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1.
Studies on autoantibody production in patients treated with tumor necrosis factor-α (TNF-α) inhibitors reported contradictory
results. We investigated in a prospective study the efficacy of a treatment with human monoclonal anti-TNF-α antibody (adalimumab)
in patients with rheumatoid arthritis (RA) and we evaluated the relationship between treatment efficacy and the incidence
and titers of disease-associated and non-organ-specific autoantibodies. Fifty-seven patients with RA not responsive to methotrexate
and treated with adalimumab were enrolled. Antinuclear, anti-double-stranded(ds)DNA, anti-extractable nuclear antigens, anti-cardiolipin
(aCL), anti-β2 glycoprotein I (anti-β2GPI) autoantibodies, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) autoantibodies were investigated
at baseline and after 6 and 12 months of follow-up. Comparable parameters were evaluated in a further 55 patients treated
with methotrexate only. Treatment with adalimumab induced a significant decrease in RF and anti-CCP serum levels, and the
decrease in antibody titers correlated with the clinical response to the therapy. A significant induction of antinuclear autoantibodies
(ANA) and IgG/IgM anti-dsDNA autoantibodies were also found in 28% and 14.6% patients, respectively, whereas aCL and anti-β2GPI autoantibodies were not detected in significant quantities. No association between ANA, anti-dsDNA, aCL and anti-β2GPI autoantibodies and clinical manifestations was found. Clinical efficacy of adalimumab is associated with the decrease
in RF and anti-CCP serum levels that was detected after 24 weeks and remained stable until the 48th week of treatment. Antinuclear
and anti-dsDNA autoantibodies, but not anti-phospholipid autoantibodies, can be induced by adalimumab but to a lower extent
than in studies with other anti-TNF blocking agents. 相似文献
2.
Meyer O Nicaise-Roland P Santos MD Labarre C Dougados M Goupille P Cantagrel A Sibilia J Combe B 《Arthritis research & therapy》2006,8(2):R40-8
The objective of this study was to evaluate the potential of serially determined anti-cyclic citrullinated peptide (CCP) antibodies
for predicting structural joint damage in patients with early rheumatoid arthritis (RA), compared to a single baseline determination.
Ninety-nine RA patients with disease durations of less than one year and no history of disease-modifying antirheumatic drug
therapy were followed prospectively for at least five years. Anti-CCP2 concentrations were measured using a second-generation
ELISA. Sharp scores as modified by van der Heijde were determined on hand and foot radiographs. Anti-CCP2 antibodies were
detected in 55.5% of patients at baseline and 63.6% at any time during the first three years. Presence of anti-CCP2 at any
time during the first three years was associated with radiographic damage at baseline (odds ratio (OR), 3.66; 95% confidence
interval (95% CI) 0.99–13.54) and with five year progression of the total Sharp score (OR, 3.17; 95% CI, 1.3–7.7), erosion
score (OR, 5.3; 95% CI, 1.4–19.2) and joint space narrowing score (OR, 2.8; 95% CI, 1.15–6.8). The presence of anti-CCP2 or
IgM RF at baseline did not predict these outcomes. Patients with negative anti-CCP2 tests throughout follow-up had less radiographic
progression than patients with increasing anti-CCP2 concentrations; they did not differ from patients with decreasing anti-CCP2
antibody levels. HLADRB1* typing showed that progression of the mean modified Sharp score was not correlated with the presence
of the shared epitope alleles. In conclusion, serially determined anti-CCP2 antibodies during the first three years of follow-up
performs better than baseline determination for predicting radiographic progression in patients with early RA. 相似文献
3.
