scholarly journals Prevalence and predictors of metabolic syndrome in rheumatoid arthritis

2017 ◽  
Vol 5 (8) ◽  
pp. 3322
Author(s):  
Muzafar Naik ◽  
Tariq Bhat ◽  
Ummer Jalalie ◽  
Mohd Tahir Ganayie ◽  
Mir Waseem ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Metabolic Syndrome ◽  
Disease Activity ◽  
Independent Predictor ◽  
Strong Association ◽  
Density Lipoprotein ◽  
Control Group ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Cardiovascular Morbidity And Mortality

Background: Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality secondary to accelerated atherosclerosis. There is a strong association of metabolic syndrome (MS) with atherosclerosis. The objective of this study was to assess the prevalence of MS in RA and to identify the predictors of MS in RA. Methods: The study included 100 patients of RA (83 females,17 males; median age 42.5(17) years diagnosed according to 2010 American College of Rheumatology-European League Against Rheumatism classification criteria who were on treatment and 110 age and sex-matched apparently healthy controls (26 males, 84 females; median age 45 (20) years). The frequency of MS was assessed using joint consensus 2009 criteria. Patients were also assessed in terms of disease activity, using disease activity score 28 CRP. Logistic regression was used to identify predictors of MS in RA.Results: Metabolic syndrome was found in 45% of RA group and 22.7% of control group according to joint consensus 2009 criteria (p<0.005). RA group was significantly more likely to have low high-density lipoprotein (65%), elevated blood pressure (60%) levels and abnormal sugar (28%). In RA group, CRP (odds ratio: 1.101, confidence interval: 1.032-1.174 (p=0.004) {adjusted for age, DAS 28 score & Anti-CCP} remained independent predictor for presence of MS in RA.Conclusions: The frequency of MS was higher in RA group compared to control group. High CRP remained independent predictor associated with presence of MS. There was no association of high disease activity with MS in our RA patients. These findings suggest that the treating physician should screen RA patients early for presence of MS.

High disease activity is associated with higher blood pressure in recent onset rheumatoid arthritis patients, post-hoc analyses of IMPROVED study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Gegenava ◽  
SA Bergstra ◽  
H Maassen ◽  
CF Allaart
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Disease Activity ◽  
Classification Criteria ◽  
Recent Onset ◽  
American College Of Rheumatology ◽  
Cardiovascular Morbidity And Mortality ◽  
The Difference ◽  
Post Hoc ◽  
Acpa Status

Abstract Funding Acknowledgements Type of funding sources: None. Background Rheumatoid arthritis (RA) is a chronic autoimmune disease with a high prevalence of cardiovascular morbidity and mortality. Purpose: purpose of our project was to investigate the association between disease activity and systolic and diastolic blood pressure (SBP, DBP) in patients with recent-onset rheumatoid arthritis (RA 2010 criteria) or undifferentiated arthritis (UA) who were treated to target disease activity score (DAS)&lt;1.6 in the IMPROVED study. Methods: The associations between disease activity and SBP/DBP were tested for 610 patients (364 RA, 246 UA), cross-sectionally and over time. GEE analyses were performed with both SBP and DBP as outcome measures and disease activity categories (DAS&lt;1.6;&gt;1.6 but ≤2.4; &gt;2.4), CRP level, treatment arms or the number of visits on a certain drug as potential predictors in separate analyses. Separate analyses tested potential contributions of gender, anti-cyclic citrullinated peptide antibodies (ACPA) status, and fulfilling the 2010 ACR/EULAR (American college of rheumatology/ European league against rheumatism) classification criteria. In addition association of BP with various levels of disease activity was tested with T-test. Results: At the baseline mean (SD) SBP was 133 (20) and DBP mean (SD) was 80 (10).  SBP &gt; 140mm Hg was observed in 40% of patients and DBP &gt; 90 mm Hg  in 21% of patients. SBP and DBP statistically significantly decreased during 5 years follow up (mainly during year 1), but the difference in mm Hg was small. Estimates from GEE analysis showed that patients with high DAS &gt;2.4 (HDAS) had a statistically significantly higher SBP (average 3 mm Hg higher, 95% CI 1.7; 4.2, p &lt; 0.01), than the patients in with DAS ≤2.4. ANOVA analyses showed a statistically significant association between SBP and DAS. In addition, post hoc analyses showed that patients with HDAS had a statistically significantly higher  SBP (mean (SD) 132 (19) than the patients with DAS &lt; 1.6 (remission) (mean (SD) 129 (20), p &lt; 0.01), and patients in LDAS but DAS≥1.6 had a statistically significantly higher SBP (mean (SD) 131 (19) than the patients in remission (mean (SD)  129 (20), p = 0.02) (Figure 1), whereas no association was found between DAS category and DBP. Gender, ACPA status or fulfilling the 2010 classification criteria did not influence the relation between DAS and blood pressure. Conclusions: In patients with RA or UA, a higher DAS is associated with higher blood pressure, but the clinical impact is unclear. Abstract Figure 1

