1
|
Muralidharan N, Mariaselvam CM, Jain VK, Gulati R, Negi VS. ATIC 347C>G gene polymorphism may be associated with methotrexate-induced adverse events in south Indian Tamil rheumatoid arthritis. Pharmacogenomics 2016; 17:241-8. [DOI: 10.2217/pgs.15.170] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To find the association of ATIC 347C>G gene polymorphism with methotrexate (MTX) treatment response and MTX-induced adverse events in south Indian Tamil patients with rheumatoid arthritis. Patients & methods: A total of 319 rheumatoid arthritis and 310 healthy controls were recruited for the study and ATIC 347C>G gene polymorphism was analyzed by PCR-RFLP method. Results: The genotype and allele frequencies of ATIC 347 C>G SNP did not differ between good and nonresponders and hence this SNP was not found to be associated with MTX treatment response. However, the ATIC 347 GG genotype (p = 0.02; odds ratio [OR]: 4.46; 95% CI: 1.28–15.52) and mutant G allele was associated with MTX-induced gastrointestinal adverse events (p = 0.01; OR: 2.60; 95% CI: 1.27–5.35). Conclusion: ATIC 347C>G gene polymorphism may be associated with the development of MTX induced gastrointestinal adverse events.
Collapse
Affiliation(s)
- Niveditha Muralidharan
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Christina M Mariaselvam
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Vikramraj K Jain
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Reena Gulati
- Genetic Services Unit, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Vir S Negi
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| |
Collapse
|
2
|
Synthesis and evaluation of the anti-nociceptive and anti-inflammatory activity of 4-aminoquinoline derivatives. Bioorg Med Chem 2015; 23:4390-4396. [DOI: 10.1016/j.bmc.2015.06.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/27/2015] [Accepted: 06/10/2015] [Indexed: 11/24/2022]
|
3
|
Walsh DA, McWilliams DF. Mechanisms, impact and management of pain in rheumatoid arthritis. Nat Rev Rheumatol 2014; 10:581-92. [PMID: 24861185 DOI: 10.1038/nrrheum.2014.64] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
People with rheumatoid arthritis (RA) identify pain as their most important symptom, one that often persists despite optimal control of inflammatory disease. RA pain arises from multiple mechanisms, involving inflammation, peripheral and central pain processing and, with disease progression, structural change within the joint. Consequently, RA pain has a wide range of characteristics-constant or intermittent, localized or widespread-and is often associated with psychological distress and fatigue. Dominant pain mechanisms in an individual are identified by critical evaluation of clinical symptoms and signs, and by laboratory and imaging tests. Understanding these mechanisms is essential for effective management, although evidence from preclinical models should be interpreted with caution. A range of pharmacological analgesic and immunomodulatory agents, psychological interventions and surgery may help manage RA pain. Pain contributes importantly to the clinical assessment of inflammatory disease activity, and noninflammatory components of RA pain should be considered when gauging eligibility for or response to biologic agents. Further randomized controlled trials are required to determine the optimal usage of analgesics in RA, and novel agents with greater efficacy and lower propensity for adverse events are urgently needed. Meanwhile, targeted use of existing treatments could reduce pain in people with RA.
Collapse
Affiliation(s)
- David A Walsh
- Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - Daniel F McWilliams
- Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| |
Collapse
|
4
|
Stack RJ, Llewellyn Z, Deighton C, Kiely P, Mallen CD, Raza K. General practitioners' perspectives on campaigns to promote rapid help-seeking behaviour at the onset of rheumatoid arthritis. Scand J Prim Health Care 2014; 32:37-43. [PMID: 24635577 PMCID: PMC4137901 DOI: 10.3109/02813432.2014.900239] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To explore general practitioners' (GPs') perspectives on public health campaigns to encourage people with the early symptoms of rheumatoid arthritis (RA) to seek medical help rapidly. DESIGN Nineteen GPs participated in four semi-structured focus groups. Focus groups were audio-recorded, transcribed verbatim, and analysed using thematic analysis. RESULTS GPs recognised the need for the early treatment of RA and identified that facilitating appropriate access to care was important. However, not all held the view that a delay in help seeking was a clinically significant issue. Furthermore, many were concerned that the early symptoms of RA were often non-specific, and that current knowledge about the nature of symptoms at disease onset was inadequate to inform the content of a help-seeking campaign. They argued that a campaign might not be able to specifically target those who need to present urgently. Poorly designed campaigns were suggested to have a negative impact on GPs' workloads, and would "clog up" the referral pathway for genuine cases of RA. CONCLUSIONS GPs were supportive of strategies to improve access to Rheumatological care and increase public awareness of RA symptoms. However, they have identified important issues that need to be considered in developing a public health campaign that forms part of an overall strategy to reduce time to treatment for patients with new onset RA. This study highlights the value of gaining GPs' perspectives before launching health promotion campaigns.
