scholarly journals EFFICACY OF METHOTREXATE VERSUS LEFLUNOMIDE VERSUS COMBINATION OF BOTH IN ACTIVE RHEUMATOID ARTHRITIS

2021 ◽  
Vol 71 (6) ◽  
pp. 1916-19
Author(s):  
Syed Haider Tirmizi ◽  
Amer Fakhr ◽  
Ahsan Amer ◽  
Kaswar Sajjad ◽  
Khurram Haq Nawaz ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Active Rheumatoid Arthritis ◽  
Disease Activity Score ◽  
Remission Rate ◽  
Activity Score ◽  
Response To Treatment ◽  
Military Hospital ◽  
P Value ◽  
Duration Of Symptoms

Objective: To determine the efficacy of Methotrexate versus Leflunomide versus combination of both among patients managed at Pak Emirates Military Hospital with active rheumatoid arthritis. Study Design: Prospective comparative study. Place and Duration of Study: Rheumatology/General Medicine Department, Pak Emirates Military Hospital Rawalpindi, from May 2019 to June 2020. Methodology: Patient of active rheumatoid arthritis who fulfilled American college of rheumatology criteria of 1997 were included in the study. They were randomly divided into three groups with group A receiving Methotrexate, group B receiving Leflunomide while group C received the combination of both Methotrexate and Leflunomide. Disease activity was assessed by using the Disease Activity Score-28 in all the three groups after three months of treatment. Results: Mean age of the study participants was 36.919 ± 6.85 years. One hundred and fifty (83.3%) patients were female while 30 (16.7%) were male. Out of 160 (88.9%) patients achieved remission according to Disease Activity Score-28 score at the end of three months while 20 (11.1%) did not achieve remission. Pearson chi-square test revealed that none of the factors studied including the treatment option had any statistically significant relationship with presence of remission among the target population (p-value 0.386, 0.815, 0.194 and 0.145 for age, gender, duration of symptoms and type of treatment respectively). Conclusion: Remission rate among the rheumatoid arthritis patients in response to treatment was overall good in the study. In terms of efficacy for symptoms of rheumatoid arthritis and achieving remission, after three months of treatment all the three options..................

scholarly journals An observational study on Assessment of disease activity in Rheumatoid Arthritis patients using Patient based Disease Activity Score 2 (PDAS 2)

2021 ◽  
Author(s):  
Harpreet Singh ◽  
Somdatta Giri ◽  
Hemant Kumar ◽  
Pratibha Yonzone ◽  
Mahima Khatkar
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Activity Index ◽  
Statistical Significance ◽  
Disease Activity Index ◽  
Activity Score ◽  
P Value ◽  
Internal Reliability ◽  
Das 28

Abstract Objective To assess the utility of Patient Based Disease Activity Score 2 (PDAS 2) in assessing the disease activity in Rheumatoid arthritis (RA). Methods A prospective cohort study was conducted on 80 patients of RA. The demographic and clinical characteristics of the patients were recorded. They were assessed for disease activity using “Disease Activity Score 28” (DAS 28), “Clinical Disease Activity Index” (CDAI) and PDAS 2 score at baseline (M0), at 2 months (M2) and at 4 months(M4) while they were on treatment. Data was analyzed for correlation of PDAS-2 with other scores and internal reliability. P < 0.05 was considered for statistical significance. Results The mean age was 40.13\(\pm\) 11.74 years with 70 females and 10 males. There was significant reduction in DAS28, CDAI and PDAS 2 score over 4 month follow up (all scores’ p values < 0.001). Internal reliability (as assessed by Cronbach’s Alpha) of PDAS 2 was 0.578. PDAS 2 showed significant correlation with DAS28 at M0, M2 and M4 (r = 0.792, 0.757 and 0.669 respectively, p value < 0.001) and CDAI (r = 0.861, 0.832 and 0.695 respectively, p value < 0.001). Overall there was a significant agreement between DAS 28 and PDAS 2 (K = 0.788,p < 0.001) and between CDAI and PDAS 2 (K = 0.766,p < 0.001). Conclusion PDAS-2 score can be routinely used in the clinical practice owing to its correlation with DAS-28/CDAI and because of the advantage that it assessed the patients’ daily living activities.

