scholarly journals Biomarkers to Personalize the Treatment of Rheumatoid Arthritis: Focus on Autoantibodies and Pharmacogenetics

Biomolecules ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1672
Author(s):  
Valeria Conti ◽  
Graziamaria Corbi ◽  
Maria Costantino ◽  
Emanuela De Bellis ◽  
Valentina Manzo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Inflammatory Disease ◽  
New Drugs ◽  
Magic Bullet ◽  
Predictive Capacity ◽  
Predictors Of Response ◽  
Specific Factors ◽  
Treatment Predictors ◽  
Background Models

Rheumatoid arthritis (RA) is a chronic inflammatory disease that is very complex and heterogeneous. If not adequately treated, RA patients are likely to manifest excess of morbidity and disability with an important impact on the quality of life. Pharmacological treatment is based on the administration of the disease-modifying antirheumatic drugs (DMARDs), subdivided into conventional synthetic (csDMARDs), targeted synthetic (tsDMARDs), and biological (bDMARDs). bDMARDs are now frequently administered in patients, both as alternative treatment and together with csDMARDs. Unfortunately, there is a therapeutic response variability both to old and new drugs. Therefore, to identify pre-therapeutic and on-treatment predictors of response is a priority. This review aims to summarize recent advances in understanding the causes of the variability in treatment response in RA, with particular attention to predictive potential of autoantibodies and DMARD pharmacogenetics. In recent years, several biomarkers have been proposed to personalize the therapy. Unfortunately, a magic bullet does not exist, as many factors concur to disease susceptibility and treatment outcomes, acting around the patient’s congenital background. Models integrating demographic, clinical, biochemical, and genetic data are needed to enhance the predictive capacity of specific factors singularly considered to optimize RA treatment in light of multidisciplinary patient management.

scholarly journals Myopenia and Musculoskeletal Aging in Rheumatoid Arthritis

2020 ◽  
Author(s):  
Dan Xu ◽  
Jiake Xu ◽  
Lei Dai
Keyword(s):  
Rheumatoid Arthritis ◽  
Muscle Function ◽  
Inflammatory Arthritis ◽  
Muscle Wasting ◽  
Management Strategies ◽  
Chronic Inflammatory Disease ◽  
Muscular Dysfunction ◽  
Younger Age ◽  
High Prevalence

Rheumatoid arthritis (RA), the commonest inflammatory arthritis, is a debilitating disease leading to decreased functional capacity, social disability and reduced quality of life. RA affects multisystems with chronic inflammatory disease characterized by destructive synovitis and muscular dysfunction leading to premature musculoskeletal aging, which has been coined with many terms including myopenia, sarcopenia, cachexia, muscle failure and muscle wasting. Myopenia is described as the presence of clinically relevant muscle wasting due to any illness at any age, associated with impaired muscle function, increased morbidity and mortality. RA myopenia has significantly less muscle mass compared to the general population muscle loss showing preservation or slight increase in fat mass. RA myopenia is unique compared to chronic disease-related myopenia in cancer, chronic heart failure, kidney disease and chronic infection as it is rarely accompanied by a net weight loss. RA myopenia has younger-age onset compared to elderly primary sarcopenia, while higher-grade inflammation has been considered as the pathophysiology of muscle wasting. Research, however, indicates that inflammation itself cannot fully explain the high prevalence of muscle wasting in RA. This chapter aims to review the literature on the casual relationships among RA myopenia, premature musculoskeletal aging and management strategies to delay musculoskeletal aging.

scholarly journals Predictors of quality of life of Pakistani women with rheumatoid arthritis: a cross-sectional study

2021 ◽  
Vol 8 (10) ◽  
pp. 4742
Author(s):  
Sucheta Sharma ◽  
Srilatha Eapi ◽  
Abdul Muqtadir ◽  
Ammar Bokhari ◽  
Mehak Zulfiqar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Chronic Inflammatory Disease ◽  
Sectional Study ◽  
Emotional Wellbeing ◽  
Cross Sectional

Background: Rheumatoid arthritis (RA) is characterized as a chronic inflammatory disease indicated by stiffness, pain, inflammation, and impaired mobility. This results in joint impairment, poor workability, productivity, and afterward, it curtails the quality and expectancy of life of an individual. The aim of this research is to assess the quality of life of Pakistan women with RA and assess various factors affecting it.Methods: It was a cross-sectional study conducted in the Orthopedics department of the Indus Hospital and Health Network, Karachi Pakistan, where we assessed quality of life in sample of women with RA. A consecutive sampling technique was used to enrol women with rheumatoid arthritis who were seen in the Orthopedics outpatient clinic during the study period (February to May 2021).Results: Of the 134 women with RA, 72.39% of women were unemployed, 54.48% of women had family monthly income of 16000 PKR or more and 44.03% of women reported at least one comorbidity other than RA. According to linear regression analyses, women having RA with severe disease activity tended to have tended to have low physical functioning, vitality, emotional wellbeing, social functioning, pain and general health as compared to patients with remission, low disease and moderate disease activity. Absence of family support in disease management can impact vitality and emotional wellbeing with decrease in scores of -85.20 and -120.66 respectively.Conclusions: Guidelines need to developed and implemented for assessing psychological domains of these patients for assessment of quality of life. This will help in maintaining and improving QoL of women with RA. 

