scholarly journals Correlation Between Carotid Intima-Media Thickness and the Activity of Rheumatoid Arthritis: A 1-Year Cross-Sectional Study

2018 ◽  
Vol 30 (3) ◽  
pp. 34-41
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Media Thickness ◽  
Das 28 ◽  
Significant Difference ◽  
The Mean

Background and objectives: Among several noninvasive techniques available, a high-resolution B-mode ultrasonography is the widely used technique to measure carotid intima-media thickness (CIMT) in rheumatoid arthritis (RA) patients with elevated cardiovascular risk. The present study was undertaken to explore the clinical relationship between CIMT and disease activity in patients with RA. Methods: This study involved 50 adult patients with RA. Demographic, physical, systemic, and clinical data and history of the patients were recorded. Investigations, such as erythrocyte sedimentation rate, highly sensitive C-reactive protein, renal and liver function tests, RA factor, and anticyclic citrullinated peptide antibody tests were performed. CIMT was assessed using highresolution B-mode ultrasonography and the disease severity was assessed based on disease activity score (DAS) 28. Results: The mean age of the RA patients was 49.88 ± 12.12 years with male predilection. The mean duration, mean European League Against Rheumatism (EULAR) criteria score, and mean DAS 28 score in RA patients were 3.62 ± 3.25 years, 8.10 ± 1.58, and 4.91 ± 1.11, respectively. The mean CIMT observed in RA patients was 0.94 ± 0.31 cm. Significant difference was observed in the mean CIMT values of different variables, including duration of joint pain (P = 0.007), tender joint count (P < 0.001), swollen joint count (P < 0.001), EULAR criteria score (P < 0.001), and DAS 28 score (P < 0.001). Also, CIMT correlated positively with tender joint count (r = 0.711; P < 0.001), swollen joint count (r = 0.673; P < 0.001), EULAR criteria score (r = 0.611; P < 0.001), and DAS 28 score (r = 0.729; P < 0.001). Conclusion: A strong correlation was observed between CIMT and disease activity in patients with RA. Hence, CIMT can be a useful surrogate marker for detecting atherosclerosis in patients with RA.

scholarly journals Factors affecting carotid intimal medial thickness in patients with rheumatoid arthritis, an analytical cross-sectional study

2019 ◽  
Vol 6 (3) ◽  
pp. 628
Author(s):  
K. M. Prabhuswamy ◽  
M. Virgin Joena
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional ◽  
Media Thickness ◽  
The Mean

Background: IMT assessment as a non-invasive imaging test is quite widely used especially among RA patients, the clinical applications of using such knowledge is scarce, hence study was conducted to compare the carotid artery intima-media thickness (CIMT) in patients with rheumatoid arthritis (RA) with healthy controls also to study the correlation between duration of rheumatoid arthritis, the activity of rheumatoid arthritis and other factors influencing (CIMT).Methods: In analytical cross-sectional study, of 80 participants of RA and 40 healthy controls, “DAS28” was used to assess disease activity.  Carotid intima-media thickness assessed using carotid ultrasonography.Results: Mean age of the cases and controls was 43.9 and 44.38 years. Subjects with duration of disease <2 years, to 5 years and >5 years were 35%, 45% and 20%. The mean carotid intima-media thickness was 5.61mm in controls, and CIMT was 6.11mm in people below 2 years and 7.08 mm in people between 2 to 5 years and 8.00mm in people above 5 years which was statistically significant. The mean carotid intima-media thickness was 5.61mm controls and 6.86mm in people with low, 7.00mm in people with moderate and 6.95mm in people with high disease activity, which was statistically significant.Conclusions: Study findings revealed risk of increase in carotid intima-media thickness higher among RA patients in the later stages and can increase the patients’ susceptibility to cardiovascular events. The factors showing strong association with intimal medial thickness were the age and symptoms duration.