scholarly journals The effect of a multidisciplinary lifestyle program for patients with rheumatoid arthritis, an increased risk for rheumatoid arthritis or with metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wendy Walrabenstein ◽  
Marike van der Leeden ◽  
Peter Weijs ◽  
Henriët van Middendorp ◽  
Carlijn Wagenaar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Metabolic Syndrome ◽  
Randomized Controlled Trial ◽  
Disease Activity ◽  
Controlled Trial ◽  
Control Group ◽  
Lifestyle Interventions ◽  
Randomized Controlled ◽  
Lifestyle Program ◽  
Increased Risk

AbstractLow-grade inflammation and metabolic syndrome are seen in many chronic diseases, including rheumatoid arthritis (RA) and osteoarthritis (OA). Lifestyle interventions which combine different non-pharmacological therapies have shown synergizing effects in improving outcomes in patients with other chronic diseases or increased risk thereof, especially cardiovascular disease. For RA and metabolic syndrome-associated OA (MSOA), whole food plant-based diets (WFPDs) have shown promising results. A WFPD, however, had not yet been combined with other lifestyle interventions for RA and OA patients. In this protocol paper, we therefore present Plants for Joints, a multidisciplinary lifestyle program, based on a WFPD, exercise, and stress management. The objective is to study the effect of this program on disease activity in patients with RA (randomized controlled trial [RCT] 1), on a risk score for developing RA in patients with anti-citrullinated protein antibody (ACPA) positive arthralgia (RCT 2) and on pain, stiffness, and function in patients with MSOA (RCT 3), all in comparison with usual care.We designed three 16-week observer-blind RCTs with a waiting-list control group for patients with RA with low to moderate disease activity (2.6 ≤ Disease Activity Score [DAS28] ≤ 5.1, RCT 1, n = 80), for patients at risk for RA, defined by ACPA-positive arthralgia (RCT 2, n = 16) and for patients with metabolic syndrome and OA in the knee and/or hip (RCT 3, n = 80). After personal counseling on diet and exercise, participants join 10 group meetings with 6–12 other patients to receive theoretical and practical training on a WFPD, exercise, and stress management, while medication remains unchanged. The waiting-list control group receives usual care, while entering the program after the RCT. Primary outcomes are: difference in mean change between intervention and control groups within 16 weeks for the DAS28 in RA patients (RCT 1), the RA-risk score for ACPA positive arthralgia patients (RCT 2), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score for MSOA patients (RCT 3). Continued adherence to the lifestyle program is measured in a two-year observational extension study.

scholarly journals Metabolic Syndrome Among Patients with Rheumatoid Arthritis and the Correlation with Disease Activity

