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Aim The aim of this study was to determine the efficacy and safety of a weekly dose of leflunomide (50 mg/week) in early rheumatoid arthritis patients with mild or moderate disease activity. Methods The patients of early rheumatoid arthritis (ERA) with mild or moderate disease activity were randomly selected for inclusion in this study and were assigned to either the treatment group (leflunomide 50 mg/week, LEF50) or the control group (leflunomide 10 mg/day, LEF10). All patients were treated for 24 weeks. Clinical efficacy was assessed using the disease activity score in 28 joints ( DAS28) - erythrocyte sedimentation rate (ESR) and European League Against Rheumatism ( EULAR) response. A Chi-squared test, Fisher's exact-test and paired t-tests were used to analyze the data. Results A total of 244 patients who met the inclusion criteria and received at least one medicine dose were analyzed. At the baseline, the DAS28 (ESR) of the ERA patients were 4.41 ± 0.69 in LEF 50 group and 4.52 ± 0.64 in LEF 10 group, respectively. At week 24, the DAS28 (ESR) in two groups ( 2.94 ± 1.10 and 3.02 ± 1.14 ) were significant decreased compare with the baseline, respectively ( P<0.01). There was no significant difference in DAS28 (ESR) between the LEF50 and LEF10 groups at week 24. ( P > 0.05). At weeks 8, 12 and 24, the EULAR response (good responses + moderate responses) were 47.6%, 58.7% and 59.5%, in the LEF50 group and 43.2%, 49.1% and 53.4% in the LEF10 group, respectively. There was no significant different of EULAR response rates in the two groups at week 8, 12, and 24, respectively ( P>0.05). There was no serious adverse events during the study. Conclusion A weekly dose of 50 mg leflunomide showed similar benefits to a daily dose of 10 mg leflunomide for the treatment of mild-to-moderate early rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the effects of lentivirus-mediated overexpression of the SOCS3 gene on proliferation and apoptosis of fibroblasts-like synoviocytes (FLSs) in rheumatoid arthritis (RA). A total of 20 Lewis rats were randomly assigned into experimental and normal groups. Rats in the experimental group were modeled with adjuvant arthritisand the normal group was given no treatment. After culture for 28 days, rats in the experimental group were sacrificed, and the third-generation FLSs were collected and randomly allocated into SOCS3 group, control group, and blank group. MTT assay was used for detecting cell viability, flow cytometry was used for analysis ofcell apoptosis, and enzyme-linked immunosorbent assay (ELISA) was used to determine levels of inflammatory factors (interleukin [IL]-2, interferon [IFN-γ] and tumor necrosis factor [TNF-α]). MTT assay showed that the optical density of the SOCS3 group was significantly higher than that of the control and blank groups. Flow cytometry showed that the apoptosis rate of FLSs in the SOCS3 group was significantly lower than that in the control and blank groups. The results of ELISA assay showed that the levels of IL-2, IFN-γ and TNF-α in the SOCS3 group were higher than those in the control and blank groups. Our study demonstrates that over-expression of SOCS3 promotes proliferation and inhibits apoptosis of FLSs in RA., Competing Interests: None., (IJCEP Copyright © 2018.)

Objective: to study the features of rheumatoid arthritis (RA) on MRI of hands and wrists and compare MRI with clinical manifestations and laboratory tests of RA., Methods: a total of 25 patients fulfilling the 2009 ACR/EULAR RA criteria were enrolled. MRI and plain films of hands and wrists and clinical data of swollen joints, tender joints, visual scale (VAS) score, DAS28 score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), RF classification, anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies) were obtained simultaneously., Results: MRI revealed pathologic findings on the wrist and hand joints in all diagnosed RA patients. VAS had a positive correlation with bone marrow edema(r = 0.562, P = 0.003). Although the disease duration was less or more than 1 year, the difference of bone erosion had statistical significance between anti-CCP antibody-positive group and anti-CCP antibody negative group (all P = 0.000). The serum concentration of RF-IgA had a positive correlation with bone marrow edema (r = 0.561, P = 0.041). The synovitis score of MRI of RA was higher in the RF-IgG positive group than that in the RF-IgG negative group (P = 0.035). There was significant difference in MRI synovitis between the RF-IgG or RF-IgM positive and negative groups of patients with a disease course of under 1 year (P = 0.015, P = 0.007). The serum CRP level had a positive correlation with arthroderma (r = 0.457, P = 0.022)., Conclusion: MRI is proved to be a valuable examination for an early diagnosis and assessment of RA.

Objective: To investigate the significance of citrullinated collagen type II and its antibodies in the pathogenesis and diagnosis of rheumatoid arthritis (RA)., Methods: Serum samples were obtained from 175 patients with RA, 112 patients with systemic lupus erythematosus (SLE), 37 patients with osteoarthritis (OA), and 160 healthy controls. Arginine residues of bovine collagen type II (bCII) were converted to citrulline residues by peptidylarginine deiminase (PAD). The presence of antibodies against citullinated bCII (Cit-bCII) and bCII, a substrate protein of PAD, were examined by using enzyme-linked immunosorbent assay (ELISA) and Western blotting. The levels of anti-cyclic citrullinated peptide (CCP) antibodies, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) in the above patients were detected., Results: The positive rate of anti-CitbCII antibodies of the RA patients was 50.3% (88/175), significantly higher than those of the SLE patients (17.9%, 20/112), OA patients (18.9%, 7/37), and healthy controls (2.5%, 4/160). The positive rate of anti-b of the RA patients was 33.7% (59/175), significantly lower than that of the CII antibodies. The levels of anti-CitbCII and anti-bCII antibodies were not statistically different from SLE and OA patients. There was a close correlation between anti-CitbCII and anti-CCP antibodies. Spearman correlation analysis showed that anti-CitbCII antibodies were positively correlated with anti-CCP antibodies, and CRP, ESR, RF, X ray imaging, course of disease, and age were not associated with anti-CitbCII antibodies., Conclusion: Anti-citrullinated bCII antibody is relatively RA-specific. Citrullination appears to be important in RA.