scholarly journals The prediction and long-term maintenance of low disease activity during therapy with disease modifying anti-inflammatory drugs for rheumatoid arthritis

2014 ◽  
Vol 0 (2) ◽  
pp. 66 ◽  
Author(s):  
E.L. Luchikhina
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Low Disease Activity ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
Anti Inflammatory ◽  
Term Maintenance

scholarly journals Regular use of non-steroidal anti-inflammatory drugs can effectively control pain and global health in patients with moderate activity of rheumatoid arthritis

2021 ◽  
Vol 15 (2) ◽  
pp. 57-63
Author(s):  
A. E. Karateev ◽  
E. Yu. Pogozheva ◽  
V. N. Amirdzhanova ◽  
E. S. Filatova ◽  
V. A. Nesterenko
Keyword(s):  
Rheumatoid Arthritis ◽  
Global Health ◽  
Disease Activity ◽  
Baseline Level ◽  
Mean Value ◽  
Moderate Activity ◽  
Low Disease Activity ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Control Pain

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to control pain in rheumatoid arthritis (RA). However, many aspects of the therapeutic effect of NSAIDs in RA have not been sufficiently studied. In particular, this concerns the effect of NSAIDs on the inflammatory activity of the disease.Objective: to study the comparative efficacy and safety of NSAIDs in RA patients with moderate and low disease activity.Patients and methods. The study group consisted of 404 patients with RA, 69% women and 31% men, mean age 58.6±10.0 years, with moderate and low disease activity – DAS28<5.1 (mean value 3.7±1.5), who initially had moderate or severe pain: >4 cm on the visual analog scale (VAS) 0–10 cm. All patients received DMARDs, mostly methotrexate 15 to 25 mg weekly, 8.2% biological agents, 18.6% glucocorticoids. All patients were prescribed NSAIDs at the full therapeutic dose. The results of treatment were evaluated after 2 weeks, 1, 3 and 6 months. Criteria of efficacy were the dynamics of pain (10 cm VAS), Patient Global Health (PGH on a 10-cm VAS), the change in the tender joints count (TJC) and swollen joints count(SJC), and dynamics of RA activity (DAS28).Results and discussion. 54.2% of patients received aceclofenac, 19.8% nimesulide, 14.3% meloxicam, 9.1% diclofenac, 2.6% – other NSAIDs. After 2 weeks, the pain decreased from 6.3±1.2 cm to 4.5±1.5 cm on VAS (p<0.001). The severity of pain continued to decrease further, and after 6 months of observation was 4.0±1.2 (p< 001, compared with the baseline level). A similar result was observed for the TJC, SJC, and PGH: the dynamics of these indicators, in comparison with the baseline level, was statistically significant after 2 weeks and after 1, 3, and 6 months of observation (p< 0.05). There was a decrease in the disease activity by DAS28: from 3.7±1.5 to 3.4±1.1 after 3 months (p=0.041) and 3.1±0.9 after 6 months (p=0.02). The effectiveness of aceclofenac and other NSAIDs for pain reduction, TJC, SJC, PGH and DAS28 did not differ. The tolerability of aceclofenac was better than of other NSAIDs: the frequency of dyspepsia after 2 weeks was 23.3% and 36.2% (p=0.004). The frequency of arterial hypertension and edema in patients who used aceclofenac, after 2 weeks and 6 months was slightly lower than in patients treated with other NSAIDs, but the difference was not statistically significant.Conclusion. The use of NSAIDs can effectively control the pain and other symptoms of RA, as well as the disease activity by DAS28 in patients with moderate or low disease activity. Aceclofenac is not inferior to other NSAIDs in analgesic potential and exceeds them in tolerability.

scholarly journals Change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yoshinari Matsumoto ◽  
Nitin Shivappa ◽  
Yuko Sugioka ◽  
Masahiro Tada ◽  
Tadashi Okano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Quantitative Measure ◽  
Inflammatory Change ◽  
Multivariable Logistic Regression Analysis ◽  
Dietary Inflammatory Index ◽  
Low Disease Activity ◽  
Inflammatory Index ◽  
Rheumatoid Arthritis Disease ◽  
Anti Inflammatory