Atzeni F Sarzi-Puttini P Dell' Acqua D de Portu S Cecchini G Cruini C Carrabba M Meroni PL 《Arthritis research & therapy》2006,8(1):R3
Studies on autoantibody production in patients treated with tumor necrosis factor-alpha (TNF-alpha) inhibitors reported contradictory results. We investigated in a prospective study the efficacy of a treatment with human monoclonal anti-TNF-alpha antibody (adalimumab) in patients with rheumatoid arthritis (RA) and we evaluated the relationship between treatment efficacy and the incidence and titers of disease-associated and non-organ-specific autoantibodies. Fifty-seven patients with RA not responsive to methotrexate and treated with adalimumab were enrolled. Antinuclear, anti-double-stranded(ds)DNA, anti-extractable nuclear antigens, anti-cardiolipin (aCL), anti-beta2 glycoprotein I (anti-beta2GPI) autoantibodies, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) autoantibodies were investigated at baseline and after 6 and 12 months of follow-up. Comparable parameters were evaluated in a further 55 patients treated with methotrexate only. Treatment with adalimumab induced a significant decrease in RF and anti-CCP serum levels, and the decrease in antibody titers correlated with the clinical response to the therapy. A significant induction of antinuclear autoantibodies (ANA) and IgG/IgM anti-dsDNA autoantibodies were also found in 28% and 14.6% patients, respectively, whereas aCL and anti-beta2GPI autoantibodies were not detected in significant quantities. No association between ANA, anti-dsDNA, aCL and anti-beta2GPI autoantibodies and clinical manifestations was found. Clinical efficacy of adalimumab is associated with the decrease in RF and anti-CCP serum levels that was detected after 24 weeks and remained stable until the 48th week of treatment. Antinuclear and anti-dsDNA autoantibodies, but not anti-phospholipid autoantibodies, can be induced by adalimumab but to a lower extent than in studies with other anti-TNF blocking agents. 相似文献
4.
Correa PA Tobón GJ Citera G Cadena J Schneeberger E Camargo JF Maldonado-Cocco JA Anaya JM 《Biomédica : revista del Instituto Nacional de Salud》2004,24(2):140-152
The specificity and sensitivity of anti-cyclic citrullinated peptide antibodies (anti-CCP) was examined in Latin-American patients with rheumatoid arthritis (RA). The variables considered included: 1) relation with the activity of disease, 2) extra-articular manifestations (EAM), 3) synthesis of cytokines (IL-4, IL-10, IL-12, TNF-alpha, and IFN-gamma) and IgM and IgA rheumatoid factor (RF), and 4) the association with HLA-DRB1 polymorphism. Seventy-nine RA patients were assessed (69 with established RA, and 10 with recent-onset RA not receiving any treatment), 56 with ankylosing spondylitis (AS), 25 with systemic lupus erythematosus (SLE), 50 with primary Sj?gren's syndrome (pSS), and 10 healthy individuals. Of the 69 patients with established RA, 36 were reexamined 2 years later. The activity of the RA was measured by criteria adopted by the American College of Rheumatology. Anti-CCP2, RF and cytokines levels were determined by ELISA. HLA genotypes were established by first, PCR sequence amplification using sequence-specific primers and then, complete sequencing of the product. Anti-CCP antibodies were observed in 96% of patients with RA during the first evaluation and in 86% at the second evaluation (p = 0.12). No significant change in antibody titre was observed between the two evaluations (131 +/- 58.7 and 130.6 +/- 67.1 IU, respectively). The overall sensitivity and specificity was 94% and 92%, respectively; however, at titres > 60 IU, the values were 84% and 95%, respectively. The anti-CCP likelihood ratio positive test was 12 and the likelihood ratio negative test was 0.06. The positive predictive value was 87%, and the negative predictive value was 96%. Anti-CCP antibodies were observed in 12% of SLE and pSS patients, in 2% of AS patients, and in 10% of healthy controls. In RA patients, these antibodies were not associated with the activity of disease, EAM or HLA-DRB1 alleles; no significant correlation was observed between antibody titre and cytokines level. Although anti-CCP antibodies have potential as a diagnostic tool for RA, they are not useful for monitoring clinical activity or predicting the clinical course of disease. Antibody synthesis is HLA-DRB1 independent and not correlated with Th1/Th2 cytokines. 相似文献
5.
Yukawa N Fujii T Kondo-Ishikawa S Yoshifuji H Kawabata D Nojima T Ohmura K Usui T Mimori T 《Arthritis research & therapy》2011,13(6):R213
Introduction
The induction of antinuclear antibodies (ANAs) or anti-double-stranded (ds) -DNA antibodies (Abs) after infliximab (IFX) therapy in rheumatoid arthritis (RA) is a well-known phenomenon, but the correlation of such Abs with the clinical response to IFX has not yet been determined. The aims of this retrospective observational study were to examine the prevalence of positive ANA and anti-ds-DNA Abs before and after IFX therapy in patients with RA and to investigate whether an increased titer of such Abs is associated with the clinical efficacy of IFX. 相似文献6.
