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[3',5'-cAMP phosphodiesterase inhibitors in the combined treatment of patients with rheumatoid arthritis]

https://arctichealth.org/en/permalink/ahliterature14188
Source
Lik Sprava. 1998 Aug;(6):34-7
Publication Type
Article
Date
Aug-1998
Author
O I Bakaliuk
M I Shved
M V Hrebenyk
Source
Lik Sprava. 1998 Aug;(6):34-7
Date
Aug-1998
Language
Ukrainian
Publication Type
Article
Keywords
3',5'-Cyclic-Nucleotide Phosphodiesterase - antagonists & inhibitors
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy - immunology - metabolism
Combined Modality Therapy
Comparative Study
Drug Evaluation
English Abstract
Glucosephosphate Dehydrogenase - blood - drug effects
Humans
Immunity, Cellular - drug effects
Immunity, Natural - drug effects
Lipid Peroxidation - drug effects
Papaverine - therapeutic use
Phosphodiesterase Inhibitors - therapeutic use
Prospidium - therapeutic use
Abstract
A study was made of clinical effectiveness and mechanism of action of the inhibitor of the specific 3',5'-cAMP phosphodiesterase papaverine in a therapeutic complex of measures designed to treat RA patients involving an immunodepressive preparation free from any cytopenic effect prospidin as a basic mediator. It has been shown that the papaverine antiarthritic action is associated with its positive effects on the unspecific component of the immune-complex inflammation, viz. processes of lipid peroxidation, activity of the antioxidant system of defence as well as on the vascular tone and microcirculation. All this improves tissue metabolism, and in this way enhances efficiency of RA basic therapy.
PubMed ID
9844866 View in PubMed
Less detail

Access to biologic therapies in Canada for children with juvenile idiopathic arthritis.

https://arctichealth.org/en/permalink/ahliterature121976
Source
J Rheumatol. 2012 Sep;39(9):1875-9
Publication Type
Article
Date
Sep-2012
Author
Claire M A Leblanc
Bianca Lang
Alma Bencivenga
Anne-Laure Chetaille
Paul Dancey
Peter Dent
Paivi Miettunen
Kiem Oen
Alan Rosenberg
Johannes Roth
Rosie Scuccimarri
Shirley M L Tse
Susanne Benseler
David A Cabral
Sarah Campillo
Gaëlle Chédeville
Ciaran M Duffy
Karen Watanabe Duffy
Elie Haddad
Adam M Huber
Ronald Laxer
Deborah Levy
Nicole Johnson
Suzanne Ramsey
Natalie Shiff
Heinrike Schmeling
Rayfel Schneider
Elizabeth Stringer
Rae S M Yeung
Lori B Tucker
Author Affiliation
McGill University, and Department of Pediatrics, Montreal Children's Hospital, 2300 Rue Tupper, Montreal, Quebec H3H 1P3, Canada. claire.leblanc@muhc.mcgill.ca
Source
J Rheumatol. 2012 Sep;39(9):1875-9
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Antirheumatic Agents - therapeutic use
Arthritis, Juvenile - drug therapy
Biological Products - therapeutic use
Canada
Child
Female
Health Care Surveys
Health Services Accessibility
Humans
Male
Severity of Illness Index
Abstract
To compare access to biologic therapies for children with juvenile idiopathic arthritis (JIA) across Canada, and to identify differences in provincial regulations and criteria for access.
Between June and August 2010, we compiled the provincial guidelines for reimbursement of biologic drugs for children with JIA and conducted a multicenter Canada-wide survey of pediatric rheumatologists to determine their experience with accessing biologic therapies for their patients.
There were significant difficulties accessing biologic treatments other than etanercept and abatacept for children. There were large discrepancies in the access criteria and coverage of biologic agents across provinces, notably with age restrictions for younger children.
Canadian children with JIA may not receive optimal internationally recognized "standard" care because pediatric coverage for biologic drugs through provincial formularies is limited and inconsistent across the country. There is urgent need for public policy to improve access to biologic therapies for these children to ensure optimal short-term and longterm health outcomes.
Notes
Comment In: J Rheumatol. 2013 Mar;40(3):33923577350
Comment In: J Rheumatol. 2013 Mar;40(3):33823457402
PubMed ID
22859344 View in PubMed
Less detail

Achievement of Remission and Low Disease Activity Definitions in Patients with Rheumatoid Arthritis in Clinical Practice: Results from the NOR-DMARD Study.