2019 ◽  
Vol 70 (6) ◽  
pp. 2108-2111
Author(s):  
Cristina Gabriela Ene ◽  
Mihaela Mitroi ◽  
Ionela Mihaela Vladu ◽  
Lucretiu Radu ◽  
Tiberiu Stefanita Tenea Cojan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Metabolic Syndrome ◽  
Disease Activity ◽  
Joint Involvement ◽  
Control Group ◽  
Cvd Risk ◽  
Systemic Involvement ◽  
The Metabolic Syndrome ◽  
Cardio Vascular

Rheumatoid arthritis is a systemic inflamatory disease that affects primarily the synovial joints and it is associated with a progressive disability and a important socio-economic burden. [1] Although the main characteristic is the joint involvement, it is important to remember that RA is a disorder with systemic involvement mainly due to it�s chronic inflamation. Patients with RA have a higher risk of cardio-vascular mortality that in general population. There are numerous studies that sugest that inflamation plays a key�role in the develompent of aterosclerosis and heart disease, therefore a better understanding of the inflamatory response in RA may lead to better outcomes for patients with RA. Metabolic Syndrome is described as a congregate of major risk factors for cardiovascular diseases (CVD): Diabetes and raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood presure[2]. The clustering of CVD risk factors that typifies the metabolic syndrome is now considered to be the driving force for a new CVD epidemic [3]. The conducted study aims to assess and evaluate the presence of metabolic syndrome (MetS) in RA patients. 120 patients with RA (89 women and 31 men) and 120 (85 women and 35 men) patients without RA were included in the study. The prevalence of MetS in RA patients was 39.16% and 22.5% for the control group. RA patients with MetS had significantly higher disease activity score of 28 joints index (DAS28-ESR) than patients without MetS ( 3.70 � 0.644 vs. 3.35 �0.725; p=0.006).

scholarly journals Investigation of the Association between Metabolic Syndrome and Disease Activity in Rheumatoid Arthritis

2011 ◽  
Vol 11 ◽  
pp. 1195-1205 ◽  
Author(s):  
Maryam Sahebari ◽  
Ladan Goshayeshi ◽  
Zahra Mirfeizi ◽  
Zahra Rezaieyazdi ◽  
Mohammad R. Hatef ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Metabolic Syndrome ◽  
Disease Activity ◽  
Multiple Logistic Regression Analysis ◽  
Considerable Proportion ◽  
Control Group ◽  
Das28 Score ◽  
Reduced Physical Activity ◽  
The Relationship ◽  
Apparently Healthy

Rheumatoid arthritis (RA) is the most common form of autoimmune arthritis. Increased prevalence of metabolic syndrome (MetS) in RA may occur secondary to specific drug treatment and reduced physical activity associated with this condition. However, some recent studies suggest contradictory theories about the association of RA with MetS. This study was designed to evaluate the frequency of MetS in RA patients and the relationship between MetS with RA disease activity and body mass index (BMI). The study was conducted on 120 RA patients and 431 age- and sex-matched apparently healthy controls. A considerable proportion of patients were being treated with prednisolone and/or methotrexate and/or hydroxychloroquine. Disease activity was measured by the 28 joint count of disease activity score-Cerythrocyte sedimentation rate (DAS28ESR). MetS was evaluated according to International Diabetic Federation (IDF) and Adult Treatment Panel III (ATP III) criteria. The prevalence of MetS was significantly higher in the control group (p= 0.005). We did not find any difference in the prevalence of MetS between the patients with DAS < 3.2 and DAS ≥ 3.2. There was no association between the DAS28 score and the presence of MetS components by either definition. Multiple logistic regression analysis showed that the odds of a DAS > 3.2 in patients with BMI between 25 and 30 kg/m2(OR = 0.1,p= 0.01) and BMI > 30 kg/m2(OR = 0.3,p= 0.1), in comparison to BMI < 25 kg/m2, was 1/5 and 1/3, respectively. RA was not found to increase the risk of MetS. In addition, disease activity in RA patients was not influenced by the presence of MetS.