Marian L Burr Sebastien Viatte Marwan Bukhari Darren Plant Deborah P Symmons Wendy Thomson Anne Barton 《Arthritis research & therapy》2012,14(3):R109-10
Introduction
The utility of reassessing anti-cyclic citrullinated peptide (anti-CCP) antibody status later in disease in patients presenting with early undifferentiated inflammatory polyarthritis, particularly in those who test negative for both anti-CCP and rheumatoid factor (RF) at baseline, remains unclear. We aimed therefore to determine the stability of CCP antibody status over time and the prognostic utility of repeated testing in subjects with early inflammatory polyarthritis (IP).Methods
Anti-CCP and RF were measured at baseline and 5 years in 640 IP patients from the Norfolk Arthritis Register, a primary care-based inception cohort. The relation between change in anti-CCP status/titer and the presence of radiologic erosions, the extent of the Larsen score, and Health Assessment Questionnaire (HAQ) score by 5 years was investigated.Results
With a cut-off of 5 U/ml, 28% subjects tested positive for anti-CCP antibodies, 29% for RF, and 21% for both at baseline. Nine (2%) anti-CCP-negative patients seroconverted to positive, and nine (4.6%) anti-CCP-positive individuals became negative between baseline and 5 years. In contrast, RF status changed in 17% of subjects. However, change in RF status was strongly linked to baseline anti-CCP status and was not independently associated with outcome. Ever positivity for anti-CCP antibodies by 5 years did not improve prediction of radiographic damage compared with baseline status alone (accuracy, 75% versus 74%). A higher baseline anti-CCP titer (but not change in anti-CCP titer) predicted worse radiologic damage at 5 years (P < 0.0001), even at levels below the cut-off for anti-CCP positivity. Thus, a titer of 2 to 5 U/ml was strongly associated with erosions by 5 years (odds ratio, 3.6 (1.5 to 8.3); P = 0.003).Conclusions
Repeated testing of anti-CCP antibodies or RF in patients with IP does not improve prognostic value and should not be recommended in routine clinical practice. 相似文献7.
Bombardieri M Alessandri C Labbadia G Iannuccelli C Carlucci F Riccieri V Paoletti V Valesini G 《Arthritis research & therapy》2004,6(2):R137-R141
This study was performed to assess the utility of anti-cyclic citrullinated peptide (anti-CCP) antibodies in distinguishing
between patients with rheumatoid arthritis (RA) and patients with polyarticular involvement associated with chronic hepatitis
C virus (HCV) infection. Serum anti-CCP antibodies and rheumatoid factor (RF) were evaluated in 30 patients with RA, 8 patients
with chronic HCV infection and associated articular involvement and 31 patients with chronic HCV infection without any joint
involvement. In addition, we retrospectively analysed sera collected at the time of first visit in 10 patients originally
presenting with symmetric polyarthritis and HCV and subsequently developing well-established RA. Anti-CCP antibodies and RF
were detected by commercial second-generation anti-CCP2 enzyme-linked immunosorbent assay and immunonephelometry respectively.
Anti-CCP antibodies were detected in 23 of 30 (76.6%) patients with RA but not in patients with chronic HCV infection irrespective
of the presence of articular involvement. Conversely, RF was detected in 27 of 30 (90%) patients with RA, 3 of 8 (37.5%) patients
with HCV-related arthropathy and 3 of 31 (9.7%) patients with HCV infection without joint involvement. Finally, anti-CCP antibodies
were retrospectively detected in 6 of 10 (60%) patients with RA and HCV. This indicates that anti-CCP antibodies can be useful
in discriminating patients with RA from patients with HCV-associated arthropathy. 相似文献
8.