Anemia of Chronic Disease in Rheumatoid Arthritis and its Relationship with Disease Activities

2020 ◽  
Vol 33 (2) ◽  
pp. 85-93
Author(s):  
Md Rofiqul Islam ◽  
Md Shafiqul Islam ◽  
Mst Musarrat Sultana
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Disease ◽  
Disease Activity ◽  
Morning Stiffness ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Anemia Of Chronic Disease ◽  
Das 28 ◽  
Significant Difference ◽  
The Relationship

Background: Rheumatoid arthritis is the most common form of inflammatory arthritis. Anemia is a common extra-articular manifestation and anemia of chronic disease (ACD) is the most common form of anemia in rheumatoid arthritis that reduces the quality of life. Objectives: The purpose of this study was to find out the prevalence of anemia of chronic disease (ACD) in Rheumatoid arthritis and to determine the relationship between ACD and disease activity of rheumatoid arthritis patients and to Identify the relationship between ACD and disease activity of rheumatoid arthritis patients. Methods: This was an observational cross-sectional study was conducted at the Department of Medicine, Rajshahi Medical College Hospital, Rajshahi. Consecutive 165 patients of rheumatoid arthritis with anemia who fulfilled the inclusion and exclusion criteria were enrolled in this study. Results: In this study mean age of these patients was 43.2±13.5 years. Male were 27(16.4%) and female 135(83.6%) with male: female ratio was 1:5.1. Most of the patients (29.1%) were illiterate, maximum participants (81.8%) were married and housewife 73.3%. DAS- 28 score (p< 0.001), tender and swollen joint count (p<0.001 for both tender and swollen joint count), ESR (p< 0.001) and HAQ score (p< 0.001) were significantly higher in anemic group of patients as compared to non-anemic. But there was no significant difference in terms of disease duration, morning stiffness and RF positivity between mentioned groups (p> 0.05). Comparing disease activity related characteristics between pure ACD and ACD with co-existent IDA sub group of patients, DAS 28 (p< 0.001), tender joint count (p= 0.03), swollen joint count (p= 0.03) and HAQ score (p= 0.03) were significantly higher in pure ACD patients than ACD and concomitant IDA patients with RA. But no significant difference was observed between two subgroups in terms of disease duration, morning stiffness, ESR and RF positivity (p> 0.05).Comparison of disease activity indices at different cut off levels between two groups and subgroups. Higher DAS- 28 score, tender joint count, swollen joint count and HAQ score was significantly found in anemic group of patients as compared to non-anemic. No significant difference was found between two groups at differing levels of morning stiffness (p= 0.337). Conclusions: ACD is frequently encountered with high frequency of iron deficiency anemia among rheumatoid arthritis patients and RA patients with anemic tend to have more severe disease than non-anemic RA patients. TAJ 2020; 33(2): 85-93

scholarly journals AB0234 ASSOCIATION OF HOMOCYSTEINE LEVEL AND CAROTID INTIMA-MEDIA THICKNESS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1417.3-1417
Author(s):  
D. Anghel ◽  
L. Otlocan ◽  
R. Bursuc ◽  
E. Busuioc ◽  
A. Manolache ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Homocysteine Level ◽  
Intima Media Thickness ◽  
Antiplatelet Agents ◽  
Carotid Intima Media Thickness ◽  
Tnf Alpha ◽  
Das28 Score ◽  
Media Thickness ◽  
Alpha Therapy

