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.

Abstract 631: Evaluation of Risk Factors for Cardiovascular Disease in Rheumatoid Arthritis

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Vitor M Rocha ◽  
Maria Guadalupe B Pippa
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Total Cholesterol ◽  
Normal Population ◽  
Control Group ◽  
American College Of Rheumatology ◽  
Increased Risk ◽  
Systemic Inflammatory Disease

Backgroung: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease, that appear to be responsible for 50% of mortality for thrombotic events such as Myocardial Infarction (MI) and Ischemic Stroke (SI) in RA patients. Occur approximately a decade earlier in these patients compared with the normal population. Objectives: To determine the risk of developing cardiovascular disease in patients with Rheumatoid Arthritis according to the classification criteria of the American College of Rheumatology. Methods: To assess the risk of cardiovascular diseases we studied 78 patients diagnosed with Rheumatoid Arthritis. For this we used the criteria of the risk score of Acute Coronary Disease in 10 years according to the Framingham Heart Study. A control group consisted of 21 patients with osteoarthritis and fibromyalgia was also assessed using the same criteria, where age, sex, systolic blood pressure values, total cholesterol, cholesterol HDL, presence of smoking and diagnosis of diabetes, were scored. Results: Patients with rheumatoid arthritis had a mean disease duration of 12.8 years (SD=7.4), age 58.6 years (SD=10.3) and the control group 59.3 years (SD=10,0). The old values of total cholesterol, HDL, blood pressure and being with Diabetes Mellitus showed positive correlations with the Cardiovascular Risk, and Blood Pressure in the index this correlation was stronger (r=+0.593) in Rheumatoid Arthritis and age (r=+0.702) in the control group. The Global Cardiovascular Risk in each group were considered low (7,8 points to Rematoid Artrhrits and 9,3 points to the control group). Conclusion: The results showed no increased risk of cardiovascular disease when compared to control group. Remember that control group fact be constituted by a larger number of diabetics, which likely impact these results.

scholarly journals Increased Risk of Temporomandibular Joint Disorder in Patients with Rheumatoid Arthritis: A Longitudinal Follow-Up Study

2020 ◽  
Vol 9 (9) ◽  
pp. 3005
Author(s):  
Soo-Hwan Byun ◽  
Chanyang Min ◽  
Hyo-Geun Choi ◽  
Seok-Jin Hong
Keyword(s):  
Rheumatoid Arthritis ◽  
Temporomandibular Disorder ◽  
Population Data ◽  
Control Group ◽  
Chi Square ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Joint Disorder

We evaluated the incidence of temporomandibular disorder (TMD) in patients with rheumatoid arthritis (RA) and examined the association between TMD and RA, through longitudinal follow-up. Population data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. From 514,866 subjects, 3122 with RA were matched with 12,488 controls in a 1:4 ratio. The crude and adjusted models (for obesity, smoking, alcohol consumption, blood pressure, blood glucose, total cholesterol, and Charlson Comorbidity Index scores) were calculated. Chi-square tests, Kaplan-Meier (KM) analysis, and two-tailed analyses were used for statistical analysis. Stratified Cox proportional hazard models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for TMD in the RA group, compared to those in the control group. The adjusted HR for TMD in RA was 2.52 (95% CI = 1.70–3.74), compared to the control group. The results were consistent with the subgroup analyses, according to age and sex, except in men older than 60 years of age. KM analysis showed similar results. Hence, we found that patients with RA have a higher risk of TMD, and should be observed for symptoms of the initial stage of TMD to prevent the risk of aggravation.

scholarly journals The Key Comorbidities in Patients with Rheumatoid Arthritis: A Narrative Review

2021 ◽  
Vol 10 (3) ◽  
pp. 509
Author(s):  
Peter C. Taylor ◽  
Fabiola Atzeni ◽  
Alejandro Balsa ◽  
Laure Gossec ◽  
Ulf Müller-Ladner ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Patient Outcomes ◽  
Tumour Necrosis ◽  
Treatment Benefit ◽  
Drug Classes ◽  
Skin Cancers ◽  
Advanced Therapies ◽  
The Impact ◽  
Nonmelanoma Skin Cancers ◽  
Necrosis Factor