Abstract Background The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, the association between DII score and disease activity of rheumatoid arthritis (RA) is unclear. Therefore, this study was designed to test whether higher DII score contributes to disease activity and as a corollary, whether reducing DII score helps to achieve or maintain low disease activity or remission in patients with RA. Methods We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a cohort study consisting of 208 RA patients and 205 gender- and age-matched controls started in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DII™) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis. Results One hundred and seventy-seven RA patients and 183 controls, for whom clinical and dietary survey data were available, were analyzed. RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). In RA patients, E-DII score was not a factor associated with significant change in disease activity. However, anti-inflammatory change in E-DII score was associated maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR 3.46, 95% CI 0.33–8.98, p = 0.011). Conclusions The diets of RA patients had a higher inflammatory potential than controls. Although E-DII score was not a factor associated with significant disease activity change, anti-inflammatory change in E-DII score appeared to be associated with maintaining low disease activity in patients with RA. Trial registration UMIN Clinical Trials Registry, UMIN000003876. Registered 7 Aug 2010—retrospectively registered.

Effectiveness of a second biologic after failure of a non-tumor necrosis factor inhibitor as first biologic in rheumatoid arthritis

2021 ◽  
pp. jrheum.201467
Author(s):  
Katerina Chatzidionysiou ◽  
Merete Lund Hetland ◽  
Thomas Frisell ◽  
Daniela Di Giuseppe ◽  
Karin Hellgren ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Disease Activity ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Inhibitor ◽  
Primary Response ◽  
Low Disease Activity ◽  
Factor Inhibitor ◽  
Disease Modifying ◽  
Necrosis Factor

Objective In Rheumatoid Arthritis (RA), evidence regarding the effectiveness of a second biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) in patients whose first ever bDMARD was a non-tumor-necrosis-factor-inhibitor (TNFi) bDMARD is limited. The objective of this study was therefore to assess the outcome of the second bDMARD (non-TNFi [rituximab, abatacept or tocilizumab, separately] and TNFi) after failure of a non-TNFi bDMARD as first bDMARD. Methods We identified RA patients from the five Nordic biologics registers started treatment with a non-TNFi as first ever bDMARD but switched to a second bDMARD. For the second bDMARD, we assessed survival-on-drug (at 6 and 12 months), and primary response (at 6 months). Results We included 620 patients starting a second bDMARD (ABA 86, RTX 40, TCZ 67 and TNFi 427) following failure of a first non-TNFI bDMARD. At 6 and 12 months after start of their second bDMARD, around 70% and 50%, respectively, remained on treatment, and at 6 months less than one third of patients were still on their second bDMARD and had reached low disease activity or remission according to DAS28. For those patients whose second bMDARD was a TNFI, the corresponding proportion was slightly higher (40%). Conclusion The survival-on-drug and primary response of a second bDMARD in RA patients switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD.

scholarly journals New Therapeutic Approaches for the Treatment of Rheumatoid Arthritis may Rise from the Cholinergic Anti-Inflammatory Pathway and Antinociceptive Pathway

2010 ◽  
Vol 10 ◽  
pp. 2248-2253 ◽  
Author(s):  
Xiao Hua Pan ◽  
Jianxin Zhang ◽  
Xiaowei Yu ◽  
Ling Qin ◽  
Ligeng Kang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Therapeutic Approaches ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Drug Discovery And Development ◽  
New Therapeutic Approaches ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
Anti Inflammatory ◽  
Current Stage

Due to the complex etiology of rheumatoid arthritis (RA), it is difficult to be completely cured at the current stage although many approaches have been applied in clinics, especially the wide application of nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). New drug discovery and development via the recently discovered cholinergic anti-inflammatory and antinociceptive pathways should be promising. Based on the above, the nicotinic acetylcholine receptor agonists maintain the potential for the treatment of RA. Therefore, new therapeutic approaches may rise from these two newly discovered pathways. More preclinical experiments and clinical trials are required to confirm our viewpoint.

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