scholarly journals Association of TNF-alpha polymorphism (-308 A/G) with high activity of rheumatoid arthritis and therapy response to etanercept

2011 ◽  
Vol 139 (11-12) ◽  
pp. 784-789 ◽  
Author(s):  
Sonja Stojanovic ◽  
Tatjana Jevtovic-Stoimenov ◽  
Aleksandra Stankovic ◽  
Dusica Pavlovic ◽  
Jovan Nedovic ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Therapeutic Response ◽  
Therapy Response ◽  
Response To Treatment ◽  
Control Group ◽  
Clinical Activity ◽  
Significant Difference ◽  
Group A ◽  
One Year

Introduction. Genetic markers are significant predictive factors in the assessment of therapeutic response of rheumatoid arthritis (RA) to biological medication. Objective. The aim of the study was to determinate the association of TNF-? -308 G/A polymorphism with a high RA activity and its predictive value in therapeutic response after 12 months of treatment with Etanercept. Methods. The study enrolled 132 patients with RA treated with Methotrexate (MTX) and 58 control subjects. The -308 TNF polymorphism was examined using the polymerase chain reaction - restriction fragment length polymorphism (PCR- RFLP). The patients were divided into two groups: group A with A/A and A/G genotype and group G with G/G genotype. After 12 months, beside MTX, Etanercept was introduced in 36 patients. We compared clinical activity among the groups at the beginning and after one year of therapy by using DAS28 SE (Disease activity score with sedimentation). Results. There was no significant difference found in the distribution of G and A allele in the RA group compared to the control group. A significantly higher disease activity was noticed in A compared to the G group (DAS28 SE: 6.31 to 5.81; p<0.05). The patients with A allele kept the majority of the disease activity even after a year of study (DAS28 SE: 5.25 to 3.89). After a year of MTX and Etanercept therapy, a significantly larger proportion of patients in the G group displayed a good clinical response to treatment compared to the A group (81.5% to 25%; p<0.05). The average change of DAS28 SE in G group was 2.24, while in the A group DAS 28 reduction was significantly lower (1.17; p=0.005). Conclusion. There was no significant difference in the frequency of A in the patients with RA compared to healthy subjects. The presence of A allele is associated with more serious clinical presentation of the disease and lower therapeutic response to Etanercept.

scholarly journals AB1119 U9: A NOVEL CLINICALLY ORIENTED ULTRASONOGRAPHIC SCALE AS A USEFUL MARKER FOR MONITORING THERAPEUTIC RESPONSE IN RHEUMATOID ARTHRITIS (MULTI CENTERS STUDY)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.2-1849
Author(s):  
M. A. Mortada ◽  
H. Eitta ◽  
R. Elmallah ◽  
A. Radwan ◽  
A. Elsaman
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Laboratory ◽  
Pearson Correlation ◽  
Response To Treatment ◽  
P Value ◽  
Clinical Parameters ◽  
Biologic Dmards ◽  
Das 28 ◽  
Significant Difference