Short-term Risk of Total Malignancy and Nonmelanoma Skin Cancers with Certolizumab and Golimumab in Patients with Rheumatoid Arthritis: Metaanalysis of Randomized Controlled Trials

2012 ◽  
Vol 39 (4) ◽  
pp. 712-715 ◽  
Author(s):  
PIERRE LE BLAY ◽  
GAEL MOUTERDE ◽  
THOMAS BARNETCHE ◽  
JACQUES MOREL ◽  
BERNARD COMBE
Keyword(s):  
Rheumatoid Arthritis ◽  
Control Group ◽  
Chi Square ◽  
American College Of Rheumatology ◽  
Skin Cancers ◽  
European League Against Rheumatism ◽  
Increased Risk ◽  
Statistical Heterogeneity ◽  
Nonmelanoma Skin Cancers ◽  
Necrosis Factor

Objective.To assess the risk of total malignancy and nonmelanoma skin cancers (NMSC) in patients with rheumatoid arthritis (RA) receiving certolizumab and golimumab through a metaanalysis of data from randomized control trials (RCT).Methods.We systematically reviewed the literature up to May 2011 in Medline databases, as well as abstracts from the 2009 and 2010 annual meetings of the European League Against Rheumatism and the American College of Rheumatology. Mantel-Haenszel method was used to determine a common odds ratio (OR). Statistical heterogeneity was assessed by chi-square Q test. We selected only RCT including more than 30 RA subjects randomly assigned to an anti-tumor necrosis factor (TNF) or a nonbiological disease-modifying antirheumatic drug (DMARD) control group.Results.The literature search identified 793 articles; 6 (2 with certolizumab and 4 with golimumab) were selected for metaanalysis. A total of 2710 patients received at least 1 dose of certolizumab or golimumab. For anti-TNF-treated patients, 18 cancers (excluding NMSC) and 9 NMSC were observed versus 4 cases of total malignancy and 3 NMSC in control groups. Metaanalysis revealed a pooled OR of 1.06 (95% CI 0.39–2.85) for risk of total malignancy and 0.69 (95% CI 0.23–2.11) for risk of NMSC with certolizumab and golimumab versus DMARD. Heterogeneity was not significant.Conclusion.Metaanalysis of RCT of golimumab and certolizumab did not find an increased risk of total malignancy and NMSC. These results must be confirmed with longterm extension studies and registry studies, and careful monitoring remains mandatory.

scholarly journals Evaluation of the pulse wave velocity in African rheumatoid arthritis subjects

2016 ◽  
Vol 5 (1) ◽  
pp. 138
Author(s):  
Maïmouna Touré ◽  
Valentin Ouédraogo ◽  
Demba Dièdhiou ◽  
Moustapha Niasse ◽  
Souleymane Thiam ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Arterial Stiffness ◽  
Pulse Wave ◽  
Systemic Disease ◽  
Control Group ◽  
Vascular Events ◽  
Black African ◽  
American College Of Rheumatology ◽  
Cardiovascular Morbidity And Mortality ◽  
African Patients

Background: Rheumatoid arthritis is a systemic disease with often fatal vascular events. In addition to traditional cardiovascular risk factors, disease-specific elements contribute to this cardiovascular mortality. The aim of this study was to assess arterial stiffness in rheumatoid arthritis and to determine the factors involved.Methods: We have recruited the black African patients followed in rheumatology and had rheumatoid arthritis diagnosis. Only patients between 18 and 60 years and meeting the American College of Rheumatology criteria were included. All controls were healthy. We evaluated the propagation velocity of the pulse wave finger-toe (PWVft) measured by the pOpmètre®.Results: Present study shows that the PWVft was significantly elevated in over half of patients (55.10%). Besides, the mean patients PWVft was significantly higher than that of the control (respectively 9.40±0.51 and 7.22±0.33 p=0.001). In the patients, no factor was significantly involved in the arterial stiffness, but cons in the control group, the PWVft was significantly correlated with age (p=0.023 and r=0.55).Conclusions: Rheumatoid arthritis patients had higher PWVft compared to controls. Due to the importance of its cardiovascular morbidity and mortality, arthritis requires a regular monitoring element as arterial stiffness, which is currently a major vascular parameter monitoring.

