scholarly journals Effect of low dose Methotrexate in newly diagnosed Rheumatoid arthritis case

2021 ◽  
Vol 9 (1) ◽  
pp. 34-37
Author(s):  
Fauzia Sobhan ◽  
Khaza Moiz ◽  
Naima Siddiquee ◽  
Aditi Debnath ◽  
Fazlul Haque ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Low Dose ◽  
Disease Activity Score ◽  
Joint Disease ◽  
Newly Diagnosed ◽  
Physical Medicine ◽  
Disease Modifying Antirheumatic Drugs ◽  
Medical College ◽  
Dose Methotrexate

Rheumatoid arthritis is a painful debilitating joint disease with the proliferation of the synovium and progressive erosion of cartilage and bone. Methotrexate (MTX) has been used for the treatment of Rheumatoid Arthritis (RA) for about 3 decades. It is most effective and commonly used Disease Modifying Antirheumatic Drugs (DMARDS) because it improves symptoms, signs, disease activity and functions. This study was done from January 2016 to December 2016 for a period of 1 year under Physical Medicine and Rehabilitation department, Jalalabad Ragib-Rabeya Medical College (JRRMC), Sylhet. Here we treated the patients with low dose methotrexate. Study was done to see the effect of low dose MTX in newly diagnosed RA patients by clinical examination and DAS 28. DAS stands for disease activity score and 28 joints that are examined in this assessment. The result concluded low dose MTX improves the symptoms, signs, disease activity and functions of the patients. Bangladesh Crit Care J March 2021; 9(1): 34-37

scholarly journals Further Optimization of the Reliability of the 28-Joint Disease Activity Score in Patients with Early Rheumatoid Arthritis

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e100544 ◽  
Author(s):  
Liseth Siemons ◽  
Peter M. ten Klooster ◽  
Harald E. Vonkeman ◽  
Mart A. F. J. van de Laar ◽  
Cees A. W. Glas
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Disease Activity Score ◽  
Joint Disease ◽  
Activity Score

scholarly journals Elevated APE1/Ref-1 Levels of Synovial Fluids in Patients with Rheumatoid Arthritis: Reflection of Disease Activity

2021 ◽  
Vol 10 (22) ◽  
pp. 5324
Author(s):  
In Seol Yoo ◽  
Yu-Ran Lee ◽  
Seong Wook Kang ◽  
Jinhyun Kim ◽  
Hee-Kyoung Joo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Inflammatory Responses ◽  
Joint Destruction ◽  
Joint Inflammation ◽  
Joint Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Control ◽  
The Relationship

There is growing evidence that apurinic/apyrimidinic endonuclease 1/redox factor-1 (APE1/Ref-1) regulates inflammatory responses. Rheumatoid arthritis (RA) is an autoimmune disease, which is characterized with synovitis and joint destruction. Therefore, this study was planned to investigate the relationship between APE1/Ref-1 and RA. Serum and synovial fluid (SF) were collected from 46 patients with RA, 45 patients with osteoarthritis (OA), and 30 healthy control (HC) patients. The concentration of APE1/Ref-1 in serum or SF was measured using the sandwich enzyme-linked immunosorbent assay (ELISA). The disease activity in RA patients was measured using the 28-joint disease activity score (DAS28). The serum APE1/Ref-1 levels in RA patients were significantly increased compared to HC and OA patients (0.44 ± 0.39 ng/mL for RA group vs. 0.19 ± 0.14 ng/mL for HC group, p < 0.05 and vs. 0.19 ± 0.11 ng/mL for OA group, p < 0.05). Likewise, the APE1/Ref-1 levels of SF in RA patients were also significantly increased compared to OA patients (0.68 ± 0.30 ng/mL for RA group vs. 0.31 ± 0.12 ng/mL for OA group, p < 0.001). The APE1/Ref-1 concentration in SF of RA patients was positively correlated with DAS28. Thus, APE1/Ref-1 may reflect the joint inflammation and be associated with disease activity in RA.

Rheumatoid Arthritis and Fibromyalgia: A Frequent Unrelated Association Complicating Disease Management

2009 ◽  
Vol 36 (1) ◽  
pp. 58-62 ◽  
Author(s):  
FABIENNE COURY ◽  
ARNAUD ROSSAT ◽  
ALEXANDRE TEBIB ◽  
MARIE-CLAUDE LETROUBLON ◽  
ANNE GAGNARD ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Joint Destruction ◽  
Constant Factor ◽  
Joint Disease ◽  
Psychosocial Characteristics ◽  
Inappropriate Treatment ◽  
The Relationship ◽  
Worse Prognosis

