The presence of rheumatoid nodules at early rheumatoid arthritis diagnosis is a sign of extra-articular disease and predicts radiographic progression of joint destruction over 5 years

“…Nearly a quarter of patients in this cohort had RN, and this is higher than the 10% prevalence described elsewhere in patients with early disease (20). As in other studies, RN was associated with higher disease activity and radiological damage scores (20).…”

Section: Discussionsupporting

confidence: 47%

Exaggerated circulating Th-1 cytokine response in early rheumatoid arthritis patients with nodules

et al. 2012

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“…It is important to further explore obesity and its association with RN as obesity and RN are risk factors for aggressive RA [1,5,26] , but obesity is also a well-known risk factor for associated comorbidities such as cardiovascular diseases [27,28] and should carefully be taken into consideration in such patients. Similar to what has previously been reported, patients with RN had a more deforming disease and a higher frequency of sicca symptoms [1] .…”

Section: Discussionmentioning

confidence: 99%

“…They are considered among the most common extra-articular manifestations of RA, reported in 30-40% of patients [1] . RN have been found to be associated with a more severe and progressive form of RA [1] , positivity for rheumatoid factor (RF) [2] , positivity for anti-cyclic citrullinated peptide antibodies (ACPA) [3] , extra-articular features such as sicca symptoms, and impaired physical functions [4,5] . An association of methotrexate treatment with the development and progression of RN has been reported [6] .…”

Section: Introductionmentioning

confidence: 99%

Low Prevalence of Nodules in Rheumatoid Arthritis Patients in Kuwait: A Description and a Comparison of Patients from the Kuwait Registry for Rheumatic Diseases

Al‐Herz

Al-Awadhi²,

Saleh³

et al. 2016

Med Princ Pract

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Objectives: To describe the prevalence of rheumatoid nodules (RN) in patients with rheumatoid arthritis (RA) and to compare their features with those of patients without RN. Subjects and Methods: Adult RA patients (n = 952) in the Kuwait Registry for Rheumatic Diseases from February 2013 to December 2015 were evaluated for RN. Demographic and serological features and disease activity and severity were obtained from the registry. Results: Of the 952 RA patients, 22 (2.3%) had RN and 930 (97.7%) did not. Age, sex, disease duration, smoking, and family history of an autoimmune rheumatic disease were similar. Obesity was more prevalent in the RN group, i.e. 11 (50%) vs. 326 (35.1%), p = 0.016. There was no difference in rheumatoid factor (RF) or anti-cyclic citrullinated peptide antibody positivity. Patients with RN had more sicca symptoms, i.e. 8 (36.4%) vs. 152 (16.3%), p = 0.025, a higher mean score on the visual analogue scale pain (3 ± 2.9 vs. 2 ± 2.7, p < 0.001), more tender joints (6.4 ± 8.8 vs. 4.2 ± 7.2, p = 0.001), a higher patient global assessment of disease activity (3.3 ± 2.7 vs. 2.3 ± 2.7, p < 0.001), and more deformities, i.e. 3 (13.6%) vs. 74 (8%), p = 0.034. The mean health assessment questionnaire score in RN patients was 1.1 versus 0.9 in patients without RN (p = 0.08). Patients with RN had a low disease activity (means: disease activity score [DAS-28], 3.02; clinical disease activity index, 7.7; and simple disease activity index, 10.4), similar to the other group. While the rates of methotrexate treatment were comparable, biologic therapy was administered more in patients with RN (i.e. 15 [68.2%] vs. 478 [51.4%], p < 0.001). Conclusion: In Kuwait, the prevalence of RN is low among RA patients. Patients with and without RN are similar in terms of demographics and serologic features, except for more obesity. However, patients with RN have more sicca symptoms, joint deformities, and painful and tender joints. Disease activity scores are low with more frequent biologic therapy.

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“…10 The overall occurrence rates have been reported in as many as 35% of individuals, 6 In a study examining Asian and Hispanic populations placing overall prevalence at approximately 17%, prevalence was higher in the Hispanic population. 11 Most patients with rheumatoid nodules have positive RF factor.…”

Section: Prevalence Of Rheumatoid Nodulesmentioning

confidence: 99%

Rheumatoid Nodules

Tilstra

Lienesch

2015

Dermatologic Clinics

101

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Rheumatoid nodules are a common manifestation of rheumatoid arthritis. These lesions are often easily identified based on typical diagnostic features and characteristic locations. When biopsied, nodules have a characteristic histologic appearance. Uncommonly, rheumatoid nodules can occur in systemic locations. There is no evidence that systemic therapy treats underlying rheumatoid nodules. Paradoxically, methotrexate and possibly tumor necrosis factor inhibitors can increase nodule development. Treatment of rheumatoid nodules is often not necessary, unless patients are experiencing pain or there is interference of mechanical function. This review outlines the available data on and associations of rheumatoid nodules.

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The presence of rheumatoid nodules at early rheumatoid arthritis diagnosis is a sign of extra-articular disease and predicts radiographic progression of joint destruction over 5 years

Cited by 41 publications

References 44 publications

Exaggerated circulating Th-1 cytokine response in early rheumatoid arthritis patients with nodules

Exaggerated circulating Th-1 cytokine response in early rheumatoid arthritis patients with nodules

Low Prevalence of Nodules in Rheumatoid Arthritis Patients in Kuwait: A Description and a Comparison of Patients from the Kuwait Registry for Rheumatic Diseases

Rheumatoid Nodules

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