scholarly journals POS0558 STATE OF ADIPOCYTOKINES IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH SUBCLINICAL ATHEROSCLEROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 514.1-514
Author(s):  
I. Krivotulova ◽  
T. Chernysheva
Keyword(s):  
Rheumatoid Arthritis ◽  
Subclinical Atherosclerosis ◽  
Control Group ◽  
Adiponectin Concentration ◽  
American College Of Rheumatology ◽  
Group I ◽  
European League Against Rheumatism ◽  
Tnf Α ◽  
The Mean ◽  
European League

Background:The causes of accelerated atherosclerosis in rheumatoid arthritis (RA) are not completely understood [1]. Therefore, there is a need to identify new biomarkers of increased cardiovascular risk in RA.Objectives:To establish the relationship of adipocytokines (adiponectin and leptin) with metabolic and inflammatory markers of subclinical atherosclerosis in RA patients.Methods:The study included 88 women with RA according to the ACR (American College of Rheumatology)/EULAR (European League Against Rheumatism) criteria, 2010 [2] who visited the adaptation therapy clinic of Orenburg State Medical University. The mean±SD age was 46.43±8.5 years and the mean±SD disease duration was 8.21±5.56 years.We evaluated the following laboratory parameters in all patients: erythrocyte sedimentation rate (ESR), total cholesterol, triglycerides (TAG), high-density lipoproteins (HDL), low-density lipoproteins (LDL) and C-reactive protein (CRP). Serum concentrations of adiponectin, leptin, rheumatoid factor (RF), tumor necrosis factor-α (TNF-α), and interleukin-17 (IL-17) were determined by enzyme-linked immunosorbent assay (ELISA).We carried out ultrasound (US) duplex scanning of the carotid arteries by the device “Philips Epiq 7” with linear transducer with frequency of 4-18 MHz with the division into 2 groups of patients: group I consisted of 44 women with US signs of subclinical atherosclerosis, group II – 44 women without these signs. The control group included 30 women without inflammatory joint diseases and US signs of subclinical atherosclerosis and similar in gender, age and body mass index (BMI) to RA patients.The program STATISTICA, 12.0 was used for statistical analysis.Results:The serum adiponectin level was significantly higher in RA patients compared to the control group (p<0.0001): 40.88±13.60 ng/ml versus 22.75±11.27 ng/ml. The level of leptin in the blood serum of women with RA and healthy individuals was approximately the same and amounted to 18.07±14.02 ng/ml and 16.60±11.45 ng/ml respectively. When comparing the levels of adipocytokines in RA patients, the predominance of concentrations of both adipokines in patients with paraclinical atherosclerosis were noted. The adiponectin concentration was 46.08±14.44 ng/ml versus 35.70±10.51 ng/ml (p<0.001). The leptin level was 26.40±20.06 ng/ml versus 14.96±16.62 ng/ml (p<0.01).Correlation analysis showed an negative relationship between adiponectin levels and metabolic markers of atherosclerosis: BMI (r=-0.52; p<0.05), neck circumference (NC) (r=-0.50; p<0.05), levels of LDL (r=-0.77; p<0.001) and TAG (r=-0.59; p<0.05) as well as proinflammatory cytokines: TNF-α (r=-0,48; p<0.05), IL-17 (r= -0.60; p<0.01) in patients of both groups. The increase in adiponectin concentration in group II patients was associated with the duration of administration of methotrexate (r=0.49; p<0.05) and glucocorticosteroids (r=0.71; p<0.001). Direct correlations were found between the level of leptin and BMI (r=0.48; p<0.05), NC (r=0.48; p<0.05), LDL (r=0.54; p<0.05) and TAG (r=0.45; p<0.05), CRP (r=0.49; p<0.05) and IL-17 (r= 0.52; p<0.05) in group I patients.Conclusion:There is a significant increase in the production of adipocytokines in RA with subclinical atherosclerosis. Correlations of levels of adipokines with metabolic and inflammatory markers of atherosclerosis, on the one hand, indicate the influence of adipose tissue on systemic inflammation and, on the other hand, confirm the involvement of proinflammatory cytokines in the development of atherosclerotic vascular damage in patients with RA.References:[1]Mahmoudi M, Aslani S, Fadaei R, Jamshidi AR. New insights to the mechanisms underlying atherosclerosis in rheumatoid arthritis. Int J Rheum Dis. 2017;20(3):287-297. doi: 10.1111/1756-185X.12999[2]Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69:1580—8. doi:10.1136/ard.2010.138461Disclosure of Interests:None declared