Background:Musculoskeletal Ultrasonography (MSUS) is now a widely used tool for monitoring of rheumatoid arthritis (RA). Although there are many proposed sets of composite scores, a fixed set of joints may not be an ideal tool to assess a disease like RA, which affects many joints and tendons in different presentations. In previous study (1) U9 score was proven to be correlated with disease activity parameters.Objectives:To determine whether US assessment using U9 score is useful for monitoring response to treatment for RA or not?Methods:A prospective, multicenter study were conducted in period from July 2019 to December 2019. All recruited RA patients were subjected to: Disease activity assessment by clinical disease activity indices (CDAI and DAS28 ESR). Functional status assessment by (HAQ) and ultrasonographic assessment using U9 score which include 8 joints (bilateral wrists,2ndMCP,3RDMCP and knees) plus most clinically affected joint or tendon (one joint or one tendon). Most clinically affected joints from 48 joints. Any affected tendons could be choosing. All targeted joints were evaluated according to EULAR guidlines and by EULAR/ OMERACT combined score (0-3). Targeted tendons were scored (0-3).All patients received their treatment (biologic and non biologic DMARDs) according to the decision of the treating physicians. No specific therapy is needed. CDAI and DAS28 ESR, HAQ and U9 score were repeated after 3 months to detect the response to change after receiving the therapy.Results:One hundred and forty patients (23.6% were male) with mean age 39.26±11.30 were recruited from 4 tertiary referral university hospitals.There was a significant difference (<0.001) between the first and second visits as regards clinical, laboratory and ultrasonographic parameters. DAS 28 decreased form (5.29±1.21) to (3.95±0.99), ESR decreased from (42.12±15.24) to (26.84±12.32), HAQ2 improved from (0.652±0.350) to (0.510±0.237) and U9 total US score decreased from (13.56±5.18) to (8.02±4.28).There was significant correlation between U9 ultrasonographic score and clinical parameters at both visits (table 1).Table 1.correlation between U9 ultrasonographic score and clinical parameters.U9 at 1stvisitU9 at 2ndvisitDAS-28Pearson Correlation(P value)0.806<0.0010.790<0.001CDAIPearson Correlation(P value)0.787<0.0010.773<0.001HAQPearson Correlation(P value)0.431<0.0010.317<0.001We found that the most suitable cut-off value of U9 score to predict high disease activity was 11.5 (sensitivity 85.7% and specificity 80.6%), cut off value for moderate disease activity was 5.5(sensitivity 83.2% and specificity 88%) and cut off value for low disease activity was 3.5 (sensitivity of 83.3% and specificity 57.1%). These results are summarized in the following table:Conclusion:U9 ultrasonographic score is very useful method for evaluating the monitoring the response of treatment.References:[1]Mortada, et al. Annals of the Rheumatic Diseases 2019;78:1009.Disclosure of Interests:None declared

scholarly journals OP0185 RADIOGRAPHIC PROGRESSION DESPITE PERSISTENT LDA OR REMISSION IS INFLUENCED BY CURRENT SMOKING RATHER THAN THE RESPECTIVE DAS 28 LEVEL, RESULTS OF THE SWISS RHEUMATOID ARTHRITIS REGISTER (SCQM)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 112.1-112
Author(s):  
L. Brandt ◽  
H. Schulze-Koops ◽  
T. Hügle ◽  
M. J. Nissen ◽  
H. Paul ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Radiographic Progression ◽  
X Rays ◽  
Das28 Score ◽  
Das 28 ◽  
Significant Difference ◽  
Control Disease ◽  
One Year ◽  
Ratingen Score

Background:The therapeutic aim for rheumatoid arthritis (RA) is to control disease activity and prevent radiographic progression. Various clinical scores are utilized to describe disease activity in RA patients. The DAS28 score can define states of low disease activity (LDA) and remission. Despite achieving LDA or remission, radiographic progression may nevertheless occur. However, the rates and frequency of this occurrence have not been analyzed in detail.Objectives:To describe the frequency and rate of radiographic progression in patients with persistent LDA or remission.Methods:Analysis of RA patients from the SCQM cohort. Persistent LDA or remission were defined as DAS 28 ≤3.2 or <2.6 respectively, at two subsequent follow up time points in the database. We included patients with at least two sets of radiographs within these intervals of LDA and/or remission. Radiographic progression was measured with the Ratingen-score (range 0-190), which describes joint erosions numerically. Repair was defined as an improvement in the Ratingen score >5 points/year and progression as >2 or >5 points change in the Ratingen score within one year.Results:Among 10’141 RA patients, 4’342 episodes of remission occurred in 3’927 patients with 1’776 sets of X rays available within these episodes. Similarly, 8’136 episodes of LDA in 6’765 patients and 2’358 sets of X rays were present within these intervals. For patients in LDA or remission, rates of repair were 5.5% and 4.8%, respectively, while for radiographic progression >5 points in the Ratingen score/year were 10.3% in both groups and for >2 points change of Ratingen score/year were 27.7 and 25.4%, respectively).No differences for demographic factors or measures of disease activity, rheumatoid factor or ACPA were found comparing patients with radiographic progression or non-progression despite LDA or remission at the beginning of the episode of LDA and/or remission.Interestingly, 42.9% of patients in LDA with progression of >5 points in the Ratingen score/year were current smokers vs 29.4% among the non-progressors (X2 = 6.55, p = 0.01). This significant difference vanished when the cut-off for radiographic progression was set at >2 points yearly change in Ratingen score or in patients in remission.Conclusion:Radiographic progression despite LDA or remission are more frequent than expected. No differences in radiographic progression were found comparing LDA and remission suggesting that the goal of LDA is appropriate. Smoking seems to be an independent risk factor for radiographic progression despite LDA. Why the effect of smoking could was not demonstrated in patients in remission, remains unclear.Disclosure of Interests:Lena Brandt: None declared, Hendrik Schulze-Koops: None declared, Thomas Hügle Consultant of: GSK, Abbvie, Pfizer, Jansen, Novartis, Eli Lilly., Michael J. Nissen Consultant of: Abbvie, Celgene, Eli-Lilly, Janssen, Novartis and Pfizer, Hasler paul Consultant of: Abbvie, Lilly, Rudiger Muller Consultant of: AbbVie, Novartis, Grant/research support from: Gebro