Comorbidities in patients with rheumatoid arthritis (RA) are often associated with poor health outcomes and increased mortality. Treatment decisions should take into account these comorbidities due to known or suspected associations with certain drug classes. In clinical practice, it is critical to balance potential treatment benefit against the possible risks for comorbidities as well as the articular manifestations of RA. This review summarises the current literature relating to prevalence and risk factors for the important comorbidities of cardiovascular disease, infections, lymphomas and nonmelanoma skin cancers in patients with RA. The impact on patient outcomes and the interplay between these comorbidities and the therapeutic options currently available, including tumour necrosis factor inhibitors and newer biological therapies, are also explored. As newer RA therapies are developed, and patients gain wider and earlier access to advanced therapies, in part due to the emergence of biosimilars, it is important to consider the prevention or treatment of comorbidities as part of the overall management of RA.

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.

scholarly journals Risk of Nonmelanoma Skin Cancers and Parkinson’s Disease—Meta-Analysis and Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 587
Author(s):  
Danuta Krasowska ◽  
Agnieszka Gerkowicz ◽  
Radosław Mlak ◽  
Milena Leziak ◽  
Teresa Małecka-Massalska ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cell Carcinoma ◽  
Meta Analysis ◽  
Control Group ◽  
Skin Cancers ◽  
Increased Risk ◽  
Comprehensive Search ◽  
Nonmelanoma Skin Cancers

Patients with Parkinson’s disease (PD) have an increased risk of melanoma compared with the general population. Considering that Nonmelanoma Skin Cancers (NMSCs) share similar risk factors with melanoma, there is a need to understand a possible connection between PD and NMSCs. The aim of the study was the evaluation of NMSC risk among PD patients via meta-analysis and systematic review. A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted, including studies from January 2000 to April 2020. We identified 16 eligible studies including 140291 PD patients. Upon statistical analysis, a significantly higher risk of developing NMSCs in PD patients was found compared with the control group (odds ratio (OR) = 1.25, 95% CI: 1.17–1.33; p < 0.0001). Among all NMSCs, the risk of developing basal cell carcinoma in PD patients was significantly higher (OR = 1.30, 95% confidence interval (CI): 1.15–1.47; p < 0.0001), contrary to squamous cell carcinoma. Further analysis revealed a significantly higher risk of developing NMSCs in patients with previously diagnosed PD (OR = 1.26, 95% CI: 1.19–1.33; p < 0.0001). Our data suggest the necessity for regular skin examination of PD patients, though further studies are required to explore the mechanisms forming this relationship.

Limitations in the Classification of Childhood-onset Rheumatoid Arthritis

2014 ◽  
Vol 41 (3) ◽  
pp. 547-553 ◽  
Author(s):  
Emily G. Ferrell ◽  
Lori A. Ponder ◽  
Lauren S. Minor ◽  
Sheila T. Angeles-Han ◽  
Christine W. Kennedy ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Childhood Onset ◽  
Chi Square ◽  
Exact Test ◽  
Number Of Children ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Peptide Antibody ◽  
Student’S T

Objective.Rheumatoid factor-positive polyarthritis (RF+ poly) is the juvenile idiopathic arthritis (JIA) category that resembles adult seropositive rheumatoid arthritis (RA). We studied children with RF+ and/or anticyclic citrullinated peptide antibody (anti-CCP)+ JIA to determine what proportion of those children meet International League of Associations for Rheumatology (ILAR) criteria for RF+ poly JIA and to assess for significant differences between children who meet RF+ poly criteria and those who are classified in other categories.Methods.Charts of children with JIA who were RF+ and/or anti-CCP+ were reviewed. Children with RF+ poly JIA were compared to children in other categories. Statistical analysis was performed using chi-square, Fisher’s exact test, and the Student’s t-test.Results.Of 56 children with RF+ and/or anti-CCP+ JIA, 34 (61%) met ILAR criteria for RF+ poly JIA. Twelve children had RF–/anti-CCP+ JIA with low anti-CCP titers. When these 12 children were excluded, there were few significant differences between children who met criteria for RF+ poly and those who were classified in other categories. The American College of Rheumatology/European League Against Rheumatism criteria for RA identified more RF+ children than did the ILAR RF+ poly classification (100% vs 77%).Conclusion.A number of children with RF+ arthritis were excluded from the RF+ poly JIA classification, though many demographic features and disease measures were similar to those of children who met criteria for RF+ poly JIA. We propose prioritization of RF/anti-CCP positivity over specific exclusions, along with inclusion of anti-CCP, in future revisions of the JIA classification criteria, to improve the sensitivity of diagnosing childhood-onset RA.