Background:Homocysteine (Hcy) has been implicated in atherogenesis. High homocysteine level can predict cardiovascular events, including death. Atherosclerosis has a high incidence in patients with Rheumatoid Arthritis (RA).Objectives:The aim of this study is to evaluate the relationship between serum homocysteine levels and carotid atherosclerosis in patients with RA and anti-TNF therapy.Methods:Our study included 80 RA patients divided into two groups: 45 patients were with anti-TNF-alpha therapy (Adalimumab, Infliximab, Etanercept) and 35 RA patients with disease-modifying antirheumatic drugs (DMARDs). The patients were diagnosed with RA used ACR/EULAR 2010 Classification Criteria. We measured carotid intima-media thickness (CIMT) using high-resolution Doppler ultrasonography at baseline and then at 12 months. CIMT above 0.9 mm is an atherosclerosis marker. We considered high levels of homocysteine in the serum above 15 µmol/L. All patients had treatment with hypolipemiant drugs and antiplatelet agents during the 12 months. Other parameters were analyzed at baseline and after 12 months: age, lipid profile (HDL, LDL, and cholesterol), ESR and disease activity score (DAS28<2.6 means remission; DAS28=2.6-3.2 means low disease activity, DAS28=3.2-5.1 means moderate disease activity; DAS28>5.1 high disease activity).Results:45 patients received anti-TNF-alpha therapy (mean age 45.50±9.69 years) and 35 RA patients had treatment with DMARDs (mean age 48.3±8.9 years). High Hcy levels were found on 34% patients in DMARDs group and 21% patients in anti-TNF group. After 12 months of treatment, patients with high levels of Hcy and anti-TNF therapy had a significant decrease in CIMT. In patients with low Hcy level the decrease in CIMT was insignificantly statistic. In DMARDs group atherosclerotic plaque was detected to 26 patients (74.29%) and 21 (46.66%) patients were detected into anti-TNF group. After 12 months CIMT was significantly higher in DMARDs group and the difference was statistically significant compared to baseline and to anti-TNF group (p=0.0002). High DAS28 score was associated with increased CIMT and hyperhomocysteinemia in both groups (p=0.0001).Conclusion:Increased Hcy levels were associated with increased CIMT values in both groups. In RA patients with anti-TNF therapy and high Hcy levels, reduction of CIMT was statistically higher than in patients with DMARDs treatment.Disclosure of Interests:None declared

scholarly journals Interleukin-37 as an anti-inflammatory cytokine: does its relation to disease activity suggest its potential role in rheumatoid arthritis therapy?

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Tender Joint ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Significant Difference ◽  
The Mean ◽  
Anti Inflammatory

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.

Evaluation of serum endothelial cell-specific molecule-1 levels and carotid intima-media thickness in patients with ankylosing spondylitis / Ankilozan spodilitli hastalarda serum endothelial cell-specific molecule-1 ve karotis intima media kalınlığının değerlendirilmesi

2016 ◽  
Vol 41 (1) ◽  
Author(s):  
Hakan Türkön ◽  
Ferhat Gökmen ◽  
Sema Uysal ◽  
Ayla Akbal ◽  
Beşir Şahin İnceer ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Chronic Inflammatory Disease ◽  
Control Group ◽  
Media Thickness ◽  
Significant Difference

AbstractObjective: Ankylosing spondylitis (AS) is a chronic inflammatory disease and the increased mortality in these patients is largely caused by cardiovascular diseases. Endothelial cell-specific molecule-1 (ESM-1) is a novel marker to assess endothelial dysfunction and expressed by the vascular endothelium. In this study, the serum ESM-1 levels in patients with AS and the possible association between serum ESM-1 and carotid intima-media thickness (CIMT) as a marker of atherosclerosis was evaluated.Methods: A total of thirty-seven patients with AS and thirty healthy control subjects were included in this study. ESM-1, erythrocyte sedimentation rate(ESR),C-reactive protein (CRP) and CIMT were measured in all subjects. ESM-1 levels were measured by ELISA method. The disease activity of patients with AS were assessed using questionnaires Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Results: Serum ESM-1 levels were lower in AS patients than in healthy controls. However, there was no statistically significant difference between ESM-1 levels (304.3±185.2 vs. 373.9±206.9 ng/L, respectively; p=0.064). Patients with AS had significantly higher CIMT levels compared with controls (0.77±0.16 vs. 0.53±0.09 mm, respectively; p<0.001). While a statistically significant positive correlation was detected in all subjects between CIMT levels and ESR, CRP (r=0.378, p=0.002, r=0.547, p<0.001, respectively), no significant correlation was detected between serum ESM-1 levels and ESR, CRP, BASDAI, BASFI and CIMT.Conclusion: The results showed that CIMT values in AS patients were increased when compared to control group. There was no correlation among ESM-1 levels, disease activity and CIMT. In order to reveal the pathological role of the ESM-1 levels in patients with AS need more studies.

scholarly journals POS0634 DO BIOLOGICS IMPROVE FATIGUE IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 555.1-555
Author(s):  
A. Fazaa ◽  
H. Boussaa ◽  
K. Ouenniche ◽  
S. Miladi ◽  
M. Sellami ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Demographic Data ◽  
Tender Joint Count ◽  
P Value ◽  
Tender Joint ◽  
Direct Role ◽  
The Mean ◽  
Disease Modifying ◽  
Improve Fatigue

