Search

This paper reports the clinical case of a 46 year old woman from Ciudad Valles, San Luis Potosí, Mexico, with a history of type 2 diabetes mellitus, seropositive rheumatoid arthritis diagnosed in 2014, primary hypothyroidism and multinodular goiter diagnosed in 2016, adenocarcinoma ductal in situ treated with right modified radical mastectomy in 2016 as well as diagnosis of pyoderma gangrenosum superficial pustular variety refractory to treatment with methotrexate and glucocorticoids, with improvement of the lesions after initiation of biological therapy against TNF-a with adalimumab. [ABSTRACT FROM AUTHOR]

This paper reports the case of a 46-year-old woman with a 6-month history of duration of arthritis of metacarpophalangeal, proximal interphalangeal, carpal and elbow joints of 6 months duration. Three years before she reported headache and diabetes mellitus. Due to changes suggestive of acromegaly on the face and extremities more studies were requested. In view of the elevated levels of GH, IGF-1, positive rheumatoid factor, arthritis, hyperglycemia, and the presence of a pituitary adenoma, the patient was diagnosed with acromegaly, rheumatoid arthritis and diabetes mellitus. The patient underwent trans-sphenoidal resection, which resulted in normalization of hyperglycemia, headache, eradication of the tumor mass, GH and IGF-1 levels and remission of her rheumatoid arthritis with oral methotrexate. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the systematic review was to evaluate the safety and efficacy of rituximab for the treatment of rheumatoid arthritis patients, as part of the Consensus on the use of rituximab in rheumatoid arthritis. A document with evidence based recommendations5. Methods: All papers published from January 2003 to September 2009 were reviewed in a systematic way in Medline, EMBASE and Cochrane Library database. The Mesh terms used were: «Rituximab», «Rheumatoid arthritis», «and Anti-CD20», «Biologics». The abstracts of the EULAR and ACR congress of 2003 to 2009 were also reviewed, as well data of Roche Pharma. Two rheumatologists (BHC y MGH) made the bibliographic review by title and summary of each work. Two authors (BHC y RAA) selected them by quality according the GRADE SCALE after they review. The data were collected in paper. The outcomes evaluated were of efficacy in agreement with OMERACT13 (Outcome Measurements in Rheumatoid Arthritis Clinical Trials) and The Musculoskeletal Cochrane Study Group. The outcomes of safety evaluated were: mortality, severe infections, severe adverse events, withdraw for any cause, for severe adverse events, and for infusion related reactions. The review was conducted with Cochrane methodology. The odds ratio and relative risk for dichotomist variables; and mean difference between baseline and final measurements for continuous variables, and risk differences were calculated with RevMan 519. The number of patients needed to treat was calculated with Cares' calculator20. Results: RTX is an effective drug in three groups of patients with RA: patients who fail to MTX, those who fail anti-TNF and in patients with no prior exposure to MTX. It is necessary to treat 7 (5-10) patients with RTX vs. placebo to obtain an ACR70 response; 9 (6-15) to achieve a DAS28 < 2.6: and 5 (4-8) to achieve a HAQ improvement >0.2. Safety of the drug was similar to that of placebo except for infusion reactions where 12 (8-26) patients need to be treated with RTX vs. placebo to see a reaction to the first infusion with steroid premeditation. Severe adverse events to the infusion had an incidence of 0.7% in patients of the RTX treated group. It was impossible to identify a larger increase in the number of severe infections, probably due to methodological problems, however, the risk of developing infections in patients treated with RTX seems to be comparable to that of other anti-TNF and biologics. [ABSTRACT FROM AUTHOR]

The coexistence of two or more connective tissue diseases in a patient is little frequent, particularly the coexistence of systemic lupus erythematosus and rheumatoid arthritis, disease nominated rhupus. This is a little frequent entity, there are less than 150 cases reported in literature, with prevalence of 0.09%. This paper reports the case of a 67-year-old female patient with manifestations of systemic lupus erythematosus and rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Transforming growth factor-beta (TGF-β) is a cytokine with pleiotropic functions in hematopoiesis, angiogenesis, cell proliferation, differentiation, migration and apoptosis. Although its role in rheumatoid arthritis is not well defined, TGF-β activation leads to functional immunomodulatory effects according to environmental conditions. The function of TGF-β in the development of arthritis in murine models has been extensively studied with controversial results. Recent findings point to a non-relevant role for TGF-p in a mice model of collagen-induced arthritis. The study of TGF-β on T-cell responses has shown controversial results as an inhibitor or promoter of the inflammatory response. This paper presents a review of the role of TGF-β in animal models of arthritis. [ABSTRACT FROM AUTHOR]

Resistance to insulin action is a feature that accompanies certain diseases among which chronic inflammatory states like rheumatoid arthritis are included. What is, what its pathogenesis is, how it is measured, and what clinical and therapeutic implications have in rheumatoid arthritis patients is a topic not familiar to rheumatologists that is reviewed in this paper. [ABSTRACT FROM AUTHOR]

The advent of biological therapies has revolutionized the management of rheumatoid arthritis, demonstrating effectiveness in controlling clinical and radiological damage. However, 20 to 40% of the patients will not respond to these therapies, which are associated to a very high cost. In addition, non-responder patients are exposed to possible adverse effects. For these reasons, we need to identify predictors of response to these treatments. These predictors are reviewed in this evidence-based paper and classified into genetic and non-genetic. Despite extensive search, nowadays there are no predictors powerful enough to be used in regular clinical practice. Serum factors, the presence of rheumatoid factor and anti-cyclic citrullinated peptide antibodies, are the only factors currently being used to predict the response to specific biological therapy. In the future, probably thanks to new technologies based on genomics, transcriptomics and proteomics, it will be possible to identify genetic predictors of response to biological drugs that will allow us to select suitable patients for a specific biological therapy. [ABSTRACT FROM AUTHOR]

Pain is a key symptom in patients with rheumatoid arthritis (RA), usually determining the patient's adjustment to illness and his/her overall quality of life. Based on recent research, this article provides a review and discussion of RA pain from a psychological approach. Negative emotions and their relations to pain are assessed, and the most effective psychological techniques for pain management are described. It is concluded that pain is a key symptom in RA patients, being frequently predicted by negative emotions --which are more prevalent in RA patients than in the general population. Moreover, studies suggest that the cognitive-behavioural approach is effective in RA patients since it improves not only the pain but also the psychological fit to the disease, being an additional benefit for RA patients when this approach adds to the standard medical care. With a view to the future, this paper suggests the need of further studies with Spanish samples on negative emotions and coping skills patterns related to pain. [ABSTRACT FROM AUTHOR]