scholarly journals IL-22 and ACPA Levels and their Relationship to the Disease Activity in Rheumatoid Arthritis Patients

2021 ◽  
Vol 6 (1) ◽  
pp. 1-7
Author(s):  
Khater ES
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Solid Phase ◽  
Sandwich Elisa ◽  
Control Group ◽  
Erosive Disease ◽  
Das 28 ◽  
Significant Difference ◽  
Hs Crp ◽  
And Control

Aim: to determine ACPA IgG and IL-22 levels in RA patients and their relationship to the disease activity Place and duration of the study: A cross sectional study and prospective cohort study was performed from August 2020 to January 2021 in rheumatology outpatient clinic and laboratory of Al- Quwayiyah General hospital. Methodology: Forty five rheumatoid arthritis patients were included and 35 healthy participants free of any diseases considered as control group. The patients in this study met the American College of Rheumatology's 2010 guidelines. RA Disease activity was assessed for rheumatoid patients using DAS28 scoring. Serum samples collected from the patients and control to perform ESR, Hs-CRP, RF factors and also IL22 and ACPA IgG which were detected using sandwich ELISA and indirect solid phase enzyme immunoassay techniques respectively. Results: Out of the 45 RA patients, 34(75.6%) were females and 11(24.4%) were males aged from (28-67years) with median patient age 42 years. There was no statistically significant difference regarding age and sex between RA patients and control. Thirty (66.7%) of the 45 RA patients had low disease activity or remission, while 15 (33.3%) had moderate to extreme disease activity. Thirty two 32(71.1%) patients of the 45 RA patients had erosive disease. The level of ESR, hs-CRP and RF are increased in the patient group than control, in spite that there were significant differences in the Mean± SD among RA group and control group regarding RF, there was no significant statistical differences ESR, hs-CRP. in the study there was an increase in ACPA and IL-22 levels in patients suffering of RA; 21.52±1.29 U/ml and 71.22±10.63 pg\ml. respectively. While among control there was low serum levels; 14.06±2.01U/ml 33.25±2.41pg\ml and respectively. Significant statistical difference was observed regarding IL-22 and ACPA IgG levels among RA patients and control (P=0.038 and P=0.019 respectively). There is a significant positive relationship (positive correlation) detected between ACPA and IL-22 levels, (r=-0.810; p=0.597). The levels of IL-22 and ACPA were significantly associated with DAS 28. Their relationship was strong as the r value was 0.427 and 0.411 respectively. Conclusion: IL-22 and ACPA IgG levels were highly increased among RA patients in comparison to the control group. The IL-22 and ACPA IgG levels were strongly correlated with the rheumatoid disease activity, DAS 28. These results suggest that Il-22 can be used in association with ACPA IgG level as diagnostic and prognostic markers of rheumatoid arthritis

scholarly journals The Distribution of Vascular Endothelial Growth Factor (VEGF), Human Beta-Defensin-2 (HBD-2), and Hepatocyte Growth Factor (HGF) in Intra-Abdominal Adhesions in Children under One Year of Age

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Anna Junga ◽  
Māra Pilmane ◽  
Zane Ābola ◽  
Olafs Volrāts
Keyword(s):  
Growth Factor ◽  
Control Group ◽  
Relative Distribution ◽  
Abdominal Adhesions ◽  
Related Factors ◽  
Hypoxic Conditions ◽  
Significant Difference ◽  
Group A ◽  
One Year ◽  
Endothelial Growth Factor