scholarly journals Treatment strategy for patients with rheumatoid arthritis

2020 ◽  
Vol 63 (7) ◽  
pp. 422-430
Author(s):  
Soo-Kyung Cho ◽  
Yoon-Kyoung Sung
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Targeted Therapies ◽  
Functional Disability ◽  
Joint Destruction ◽  
Joint Damage ◽  
Chronic Inflammatory Disease ◽  
Biologic Dmards

Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the joints, causing joint destruction, functional disability, and reduced quality of life in patients. The aim of RA treatment is to decrease the inflammation, prevent joint damage, and improve patientsʼ quality of life while minimizing progression of the disease. Both early detection and intervention with disease-modifying anti-rheumatic drugs (DMARDs) have been reported to improve therapeutic outcomes. Treatment with DMARDs should be started immediately after the diagnosis is established, with methotrexate as the best initial drug of choice. Disease activity should be regularly monitored. Targeted therapies can be considered in patients with persistent active disease despite methotrexate therapy. Remission or low disease activity is the preferred treatment target. There are two major classes of DMARDs: conventional synthetic DMARDs and the targeted therapies specific to pro-inflammatory cytokines including biologic DMARDs and small molecule inhibitors. Recently, the importance of shared decision making, in which patients and clinicians make decisions together, and education of the patient has been emphasized in the treatment strategies of RA. This review summarizes the effectiveness and safety of the DMARDs currently available for RA treatment. Recommendations for RA management would also be discussed in this article.

scholarly journals New approved drugs for psoriatic arthritis

Reumatismo ◽  
2016 ◽  
Vol 68 (2) ◽  
pp. 57 ◽  
Author(s):  
F.M. Perrotta ◽  
E. Lubrano
Keyword(s):  
Clinical Trials ◽  
Psoriatic Arthritis ◽  
Structural Damage ◽  
Randomized Clinical Trials ◽  
Poor Quality ◽  
Chronic Inflammatory Disease ◽  
New Drugs ◽  
Approved Drugs ◽  
Symptoms And Signs

Psoriatic arthritis (PsA) is a chronic inflammatory disease that possibly leads to structural damage and to a reduction of joint function and poor quality of life. Treatment of PsA has changed since its introduction of anti- TNF drugs, which have shown to reduce the symptoms and signs of the disease and slow the radiographic progression. However, recently, the discovery of new pathogenic mechanisms have made possible the development of new molecules that target pro-inflammatory cytokines involved in skin, joint and entheseal inflammation. New drugs like ustekinumab, secukinumab and apremilast inhibit interleukin axis and intracellular pathways and showed their efficacy and safety in randomized clinical trials. These drugs have been recently approved for the treatment of PsA and included in the new EULAR and GRAPPA treatment recommendations. The aim of this paper is to briefly review the clinical trials that led to their approval for PsA.

Effects of Treatment at a Medical Resort on the Quality of Life in Patients with Rheumatoid Arthritis

2020 ◽  
Vol 62 (2) ◽  
pp. 77-81
Author(s):  
Włodzisław Kuliński ◽  
Aleksandra Dryja
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Physical Therapy ◽  
Joint Stiffness ◽  
Well Being ◽  
Chronic Inflammatory Disease ◽  
Walking Distance ◽  
Hospital Treatment ◽  
Statistical Correlations

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease of the connective tissue that damages articular and periarticular tissue and leads to the development of permanent deformities and disability. Aim: To assess the quality of life of rheumatoid arthritis patients after treatment at a medical resort. M aterial and Methods: The study assessed 30 patients with rheumatoid arthritis treated at a medical hospital in Busko-Zdrój. The study group consisted of 18 women and 12 men over the age of 50 years. The patients underwent sulphide/hydrogen sulphide baths and physical therapy procedures. The data collected in the study was statistically analysed using Excel; calculations were performed with the SPSS Statistica 21.0 software. A chi-squared test was used to assess statistical correlations between variables. Results: After spa hospital treatment, all patients reported reduced pain, improved well-being, reduced duration of morning joint stiffness, and improved independence; the pain-free walking distance markedly increased. The treatment had a beneficial influence on the quality of life of study patients. Conclusions: 1. Rheumatoid arthritis is a difficult clinical and social problem. 2. The balneotherapy and physical therapy used in the study reduced the duration of morning joint stiffness and pain experienced by the patients. 3. The balneotherapy and physical therapy used in the study had a positive effect on the ability to ambulate, increasing the pain-free walking distance, and improving the quality of life.

scholarly journals Pyridinone Derivatives as Interesting Formyl Peptide Receptor (FPR) Agonists for the Treatment of Rheumatoid Arthritis