《Arthritis research & therapy》2005,8(1):R19
We analysed relationships between the PTPN22 1858 polymorphism and antibodies to cyclic citrullinated peptide (CCP), rheumatoid factors (RFs) and the shared epitope (SE)
gene (HLA-DRB1*0404 or 0401) and determined their combined predictive value for rheumatoid arthritis (RA) in individuals who
subsequently developed RA. This case-control study was nested within the Medical Biobank of Northern Sweden. Patients with
RA (n = 92) were identified from amongst blood donors antedating onset of disease by a median of 2.4 (interquartile range
1.2 to 4.9) years. Matched controls were selected randomly from the same cohorts (n = 368). Anti-CCP antibodies and RFs were
determined using enzyme-linked immunoassays. Genotyping was performed using an ABI PRISM 7900HT instrument and HLA-SE genes
were identified using PCR sequence-specific primers. The 1858T allele and also carriage of T were associated with future onset
of RA (odds ratio (OR) = 2.29, 95% confidence interval (CI) 1.45–3.61 and OR = 2.64, 95% CI 1.56–4.47, respectively). The
combination of the 1858T variant and anti-CCP antibodies gave 100% specificity for the disease. None of the 368 controls expressed
this combination. The PTPN22 1858T variant and anti-CCP antibodies were clearly associated (OR = 3.80, 95% CI 1.51–9.57). A combination of the PTPN22 1858T variant and anti-CCP antibodies gave a much higher relative risk (>132.03) for developing RA than the combination of
the T variant and HLA-SE (OR = 7.85). The PTPN22 1858T variant was associated with future development of RA. There was an association between the T variant and anti-CCP antibodies
and their combination, found only among pre-patients, gives a very high relative risk for development of RA. The combination
gave a specificity of 100% for diagnosing RA. 相似文献
9.
Boire G Cossette P de Brum-Fernandes AJ Liang P Niyonsenga T Zhou ZJ Carrier N Daniel C Ménard HA 《Arthritis research & therapy》2005,7(3):R592-R603
The prognostic value of two antibodies targeting citrullinated antigens, anti-Sa and anti-cyclic citrullinated peptide (CCP),
present at inclusion, was evaluated prospectively in a cohort of 165 consecutive patients with recent-onset or early polyarthritis
(EPA) followed for up to 30 months. Patients were treated according to current Good Clinical Practice standards. Predefined
outcomes were severe arthritis and persistent arthritis. At inclusion, a median of 3 months after disease onset, 133 (81%)
patients fulfilled at least four American College of Rheumatology criteria for rheumatoid arthritis and 30 (18%) had erosive
changes on radiographs of hands and feet. Disease-modifying anti-rheumatic drugs were used in close to 80% of the patients
at 30 months. Joint damage increased linearly over time, whereas disease activity declined markedly and remained low at each
follow-up. Autoantibodies were identified in 76 (46%) patients: rheumatoid factor (RF) in 68 (41%), anti-CCP in 53 (33%),
and anti-Sa in 46 (28%). All three antibodies were correlated, but anti-Sa antibodies best predicted severity at 18 and 30
months. RF and anti-CCP performed less well. For both outcomes, anti-Sa alone performed better than any combination of antibodies.
The presence of any autoantibody identified about 50 to 60% of the patients with poor outcomes. In multivariate analysis,
anti-Sa (odds ratio (OR) 8.83), the presence of erosions at inclusion (OR 3.47) and increasing age (OR 1.06/year) were significantly
associated with severity, whereas RF and anti-CCP were not significant predictors. Persistent arthritis was present in up
to 84% of patients; autoantibodies were specific but poorly sensitive predictors of this outcome. We conclude that assays
for antibodies against citrullinated antigens differ in their ability to predict poorer outcomes in patients with EPA. In
our EPA cohort treated in accordance with current standards, detection of anti-Sa but not of RF or anti-CCP antibodies, in
combination with clinical and radiological variables present at the first encounter, allowed the identification of a subgroup
of EPA patients suffering more rapid and more severe joint damage over 30 months. 相似文献
10.
Mewar D Coote A Moore DJ Marinou I Keyworth J Dickson MC Montgomery DS Binks MH Wilson AG 《Arthritis research & therapy》2006,8(4):R128-5
Several recent publications have established a strong association between anti-cyclic citrullinated peptide antibody (anti-CCP)-positive
rheumatoid arthritis (RA) and carriage of shared epitope (SE) alleles. Although anti-CCP have also been associated with more
severe RA, the issue of whether this is independent of rheumatoid factor (RF) has not been addressed. To identify associations
between RF, anti-CCP, SE status and radiological damage, we studied a large cross-sectional cohort with longstanding RA. Individuals
(n = 872) enrolled in the study all fulfilled the American College of Rheumatology criteria for RA, had a minimum disease duration
of 3 years, and at least one definite radiographic erosion was present in hands or feet. Radiographs were scored blind at
study entry by a single musculoskeletal radiologist using a modified Larsen's score. Anti-CCP and RF levels were determined
using enzyme-linked immunosorbent assay, and DRB1 typing was performed using polymerase chain reaction based methodology.
