Traditional and modern management strategies for rheumatoid arthritis

Akram, Muhammad; Daniyal, Muhammad; Sultana, Sabira; Owais, Aymen; Akhtar, Naheed; Zahid, Rabia; Said, Fahad; Bouyahya, Abdelhakim; Ponomarev, Evgeny; Shariat, Mohammad Ali; Thiruvengadam, Muthu

doi:10.1016/j.cca.2020.11.003

Cited by 57 publications

(27 citation statements)

References 150 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to severe symptoms described above, excess comorbidities (including fragility fracture, osteoarthritis, etc) are also along with RA patients, which could reduce their quality of life 6,7 . Aiming to control symptoms and progression of RA, many treatments have been applied, which mainly include nonsteroidal anti‐inflammatory drug (NSAID), conventional synthetic disease‐modifying antirheumatic drugs (cDMARDs), glucocorticoids (GC), biologic DMARDs, etc 8‐11 . However, many RA patients still suffer from poor treatment response and remission; therefore, exploring biomarkers assisting to predict treatment outcomes can help the clinicians to stratify RA patients, individualize their treatment, and improve the outcomes in RA patients 12,13 …”

Section: Introductionmentioning

confidence: 99%

Inter‐alpha‐trypsin inhibitor heavy chain 4: A serologic marker relating to disease risk, activity, and treatment outcomes of rheumatoid arthritis

2022

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Objective Inter‐alpha‐trypsin inhibitor heavy chain 4 (ITIH4) regulates immunity and inflammation, but its clinical role in rheumatoid arthritis (RA) patients remains unclear. Hence, this study was conducted to explore the association of circulating ITIH4 with disease risk, clinical features, inflammatory cytokines, and treatment outcomes of RA. Methods After the enrollment of 93 active RA patients and 50 health controls (HCs), their serum ITIH4 level was analyzed by enzyme‐linked immunosorbent assay (ELISA). For RA patients only, serum ITIH4 level at week (W) 6 and W12 after treatment was also analyzed. Besides, serum tumor necrosis factor‐alpha (TNF‐α), interleukin (IL)‐1β, IL‐6, and IL‐17A at baseline of RA patients were also detected by ELISA. Results ITIH4 was downregulated in RA patients (151.1 (interquartile range (IQR): 106.2–213.5) ng/mL) than in HCs (306.8 (IQR: 238.9–435.1) ng/mL) (p < 0.001). Furthermore, ITIH4 was negatively related to C‐reactive protein (CRP) (rs = −0.358, p < 0.001) and 28‐joint disease activity score using erythrocyte sedimentation rate (DAS28‐ESR) (rs = −0.253, p = 0.014) in RA patients, but not correlated with other clinical features (all p > 0.05). Besides, ITIH4 was negatively linked with TNF‐α (rs = −0.337, p = 0.001), IL‐6 (rs = −0.221, p = 0.033), and IL‐17A (rs = −0.368, p < 0.001) in RA patients, but not correlated with IL‐1β (rs = −0.195, p = 0.061). Moreover, ITIH4 was gradually elevated in RA patients from baseline to W12 after treatment (p < 0.001). Additionally, the increment of ITIH4 at W6 and W12 was linked with treatment response and remission in RA patients (all p < 0.05). Conclusion Circulating ITIH4 possesses clinical utility in monitoring disease risk, inflammation, disease activity, and treatment outcomes of RA.

show abstract

Section: Introductionmentioning

confidence: 99%

Inter‐alpha‐trypsin inhibitor heavy chain 4: A serologic marker relating to disease risk, activity, and treatment outcomes of rheumatoid arthritis

2022

Clinical Laboratory Analysis

View full text Add to dashboard Cite

show abstract

“…As a result, patients with intestinal BD unresponsive to conventional treatments might be treated effectively with anti-TNF-α agents. 37 , 38 …”

Section: Discussionmentioning

confidence: 99%

Anti-TNF-α agents for refractory intestinal Behçet’s disease: case series and meta-analysis

