The Impact of Pharmaceutical Care Services on Patients with Active Rheumatoid Arthritis: A Randomized Controlled Study

Elmenshawy, Hagar; Farouk, Hanan Mohamed; Sabri, Nagwa A.; Ahmed, Marwa F.

doi:10.21608/aps.2022.143040.1092

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…For instance, omega-3 fatty acid attenuated methotrexate-induced nephrotoxicity in a pre-clinical trial ( 32 ), although it is necessary to further validate whether the use of omega-3 fatty acid lowers the risk of ESRD in patients with RA. In this context, it is worthy of note that Hagar et al reported that the introduction of pharmaceutical care services in RA patient treatment protocol effectively resulted in an improvement in the detection and prevention of drug-related problems and showed a significant reduction in Disease Activity Score 28, Health Assessment Questionnaire, and Rheumatoid Arthritis Quality of Life Questionnaire scores ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis and the risk of end-stage renal disease: A nationwide, population-based study

Suh

Jung

et al. 2023

Front. Med.

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IntroductionDespite the risk of incident chronic kidney disease among the patients with rheumatoid arthritis (RA), the association of RA and the risk of end-stage renal disease (ESRD) has not been clearly elucidated. We aimed to investigate the association of RA and the risk of ESRD.Materials and methodsA total of 929,982 subjects with (n = 154,997) or without (n = 774,985) RA from the National Health Insurance Service (NHIS) database in Koreas (corresponding to the period between 2009 and 2017) were retrospectively analyzed. RA was defined by the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), codes plus any dispensing of disease-modifying anti-rheumatic drugs. The primary outcome was incident ESRD, identified by a combination of the ICD-10-CM codes and a special code assigned to patients receiving maintenance dialysis for ≥ 3 months or those with a transplant kidney.ResultsCompared to the subjects without RA, the subjects with RA resulted in an increased incidence of ESRD (incidence rates of 0.374 versus 0.810 cases per 1,000 person-years). Accordingly, compared to the subjects without RA, the risk of ESRD was significantly increased among the subjects with RA (adjusted hazard ratio 2.095, 95% confidence interval 1.902–2.308). Subgroup analyses revealed that the risk of ESRD imposed by RA is relatively higher in relatively young and healthy individuals.ConclusionRheumatoid arthritis (RA) increase the risk of ESRD. As the risk of ESRD imposed by RA is relatively higher in relatively young and healthy individuals, kidney-protective treatment, such as biologic agents, should be preferentially considered among these patients with RA.

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Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis and the risk of end-stage renal disease: A nationwide, population-based study

Suh

Jung

et al. 2023

Front. Med.

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“…For example, animal studies have shown that metformin can treat inflammatory bowel disease, multiple sclerosis, and autoimmune diseases [ 17 , 18 , 19 ]. Hagar et al [ 20 ] reported that the introduction of pharmaceutical care services in the RA patient treatment protocol effectively resulted in an improvement in the detection and prevention of drug-related problems and showed a significant reduction in disease activity score 28 (DAS28), health assessment questionnaire (HAQ), and RA quality of life (RAQoL) scores. Metformin modulates immune response, autophagy, mitophagy, endoplasmic reticulum (ER) stress, and apoptosis and exerts epigenetic effects [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Metformin Treatment Reduces the Incidence of Rheumatoid Arthritis: A Two-Sample Mendelian Randomized Study

Liang

Cai

Zhang

et al. 2023

JCM

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Several studies have shown that rheumatologic patients can benefit from metformin, but it remains unclear whether metformin treatment is causally associated with the risk of rheumatoid arthritis (RA). A two-sample Mendelian randomization (MR) study was conducted to investigate the causal relationship between metformin treatment and the incidence of rheumatoid arthritis. The genome-wide significant (p < 5 × 10−8) single-nucleotide polymorphisms (SNPs) associated with metformin use were selected as instrumental variables (IVs). Summary statistics on RA were extracted from a large genome-wide association study (GWAS) meta-analysis. The inverse variance-weighted (IVW) method was used as the determinant of the causal effects of metformin treatment on RA. Cochran’s Q was used to detect heterogeneity. Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) test and MR-Egger regression were used to detect horizontal pleiotropy. A total of 34 SNPs significantly associated with metformin treatment were obtained. Thirty-two SNPs were selected as IVs after removing two SNPs for being palindromic with intermediate allele frequencies (rs11658063 and rs4930011). The IVW results showed a negative causal association between metformin treatment and RA (OR = 0.0232, 95% CI 1.6046 × 10−3 − 0.3368; p = 0.006). Meanwhile, no heterogeneity or pleiotropy was detected, indicating that the results were reliable. This study indicated a negative causality between metformin treatment and RA, indicating that the treatment of metformin can prevent the pathogenesis of RA.

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The Impact of Pharmaceutical Care Services on Patients with Active Rheumatoid Arthritis: A Randomized Controlled Study

Cited by 2 publications

References 17 publications

Rheumatoid arthritis and the risk of end-stage renal disease: A nationwide, population-based study

Rheumatoid arthritis and the risk of end-stage renal disease: A nationwide, population-based study

Metformin Treatment Reduces the Incidence of Rheumatoid Arthritis: A Two-Sample Mendelian Randomized Study

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