Background:Fatigue is a significant issue in rheumatoid arthritis (RA) with no accepted evidence-based management guidelines. Several studies suggested that biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) have a direct role on fatigue in RA.Objectives:This study aimed to compare fatigue between patients treated with bDMARDs and conventional synthetic Disease Modifying Anti-Rheumatic Drugs (cs DMARDs).Methods:We conducted a longitudinal study including patients with RA (ACR/EULAR 2010). Patients with other acute or chronic diseases that may induce fatigue (such as cancer, infection or depression) were excluded. Demographic data and the following disease-related parameters were collected: pain Visual Analog Scale (VAS), Global Patient Assessment (GPA), tender joint count (TJC), swollen joint count (SJC), Erythrocyte Sedimentation Rate (ESR), C Protein Reactive (CRP), Disease Activity Score 28 (DAS28), Health Assessment Questionnaire (HAQ) and DMARDs used. Fatigue was assessed at baseline (T0), at 6 months (T6) and at 12months (T12) using the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) which is a short 13-item questionnaire validated in RA. The score FACIT-F ranges between 0 and 52. Fatigue was considered mild if the FACIT-F score was ≥40, moderate if 20≤FACIT-F<40 and severe if 0≤FACIT-F<20. A p value inferior to 0.05 was considered significant.Results:We included 100 RA patients (84 women and 16 men) with a mean age of 49.5±10 years old [18-65]. The mean disease duration was 87.3 months [1-360]. The mean pain VAS was 49 cm [0-100] and the mean GPA was 47.8 cm [0-100]. The mean TJC and SJC were 5.3 [0-36] and 1 [0-9] respectively. The mean levels of ESR and CRP were 38.1 mm [10-120] and 10.8 mg/l [2-61] respectively. The mean DAS28 ESR was 3.68 [1.90-8.33] and the mean HAQ score was 0.90 [0-2.75].Eighty-three percent of patients used csDMARDs: Methotrexate (n=96), sulphasalazine (n=28), leflunomide (n=21), and hydroxychloroquine (n=12). bDMARDs were prescribed in 17% of patients: Rituximab (n=10), Infliximab (n=9), and Etanercept (n=5).At baseline, the mean FACIT-F score was 27.1 [0-51]. Moderate fatigue was noted in 57% of cases and severe fatigue in 26% of cases. Patients on csDMARDs had a lower FACIT-F score when compared to patients on bDMARDs (26.89 versus 28.41), but the difference was not statistically significant (p=0.630).The mean FACIT-F score was 27.41 in bDMARDs patients versus 29.80 in csDMARDs patients (p=0.497) at T6, and 32.35 versus 33.65 respectively at T12 (p=0.695).The mean delta FACIT-F was 2.18 in bDMARDs patiens versus 2.73 in csDMARDs patients between T6 and T0 (p=0.815), and 3.94 versus 7.2 respectively between T12 and T0 (p=0.807).When considering all patients, a significant positive correlation was noted between delta FACIT-F and delta DAS28 at T6 (r=0.418, p<0.001) and at T12 (r=0.338, p<0.001).Conclusion:RA patients treated with bDMARDs didn’t show significant improvement of fatigue in comparison with those treated with csDMARDs. Further studies are needed to determine if biologics improve fatigue, and whether the improvement results from a direct action on fatigue or indirectly through reduction in disease activity.Disclosure of Interests:None declared

scholarly journals AB0174 FATIGUE IN RHEUMATOID ARTHRITIS: A CASE-CONTROL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1113.2-1113
Author(s):  
A. Fazaa ◽  
H. Boussaa ◽  
K. Ouenniche ◽  
S. Miladi ◽  
M. Sellami ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Demographic Data ◽  
Tender Joint Count ◽  
P Value ◽  
Common Symptom ◽  
Healthy Controls ◽  
Tender Joint ◽  
Cross Sectional ◽  
The Mean

