Introduction Aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) plays a major role in improving early rheumatoid arthritis (RA) patient outcomes. Persistence and adherence with medication occurs variably (20% to 70%). The objectives of the study were to determine medication persistence (MP) in early RA patients over 13 consecutive visits each 2 months apart, to investigate the relationship between MP and disease activity, disability and structural damage, and to identify baseline prognosticators.
Background
Colchicine is an available, safe, and effective anti-inflammatory drug and has been suggested as a COVID-19 treatment, but its usefulness in hospitalized severe COVID-19 patients has not been thoroughly demonstrated.
Objective
To address the safety and efficacy of colchicine in hospitalized patients with severe COVID-19.
Design
We conducted a triple-blind parallel non-stratified placebo-controlled clinical trial.
Participants
We recruited 116 hospitalized patients with severe COVID-19 in Mexico.
Interventions
Patients were randomized to receive 1.5 mg of colchicine or placebo at the time of the recruitment in the study (baseline) and 0.5 mg BID PO to complete 10 days of treatment.
Main Measures
The primary composite outcome was the progression to critical disease or death. Besides, we evaluated immunological features at baseline and after recovery or disease progression in 20 patients.
Key Results
Fifty-six patients were allocated to colchicine and 60 patients received placebo. The study was suspended after the second interim analysis demonstrated colchicine had no effect on the primary outcome (OR 0.83, 95%CI 0.35–1.93, P = 0.67), nor in the days of ICU and hospital stays. Adverse events were similar between groups (OR 1.63, 95% CI 0.66–3.88, P = 0.37). After colchicine treatment, patients had higher BUN and lower serum levels of IL-8, IL-12p70, and IL-17A.
Conclusions
Colchicine is safe but not effective in the treatment of severe COVID-19.
Trial Registration
ClinicalTrials.gov Identifier: NCT04367168.
Serial Power Doppler ultrasonography-assessed synovitis was greater in patients who developed erosions than in those who did not. More power Doppler positive (hypervascular) synovitis and more ACR classification criteria, both at baseline, were the only predictors of erosions.
Background: An increasing role of dual-energy computed tomography (DECT) scan in tophaceous gout assessment is recognized, whereas its role in asymptomatic hyperuricemia is unknown.Objective: The objective of this study was to assess the prevalence of joint and renal monosodium urate deposits by DECT in asymptomatic hyperuricemia.Methods: Among a renal transplant population with at least 1 year of follow-up, we included 27 patients with sustained hyperuricemia and 11 with normal serum uric acid (SUA) levels. We excluded patients with gout or history of monoarthritis or oligoarthritis. We registered demographic data, drugs, hyperuricemia onset, comorbidities, renal function, and SUA. We used a 128-slice dual-source CT system, and the acquisition protocol included the pelvis and imaging of elbows, wrists, hands, knees, ankles, and feet. The reading process was performed by 2 radiologists.Results: The mean age was 43.7 ± 12 years, 57.8% were males, and median follow-up was 7 years. Hyperuricemia presented after a median time of 0.61 years after transplantation and had persisted for a median of 3.2 years (0.5-16.8 years). For the hyperuricemic group, the median SUA at the DECT scan and the maximum SUA levels were 7.9 and 8.9 mg/dL, respectively. Groups were similar in most of the clinical variables. We did not find any articular or renal deposit; conversely, we demonstrated a quadriceps tendon deposition in 1 patient with hyperuricemia (prevalence of 0.03%; 95% confidence interval, 0.006%-0.17%).Conclusions: In these patients with asymptomatic hyperuricemia, the prevalence of monosodium urate deposition assessed by DECT was low; however, larger studies need to be performed for further validation.
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