Collapse
Affiliation(s)
- Rebecca J. Stack
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| | - Zara Llewellyn
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| | - Chris Deighton
- Department of Rheumatology, Derby Hospitals NHS Foundation Trust, Derby, UK
| | - Patrick Kiely
- Department of Rheumatology, St Georges Healthcare Trust, London, UK
| | | | - Karim Raza
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
5
|
Filková M, Aradi B, Senolt L, Ospelt C, Vettori S, Mann H, Filer A, Raza K, Buckley CD, Snow M, Vencovský J, Pavelka K, Michel BA, Gay RE, Gay S, Jüngel A. Association of circulating miR-223 and miR-16 with disease activity in patients with early rheumatoid arthritis. Ann Rheum Dis 2013; 73:1898-904. [PMID: 23897768 PMCID: PMC4173742 DOI: 10.1136/annrheumdis-2012-202815] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Identification of parameters for early diagnosis and treatment response would be beneficial for patients with early rheumatoid arthritis (ERA) to prevent ongoing joint damage. miRNAs have features of potential biomarkers, and an altered expression of miRNAs was shown in established rheumatoid arthritis (RA). OBJECTIVE To analyse RA associated miRNAs in the sera of patients with ERA to find markers of early disease, clinical activity or predictors of disease outcome. METHODS Total RNA was isolated from whole sera in ERA patients (prior to and after 3 and 12 months of therapy with disease modifying antirheumatic drugs), in patients with established RA and in healthy controls (HC) using phenol-chloroform extraction. Expression of miR-146a, miR-155, miR-223, miR-16, miR-203, miR-132 and miR-124a was analysed by TaqMan Real Time PCR. RESULTS From all analysed miRNAs, levels of miR-146a, miR-155 and miR-16 were decreased in the sera of ERA patients in comparison with established RA. A change in circulating miR-16 in the first 3 months of therapy was associated with a decrease in DAS28 in long term follow-up in ERA (p=0.002). Levels of circulating miR-223 in treatment naïve ERA correlated with C reactive protein (p=0.008), DAS28 (p=0.031) and change in DAS28 after 3 months (p=0.003) and 12 months (p=0.011) of follow-up. However, neither miR-16 nor miR-223 could distinguish ERA from HC. CONCLUSIONS Differential expression of circulating miR-146a, miR-155 and miR-16 in the sera of ERA patients may characterise an early stage of the disease. We suggest miR-223 as a marker of disease activity and miR-16 and miR-223 as possible predictors for disease outcome in ERA.
Collapse
Affiliation(s)
- Mária Filková
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Borbala Aradi
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Ladislav Senolt
- Department of Clinical and Experimental Rheumatology of the 1st Faculty of Medicine, Institute of Rheumatology, Charles University in Prague, Prague, Czech Republic
| | - Caroline Ospelt
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Serena Vettori
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Heřman Mann
- Department of Clinical and Experimental Rheumatology of the 1st Faculty of Medicine, Institute of Rheumatology, Charles University in Prague, Prague, Czech Republic
| | | | - Karim Raza
- University of Birmingham, Birmingham, UK
| | | | - Martyn Snow
- Royal Orthopaedic Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jiří Vencovský
- Department of Clinical and Experimental Rheumatology of the 1st Faculty of Medicine, Institute of Rheumatology, Charles University in Prague, Prague, Czech Republic
| | - Karel Pavelka
- Department of Clinical and Experimental Rheumatology of the 1st Faculty of Medicine, Institute of Rheumatology, Charles University in Prague, Prague, Czech Republic
| | - Beat A Michel
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Renate E Gay
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Steffen Gay
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Astrid Jüngel
- Centre of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
6
|
Abstract
Although treat-to-target goals for rheumatoid arthritis (RA) have been well-established through several guidelines in recent years, concerns regarding treat-to-prevent goals for RA remain unclear. RA patients are typically subjected to over- or under-treatment because it is difficult for clinicians to determine the prognosis of RA patients. This typically results in failure to select and identify patient subsets that should receive monotherapy or combination therapy to treat early RA. Understanding treat-to-prevent goals, as well as unfavorable prognoses, risk factors, and prediction methods for RA, is therefore critical for making treatment decisions. Rapid radiographic progression plays a central role in contributing to other composite RA indices, so this may be the best method for defining treat-to-prevent goals for RA. Accordingly, risk factors of rapid radiographic progression have been defined and two prediction models were retrospectively derived based on clinical trial data. Additional studies are required to develop risk models that can be used for accurate predictions.
Collapse
Affiliation(s)
- Min Yang
- Rheumatology Center, PLA General Hospital of Chengdu Military Area Command, Chengdu, Sichuan Province, PR China
| | - Mingyang Guo
- Rheumatology Center, PLA General Hospital of Chengdu Military Area Command, Chengdu, Sichuan Province, PR China
| |
Collapse
|
7
|
Wollenhaupt J, Krüger K. [Early and advanced rheumatoid arthritis. Diagnosis and state of the art therapy strategy]. Z Rheumatol 2012; 71:53-61; quiz 62-3. [PMID: 22286356 DOI: 10.1007/s00393-011-0932-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The diagnosis of rheumatoid arthritis (RA) is often based on classification criteria. In 2010 ACR and EULAR presented new classification criteria for RA which allow patients with a high risk for persistent, chronic and erosive arthritis and therefore fulfill the current definition of RA, to be defined. Therapy of RA should be initiated as early as possible. Methotrexate remains the first-line therapy of RA. In patients showing insufficient response of RA, biological agents have been demonstrated to be an effective second-line therapy. It is essential to define and follow an individual treatment target to obtain remission or low disease activity. This target should be reassessed regularly and treatment should be correspondingly adapted to achieve the target.
Collapse
Affiliation(s)
- J Wollenhaupt
- Klinik für Rheumatologie und klinische Immunologie und Rheumatologikum, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland.
| | | |
Collapse
|
8
|
Current World Literature. Curr Opin Rheumatol 2012; 24:342-9. [DOI: 10.1097/bor.0b013e328352d26c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|