The regulatory role between ischemia related factors and antimicrobial peptides in congenital intra-abdominal adhesions has not yet been defined. The aim of this research was to investigate the appearance and relative distribution of VEGF, HBD-2, and HGF in congenital intra-abdominal adhesions compared with relatively healthy tissue controls. The study group material was obtained from 48 patients who underwent abdominal surgery due to partial or complete bowel obstruction. VEGF, HBD-2, and HGF were detected using immunohistochemistry methods and their relative distribution was evaluated by means of the semiquantitative counting method. The results were analyzed using nonparametric statistic methods. A moderate number of VEGF positive endotheliocytes were detected, but there was no statistically significant difference between the groups. In the experimental group, a moderate to high number of VEGF positive macrophages was observed. In control group tissues, such macrophages were seen in significantly lower number (U = 61.0, p = 0.001). The increase of VEGF positive cells indicates support of angiogenesis due to the hypoxic conditions in case of adhesion disease. The number of HBD-2 marked fibroblasts and macrophages was moderate to high, but only few positive endotheliocytes were observed. Persisting appearance of HBD-2 positive structures might be a result of the inflammatory process. Most specimens showed occasional HGF positive macrophages and fibroblasts and there was no statistically significant difference between the groups. The relatively weak appearance of HGF suggests that the lack of this factor promotes the formation of fibrotic changes in case of intra-abdominal adhesions.

Early clinical response to treatment predicts 5-year outcome in RA patients: follow-up results from the CAMERA study

2011 ◽  
Vol 70 (6) ◽  
pp. 1099-1103 ◽  
Author(s):  
M F Bakker ◽  
J W G Jacobs ◽  
P M J Welsing ◽  
S A Vreugdenhil ◽  
C van Booma-Frankfort ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Treatment Strategies ◽  
Early Response ◽  
Response To Treatment ◽  
Computer Assisted ◽  
Significant Difference ◽  
Assisted Management

ObjectiveTo investigate the long-term effects of the tight control (TC) and conventional (CT) methotrexate-based strategies of the Computer Assisted Management in Early Rheumatoid Arthritis trial in early rheumatoid arthritis and evaluate the predictive value of an early response to treatment.MethodsClinical and radiographic 5-year outcome was compared between initial strategies. Patients were classified according to the EULAR response criteria. The prognostic value of early response to treatment in addition to established predictors was analysed by multiple linear regression analyses.Results5 years of data were available for 205 of 299 patients, with no indication for selective drop-out. At 5 years there was no longer any significant difference for clinical and radiographic outcomes between treatment strategies applied during the first 2 years. Good-responders had a mean disease activity score of 2.39 (1.2) and median yearly radiographic progression rate of 0.6 (0.0 to 2.2) at 5 years; significantly lower (both p<0.02) when compared to moderate- and non-responders. Multiple regression analysis showed that early response to treatment is an independent predictor of 5-year outcome, irrespective of treatment strategy.ConclusionsThe difference in disease activity between treatment strategies disappeared over the years. Good-response to treatment independently predicts significantly better 5-year clinical and radiographic outcome. The TC principle probably should be continued in the long-term.

scholarly journals AB0278 REAL LIFE EXPERIENCE OF DISEASE ACTIVITY AND QUALITY OF LIFE IN PATIENTS TREATED WITH BIOLOGICAL DMARDS VERSUS TOFACITINIB.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1438.2-1438
Author(s):  
V. Boyadzhieva ◽  
N. Stoilov ◽  
E. Kurteva ◽  
R. Stoilov
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Real Life ◽  
Disease Activity Index ◽  
Significant Difference ◽  
One Year