Background:Fatigue is a common symptom in many chronic inflammatory diseases, including rheumatoid arthritis (RA). It is considered one of the most frustrating, uncontrollable, and overwhelming symptoms. However, most of rheumatologists do not assess fatigue despite its clinical significance and its impact on patients’ lives.Objectives:The aims of this study were to determine whether RA patients express more fatigue than healthy controls, and to analyze its correlation with disease activity.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010) and healthy controls matched for sex and age. Patients with other acute or chronic diseases that may induce fatigue (such as cancer, infection or depression) were excluded. Demographic data and the following clinical parameters were collected: pain Visual Analog Scale (VAS), Global Patient Assessment (GPA), tender joint count (TJC) and swollen joint count (SJC), Erythrocyte Sedimentation Rate (ESR), C Protein Reactive (CRP), Disease Activity Score 28 (DAS28), and Health Assessment Questionnaire (HAQ). Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) which is a short 13-item questionnaire validated in RA. The score FACIT-F ranges between 0 and 52. Fatigue was considered mild if the FACIT-F score was ≥40, moderate if 20≤FACIT-F<40 and severe if 0≤FACIT-F<20. A p value inferior to 0.05 was considered significant.Results:We included 100 RA patients (84 women and 16 men) with a mean age of 49.5±10 years old [18-65]. The mean disease duration was 87.3 months [1-360]. The mean pain VAS was 49 cm [0-100] and the mean GPA was 47.8 cm [0-100]. The mean TJC and SJC were 5.3 [0-36] and 1 [0-9] respectively. The mean levels of ESR and CRP were 38.1 mm [10-120] and 10.8 mg/l [2-61] respectively. The mean DAS28 ESR was 3.68 [1.90-8.33] and the mean HAQ score was 0.90 [0-2.75].Thirty-nine healthy controls were enrolled including 35 women and 4 men with a mean age of 51.2 years old [30-64].The mean FACIT-F score was 27.1 [0-51] in RA patients versus 46.2 [0-52] in healthy controls (p<0.001). Among RA patients, 57% had moderate fatigue and 26% had severe fatigue.A significant negative correlation was noted between the FACIT-F score and the following parameters in RA patients: TJC (r=-0.568, p<0.001), SJC (r=-0.274, p<0.001), pain VAS (r=-0.605, p<0.001), GPA (r=-0.658, p<0.001), ESR (r=-0.405, p<0.001), CRP (r=-0.149, p<0.001), DAS28 (r=-0.837, p<0.001) and HAQ (r=-0.634, p<0.001).Conclusion:Fatigue was significantly more observed in RA patients. This symptom was correlated with disease activity and disability. It is important to recognize and manage fatigue in order to improve patients’ quality of life.Disclosure of Interests:None declared

scholarly journals Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

2021 ◽  
pp. 38-48
Author(s):  
Riham A. El-Sehly ◽  
Abeer A. Shahba ◽  
Raghda G. Elsheik ◽  
Mahmoud F. Selim
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Function ◽  
Disease Activity ◽  
Brachial Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
University Hospital ◽  
Control Group ◽  
Carotid Imt ◽  
Media Thickness

Introduction: Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in RA disease. In active RA patients, the majority of cardiovascular deaths result from accelerates atherosclerosis. Aim of the Work: The aim of this work is to assess carotid intima media thickness (C-IMT) and endothelial function by brachial artery flow mediated dilatation (FMD) in Rheumatoid arthritis patients and relation to the disease activity. Subjects and Methods: Our study included 50 RA patients, from Tanta University Hospital. 47 women and 3 men and their age ranged from 30-62 years.  They were divided into group 1:  25 active RA patients, group 2:  25 inactive RA patients who were   diagnosed by American College of Rheumatology (ACR) revised criteria for diagnosis of RA 1987 and disease activity was evaluated using disease activity score 28(DAS28). Group 3: 25 normal subjects as a control group.  We measured C-IMT and FMD in all groups. Results: By comparing the groups, we found that active RA patients had increased C-IMT compared to inactive rheumatoid arthritis patients and controls which is indicator of atherosclerosis. FMD of the brachial artery impaired in RA patients compared to controls which is indicator of endothelial dysfunction. There was highly statistically significant relation between duration, activity of RA disease and atherosclerosis in RA patients. Conclusion: With increasing the frequency of atherosclerosis in asymptomatic RA patients, carotid IMT increased and FMD impaired when compared with general population. Active RA patients have increased carotid IMT and impaired FMD compared with inactive RA patients.

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