Both anti-CCP and RF levels were strongly associated with radiographic severity (P < 0.0001). In subgroups stratified for both anti-CCP and RF status, evidence of independent associations of both antibodies
with radiographic outcome was found (P < 0.0001). An association of SE alleles with radiographic severity was present only in RF-negative individuals. Anti-CCP
positivity was associated with SE status with evidence of a gene-dose effect, most markedly in RF-negative individuals (P < 0.01). Anti-CCP and RF status are independent severity factors for RA, with SE alleles playing at most a secondary role.
Our data support the view that previously described associations between SE and radiological severity, especially in RF-negative
patients, may be indirect and due to an association with anti-CCP. 相似文献
11.
Jun Ren Lingyun Jia Li Xu Xue Lin Zhiqian Pi Jian Xie 《Journal of chromatography. B, Analytical technologies in the biomedical and life sciences》2009,877(11-12):1200-1204
Extracorporeal immunoadsorption (ECI) therapy using Staphylococcal Protein A columns has proven effective for removing autoantibodies and circulating immune complexes from patients selectively, providing a promising treatment for autoimmune diseases. However, due to the drawbacks of Protein A in terms of cost and stability, the widespread use of Protein A based ECI is limited. In this study, we investigated the feasibility of 4-mercaptoethylpyridine (MEP, MW 139 Da), a simple and inexpensive synthetic compound, as an alternative to Protein A for autoantibody removal therapy. MEP-based adsorbents were prepared by coupling MEP to Sepharose CL-6B. We found that ligand density was an adjustable parameter for the synthesis of adsorbents aiming at different pathogenic factors, depending on the class of antibody. MEP-Sepharose with a ligand density of 98.8 μmol/ml could remove 80% of the anti-double-stranded DNA antibodies from human serum, whereas a ligand density of 64.5 μmol/ml was enough to remove 96% of the rheumatoid factor (RF) in the serum. Moreover, MEP-based adsorbents showed a lower degree of individual differences compared to Protein A-Sepharose. RF removal of 90% was achieved for all 12 serum samples from different individuals. Among the 14 serum samples derived from systemic lupus erythematosus patients, 11 samples had markedly reduced antinuclear antibody titers. In addition, non-specific adsorption of plasma components to MEP-Sepharose was limited, and the binding capacity of the absorbent for IgG was still about 20 mg/ml of gel after 10 cycles. The results indicated that MEP-based adsorbent could offer a new type of adsorber for the treatment of autoimmune diseases. 相似文献
12.
Amezcua-Guerra LM Springall R Marquez-Velasco R Gómez-García L Vargas A Bojalil R 《Arthritis research & therapy》2006,8(5):R144-5
'Rhupus' is a rare condition sharing features of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). If rhupus is a distinctive entity, an overlap between RA and SLE or a subset of SLE is currently debated. This study was performed to explore the prevalence of antibodies against cyclic citrullinated peptides (anti-CCP antibodies) in rhupus. Patients meeting American College of Rheumatology criteria for RA, SLE, or both were included. Clinical and radiographic features were recorded and sera were searched for anti-CCP antibodies, rheumatoid factor, antinuclear antibodies, anti-extractable nuclear antigens, and antibodies against double-stranded DNA (anti-dsDNA antibodies). Seven patients for each group were included. Clinical and serological features for RA or SLE were similar between rhupus and RA patients, and between rhupus and SLE patients, respectively. Values for anti-CCP antibodies obtained were significantly (p < 0.05) higher in RA (6/7) and rhupus (4/7) than in SLE patients (0/7) and healthy subjects (0/7). Our data support the possibility that rhupus is an overlap between RA and SLE, because highly specific autoantibodies for RA (anti-CCP) and for SLE (anti-dsDNA and anti-Sm) are detected in coexistence. 相似文献
13.
