Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0152031 (swollen joints)
 535 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a series of 100 adult patients with definite rheumatoid arthritis of at most 3 years' duration and with no previous penicillamine, gold or systemic corticosteroid treatment, 50 patients were treated with D-penicillamine and 50 with gold for one yar. The dose of penicillamine was 600 mg daily. Sodium aurothiomalate was given 50 mg weekly up to a total of 13 mg/kg and thereafter 50 mg once a month. In both treatment groups a statistically significant decrease in the number of painful and/or swollen joints, an increase in haemoglobin and a decrease in ESR, serum ceruloplasmin-, alpha1-acid glycoprotein-, IgG-, IgM- and IgA levels was observed. All the changes in these clinical and laboratory tests were of the same degree in both treatment groups. In the penicillamine group 12 out of 20 seropositive patients became seronegative and in another 5 the Waaler-Rose titre dropped clearly. In the gold group, 7 out of 16 seropositive patients became seronegative, and the Waaler-Rose titre dropped in another 5. An equal increase in the number of eroded joints in hands and toes was seen in the penicillamine and the gold group. Penicillamine was discontinued because of side effects in 13 patients (26%), and gold treatment in 15 (30%). Proteinuria and/or haematuria were the most common causes of discontinuation in the penicillamine group.
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PMID:Comparison of penicillamine and gold treatment in early rheumatoid arthritis. 10 90

The most suitable measures to assess the disease activity of rheumatoid arthritis patients treated with slow-acting anti-rheumatic drugs were considered in a prospective study. This was organised across Europe in 12 specialised centres and 282 patients were studied. The patients were all considered to be in need of therapy with a slow-acting anti-rheumatic drug and were studied at the initiation of therapy, and after 3 and 6 months of treatment. There were 215 patients who remained on treatment for 6 months. The most useful measures to assess disease activity were: the number of swollen joints, the number of tender joints, pain, the patients' assessment of response, and ESR. These should form a minimum data set when assessing the activity of rheumatoid arthritis. Some measures such as grip strength, hemoglobin, and the C-reactive protein level showed too much variation between centres and will require considerable standardisation before they can be used across Europe. There were problems in collecting functional data and further work is needed to develop a functional questionnaire available in all European languages with culturally suitable questions.
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PMID:Disease activity in rheumatoid arthritis: preliminary report of the Consensus Study Group of the European Workshop for Rheumatology Research. 829 67

This work presents results of a quasiexperimental prospective cohort study of the medium-term course of chronic rheumatoid arthritis (RA) under two different conditions of care. During 1984-1986 a total of 262 patients was recruited. All were new referrals to a university outpatient department. 121 came from the city of Hannover, FRG, and were assigned to comprehensive team care (cc) provided by two rheumatologists, a nurse, physician's assistant, occupational therapist, psychologist, and social worker; 141 came from outside Hannover and received care from a physician in training for internal medicine/rheumatology and a nurse, supervised by a senior registrar (TC). The patients in the first group were significantly older (57 vs 51 years), had more active disease (ESR 44 vs 31 mm/h), were more disabled (functional capacity 69 vs 78%), more often lived alone (27 vs 10%) and were more depressed compared with patients in the second group. There were no significant differences in gender (80% female), number of Rome criteria (5.2), and disease duration (6 years) between the two groups. 179 patients were followed for 2 years. There was no demonstrable difference between those who dropped out and those who continued in the study. Patients from both groups showed significant and clinically important improvements in ESR and number of swollen joints, whereas functional capacity and pain intensity did not change. Depression and patients' global self-rating improved only in the CC-group. Analyses adjusting for differences between the two groups were unable to show a different efficacy for either form of care.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The outcome of traditional or comprehensive outpatient care for rheumatoid arthritis (RA). Results of an open, non-randomized, 2-year prospective study. 147 35

The aim of the study was the evaluation of a potential selection process for patients with rheumatoid arthritis (RA) referred to the Mobile Service for Rheumatics in Hannover (MSRH). The MSRH is the only referral center for patients with inflammatory rheumatic diseases in Hannover. A comparison of the health status was made between 58 individuals with RA identified in a population study, and 103 RA patients from the MSRH. The following disease parameters were less favorable in the clinical group: duration of morning stiffness, functional capacity, number of swollen joints, rheumatoid factor, ESR, disease activity, and classical RA according to the Rome-criteria. Only 22% of the individuals with RA identified in the population study have been referred to the MSRH. These patients more frequently had definite or classical RA (statistically not significant: p = 0.17, p = 0.11, respectively). It was shown that the clinical group comprised more severe RA cases. Thus, data from such patients may not be generalized for the entire group of RA cases in the population.
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PMID:[Population epidemiologic evaluation of the Hannover Mobile Rheumatoid Health Service]. 147 38