https://arctichealth.org/en/permalink/ahliterature278963
Source
J Rheumatol. 2016 Apr;43(4):716-23
Publication Type
Article
Date
Apr-2016
Author
Till Uhlig
Elisabeth Lie
Vibeke Norvang
Åse Stavland Lexberg
Erik Rødevand
Frode Krøll
Synøve Kalstad
Inge C Olsen
Tore K Kvien
Source
J Rheumatol. 2016 Apr;43(4):716-23
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - diagnosis - drug therapy
Female
Humans
Male
Middle Aged
Norway
Registries
Remission Induction
Severity of Illness Index
Treatment Outcome
Abstract
To examine the frequency of 6 definitions for remission and 4 definitions for low disease activity (LDA) after starting a disease-modifying antirheumatic drug (DMARD) in patients with rheumatoid arthritis (RA) in clinical practice, and to study whether predictors for achieving remission after 6 months are similar for these definitions.
Remission and LDA were calculated according to the 28-joint Disease Activity Score (DAS28), the Clinical Disease Activity Index (CDAI), the Simplified Disease Activity Index (SDAI), the Routine Assessment of Patient Index Data (RAPID3), and both the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission definitions 3 and 6 months after 4992 DMARD prescriptions for patients enrolled in the NOR-DMARD, a 5-center Norwegian register. Prediction of remission after 6 months was also studied.
After 3 months, remission rates varied between definitions from 8.7% to 22.5% and for LDA from 35.5% to 42.7%, and increased slightly until 6 months of followup. DAS28 and RAPID3 gave the highest and ACR/EULAR, SDAI, and CDAI the lowest proportions for remission. Positive predictors for remission after 6 months were similar across the definitions and included lower age, male sex, short disease duration, high level of education, current nonsmoking, nonerosive disease, treatment with a biological DMARD, being DMARD-naive, good physical function, little fatigue, and LDA.
In daily clinical practice, the DAS28 and RAPID3 definitions identified remission about twice as often as the ACR/EULAR Boolean, SDAI, and CDAI. Predictors of remission were similar across remission definitions. These findings provide additional evidence to follow treatment recommendations and treat RA early with a DMARD.
PubMed ID
26879358 View in PubMed
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Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between Sudan and Sweden.

https://arctichealth.org/en/permalink/ahliterature287360
Source
J Rheumatol. 2016 Oct;43(10):1777-1786
Publication Type
Article
Date
Oct-2016
Author
Amir I Elshafie
Abdalla D Elkhalifa
Sahwa Elbagir
Mawahib I E Aledrissy
Elnour M Elagib
Musa A M Nur
Tomas Weitoft
Johan Rönnelid
Source
J Rheumatol. 2016 Oct;43(10):1777-1786
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Aged
Aged, 80 and over
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - blood - diagnosis - drug therapy
Biological Products - therapeutic use
Blood Sedimentation
Drug Therapy, Combination
Female
Humans
Male
Methotrexate - therapeutic use
Middle Aged
Prednisolone - therapeutic use
Rheumatoid Factor - blood
Severity of Illness Index
Sudan
Sulfasalazine - therapeutic use
Sweden
Symptom Assessment
Young Adult
Abstract
To compare clinical characteristics and treatment between simultaneously investigated Sudanese and Swedish outpatients with rheumatoid arthritis (RA).
Outpatients with RA from Sudan (n = 281) and Sweden (n = 542) diagnosed according to the 1987 American College of Rheumatology criteria were recruited between December 2008 and September 2010 and compared concerning clinical presentation, treatment, and laboratory findings, including immunoglobulin M with rheumatoid factor (IgM-RF).
Sudanese patients had lower inclusion age (median 49 vs 68 yrs), disease duration (48 vs 107 mos), and disease onset age (43 vs 56 yrs) as compared with Swedish patients (p
PubMed ID
27481904 View in PubMed
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Adalimumab (Humira) restores clinical response in patients with secondary loss of efficacy from infliximab (Remicade) or etanercept (Enbrel): results from the STURE registry at Karolinska University Hospital.

