Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An open, noncomparative study at 8 rheumatology centers in Brazil assessed the efficacy and safety of auranofin (AF) when given for up to 24 months. The study enrolled 80 patients with classic or definite rheumatoid arthritis (RA); disease was severe in 20 (25%), moderate in 55 (69%), and mild in 5 (6%). Patients received auranofin, 3 mg twice daily, and varying doses of anti-inflammatory drugs (aspirin, nonsteroidal anti-inflammatory drugs, and corticosteroids). Sixty patients (75%) completed the full 24 months of therapy. No patients were withdrawn from therapy because of insufficient therapeutic effect. There was statistically significant improvement (p less than 0.001) in 9 clinical parameters of disease activity, evident as early as 3 months after beginning AF therapy, increasing steadily over 12 months, and remaining at improved levels for another 12 months. Improvements in some parameters were particularly striking. By 24 months, assessment of well-being had increased by 150%, intensity of pain had decreased by 66%, and duration of morning stiffness had decreased by 78%. The average daily dose of anti-inflammatory drugs also decreased over time. The safety profile of AF was similar to that found in comparable trials. Ten patients (12.5%) were withdrawn because of adverse events: 6 for diarrhea (7.5%), 2 for proteinuria (2.5%), and 1 each for pruritus and anemia (1.25%). Adverse events occurred in 24 of 80 patients; some reported more than one adverse event. The most common adverse events were loose stools (20 patients) or diarrhea (11 patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy of auranofin as demonstrated by improvement in clinical parameters and decrease in anti-inflammatory usage: a long-term, multicenter study. 329 82

The clinicopathological features in 4 patients are described where nonsteroidal antiinflammatory drugs appear to have caused small intestinal strictures. Two patients had rheumatoid arthritis and 2 patients had osteoarthritis; all had received nonsteroidal antiinflammatory drugs for 1.5-30 yr. Three patients had an initial illness characterized by diarrhea, profound weight loss, and hypoalbuminemia. Intestinal radiology at this stage ranged from subtle changes to those of Crohn's disease. Three patients underwent surgery. At operation the bland external appearance contrasted with the striking mucosal appearances of multiple concentric, circumferential, diaphragmatic strictures that caused luminal stenosis to a pinhole. These septa were due to submucosal fibrosis and the histopathological picture appears to represent a new nosological entity.
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PMID:Clinicopathological features of nonsteroidal antiinflammatory drug-induced small intestinal strictures. 334 76

Fourteen patients with severe rheumatoid arthritis refractory to hydroxychloroquine, gold-thioglucose, D-penicillamine and azathioprine completed a 6-month open study with oral methotrexate (2.5 to 5 mg every 12 hours, three doses weekly). Twelve of them were followed up for 12 months. Compared with pretreatment values, there was a significant reduction in duration of morning stiffness (p less than 0.01), in the number of tender or painful joints (p less than 0.02), number of swollen joints (p less than 0.01), visual analog scale, patient's assessment of joint discomfort and overall well-being (p less than 0.01) after 2, 6 and 12 months. Likewise there was an improvement in the erythrocyte sedimentation rate (p less than 0.001) C-reactive protein (p less than 0.01) and the levels of IgG, IgM and IgA (p less than 0.01). Two patients were withdrawn from the study, one for severe diarrhoea and one because of a depression. Adverse reactions during methotrexate therapy included nausea (5/16) and transaminase elevation (4/16). We conclude that this pilot study provides evidence that a weekly low dose of methotrexate is effective in the short-term treatment for patients with rheumatoid arthritis, refractory to hydroxychloroquine, auriothioglucose, D-penicillamine and azathioprine.
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PMID:Methotrexate in refractory rheumatoid arthritis. 341 68

This article is an update on the importance of some gastrointestinal diseases such ulcerative colitis, coeliac disease and some types of diarrhoea, in preceding an autoimmune response. A correlation with autoimmune disease without digestive symptoms, is made (rheumatoid arthritis, Hashimoto's thyroiditis, ankylosing spondylitis, and so on). Recognising such interrelations should be followed by search of extradigestive symptoms of autoimmune gastrointestinal diseases, allowing a better understanding of the immunologic phenomena involved.
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PMID:Autoimmunity in gastrointestinal diseases. 356 76

The oral gold preparation, auranofin, used in rheumatoid arthritis has been reputed to cause chronic diarrhea. To investigate this the G.I. tract motility was measured before auranofin therapy and after 1, 3, and 5 weeks of therapy using scintigraphy following indium-111-labeled meals in three beagle dogs. The gastric emptying times of the dogs accelerated throughout the duration of the experiment, although the large bowel transit times did not seem to be affected. The affect of auranofin on the stools of the baboon Papio ursinus was also noted. The baboon stools were observed for any change in consistency. Sigmoidoscopic examination including mucosal biopsies was carried out monthly over a 6-month period. The baboon's stools were noted to become very soft in consistency, but histology indicated no mucosal changes.
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PMID:The effect of an oral gold preparation on the gastrointestinal tract motility in two species of experimental animals. 358 92

