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Rheumatoid Arthritic Pain
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Natasha S. DePesa, Chelsea Wiener, Jeffrey E. Cassisi
Unlike the more common osteoarthritis (OA), which involves mechanical “wear and tear” of joint cartilage, RA is an autoimmune disorder. During the course of RA, immune cells attack the synovial membranes, or the flexible capsules surrounding joints, resulting in chronic inflammation, pain, stiffness, and eventual damage to cartilage and bone (Aletaha et al., 2010). Clinical synovitis (“swelling”) of joints is necessary for diagnosis, with greater small joint involvement being characteristic of RA. Diagnosis can be made by clinical examination, and determination that swelling is not better accounted for by another etiology. Diagnosis also is aided by anti-citrullinated protein antibody (ACPA) and rheumatoid factor (RF) serology tests and other blood tests of acute phase reactants such as C-reactive protein and erythrocyte sedimentation rate (Aletaha et al., 2010).
Profiling of differentially expressed circRNAs and functional prediction in peripheral blood mononuclear cells from patients with rheumatoid arthritis
Published in Annals of Medicine, 2023
Li Xue, Biao Wang, Jianhong Zhu, Qian He, Fang Huang, Wei Wang, Li Tao, Yan Wang, Nan Xu, Ni Yang, Li Jin, Hua Zhang, Ning Gao, Ke Lei, Yanping Zhang, Chaoliang Xiong, Jing Lei, Ting Zhang, Yan Geng, Ming Li
Recent advances have led to better diagnostic criteria, improved serologic testing, novel new drugs and better guidelines to manage patients with RA. However, there is no standard definition of early RA [18]. Early RA known as ‘preclinical RA’ clearly begins years to months before it manifests as polyarthritis. A great proportion of these patients with preclinical RA could develop increasing joint pain and swelling in the ensuing months to years, particularly in those with positive anti-citrullinated protein antibody [19]. Since early diagnosis and treatment could prevent the progression of joint damage in 90% of patients with early RA [20], it is important to identify patients with RA as soon as possible [21]. More recent studies have demonstrated that noncoding RNAs primarily including miRNA, long noncoding RNA (lncRNA) and circRNA play a critical role in inflammation and autoimmune regulation and that they are identified as promising biomarkers for the diagnosis and treatment of RA [22]. In this study, we identified DEcircRNAs in PBMCs from RA patients compared with healthy controls and OA patients. Future studies investigating the role of these DEcircRNAs in distinguishing preclinical RA from confirmed RA would be of great interest to understand the potential application of these DEcircRNAs as novel biomarkers of early diagnosis and therapeutic targets in RA patients.
Validity of clinical psoriatic arthritis diagnoses made by rheumatologists in the Swedish National Patient Register
Published in Scandinavian Journal of Rheumatology, 2023
JK Wallman, G-M Alenius, E Klingberg, V Sigurdardottir, S Wedrén, S Exarchou, U Lindström, D Di Giuseppe, J Askling, LTH Jacobsson
The ASAS criteria for axial or peripheral SpA were fulfilled by 345 (86%) of the 400 patients (Figure 2). Of these, only 24 met the axial criteria, although this should be viewed with great caution owing to the high numbers of missing data regarding sacroiliac joint imaging and HLA-B27 status (74–86%) (Supplementary Table S3), which are central to this criteria set. Of the 345 patients fulfilling either set of ASAS criteria, only 17 did not also fulfil any of the four PsA criteria (Figure 3B). Of the 400 patients, 108 (27%) met the ACR RA criteria (Figure 2) [RF positive/negative/missing: n = 18/66/24; anti-citrullinated protein antibody (ACPA) positive/negative/missing: 9/61/38; RF and ACPA positive: n = 5], again with a substantial overlap with PsA criteria fulfilment (only 20 patients fulfilled the RA but none of the four PsA criteria) (Figure 3B).
Favorable clinical response and drug retention of anti-IL-6 receptor inhibitor in rheumatoid arthritis with high CRP levels: the ANSWER cohort study
Published in Scandinavian Journal of Rheumatology, 2022
Y Nakayama, M Hashimoto, R Watanabe, K Murakami, K Murata, M Tanaka, H Ito, W Yamamoto, K Ebina, K Hata, Y Hiramatsu, M Katayama, Y Son, H Amuro, K Akashi, A Onishi, R Hara, K Yamamoto, K Ohmura, S Matsuda, A Morinobu
However, although the clinical remission rates are similar between bDMARDs with varied mechanisms of action, each bDMARD displays a differential clinical efficacy under a specific clinical situation. Thus, although the overall efficacy with TNFi (ADA) and CTLA4-Ig (ABT) was the same, CTLA4-Ig showed an improved clinical response in patients with high titres of anti-citrullinated protein antibody (ACPA) in the AMPLE study (4). In RA patients with anaemia, IL-6Ri treatment gave a favourable clinical response that resulted in remission, whereas TNFi treatment saw a progression in structural damage (5–7). TNFi, but not CTLA4-Ig or IL-6Ri, showed reduced response rates in RA patients with high titres of rheumatoid factor (RF) (8, 9). These studies highlight the need to determine which bDMARDs show a better clinical response in specific clinical situations in a real-world setting.