https://arctichealth.org/en/permalink/ahliterature13711
Source
Scand J Rheumatol. 2005 Sep-Oct;34(5):353-8
Publication Type
Article
Author
M C Wick
S. Ernestam
S. Lindblad
J. Bratt
L. Klareskog
R F van Vollenhoven
Author Affiliation
Department of Rheumatology, Karolinska University Hospital, Solna, Sweden.
Source
Scand J Rheumatol. 2005 Sep-Oct;34(5):353-8
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibodies, Monoclonal - therapeutic use
Antirheumatic Agents - therapeutic use
Arthritis, Psoriatic - drug therapy
Arthritis, Rheumatoid - drug therapy
Drug resistance
Humans
Immunoglobulin G - therapeutic use
Middle Aged
Receptors, Tumor Necrosis Factor - therapeutic use
Registries
Research Support, Non-U.S. Gov't
Sweden
Treatment Failure
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Abstract
OBJECTIVES: To determine whether the tumour necrosis factor-alpha (TNF-alpha) antagonist adalimumab (Humira) can be efficacious after secondary loss of efficacy (i.e. loss of clinical response in patients who had initially demonstrated clinical response) to infliximab (Remicade) or etanercept (Enbrel). PATIENTS AND METHODS: We studied 36 patients from the Stockholm TNF-alpha follow-up registry (STURE) who received adalimumab after secondary loss of efficacy to infliximab (group A, n = 27) or etanercept (group B, n = 9), and 26 patients who were started on adalimumab as the first TNF-alpha antagonist (group C). RESULTS: In group A, the baseline disease activity score 28 (DAS28) at infliximab institution was 5.5+/-0.2. During infliximab treatment, the mean best DAS28 was 3.7+/-0.2 (p
PubMed ID
16234182 View in PubMed
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An evaluation of the impact of seniors on a rheumatology referral clinic: demographics and pharmacotherapy.

https://arctichealth.org/en/permalink/ahliterature131127
Source
Clin Rheumatol. 2011 Nov;30(11):1507-9
Publication Type
Article
Date
Nov-2011
Author
Angela Juby
Paul Davis
Author Affiliation
Department of Medicine, Division of Geriatric Medicine, Faculty of Medicine, University of Alberta, B139 Clinical Sciences Building, 8440 112 Street, Edmonton, Alberta, Canada. angela.juby@albertahealthservices.ca
Source
Clin Rheumatol. 2011 Nov;30(11):1507-9
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Antirheumatic Agents - therapeutic use
Arthritis - complications - drug therapy
Canada
Coronary Artery Disease - complications
Diabetes Mellitus, Type 2 - complications
Female
Glucocorticoids - therapeutic use
Humans
Hypertension - complications
Hypothyroidism - complications
Male
Osteoporosis - complications
Referral and Consultation
Retrospective Studies
Rheumatic Diseases - complications - drug therapy
Abstract
The aging population is impacting subspecialty areas outside of geriatrics. Rheumatic diseases increase with age. Therapy for these diseases can add to polypharmacy and negatively impact other comorbidities. This is a retrospective chart review of all patients attending a rheumatology subspeciality clinic over 1 year. Referrals were prescreened and excluded probable degenerative axial and peripheral disease and chronic pain syndromes. Data were collected on demographics, diagnoses, and medications. Two hundred ninety-five new patients were seen. Seventy-eight (26%) were seniors (age, >65 years) with a mean age of 73 years (65-90). Comparing the >65 to 65 age group included hypertension (31%), osteoporosis (27%), diabetes (15%), hypothyroidism (11%), and coronary artery disease (9%). Only one patient had documented dementia. There were no cases of uncontrolled hypertension identified, and all patients were receiving a mixture of anti-hypertensives. Eighty-one percent of osteoporosis patients were on antiresorptives, but only 40% of prednisone users were taking bisphosphonates. For RA, treatment was somewhat comparable between the groups, with all but two patients receiving disease-modifying antirheumatic drugs. Eleven percent were on biologics. Seniors comprise a significant number of referrals. Pharmacotherapy differs in seniors, with more use of prednisone and a probable contribution of polypharmacy. This study highlights the need for reciprocal knowledge by both geriatricians and rheumatologists to optimize the management of these complex patients.
PubMed ID
21935585 View in PubMed
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Anticitrullinated protein antibodies and rheumatoid factor fluctuate in early inflammatory arthritis and do not predict clinical outcomes.