Methotrexate induced lung diseases in rheumatoid arthritis patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Gamal Zaki ◽  
Ahmad Mohamed El Yasaky ◽  
Rana Ahmed El Hilaly ◽  
Mayada Taha Mostafa
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Lung Disease ◽  
Disease Activity Score ◽  
Pulmonary Function Tests ◽  
Activity Score ◽  
P Value ◽  
Female Ratio ◽  
Increased Risk ◽  
Significant Difference

Abstract Background Rheumatoid arthritis (RA) is a progressive, systemic autoimmune disorder characterized by articular and extra-articular manifestations. The lung is commonly a site of extra-articular disease. The lung manifestations of RA vary and may include airways, parenchymal, vascular, and pleural disease. Manifestations of lung disease in RA typically follow the development of articular disease. Methotrexate (MTX)has shown efficacy for the treatment of several diseases, especially RA. Methotrexate has also been implicated as a causative agent in interstitial lung disease. Objective to find any association between MTX intake and lung abnormalities in RA patients. Patients and Methods This study included sixty adult RA patients, recruited from Ain Shams University Hospitals. Patients were divided into thirty patients on MTX therapy, and another thirty patients on non-methotrexate therapy. All underwent history, clinical examination, chest examination, evaluation of RA by modified disease activity score 28 (DAS 28) and pulmonary function tests(PFT). Results The age of patients receiving MTX ranged from 35-65 years and the non-MTX group was 35-57 years with a mean ±SD of 47.733±5.265 and 40.700 ±5.187, respectively. Male to female ratio of MTX group was about 1:3, while Non MTX group was about 1:9.There was no significant difference regarding age and sex. There was no difference between both group regarding modified DAS score and chest manifestations. There was no difference in PFT findings between patients on high or low dose of MTX therapy .Similarly, no association was found between disease activity score and PFT findings in both groups. On the other hand, a significant association between chest symptoms and PFT, P value&lt;0.05 . Also a strong significant association was found between anticitrullinated protein antibodies (ACPA) status and PFT in both group, p value &lt;0.05. Conclusion MTX treatment was not associated with an increased risk of RA-ILD diagnosis. On the contrary, evidence showed that MTX may delay the onset of ILD. There seems no reason to confuse the association of MTX and hypersensitivity pneumonitis with the onset of RAILD.ACPA antibody is considered a major risk factor in RA-ILD, ACPA titers constitute an independent factor associated not only with the presence but also with the severity of RA-ILD

scholarly journals Disease activity score-driven therapy versus routine care in patients with recent-onset active rheumatoid arthritis: data from the GUEPARD trial and ESPOIR cohort

2011 ◽  
Vol 70 (4) ◽  
pp. 611-615 ◽  
Author(s):  
M Soubrier ◽  
C Lukas ◽  
J Sibilia ◽  
B Fautrel ◽  
F Roux ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Active Rheumatoid Arthritis ◽  
Disease Activity Score ◽  
Routine Care ◽  
Activity Score ◽  
Control Group ◽  
Tight Control ◽  
Radiological Progression ◽  
Recent Onset

ObjectivesTo compare the efficacy of disease activity score in 28 joints (DAS28ESR)-driven therapy with anti-tumour necrosis factor (patients from the GUEPARD trial) and routine care in patients with recent-onset rheumatoid arthritis (patients of the ESPOIR cohort).ResultsAfter matching GUEPARD and ESPOIR patients on the basis of a propensity score and a 1:2 ratio, at baseline all patients had comparable demographic characteristics, rheumatoid factor, anticyclic citrullinated peptide antibody positivity and clinical disease activity parameters: erythrocyte sedimentation rate, C-reactive protein, mean DAS (6.26±0.87), Sharp/van der Heijde radiographic score (SHS), health assessment questionnaire (HAQ). Disease duration was longer in GUEPARD patients (5.6±4.6 vs 3.5±2.0 months, p<0.001). After 1 year, the percentage of patients in remission with an HAQ (<0.5) and an absence of radiological progression was higher in the tight control group (32.3% vs 10.2%, p=0.011) as well as the percentage of patients in low DAS with an HAQ (<0.5) and an absence of radiological progression (36.1% vs 18.9%, p=0.045). However, there was no difference in the decrease in DAS, nor in the percentage of EULAR (good and moderate), ACR20, ACR50 and ACR70 responses. More patients in the tight control group had an HAQ below 0.5 (70.2% vs 45.2%, p=0.005). Overall, pain, patient and physician assessment and fatigue decreased more in the tight control group. The mean SHS progression was similar in the two groups as was the percentage of patients without progression.ConclusionsIn patients with recent onset active rheumatoid arthritis, a tight control of disease activity allows more patients to achieve remission without disability and radiographic progression.

Contribution of subjective Disease Activity Score 28 (DAS28) components to the response to treatment of rheumatoid arthritis

2017 ◽  
Vol 36 (6) ◽  
pp. 1221-1227 ◽  
Author(s):  
Kyeong Min Son ◽  
Sung Yeon Lee ◽  
Young Il Seo ◽  
Ji-Eun Choi ◽  
Hyun Ah Kim
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Activity Score ◽  
Response To Treatment
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