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 Relationship of Hydroxychloroquine and Ophthalmic Complications in Patients with Type 2 Diabetes in Taiwan

2021 ◽  
Vol 18 (15) ◽  
pp. 8154
Author(s):  
Hung-Chih Chen ◽  
Hung-Yu Lin ◽  
Michael Chia-Yen Chou ◽  
Yu-Hsun Wang ◽  
Pui-Ying Leong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Conditional Logistic Regression ◽  
Categorical Variables ◽  
Control Group ◽  
Case Group ◽  
Research Database ◽  
Continuous Variables ◽  
Chi Square ◽  
Increased Risk

The purpose of this study is to evaluate the relationship between hydroxychloroquine (HCQ) and diabetic retinopathy (DR) via the national health insurance research database (NHIRD) of Taiwan. All patients with newly diagnosed type 2 diabetes (n = 47,353) in the NHIRD (2000–2012) were enrolled in the study. The case group consists of participants with diabetic ophthalmic complications; 1:1 matching by age (±1 year old), sex, and diagnosis year of diabetes was used to provide an index date for the control group that corresponded to the case group (n = 5550). Chi-square test for categorical variables and Student’s t-test for continuous variables were used. Conditional logistic regression was performed to estimate the adjusted odds ratio (aOR) of DR. The total number of HCQ user was 99 patients (1.8%) in the case group and 93 patients (1.7%) in the control group. Patients with hypertension (aOR = 1.21, 95% CI = 1.11–1.31) and hyperlipidemia (aOR = 1.65, 95% CI = 1.52–1.79) significantly increased the risk of diabetic ophthalmic complications (p < 0.001). Conversely, the use of HCQ and the presence of rheumatoid diseases did not show any significance in increased risk of DR. HCQ prescription can improve systemic glycemic profile, but it does not decrease the risk of diabetic ophthalmic complications.

scholarly journals The ANGPTL8 rs2278426 (C/T) Polymorphism Is Associated with Prediabetes and Type 2 Diabetes in a Han Chinese Population in Hebei Province

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Guangsen Hou ◽  
Yong Tang ◽  
Luping Ren ◽  
Yunpeng Guan ◽  
Xiaoyu Hou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chinese Population ◽  
Han Chinese ◽  
Hebei Province ◽  
Control Group ◽  
Chi Square ◽  
Han Chinese Population ◽  
Increased Risk ◽  
Bonferroni Test

Background. Our aim was to investigate the association between the genetics of the angiopoietin protein-like 8 (ANGPTL8) rs2278426 (C/T) polymorphism with prediabetes (pre-DM) and type 2 diabetes (T2DM) in a Han Chinese population in Hebei Province, China. Methods. We enrolled 1,460 participants into this case-control study: healthy controls, n = 524; pre-DM, n = 460; and T2DM: n = 460. Ligase assays on blood samples from all participants were used to identify polymorphisms. Differences in genotype and allele distributions were compared by the chi-square test and one-way analysis of variance, and a post hoc pairwise analysis was performed using the Bonferroni test. The logistic regression technique was adjusted for age, sex, and body mass index. Results. The frequency of the TT (10.9%) genotype was significantly higher in pre-DM patients than in controls (odds ratio [OR] = 1.696, 95% confidence interval [CI] = 1.026–2.802, P = 0.039 ). In the T2DM group, the CT (48%) and TT (15%) genotypes were significantly higher compared with those in the control group (CT : OR = 1.384, 95% CI = 1.013–1.890, P = 0.041 ; TT : OR = 2.530, 95% CI = 1.476–4.334, P = 0.001 ). The frequency of the T allele was significantly higher in the pre-DM (32.8%) and T2DM (39%) groups compared with the control group (26.9%) and was significantly associated with an increased risk of pre-DM (OR = 1.253, 95% CI = 1.017–1.544, P = 0.034 ) and T2DM (OR = 1.518, 95% CI = 1.214–1.897, P = 0.001 ). Furthermore, insulin levels in the pre-DM and T2DM groups were significantly decreased in those with the TT genotype compared with the CC and CT genotypes. Conclusion. ANGPTL8 rs2278426 may be involved in the mechanism of insulin secretion and could lead to an increased risk of pre-DM and T2DM.

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