scholarly journals FRI0094 SIGNIFICANT IMPROVEMENT OF NT-PROBNP LEVELS IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH TOCILIZUMAB AND TOFACITINIB

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 625.2-626
Author(s):  
H. Gerasimova ◽  
T. Popkova ◽  
I. Kirillova ◽  
M. Cherkasova ◽  
A. Martynova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cardiovascular Death ◽  
Control Group ◽  
Activity Levels ◽  
Das 28 ◽  
Interleukin 6 Receptor ◽  
Inflammatory Drugs ◽  
Roche Diagnostics

Background:N-terminal pro-brain natriuretic peptide (NT-proBNP) is a recognized predictor of congestive heart failure (CHF) and cardiovascular death. Rheumatoid arthritis (RA) patients (pts) were shown to have higher NT-proBNP concentrations than in general population, but it remains unclear, whether NT-proBNP levels are related to RA duration, activity or treatment.Objectives:To investigate the effect of interleukin 6 receptor inhibitor - tocilizumab (TCZ) and JAK inhibitor - tofacitinib (TOFA) on NT-proBNP levels in RA pts during a 12-month (m) follow-up period.Methods:The study enrolled 60pts (50women/10men) with the lack of efficacy/resistance and/or intolerance of basic anti-inflammatory drugs (DMARDs); median age was 55[42;61] years, median disease duration 55[29;120]m, with moderate to high activity (DAS28-5,1[4,6;6,1], serum positivity for rheumatoid factor (RF)(85%)/ anti-cyclic citrullinated peptide antibodies (ACCP)(80%). The study did not include RA pts with CHF and clinically overt cardiovascular disease (CVD). Twenty nine RA pts received TCZ(8mg/kg) every 4 weeks: 61% received TCZ in combination with methotrexate (MTX), 35% - with low-dose glucocorticoids (GCs). Thirty one RA pts were prescribed oral TOFA at 5 mg BID with dose escalation to 10 mg BID in 8 (26%)pts. TOFA was used in combination with MTX in 90% pts, with GCs – in 29% pts. Pts treated with TCZ and TOFA were comparable in terms of age, sex, body mass index. RA activity rates (DAS28, SDAI, ESR, CRP) were higher in pts on TCZ -therapy compared with pts treated with TOFA. Echocardiography data and NT-proBNP levels using electrochemiluminescence method Elecsys proBNP II (Roche Diagnostics, Switzerland) were obtained at baseline and after 12m.Results:Significant positive changes in major disease activity, clinical and laboratory parameters were found in RA pts after 12 m of TCZ infusion and TOFA intake: remission (DAS28<2,6) was achieved in 54% and 39% pts, low activity levels (DAS28<3,2) – in 46% and 51% pts, respectively.The NT-proBNP levels were significantly higher in RA pts than in the control group (median 69,1 (37,9;105,8) pg/mL vs 55,3 (36,6;67,3) pg/mL,p<0.05).Six pts (10%) (three in each pts group) had NT-proBNP levels over 125pg/ml, but were asymptomatic and had unremarkable echocardiography.There was a good correlation between NT-proBNP level at baseline with age (r=0,55,p<0,001), SDAI (r=0,5, h=0,01), ACCP (r=0,23,p=0,01).Decrease of median NT-proBNP levels was documented after 12m of TCZ therapy (81,5[43,0;102,0]vs41,6[25,4;64,2]pg/ml (p<0,01) and after 12m TOFA therapy (66,1[30,5;105,0]vs16,8 [5,0;81,0]pg/ml,p=0,001).After 12m of TCZ correlations of ΔNT-proBNP were established with ΔESR (R=0,43;p<0,05], ΔСRP (R=0,46;p<0,05], ΔEe left ventricle (LV) (r=0,88,p=0,03).In the group of pts treated with TOFA ΔNT-proBNP level significantly correlated with the percentage change in DAS 28 (r=0,41,p=0,038), there was no direct correlation with changes in the parameters of the LV diastolic function.Conclusion:TCZ and TOFA treatment for 12 m reduced NT-proBNP levels in RA pts without clinically manifest CVD and CHF. Falling NT-proBNP concentrations are associated with positive dynamics of RA activity (DAS 28) and inflammatory markers (CRP, ESR), therefore allowing to suggest that increased NT-proBNP levels should be considered as a component of disease activity. Correlation between ΔNT-proBNP and ΔEeLF may be indicative as possible impact of these biomarkers on the LV diastolic function’s development in RA pts.Disclosure of Interests:None declared