Zhan

Liu

et al. 2022

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Background: Behçet’s disease (BD) is a relapsing systemic immune disorder, and intestinal BD is a significant cause of mortality in patients with BD. Conventional therapeutic strategies for intestinal BD showed unsatisfactory outcomes, especially in those patients with refractory subtypes. In recent years, biologic agents have exhibited promising results in this field. While the sample sizes of existing studies were limited, the results were heterogeneous. Objectives: This study aimed to observe the efficacy of different biologics in clinical symptomatic improvement and intestinal mucosal healing. Design: This is a study including the report of case series and meta-analysis. Data sources and methods: This meta-analysis was conducted following the PRISMA guidelines. Free-text words and subject terms, including ‘Behcet’s Syndrome’, ‘Biologics’, ‘Tumor Necrosis Factor Antagonist’, were used to systematically research the relevant studies in the electronic databases (PubMed, Web of Science, Embase, and Cochrane Library). All retrieved articles were from inception to July 2021, and the data from our institution were also included in this meta-analysis. A double arcsine transformation was performed to stabilize the variance of the original ratio. Heterogeneity was evaluated via Q-test and I2 statistics. Random-effects or fixed-effects model was used to calculate the pooled parameters, and the results were presented as forest plots with 95% confidence intervals. Results: Twelve studies were included, but only antitumor necrosis factor alpha (anti-TNF-α) agents were prescribed as biologicals for refractory intestinal BD. The symptom improvement rates at our institution ranged from 57.1 to 81.8%, and the mucosal healing rates were from 20 to 60% in different therapeutic periods. A total of 514 patients were enrolled in the meta-analysis, and the synthesized ratios showed that 59.8% ( n = 377) and 73.7% ( n = 317) of patients who received maintenance therapy with anti-TNF-α agents could achieve clinical symptomatic improvement during short-term (10–14 weeks) and long-term (48–54 weeks) periods, respectively. Furthermore, 77.8% ( n = 229) of patients with intestinal BD maintained therapeutic efficacy for a longer time (100 weeks). In addition, 60.9% ( n = 120) of the patients achieved sustained intestinal mucosal healing during a long-term follow-up (24–52 weeks). Conclusion: Anti-TNF-α treatment is effective in treating refractory intestinal BD but more studies are required to evaluate the effects of new biologics for intestinal BD in the near future. Registration: This study has been registered on PROSPERO, the ID is CRD42022329211. Plain language summary Anti-TNF-α agents are effective and safe in patients with intestinal Behçet’s disease Behçet’s disease (BD) is a disease affecting several organs including the gastrointestinal tract. Nowadays, the efficacy of existing therapy strategies is still unsatisfactory and some patients are suffering from repeated attacks of the disease. We noticed that a new kind of medicine, called antitumor necrosis factor alpha (anti-TNF-α) agents, was applied to these patients recently. The therapeutic efficacy is not convincing enough to evaluate since the number of patients receiving this new medicine was small in every individual study. Regarding this, we conducted a research to learn about the efficacy of this medicine at our own institution. Besides, we composed the results of other studies in an appropriate way. Then, we drew a conclusion on the exact efficacy of anti-TNF-α agents after the data analysis. We unveiled that the anti-TNF-α agents appeared both effective and safe in the management of intestinal BD patients when the classical therapy failed. More than half of the patients could achieve discomfort remission when they got the therapy of the new medicine at our institution. We also found that intestinal ulcers in most patients improved after they received the treatment. All in all, it offered another foothold for getting relief in these patients who were caught in this mire.

show abstract

“…The most frequently used preparations are the ATC subgroup M02AA [33], which includes anti-inflammatory, nonsteroidal drugs (NSAIDs), e.g., those listed in Figure 1. Recently, pharmacological therapy is broadened by so called disease-modifying drugs for osteoarthritis (DMOADs) and symptomatic slow-acting drugs for osteoarthritis (SYSADOA) [34]. The initial oral medication of choice in the treatment of OA involves oral NSAIDs.…”

Section: The First-line Therapy Of Osteoarthritismentioning

confidence: 99%

Overview of First-Line and Second-Line Pharmacotherapies for Osteoarthritis with Special Focus on Intra-Articular Treatment

Nowaczyk

Szwedowski

Dallo³

et al. 2022

IJMS

View full text Add to dashboard Cite

Osteoarthritis (OA) can be defined as the result of pathological processes of various etiologies leading to damage to the articular structures. Although the mechanism of degenerative changes has become better understood due to the plethora of biochemical and genetic studies, the drug that could stop the degenerative cascade is still unknown. All available forms of OA therapy are based on symptomatic treatment. According to actual guidelines, comprehensive treatment of OA should always include a combination of various therapeutic options aimed at common goals, which are pain relief in the first place, and then the improvement of function. Local treatment has become more common practice, which takes place between rehabilitation and pharmacological treatment in the hierarchy of procedures. Only in the case of no improvement and the presence of advanced lesions visible in imaging tests, should surgery be considered. Currently, an increasing number of studies are being published suggesting that intra-articular injections may be as effective or even more effective than non-steroidal anti-inflammatory drugs (NSAIDs) and result in fewer systemic adverse events. The most commonly used preparations are hyaluronic acid (HA), glucocorticosteroids (GS), and also platelet-rich plasma (PRP) in recent years. This review aims to present the mechanism of action and clinical effectiveness of different pharmacological options in relieving pain and improving functions in OA as well as the emerging approach in intra-articular treatment with PRP.

show abstract

Traditional and modern management strategies for rheumatoid arthritis

Cited by 57 publications

References 150 publications

Inter‐alpha‐trypsin inhibitor heavy chain 4: A serologic marker relating to disease risk, activity, and treatment outcomes of rheumatoid arthritis

Inter‐alpha‐trypsin inhibitor heavy chain 4: A serologic marker relating to disease risk, activity, and treatment outcomes of rheumatoid arthritis

Anti-TNF-α agents for refractory intestinal Behçet’s disease: case series and meta-analysis

Overview of First-Line and Second-Line Pharmacotherapies for Osteoarthritis with Special Focus on Intra-Articular Treatment

Contact Info

Product

Resources

About