Yufeng Yin Di Liang Lidan Zhao Yang Li Wei Liu Yan Ren Yongzhe Li Xiaofeng Zeng Fengchun Zhang Fulin Tang Guangliang Shan Xuan Zhang 《PloS one》2014,9(4)
Objective
Patients with rheumatoid arthritis (RA) are at risk to develop RA-associated interstitial lung disease (RA-ILD). This retrospective study aimed to investigate the potential association of the positivity of serum anti-cyclic citrullinated peptide antibody (anti-CCP2) and rheumatoid factor (RF) with RA-ILD in RA patients.Methods
A total of 285 RA patients were recruited at the inpatient service of Peking Union Medical College Hospital in China between 2004 and 2013. Individual patients were evaluated for the evidence of ILD. The concentrations of serum anti-CCP2 and RF in individual patients were measured. The potential risk factors for ILD in RA patients were assessed by univariate and multivariate models.Results
There were 71 RA patients with RA-ILD, accounting for 24.9% in this population. The positive rates of anti-CCP2 and RF in the patients with RA-ILD were significantly higher than that in the patients with RA-only (88.7% vs. 67.3%, p<0.001; 84.5% vs. 70.6%, p = 0.02, respectively). Univariate and multivariate logistic regression analysis revealed that RA patients with positive serum anti-CCP2, but not RF, were associated with an increased risk of ILD (crude odds ratio [cOR] 3.83, 95% confidence interval [CI] 1.74–8.43, p<0.001; adjusted odds ratio [aOR] 3.50, 95% CI 1.52–8.04, p<0.001).Conclusion
Our findings suggest that positive serum anti-CCP2, but not RF, may be associated with RA-ILD in RA patients. 相似文献14.
Kokkonen H Johansson M Innala L Jidell E Rantapää-Dahlqvist S 《Arthritis research & therapy》2007,9(3):R56
The PTPN22 1858C/T polymorphism has been associated with several autoimmune diseases including rheumatoid arthritis (RA). We have shown
that carriage of the T variant (CT or TT) of PTPN22 in combination with anti-cyclic citrullinated peptide (anti-CCP) antibodies highly increases the odds ratio for developing
RA. In the present study we analysed the association between the PTPN22 1858C/T polymorphism and early RA in patients from northern Sweden, related the polymorphism to autoantibodies and the HLA-DR
shared epitope, and analysed their association with markers for disease activity and progression. The inception cohort includes
individuals who also donated samples before disease onset. A case–control study was performed in patients (n = 505; 342 females and 163 males) with early RA (mean duration of symptoms = 6.3 months) and in population-based matched
controls (n = 970) from northern Sweden. Genotyping of the PTPN22 1858C/T polymorphism was performed using a TaqMan instrument. HLA-shared epitope alleles were identified using PCR sequence-specific
primers. Anti-CCP2 antibodies were determined using enzyme-linked immunoassays. Disease activity (that is, the number of swollen
and tender joints, the global visual analogue scale, and the erythrocyte sedimentation rate) was followed on a regular basis
(that is, at baseline and after 6, 12, 18 and 24 months). Both the 1858T allele and the carriage of T were associated with
RA (χ2 = 23.84, P = 0.000001, odds ratio = 1.69, 95% confidence interval = 1.36–2.11; and χ2 = 22.68, P = 0.000002, odds ratio = 1.79, 95% confidence interval = 1.40–2.29, respectively). Association of the 1858T variant
with RA was confined to seropositive disease. Carriage of 1858T and the presence of anti-CCP antibodies was independently
associated with disease onset at an earlier age (P < 0.05 and P < 0.01, respectively), while the combination of both resulted
in an even earlier age at onset. Smoking was identified as a risk factor independent of the 1858T variant and anti-CCP antibodies. 相似文献
15.