Patients with Rheumatoid Arthritis in Clinical Remission Manifest Persistent Joint Inflammation on Histology and Imaging Studies

2014 ◽  
Vol 41 (11) ◽  
pp. 2153-2160 ◽  
Author(s):  
Allen Anandarajah ◽  
Ralf Thiele ◽  
Ellen Giampoli ◽  
Johnny Monu ◽  
Gwy-Suk Seo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Remission ◽  
Severe Disease ◽  
Joint Inflammation ◽  
Imaging Studies ◽  
American College Of Rheumatology ◽  
Remission Criteria ◽  
Magnetic Resonance Imaging Mri ◽  
Active Inflammation

Objective.The purpose of our study was to test the hypothesis that synovitis on magnetic resonance imaging (MRI) and ultrasound (US) observed in patients with rheumatoid arthritis (RA) who meet remission criteria reflects active inflammation on histopathology.Methods.We analyzed 15 synovial specimens obtained during surgical procedures from 14 patients with RA in clinical remission as defined by the American College of Rheumatology criteria. Histological specimens were scored for hyperplasia of synovial lining and synovial stroma, inflammation, lymphoid follicles, and vascularity. The histology scores were classified as minimal, mild, moderate, or severe disease activity. US and MRI performed within a 4-month period of surgery were scored for disease activity. The correlation between histology and imaging scores was examined.Results.Four of 14 patients were receiving anti-tumor necrosis factor (TNF) therapy, 4 were receiving methotrexate (MTX) alone, 4 were taking MTX and hydroxychloroquine (HCQ), and 1 was taking HCQ and sulfasalazine. Four specimens had severe, 6 moderate, 3 mild, and 2 minimal disease activity on histology. Three of 4 specimens with minimal and mild histology were observed in subjects receiving anti-TNF therapy. Synovitis was noted on greyscale in 80% of joints and Doppler signal in 60%. MRI demonstrated synovitis and bone marrow edema in 86% of images. Positive but not significant correlations were noted between histology and synovitis scores on US.Conclusion.Despite clinical remission, histology and imaging studies documented a persistently active disease state that may explain the mechanism for radiographic progression.

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