ObjectiveTo assess the value of the 28-joint Disease Activity Score (DAS28) in evaluating disease activity in rheumatoid arthritis (RA) associated with fibromyalgia (FM). In this situation, because of the weight of the subjective measures included in the DAS28 equation, the patient’s status may be overestimated, leading to inappropriate treatment. We analyze the relationship between RA and FM and discuss whether the association is random or a marker of poor prognosis.MethodsA questionnaire, developed when biologic therapies were introduced, was administered and the results analyzed in a consecutive, female outpatient population including 105 patients with RA, 49 with RA and FM (RAF), and 28 with FM. Psychosocial characteristics, disease presentation, and radiographic joint destruction evaluation were compared in the 3 populations.ResultsThe presentation of RA was the same in patients with RA and RAF, but the 2 populations differed by socioprofessional characteristics, significantly higher disease activity in patients with RAF, and significantly more severe joint destruction in patients with RA. The RAF group was similar to the FM control population in socioprofessional and some physical characteristics. Regression analysis using the DAS28 measures differed significantly in the weight allowed to 28-joint counts for pain and swelling, but the constant factor was higher in patients with RAF.ConclusionDAS28 overestimated objective RA severity in patients who also had FM. The association between RA and FM does not appear to be a marker of worse prognosis, but rather a fortuitous association between the 2 diseases and one that may afford these patients some protection against joint destruction.

scholarly journals Is treat-to-target really working in rheumatoid arthritis? a longitudinal analysis of a cohort of patients treated in daily practice (RA BIODAM)

2020 ◽  
Vol 79 (4) ◽  
pp. 453-459 ◽  
Author(s):  
Sofia Ramiro ◽  
Robert BM Landewé ◽  
Désirée van der Heijde ◽  
Alexandre Sepriano ◽  
Oliver FitzGerald ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Activity Index ◽  
Disease Activity Index ◽  
Daily Clinical Practice ◽  
Joint Disease ◽  
Activity Score ◽  
Treat To Target

ObjectivesTo investigate whether following a treat-to-target (T2T)-strategy in daily clinical practice leads to more patients with rheumatoid arthritis (RA) meeting the remission target.MethodsRA patients from 10 countries starting/changing conventional synthetic or biological disease-modifying anti-rheumatic drugs were assessed for disease activity every 3 months for 2 years (RA BIODAM (BIOmarkers of joint DAMage) cohort). Per visit was decided whether a patient was treated according to a T2T-strategy with 44-joint disease activity score (DAS44) remission (DAS44 <1.6) as the target. Sustained T2T was defined as T2T followed in ≥2 consecutive visits. The main outcome was the achievement of DAS44 remission at the subsequent 3-month visit. Other outcomes were remission according to 28-joint disease activity score-erythrocyte sedimentation rate (DAS28-ESR), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI) and American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean definitions. The association between T2T and remission was tested in generalised estimating equations models.ResultsIn total 4356 visits of 571 patients (mean (SD) age: 56 (13) years, 78% female) were included. Appropriate application of T2T was found in 59% of the visits. T2T (vs no T2T) did not yield a higher likelihood of DAS44 remission 3 months later (OR (95% CI): 1.03 (0.92 to 1.16)), but sustained T2T resulted in an increased likelihood of achieving DAS44 remission (OR: 1.19 (1.03 to 1.39)). Similar results were seen with DAS28-ESR remission. For more stringent definitions (CDAI, SDAI and ACR/EULAR Boolean remission), T2T was consistently positively associated with remission (OR range: 1.16 to 1.29), and sustained T2T had a more pronounced effect on remission (OR range: 1.49 to 1.52).ConclusionIn daily clinical practice, the correct application of a T2T-strategy (especially sustained T2T) in patients with RA leads to higher rates of remission.

Effects of Changing from Oral to Subcutaneous Methotrexate on Red Blood Cell Methotrexate Polyglutamate Concentrations and Disease Activity in Patients with Rheumatoid Arthritis

2011 ◽  
Vol 38 (12) ◽  
pp. 2540-2547 ◽  
Author(s):  
LISA K. STAMP ◽  
MURRAY L. BARCLAY ◽  
JOHN L. O’DONNELL ◽  
MEI ZHANG ◽  
JILL DRAKE ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Steady State ◽  
Blood Cell ◽  
Disease Activity ◽  
Red Blood Cell ◽  
Disease Activity Score ◽  
Joint Disease ◽  
First Order ◽  
Methotrexate Polyglutamate ◽  
Long Chain

Objective.To determine the effects of changing from oral to subcutaneous (SC) methotrexate (MTX) in patients with rheumatoid arthritis (RA) on red blood cell MTX polyglutamate (RBC MTXGlun) concentrations, disease activity, and adverse effects.Methods.Thirty patients were changed from oral to SC MTX. Trough RBC MTXGlun concentrations were measured for 24 weeks and concentrations fitted to a first-order accumulation model. Disease activity was assessed by 28-joint Disease Activity Score (DAS28).Results.MTXGlu3, MTXGlu4, and MTXGlu5 concentrations, but not MTXGlu1 and MTXGlu2, increased significantly over 24 weeks, reaching 90% of new steady-state concentrations by about 40 weeks. A decrease in DAS28 was associated with increased RBC MTXGlu5 (p = 0.035) and RBC MTXGlu3–5 (p = 0.032). No change in adverse effect frequency occurred.Conclusion.Changing to SC MTX results in increased long-chain MTXGlun. However, it takes at least 6 months for RBC steady-state concentrations to be achieved. Increased long-chain MTXGlun concentrations were significantly associated with reduced disease activity.

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