Molecules ◽  
2021 ◽  
Vol 26 (21) ◽  
pp. 6583
Author(s):  
Letizia Crocetti ◽  
Claudia Vergelli ◽  
Gabriella Guerrini ◽  
Maria Paola Giovannoni ◽  
Liliya N. Kirpotina ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cartilage Damage ◽  
Bone Destruction ◽  
Joint Inflammation ◽  
Chronic Inflammatory Disease ◽  
New Drugs ◽  
Formyl Peptide Receptor ◽  
Pyridine Derivative ◽  
Pharmacological Tests ◽  
Formyl Peptide

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by joint inflammation, cartilage damage and bone destruction. Although the pharmacological treatment of RA has evolved over the last few years, the new drugs have serious side effects and are very expensive. Thus, the research has been directed in recent years towards new possible targets. Among these targets, N-formyl peptide receptors (FPRs) are of particular interest. Recently, the mixed FPR1/FPR2 agonist Cpd43, the FPR2 agonist AT-01-KG, and the pyridine derivative AMC3 have been shown to be effective in RA animal models. As an extension of this research, we report here a new series of pyridinone derivatives containing the (substituted)phenyl acetamide chain, which was found to be essential for activity, but with different substitutions at position 5 of the scaffold. The biological results were also supported by molecular modeling studies and additional pharmacological tests on AMC3 have been performed in a rat model of RA, by repeating the treatments of the animals with 10 mg/kg/day of compound by 1 week.

Physical capital stock, technological upgrading and modernisation in Hungary

2005 ◽  
Vol 55 (2) ◽  
pp. 201-221 ◽  
Author(s):  
Andrea Szalavetz
Keyword(s):  
Capital Accumulation ◽  
Physical Capital ◽  
Developed Countries ◽  
Point Of View ◽  
Technology Generation ◽  
Development Policies ◽  
Specific Factors ◽  
Physical Capital Accumulation

This paper discusses the relation between the quality and quantity indicators of physical capital and modernisation. While international academic literature emphasises the role of intangible factors enabling technology generation and absorption rather than that of physical capital accumulation, this paper argues that the quantity and quality of physical capital are important modernisation factors, particularly in the case of small, undercapitalised countries that recently integrated into the world economy. The paper shows that in Hungary, as opposed to developed countries, the technological upgrading of capital assets was not necessarily accompanied by the upgrading of human capital i.e. the thesis of capital skill complementarity did not apply to the first decade of transformation and capital accumulation in Hungary. Finally, the paper shows that there are large differences between the average technological levels of individual industries. The dualism of the Hungarian economy, which is also manifest in terms of differences in the size of individual industries' technological gaps, is a disadvantage from the point of view of competitiveness. The increasing differences in the size of the technological gaps can be explained not only with industry-specific factors, but also with the weakness of technology and regional development policies, as well as with institutional deficiencies.

Strategies for mitigating burnout among early career doctors in Nigeria: lessons learnt from the qualitative CHARTING study

2020 ◽  
Vol 3 (1) ◽  
pp. 97-103 ◽  
Author(s):  
Oladimeji Adebayo ◽  
Kehinde Kanmodi ◽  
Olusegun Olaopa ◽  
Omotayo Francis Fagbule ◽  
Iyanu Adufe ◽  
...  
Keyword(s):  
Sampling Method ◽  
Psychosocial Problems ◽  
Early Career ◽  
Leadership Positions ◽  
Group Discussions ◽  
Psychological Review ◽  
Psychological Issues ◽  
Specific Factors ◽  
Stakeholder Dialog

AbstractBackgroundEarly career doctors (ECDs) are faced with many challenges due to their transition from undergraduate medical/dental studentship to being postgraduate doctors and being in an early phase of their career. The specific factors that affect ECDs in their careers and endeavors at the workplace range from poor remuneration, particularly in developing countries, to psychosocial problems (such as burnout [BO] syndrome). There is a dearth of information on BO among ECDs in Nigeria. This qualitative study aims to explore the opinions of ECDs in Nigeria on the causal/predisposing factors of BO, effects of BO, and strategies for mitigating BO among ECDs in Nigeria.MethodUsing purposive sampling method, two sessions of focus group discussions (FGDs) involving 14 ECDs (key informants) holding key leadership positions and who were delegates of other ECDs in Nigeria were conducted to explore their experiences on psychological issues among ECDs. Data collected were transcribed and analyzed thematically.ResultsBO is an issue of serious concern among ECDs in Nigeria. The causes of BO are diverse, some of which include low staff strength, prolonged work hours, wrong counseling, lack of job description and specification, and abuse of powers by trainers. In order to mitigate the issue of BO among ECDs, the respondents recommended that work policy review, medical workforce strengthening, stakeholder dialog on ECDs’ welfare, regular psychological review of ECDs, and provision of free yearly medicals need to be looked into. Conclusion: Our findings revealed that the participants considered BO issues among ECDs to be common, and it affected their performance and the overall quality of care in Nigeria health system. Based on our findings, there is an urgent need to mitigate the problem of emotional exhaustion among ECDs in Nigeria.

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