Background:Assessment of disease activity and quality of life are one of the main indicators for determining the effectiveness of treatment with disease-modifying antirheumatic drugs. In recent years, a new group has entered the market - target synthetic DMARDS, which prove their effectiveness in treating RA comparable to that of biological products.Objectives:The aim of this study is to evaluate the disease activity and quality of life of patients with rheumatoid arthritis (RA) treated with biological agents in comparison with Tofacitinib (real life data from Bulgarian population) and determine whether or not the benefits of different therapies were sustained over a follow up period of 1 year.Methods:164 patients were selected with a mean age 55.34 ± 16SD years, meeting the 1987 ACR and /or ACR/ EULAR (2010) classification criteria for Rheumatoid arthritis (RA). Patients were arranged according to treatment regimens: Tocilizumab (TCL) 30 patients, Certolizumab (CZP) 16, Golimumab (GOL) 22, Etanercept (ETN) 20, Adalimumab (ADA) 20, Rituximab (RTX) 16, Infliximab (INF) 20, Tofacitinib (TOF) 20. Disease activity and quality of life was the primary concern. Independent joint assessor evaluated 28 joints on baseline, 6th and 12th month’s thereafter. CRP was used to measure the inflammatory process.DAS28-CRP, clinical disease activity index (CDAI) and simplified disease activity index (SDAI)were calculated. On baseline all of the patients’ groups had severe disease activity (mean DAS28-CRP > 5.2, mean CDAI > 22, mean SDAI > 26. The quality of life was evaluated via EQ-5D.All of the patients were on stable therapy according to the inclusion criteria, and didn’t interrupt any of the medications including biological or target synthetic treatment.Results:Significant clinical improvement and statistically significant reduction in disease activity were observed in patients treated with bDMARDS and tsDMARDS within 6 months (p <0.005) of treatment and after 12 months of follow-up (p=0.039). The mean value of DAS28-CRP after one year follow up showed an non-inferior effect of Tofacitnib (3.04± 0.81) in comparison to biological treatment (TCL: 3.07 ± 0.73; CZP: 3.06 ± 0.65; GOL: 2.49 ± 0.76; ETN: 2.85 ± 0.55; ADA: 3.15 ± 0.82; RTX: 2.90 ± 0.70; INF: 3.14; ± 0.61; TOF: 3.04± 0.81). An improvement was also observed for the 6 to 12 months of follow-up as we did not detect a significant difference in the activity of the disease assessed by CDAI among the different drug groups.The mean values showing the change of the SDAI over the study period also outline comparable profiles. All of the treatment groups achieved a rapid reduction in disease activity that continued to decrease through the 6 and 12 months period, respectively, as supported by changes in SDAI.The quality of life evaluated with EQ-5D revealed significant improvement on the 6-th month of follow up as well as after 12th month (p<0.005) without significant difference between the observed groups.Conclusion:Real-life data show that patients on biological treatment as well as those on Tofacitinib therapy achieve a significant decrease in disease activity after one year of follow-up. This gives us reason to accept the importance of non-inferior effect of jak-inhibitors and their place in treatment of Rheumatoid arthritis.Disclosure of Interests:Vladimira Boyadzhieva: None declared, Nikolay Stoilov: None declared, Ekaterina Kurteva: None declared, Rumen Stoilov Grant/research support from: R-Pharm

scholarly journals OP0156-HPR COST EFFECTIVENESS OF TELE-HEALTH FOLLOW-UP IN RHEUMATOID ARTHRITIS BASED ON A NON-INFERIORITY RANDOMIZED CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 98.2-99
Author(s):  
A. De Thurah ◽  
C. Skovsgaard ◽  
T. Maribo ◽  
N. H. Hjøllund ◽  
M. Kruse
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Disease Activity ◽  
Social Care ◽  
Control Group ◽  
Low Disease Activity ◽  
Health And Social Care ◽  
One Year ◽  
Care Costs

