Joint Damage ◽  
Nociceptive Pain ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Comorbid Diseases

Abstract Background In well-controlled rheumatoid arthritis (RA) without significant joint damage, a substantial proportion of patients complain of persistent pain. Previous studies have identified different pain phenotypes in RA, in which non-nociceptive pain phenotypes are associated with higher concurrent disease activity scores. In this longitudinal study, we explored associations between pain phenotypes and long-term disease activity outcome in RA patients. Secondly, we explored whether pain phenotype is associated with comorbid conditions. Methods One hundred eighty established RA patients were classified with a nociceptive (61%) or a non-nociceptive (39%) pain phenotype, based on their responses to the painDETECT-questionnaire. Two years of clinical follow-up data on disease activity outcomes were collected. Information on comorbid diseases was derived from electronic patient files. Results Patients with a non-nociceptive pain phenotype showed higher mean disease activity scores (DAS28, 2.57; 95% CI, 2.37–2.77 vs. 2.11; 95% CI, 1.94–2.27; p < 0.001) and a twofold lower chance of achieving sustained DAS28 remission (OR = 0.49; 95% CI, 0.26–0.92; p = 0.020). Only the tender joint count and patient global health significantly differed between the pain phenotype groups. Patients with a non-nociceptive pain phenotype had more often been diagnosed with concurrent fibromyalgia (9.9% vs. 0.9%; p = 0.007) and other pain-associated comorbid diseases (52.1% vs. 35.8%; p = 0.030) compared with patients with a nociceptive pain phenotype. Conclusion This longitudinal study showed consistently worse long-term disease activity outcomes in RA patients with a non-nociceptive pain phenotype which appeared to be mainly due to differences in the subjective components of the disease activity score. Trial registration The DREAM cohort study is registered in the Netherlands Trial Register: NTR578.

scholarly journals Lipids and Atherogenic Indices Fluctuation in Rheumatoid Arthritis Patients on Long-Term Tocilizumab Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Fabio Cacciapaglia ◽  
Maria Grazia Anelli ◽  
Angela Rinaldi ◽  
Marco Fornaro ◽  
Giuseppe Lopalco ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Joint Damage ◽  
Joint Disease ◽  
Atherogenic Index ◽  
Prolonged Treatment ◽  
Control Group ◽  
Long Term Treatment

Rheumatoid arthritis (RA) patients are at high risk of cardiovascular (CV) events, and the chronic inflammatory state may generate quantitative and qualitative changes in lipoprotein fractions. The anti-IL-6 receptor tocilizumab (TCZ), even if effective in inflammation and joint damage prevention, determined significant alterations to RA patients’ lipid levels in randomized controlled trials, but real-world data are lacking. We evaluated the changes in lipid fraction levels and disease activity in a longitudinal cohort of RA patients on long-term treatment with tocilizumab (TCZ) in a community setting. We retrospectively selected 40 naïve-biologic RA patients on treatment with intravenous TCZ compared to 20 RA patients on methotrexate treatment as the control group. Total cholesterol (Tot-Chol), low-density lipoproteins (LDL), high-density lipoprotein (HDL), and triglyceride (TG) levels were measured at the baseline and at 12, 24, and 52 weeks thereafter. At the same points, 28-joint disease activity score (DAS28), clinical disease activity index (CDAI), and EULAR clinical responses were also assessed. During the first 24 weeks, we observed in TCZ-treated patients a progressive statistically significant (p<0.001) increase in Tot-Chol, LDL, HDL, and TG, which returned close to the baseline at 52 weeks. But no changes in the lipid-related CV risk indices Tot-Chol/HDL and LDL/HDL ratios and the atherogenic index (log10 TG/HDL) were detectable. Notably, we observed a statistically significant negative correlation between changes in lipid fractions and DAS28 or CDAI. The prolonged treatment with TCZ was associated to a transient increase in cholesterol’s fractions during the first 6 months of treatment, with inverse correlation to disease activity, but with no impact on surrogate lipid indices of atherogenic risk. These findings may aid clinicians in interpreting the RA patient’s lipid profile in daily clinical practice.

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