https://arctichealth.org/en/permalink/ahliterature116618
Source
J Rheumatol. 2013 Aug;40(8):1259-67
Publication Type
Article
Date
Aug-2013
Author
Lillian Barra
Vivian Bykerk
Janet E Pope
Boulos P Haraoui
Carol A Hitchon
J Carter Thorne
Edward C Keystone
Gilles Boire
Author Affiliation
Department of Medicine, Division of Rheumatology, St. Joseph's Health Care London, University of Western Ontario, London, Ontario, Canada. lbarra2@uwo.ca
Source
J Rheumatol. 2013 Aug;40(8):1259-67
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibodies, Anti-Idiotypic - blood
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - blood - drug therapy
Biological Markers - blood
Canada
Cohort Studies
Disability Evaluation
Female
Follow-Up Studies
Humans
Male
Middle Aged
Peptides, Cyclic - immunology
Predictive value of tests
Questionnaires
Regression Analysis
Rheumatoid Factor - blood
Sensitivity and specificity
Severity of Illness Index
Treatment Outcome
Abstract
In inflammatory arthritis, rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPA) are believed to be associated with more severe clinical outcomes. Our objective was to determine whether ACPA and RF remain stable in early inflammatory arthritis and whether their trajectories over time or baseline levels predicted clinical outcomes.
The study population consisted of patients enrolled in the Canadian Early Arthritis Cohort Study with baseline and at least 12-month followup values of RF and ACPA. Primary outcomes were Disease Activity Score (DAS) remission and the presence of erosions at 12 and 24 months. Other objectives included swollen joint count, Health Assessment Questionnaire score, and DAS.
At baseline, 225/342 (66%) patients were ACPA-positive and 334/520 (64%) were RF-positive. At 24 months, 15/181 (8%) ACPA-positive patients became negative. A larger number of patients changed from ACPA-negative to positive: 13/123 (11%). For RF, fluctuations were more common: 67/240 (28%) reverted from positive to negative and 21/136 (18%) converted from negative to positive. RF and ACPA fluctuations did not predict disease outcomes. Patients who remained ACPA-positive throughout followup were more likely to have erosive disease (OR 3.86, 95% CI 1.68, 8.92).
RF and ACPA have the potential to revert and convert during the early course of disease. Fluctuations in RF and ACPA were not associated with clinical outcomes.
PubMed ID
23378461 View in PubMed
Less detail

Anti-TNF therapy in the treatment of ankylosing spondylitis: the Finnish experience.

https://arctichealth.org/en/permalink/ahliterature164877
Source
Clin Rheumatol. 2007 Oct;26(10):1693-700
Publication Type
Article
Date
Oct-2007
Author
Liisa Konttinen
Riitta Tuompo
Tea Uusitalo
Riitta Luosujärvi
Kari Laiho
Jukka Lähteenmäki
Maija Puurtinen-Vilkki
Ritva Lanteri
Saara Kortelainen
Helena Karilainen
Tuire Varjolahti-Lehtinen
Dan Nordström
Author Affiliation
University of Helsinki, Helsinki, Finland.
Source
Clin Rheumatol. 2007 Oct;26(10):1693-700
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Administration, Oral
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Antirheumatic Agents - therapeutic use
Biological Therapy - methods
Blood Sedimentation
C-Reactive Protein - metabolism
Female
Finland
Humans
Male
Middle Aged
Spondylitis, Ankylosing - drug therapy - ethnology
Tumor Necrosis Factor-alpha - antagonists & inhibitors - chemistry
Abstract
Biological therapy for ankylosing spondylitis (AS) has led to improved disease control beyond that of conventional treatments. International recommendations encourage clinicians prescribing biological treatments to register patients in national registers to collect information on outcome and toxicity. Patients with AS (n = 229) from the Register of Biological Treatment in Finland (ROB-FIN) with severe disease of long duration were followed-up for up to 24 months. Due to an active disease, one or more concomitant disease-modifying antirheumatic drugs (DMARDs) were used by 86% at commencement of biological therapy. This add-on strategy with infliximab led to a rapid pain relief and improvement of patient's and physician's global assessments, C-reactive protein/erythrocyte sedimentation rate, and swollen and tender joint counts within 6 weeks. Concomitant use of NSAID and oral corticosteroid was reduced. Corresponding results were documented at 3 months with etanercept, which was more recently approved for the treatment of spondyloarthropathies. Seventy-nine percent of the patients were ASAS 20 responders. A subgroup of AS patients with only axial involvement (n = 46) responded correspondingly. The first biological drug was discontinued in only 7% due to lack of efficacy and in 6% due to adverse events. Anti-TNF agents, often used in combination with DMARDs, appeared to have persistent effectiveness and limited toxicity in a real-life clinical setting in a cohort of Finnish AS patients with severe disease and long disease duration.
PubMed ID
17332979 View in PubMed
Less detail

Are dietary vitamin D, omega-3 fatty acids and folate associated with treatment results in patients with early rheumatoid arthritis? Data from a Swedish population-based prospective study.