Background:The clinical effectiveness of a patient-reported outcome (PRO) based telehealth intervention offered to rheumatoid arthritis (RA) patients with low disease activity or remission has previously been reported1. The TeRA study showed that PRO-based telehealth follow-up in RA achieved similar disease control as conventional outpatient follow-up among patients with low disease activity or remission. The degree of disease control did not differ between telehealth follow-up offered by rheumatologists or rheumatology nurses.Objectives:To compare the cost-effectiveness of PRO–based telehealth follow-up to patients with RA performed by rheumatologists or rheumatology nurses with conventional outpatient follow-up.Methods:A total of 294 patients were randomized (1:1:1) to either PRO-based telehealth follow-up carried out by a nurse (PRO-TN) or a rheumatologist (PRO-TR), or conventional outpatient follow-up by physicians. Quality of life (EQ-5D) was measured at baseline and at follow-up after one year. The primary outcome was a change in the Disease Activity Score, C-reactive Protetin in 28 joints (DAS-28, CRP).The focus in the health economic evaluation was on the relation between costs and EQ-5D in the period between one year prior to and one year after the intervention. All costs were measured at the individual level and consisted of: intervention costs, health and social care costs, and productivity costs. All cost data were retrieved from Danish population-based registers. Incremental cost-effectiveness rates (ICERs) were calculated on the basis of a comparison of the development in costs and effects in the two intervention groups (separately and combined) with the control group. Bootstrap with 10,000 replications were used to access significance.Results:The difference in health and social care costs during the intervention period compared to the year before were €1,072, - €50 and €519 for the control group, the PRO-TR group and the PRO-TN respectively. Hence, the change in health and social care costs was lower for both intervention groups. The PRO-TR group had a small decrease and it was significantly lower than for the control group (p=0.0027). The difference between health and social care costs in the PRO-TN group compared to the control group was only borderline significant (p=0.067). No statistically significant differences were found in QALY’s between the three groups, all three groups experienced minor, non-significant, declines in QALY over the intervention period. ICER’s were not statistically significant but below known threshold values for the PRO-RN group (ICER=€17,121).Conclusion:It is difficult to obtain statistically significant results for cost-effectiveness in small samples. However, the results point towards a possible cost-saving impact of PRO interventions in patients with low disease activity or remission. The study was unable to conclude if PRO-TR or PRO-TN were most cost-effective. Other relevant considerations, like patient satisfaction or organisational issues, should determine the way of organizing RA disease management in these patients.References:[1]de Thurah A, Stengaard-Pedersen K, Axelsen M, et al. Tele-Health Follow-up Strategy for Tight Control of Disease Activity in Rheumatoid Arthritis: Results of a Randomized Controlled Trial.Arthritis care & research2018;70(3): 353-60.Disclosure of Interests:Annette de Thurah Grant/research support from: Novartis (not relevant for the present study)., Speakers bureau: Lily (not relevant for the present study)., Christian Skovsgaard: None declared, Thomas Maribo: None declared, Niels Henrik Hjøllund: None declared, Marie Kruse: None declared

scholarly journals AB0193 ROLE OF DICKKOPF-1 IN RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1396.2-1397
Author(s):  
H. Sadek ◽  
A. Monir ◽  
S. Bahgat ◽  
M. Elwan ◽  
A. Hamed
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Status ◽  
Structural Damage ◽  
Negative Regulator ◽  
Control Group ◽  
Das 28 ◽  
Significant Difference ◽  
Dickkopf 1 ◽  
Laboratory Measures