The results of longterm therapy with the oral gold preparation auranofin in patients with rheumatoid arthritis (RA) were evaluated based on the following data: 1) Two multicenter open uncontrolled studies (MTC06) and (162EMUA-RA), 2) the reevaluation of these data for the MTC06 study after 4 years from the beginning of the study and 3) the results of a postmarketing surveillance program (PMSP) of patients on auranofin therapy. The specific rheumatologic documentation and information system (IKR inhaltkodierte rheumatologic) serves as the basis of the follow-up studies and longterm observations. The first year data on 207 patients (MTC06) indicating that duration of the disease less than 2 years was the only discriminating factor regarding a positive treatment outcome were confirmed by the two-year (151 patients). Patients, who responded favourably to Auranofin did usually well for the four-year or longer observation period. The data base of these two studies and the PMSP failed to outline any new severe or threatening side effects. Diarrhea and loose stools were more common at the beginning of the treatment. The overall withdrawal for untoward events was 11.2%. Patients who did or did not respond to previous DIMARD therapy either on i.m. gold, D-Penicillamine or Chloroquine, did usually well when treated with Auranofin, even if severe side effects leading to withdrawal had occurred on previous therapy. The favourable safety profile was confirmed by the PMSP data.
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PMID:Longterm results of auranofin therapy. 369 Sep 86

Gold compounds, often used in the treatment of rheumatoid arthritis, have been associated with gastrointestinal disturbances in some patients. Use of auranofin, an oral gold preparation, in a 50-year-old woman with rheumatoid arthritis resulted in diarrhea, abdominal tenderness, nausea, and vomiting, which persisted despite discontinuation of auranofin therapy. The presumptive diagnosis was gold-induced colitis and eosinophilia. Administration of cromolyn sodium provided relief. Although this complication may be rare, evolving bowel symptoms in patients receiving auranofin demand prompt attention.
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PMID:Auranofin-associated colitis and eosinophilia. 380 38

Twenty-eight patients with refractory rheumatoid arthritis completed a randomized 24-week double-blind crossover trial comparing oral methotrexate (2.5 to 5 mg every 12 hours for three doses weekly) with placebo. The methotrexate group had significant reductions (P less than 0.01 as compared with the placebo group) in the number of tender or painful joints, the duration of morning stiffness, and disease activity according to physician and patient assessments at the 12-week crossover visit; reductions in the number of swollen joints (P less than 0.05) and 15-m walking time (P less than 0.03) also occurred. These variables, as well as the grip strength and erythrocyte sedimentation rate, showed significant (P less than 0.01) improvement at 24 weeks in the population crossed over to methotrexate. A significantly increased frequency (P less than 0.03) of the HLA-DR2 haplotype occurred in the eight patients with the most substantial response to methotrexate. Adverse reactions during methotrexate therapy included transaminase elevation (21 per cent), nausea (18 per cent), and diarrhea (12 per cent); one patient was withdrawn from the trial because of diarrhea. One patient died while receiving the placebo. Methotrexate did not affect measures of humoral or cellular immunity. We conclude that this trial provides evidence of the short-term efficacy of methotrexate in rheumatoid arthritis, but the mechanism of action is unknown. Longer trials will be required to determine the ultimate safety and effectiveness of this drug.
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PMID:Efficacy of low-dose methotrexate in rheumatoid arthritis. 388 72

The concentrations of gold in whole blood, serum, urine and blood cells of patients with rheumatoid arthritis were measured during 6 months of oral treatment either with Auranofin or placebo. Any adverse effects attributable to the treatments were also recorded. Although the time course of gold during Auranofin therapy was similar to that of injected gold, the blood and serum gold concentrations were significantly lower than those measured in patients receiving injected gold. Between 45 and 58% of Auranofin gold in the blood was associated with blood cells. In comparison, following injections of gold thiomalate, only about 4% of the gold was present in the blood cells. During the 6-month period, 2 patients receiving Auranofin withdrew because of diarrhoea and another because of rash. 1 placebo patient withdrew because of headaches. No laboratory evidence of haematological, renal or hepatic abnormality was encountered. It is suggested that the markedly lower concentrations of gold in the body sustained during treatment with Auranofin may be the critical factor towards a greater tolerance of the drug in the treatment of rheumatoid arthritis.
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PMID:Gold concentrations and toxicity during oral gold treatment with auranofin. 391 1

A patient with rheumatoid arthritis-associated interstitial pneumonitis, treated with prednisolone, developed mild colitis due to Clostridium difficile in association with the use of cefotaxime (CTX). Diarrhea was successfully treated with the discontinuation of CTX and initiation of oral vancomycin.
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PMID:Cefotaxime-associated diarrhea and Clostridium difficile. 608 23


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