https://arctichealth.org/en/permalink/ahliterature290863
Source
BMJ Open. 2017 06 10; 7(6):e016154
Publication Type
Journal Article
Date
06-10-2017
Author
Cecilia Lourdudoss
Alicja Wolk
Lena Nise
Lars Alfredsson
Ronald van Vollenhoven
Author Affiliation
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Source
BMJ Open. 2017 06 10; 7(6):e016154
Date
06-10-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Dietary Supplements
Fatty Acids, Omega-3 - administration & dosage
Female
Folic Acid - administration & dosage
Humans
Male
Middle Aged
Prospective Studies
Sweden
Vitamin D - administration & dosage
Vitamins - therapeutic use
Abstract
Dietary intake of vitamin D and omega-3 fatty acids (FA) may be associated with superior response to antirheumatic treatments. In addition, dietary folate intake may be associated with worse response to methotrexate (MTX). The aim of this study was to investigate the association between dietary vitamin D, omega-3 FA, folate and treatment results of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA).
This prospective study was based on data from the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study, and included 727 patients with early RA from 10 hospitals in Sweden. Data on dietary vitamin D, omega-3 FA and folate intake based on food frequency questionnaires were linked with data on European League Against Rheumatism (EULAR) response after 3?months of DMARD treatment. Associations between vitamin D, omega-3 FA, folate and EULAR response were analysed with logistic regression adjusted for potential confounders.
The majority of patients (89.9%) were initially treated with MTX monotherapy and more than half (56.9%) with glucocorticoids. Vitamin D and omega-3 FA were associated with good EULAR response (OR 1.80 (95% CI 1.14 to 2.83) and OR 1.60 (95% CI 1.02 to 2.53), respectively). Folate was not significantly associated with EULAR response (OR 1.20 (95% CI 0.75 to 1.91)). Similar results were seen in a subgroup of patients who were initially treated with MTX monotherapy at baseline.
Higher intake of dietary vitamin D and omega-3 FA during the year preceding DMARD initiation may be associated with better treatment results in patients with early RA. Dietary folate intake was not associated with worse or better response to treatment, especially to MTX. Our results suggest that some nutrients may be associated with enhanced treatment results of DMARDs.
Notes
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PubMed ID
28601838 View in PubMed
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Are patients with rheumatoid arthritis still at an increased risk of tuberculosis and what is the role of biological treatments?

https://arctichealth.org/en/permalink/ahliterature265097
Source
Ann Rheum Dis. 2015 Jun;74(6):1212-7
Publication Type
Article
Date
Jun-2015
Author
Elizabeth V Arkema
Jerker Jonsson
Eva Baecklund
Judith Bruchfeld
Nils Feltelius
Johan Askling
Source
Ann Rheum Dis. 2015 Jun;74(6):1212-7
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized - therapeutic use
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy - epidemiology
Biological Products - therapeutic use
Case-Control Studies
Cohort Studies
Female
Humans
Immunoglobulin G - therapeutic use
Male
Middle Aged
Proportional Hazards Models
Receptors, Tumor Necrosis Factor - therapeutic use
Risk factors
Sweden - epidemiology
Tuberculosis - epidemiology
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Abstract
To estimate the risk of tuberculosis (TB) in patients with rheumatoid arthritis (RA) both with and without exposure to biological therapy and to directly compare the risks between therapies.
Data from the Swedish National Population Registers, Tuberculosis Register and the Swedish Biologics Register were used to conduct a prospective population-based national cohort study (2002-2011). We estimated the rate of incident TB in the general population and in a cohort of biological-naïve and biological-exposed patients diagnosed with RA. Cox models were used to estimate HRs with particular attention to risks by calendar and follow-up time and individual biologics.
Compared to the general population, RA patients not exposed to biologicals had a fourfold increased risk of TB (HR 4.2; 95% CI 2.7 to 6.7), which did not decline over calendar time. In contrast, the risk of TB in the biological-exposed RA population decreased since 2002 compared with biological-naïve; from HR=7.9 (95% CI 3.3 to 18.9) in 2002-2006 to HR=2.4 (95% CI 0.9 to 6.1) in 2007-2011. The HRs for most recent exposure to adalimumab and infliximab compared with etanercept were 3.1 (95% CI 0.8 to 12.5) and 2.7 (95% CI 0.7 to 10.9), respectively, and the HR for etanercept compared with biological-naïve RA was 1.7 (95% CI 0.6 to 4.6).
In the past decade, the risk of TB has decreased among biological-exposed RA patients but remains higher than in biological-naïve RA patients. Most cases of TB in RA occur in biological-naïve RA patients, underscoring the elevated risk also in these patients.
PubMed ID
24608401 View in PubMed
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240 records – page 1 of 24.