Background:Rheumatoid arthritis (RA) is characterized by persistent synovitis that leads to structural joint damage causing deformity and disability. Dickkopf-1(DKK-1) was shown to be a major regulator of joint remodeling, which is associated with subchondral bone erosion in RA. Dickkopf-1 is a secreted glycoprotein that also acts as a potent negative regulator of wingless signaling. Current therapies used to treat RA are not able to effectively repair damaged bone. There is a strong relationship between Wnt signaling pathway, RA and DKK-1 so; this relationship may be a therapeutic point of interestObjectives:To assess the correlation between Dickkopf-1 and RA disease activity, disability, severity and functional status.Methods:Fifty patients fulfilled the 2010 ACR -EULAR criteria for RA were included. Twenty five healthy age and sex matched individuals served as a control (for assessment of serum DKK-1 level). Excluded from the study, patients with Paget disease, Multiple myeloma, Breast cancer, Bone metastasis, Diabetes mellitus, Hyperthyroidism, patients on medication that influence bone metabolism as: heparin, anticonvulsant or thyroxin.All patients were subjected to full history and examination. Disease activity measures as disease activity score (DAS 28-ESR), Visual analogue scale (VAS) and Disease disability indices including ACR criteria of functional status in RA and Health assessment questionnaire disability index (HAQ-DI). Erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), Rheumatoid factor (RF), Anti citrullinated peptide antibody (ACPA) and Serum dickkopf-1 level. Simple erosion narrowing score (SENS) and Ultrasound DAS (US DAS) were done for all patients. Ultrasound DAS included 28 joints, Power Doppler ultrasound (PDUS) examination of 22 joints and gray scale ultrasound (GSUS) examination for Effusion/Hypertrophy (E/H) of 28 joints. Ultrasound erosion count (USEC) and Ultrasound erosion rate (USER) were assessed.Results:Dickkopf-1 level in RA patients ranged from 66 to 453 ng/ml while in the control group ranged from 15 to 87 ng/ml with statistically significant difference. RA patients were grouped in to: group 1 included 15 (30%) patients with normal DKK-1 level and group 2: included 35 (70%) patients with elevated DKK-1. The differences between both groups were highly significant regarding clinical and laboratory measures (duration of morning stiffness, DAS 28, VAS, ESR, CRP, RF and ACPA), and regarding HAQ-DI, SENS and US DAS. We found significant positive correlation between DKK-1 level and laboratory measures (ESR, CRP, RF, ACPA), radiographic parameters (SENS and erosion score), ultrasonographic parameters (US DAS, USEC and USER) and with HAQ-DI and functional status.Conclusion:Serum level of dickkopf-1 was elevated in RA patients and the results demonstrated the relationship between increased dickkopf-1 level and increased disease activity, decreased functional capacity and chronic structural damage suggesting its important role in the pathogenesis of RA.References:[1]Cardona-Rincón A D, Acevedo-Godoy M, Perdomo-Lara S, Chila L, et al. (2018).AB0001 Association of dickkopf1–1 polymorphisms with radiological damage and periodontal disease in patients with early rheumatoid arthritis. Annals of the Rheumatic Diseases; 77(2): 1206.[2]Huang Y, Liu L and Liu A. (2018).Dickkopf-1: Current knowledge and related diseases. Life sciences; 209: 249-54.Disclosure of Interests:None declared

scholarly journals 5`-Nukleotidase and adenosine deaminase in patients with rheumatoid arthritis

2017 ◽  
Vol 74 (10) ◽  
pp. 940-946 ◽  
Author(s):  
Nela Zivkovic ◽  
Boris Djindjic ◽  
Sonja Stojanovic ◽  
Ivana Krstic ◽  
Ivana Ciric ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Adenosine Deaminase ◽  
Inflammatory Diseases ◽  
Cell Damage ◽  
Control Group ◽  
Adenosine Deaminase Activity ◽  
Significant Difference ◽  
Post Hoc ◽  
Rheumatoid Arthritis Activity

The essence of rheumatoid arthritis (RA) pathogenesis is inflammation, modification of immune system and cell damage. 5'-nucleotidase (5'-NT) and adenosine deaminase (ADA) have a significant role in the process of inflammation-caused tissue damage. The aim of the paper is to define 5'-nucleotidase and adenosine deaminase activity in serum of patients with rheumatoid arthritis treated with Methotrexate and patients with rheumatoid arthritis who have not been treated with Methotrexate, as well as to determine correlation between the enzymes and disease activity. The research included 160 patients suffering from rheumatoid arthritis, 60 of which have not been treated with Methotrexate (age 56,8; 68,3% female) and 100 patients treated with Methotrexate (age 59,8; 88% female), as well as 60 healthy controls (age 58,8; 66,6% female). Patients suffering from chronic inflammatory diseases, chronic respiratory, cardiac and kidney insufficiency, severe acute diseases and other diseases which might modify inflammatory response were not included in the research. There was no statistically significant difference in 5'-NT values among groups. ADA values were significantly different in all tested groups. Post Hoc analysis (Dunnett T3 test) showed that ADA activity in RA groups were significantly higher as compared to control group (p<0.001), and that ADA in RA group with MTX was significantly smaller as compared to RA group without MTX (p<0.001). There is not significant correlation between the disease activity and activities of tested enzymes. We concluded that adenosine deaminase activity was increased in patients with rheumatoid arthritis, as well as that the application of Methotrexate led to the decrease of this enzyme in the serum of patients with rheumatoid arthritis. Activity of 5'-nucleotidase is not increased in patients with rheumatoid arthritis and did not depend on Methotrexate treatment. Serum adenosine deaminase and 5'-nucleotidase were not good indicators of rheumatoid arthritis activity.

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