Han C Smolen JS Kavanaugh A van der Heijde D Braun J Westhovens R Zhao N Rahman MU Baker D Bala M 《Arthritis research & therapy》2007,9(5):R103
In this study, we compare the health-related quality of life (HRQoL) of patients with moderate-to-severe rheumatoid arthritis
(RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS), and study the effect of treatment with infliximab on the
HRQoL of patients with these diseases. Short Form Health Survey-36 (SF-36) data from the placebo-controlled phases of 4 studies
of infliximab in patients with inflammatory rheumatic diseases (n = 1990) were evaluated. Data came from the Anti-TNF Trial in Rheumatoid Arthritis with Concomitant Therapy (ATTRACT) (n = 428), the Safety Trial for Rheumatoid Arthritis with REMICADE Therapy (START) (n = 1083), the Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy (ASSERT) (n = 279), and the Infliximab Multinational Psoriatic Arthritis Clinical Trial II (IMPACT II) (n = 200). SF-36 assessments were made at weeks 0, 10, 30, and 54 in ATTRACT, weeks 0, 6, and 22 in START, weeks 0, 12, and
24 in ASSERT, and weeks 0 and 14 in IMPACT II. All patient populations had significantly impaired physical aspects of HRQoL
at baseline relative to the general population of the United States, and the magnitude of impairment was similar across the
diseases. Mean baseline physical component summary scores were 29 in the RA cohort, 32 in the PsA cohort, and 29 in the AS
cohort. In all 3 diseases, patients who received infliximab showed significant improvement in physical component summary scores
compared with those who received placebo. The magnitude of the difference of improvement (effect size, 95%CI) between infliximab
and placebo groups was similar in the AS (10.1, 9.2–11.0), PsA (8.6, 7.8–9.4), and RA (10.1, 9.2–11.0) cohorts. Patients with
RA and those with PsA treated with infliximab also showed greater improvement in the mental component summary score than those
in the placebo group with an effect size of 4.6 (4.2–5.1) in RA and 2.7 (2.4–3.1) in PsA. Patients in large randomized controlled
studies of infliximab in RA, PsA, and AS had similar impairment in physical aspects of HRQoL at baseline and showed significantly
greater improvement in HRQoL after treatment with infliximab. 相似文献
16.
JJ Malemba JM Mbuyi-Muamba J Mukaya X Bossuyt MP Emonds K Deiteren R Westhovens P Verschueren 《Arthritis research & therapy》2013,15(4):R89
Introduction
Little is known about rheumatoid arthritis in the black, particularly in Congolese, populations. Our objective was to describe the phenotype and genotype of rheumatoid arthritis (RA) in Congolese.Methods
All consecutive rheumatoid arthritis (RA) patients attending Kinshasa University Hospital in a three-year time period were included. Demographics, clinical features and tobacco consumption were noted. Disease Activity Score (DAS)-28 based on the erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire (HAQ), anti-citrullinated peptide antibodies (CCP) antibodies and rheumatoid factor (RF) were determined. Radiographs were scored according to Sharp-van der Heijde. On a subset of patients and controls HLA-DRB1 typing was performed.Results
A total of 114 females and 14 males aged 51.2 ± 14.9 were included. Mean duration of symptoms was four years. Moderate tobacco consumption was reported in a minority of patients. DAS-28 at first visit was >5.1 and HAQ ≥0.5 in all patients. X-rays showed joint erosions and/or joint space narrowing, mostly of a moderate grade in 55.8% of patients. Anti-CCP and/or RF were present in 48.6% of patients with available data (n = 72) and in 3.0% of controls (n = 67). Radiographic changes and nodules were more frequent in RF or anti-CCP positive patients. One copy of the shared epitope was found in 13 patients (35.1%) and 3 controls (12.5%). Two copies were found in one patient (2.7%) and in one control (4.2%).Conclusion
Congolese patients with RA consult long after disease onset. Despite this delay, the majority presents without major damage and is RF, anti-CCP and SE negative. We put forward the hypothesis that besides different environmental factors there is probably also a particular genetic risk profile in Congolese patients, different from the HLA-DRB1 shared epitope. 相似文献17.
Contents of antinuclear antibodies (ANA), rheumatoid factor (RF), tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were
measured in serum from 20 dogs with immune-mediated fever. Seven out of 20 patients were ANA positive, 1 out of 20 was positive
to antibodies against extractable nuclear antigens (ENA), 1 out of 20 was positive to antibodies against deoxynucleoproteins
(DNP), 2 out of 13 were RF positive and none out of 20 patients had antibodies against native DNA in the serum. TNF-α was
not detected in any serum of 15 dogs with immune-mediated fever, while 10 out of 13 presented with elevated IL-6. The results
varied between patients, but the IL-6 level was high in most of them. This indicate a role for IL-6 in the pathogenesis of
immune-mediated fever in most cases. 相似文献
18.
Kapetanovic MC Larsson L Truedsson L Sturfelt G Saxne T Geborek P 《Arthritis research & therapy》2006,8(4):R131-7
In the present study we evaluated the impact of baseline antinuclear antibody (ANA) status and use of methotrexate on development
of infliximab-related infusion reactions in patients with rheumatoid arthritis (RA) or spondylarthropathies (SpAs), including
psoriatic arthritis. All patients with RA (n = 213) or SpA (n = 76) treated with infliximab during the period 1999–2005 at the Department of Rheumatology in Lund, Sweden were included.
ANAs were present in 28% and 25% of RA and SpA patients, respectively. Because of differences in baseline characteristics,
we used a binary logistic regression model to calculate odds ratios (ORs), adjusting for age, sex and prednisolone dosage.
Altogether 21% of patients with RA and 13% of patients with SpA developed infusion reactions (P = 0.126). The OR for development of infusion reactions in RA patients with baseline ANA positivity alone was 2.1. Infliximab
without methotrexate and infliximab as monotherapy were associated with ORs of 3.1 and 3.6, respectively. Combining infliximab
without methotrexate and ANA positivity yielded an OR for infusion reaction of 4.6. Lower age at disease onset and longer
disease duration were associated with infusion reactions (P = 0.012 and P = 0.036, respectively), but age, sex, C-reactive protein, erythrocyte sedimentation rate, Health Assessment Questionnaire
and Disease Activity Score-28 at baseline were not. No predictors of infusions reactions were identified in SpA patients.
RA patients treated with infliximab without methotrexate, and who are positive at baseline for ANAs are at increased risk
for developing infliximab-related infusion reactions. 相似文献
19.
Siwen Zhang Jing Hu Shuqi An Mujinyan Li Fande Li Peng Zhang Xiangyi Zhang Huixin Yang Taijun Wang Jingjing Luo Fangfang Hu Jiashuo Liu Qing Zhen 《PLoS neglected tropical diseases》2021,15(9)
BackgroundBrucellosis is a critical zoonotic disease in the world, it is the non-specific arthralgia that make brucellosis patients easily misdiagnosed as rheumatoid arthritis (RA) in endemic regions. Elevated rheumatoid factor (RF) is an essential indicator of RA, and the RF in brucellosis patients is significantly higher than healthy people. Therefore, this study further explored the distribution of RF and the relevant factors of the RF positivity in brucellosis patients with arthralgia, in order to strengthen the recognition of physicians for brucellosis patients with RF positivity, especially in brucellosis-endemic areas, so as to avoid misdiagnosis and untimely treatment that may lead to malignant outcomes.Methodology and principal findingsThe medical records of all 572 brucellosis inpatients were collected in the Sixth People’s Hospital of Shenyang, China from 2015 to 2016. After excluding 106 patients without arthralgia, 5 patients who unwilling to perform RF testing and 16 patients with diseases that may affect RF, 445 brucellosis inpatients with arthralgia were involved in this retrospective cross-sectional study. 143 (32.1%) patients with RF >10 IU/ml were classified into the RF positive group, with an average level of 16.5[12.2, 34.7] IU/ml, of which 45 (10.1%) patients were high-positive with RF >30 IU/ml. Multivariate logistic regression model was used to further analyze the relevant factors of the RF positivity and found that age, wrist joint pain and elevated C-reactive protein (CRP) were positively associated with RF positivity, with OR of 1.02 (P = 0.024), 8.94 (P = 0.008) and 1.79 (P = 0.019), respectively.ConclusionThe prevalence of positive RF in brucellosis patients with arthralgia was critical, nearly one-third of patients had RF positive. Elderly men brucellosis patients with arthralgia, wrist joint pain and elevated CRP were at high risk of positive RF. It is reminded that physicians should focus on differential diagnosis during clinical diagnosis and treatment, especially in brucellosis-endemic regions. 相似文献
20.
Atzeni F Sarzi-Puttini P Lama N Bonacci E Bobbio-Pallavicini F Montecucco C Caporali R 《Arthritis research & therapy》2008,10(3):R51