14 patients suffering from Juvenile Chronic Arthritis unresponsive to NSAIDS were enrolled in this open study. There were two patients with a systemic form, nine patients with polyarticular form. All patients received methotrexate administered orally in one or two divided doses; the dose was 0.3-0.5 mg/kg/week. Clinical improvement occurred in most of the cases; remission was achieved in 5 out of 9 polyarticular form, in one out of the two systemic form and in two out of the three pauciarticular form. All patients showed a significant improvement in the clinical parameters except one with a pauciarticular form (duration of morning stiffness, number of swollen joints and number of painful joints). The effects on laboratory indexes were a decrease in ESR and CRP in about 50% of the cases, an increase up to the normal value of hemoglobin in about 30% of the cases. Two patients experienced a transient gastrointestinal discomfort and 3 had a mild elevation of serum aminotransferase levels which were restored after a reduction of the drug. In conclusion our data confirm that methotrexate at low dosage is more effective than other second-line agents and has fewer side effects. In our opinion methotrexate can today be considered the first choice for Juvenile Chronic Arthritis unresponsive to NSAIDS.
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PMID:[Treatment with low-dose methotrexate in intractable juvenile chronic arthritis]. 148 7

High intravenous doses (400 mg/kg) of gammaglobulin (IVIG) were administered monthly for six months to 7 patients with severe rheumatoid arthritis (RA). In all cases, previous treatment with NSAIDs and corticosteroids and in 3 of them with gold and/or methotrexate had been ineffective. A 50 per cent improvement of Ritchie index was obtained in 6/7 patients, morning stiffness was reduced from greater than 2 hours to less than 30 minutes in 6/7 patients. Swollen joints and Lee index improved in all patients. ESR did not show any change but RCP improved in 6/7 patients. The study of lymphocyte subpopulation showed no substantial changes in CD20+, CD3+, CD4 and CD8 cells as well as in CD4/CD8 ratio and a significant increase in 2H4+T cells without changes in 4B4+ subpopulation. IVIG improved the clinical and laboratory features of patients with severe RA. The major problem raised by IVIG therapy is its high cost suggesting that this therapy should only be applied in well selected patients with RA.
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PMID:[High-dose immunoglobulins for the treatment of rheumatoid arthritis: pilot study of 7 cases]. 171 19

Monoclonal antibodies (mAb) to the CD4 surface molecule inhibit the function of CD4+ T cells in vitro and have been used for treatment of autoimmune diseases in several animal models. Recently, an anti-CD4 mAb has been described that improved the clinical situation of rheumatoid arthritis (RA) patients although no change in laboratory parameters could be observed. Here, we report on a different high-affinity anti-CD4 mAb (MAX.16H5) and its use for treatment of RA. Reduction of the Ritchie index, morning stiffness and the number of swollen joints demonstrated the clinical benefits of the therapy. In addition, laboratory parameters like ESR, CRP, and rheumatoid factor were reduced in 6/12 treatments. A rapid depletion of CD4+ T cells was observed in all patients which reached a minimum 1 hour after administration. However, efficacy of treatment did not correlate with T cell depletion. The antibody accumulates at the site of inflamed joints as detected by 99m-Tc-labelling. Affected digital joints were detected earlier by virtue of helper T cell imaging than by conventional bone scans.
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PMID:An anti-CD4 antibody for treatment of chronic inflammatory arthritis. 206 85

A 6-month double-blind study of OM-8980 and auranofin in 145 patients with rheumatoid arthritis was followed by an open observation period of 6 months for which 100 OM-8980-treated patients could be assessed. At the end of this second phase, the Ritchie index, number of swollen joints, pain scale, morning stiffness, grip strength and ESR had all improved further with respect to the significant improvements already recorded under OM-8980 and auranofin in the double-blind phase. The statistical analysis of the Ritchie index, pain scale and ESR showed significant changes in these 3 parameters during both the 6-month follow-up phase and the entire 12-month period. As regards the tolerance, 2 patients reported gastrointestinal disorders during the follow-up. The investigators' final assessment of efficacy indicated an improvement in 76% of the patients during the follow-up phase and in 95% during the entire 12-month period.
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PMID:Follow-up with OM-8980 after a double-blind study of OM-8980 and auranofin in rheumatoid arthritis. 226 35

The etiology of rheumatoid arthritis is unknown. Virus infection is one of alleged factors initiating the disease process. In view of this, the authors undertook a trial of administration of an antiviral and immunostimulating preparation - isoprinosine, given in the early phase of the disease prior to the development of erosions. Isoprinosine was given to ten seropositive cases of rheumatoid arthritis (two males, eight females) aged 34-61 years, with disease duration from 6 months to 5 years treated previously only with non-steroidal anti-inflammatory drugs. Isoprinosine was administered for 4 weeks (2 weeks of 3.0 g daily and 2 weeks of 1.5 g daily). After the treatment, a statistically significant reduction was observed in the number of joints painful on pressure, the number of swollen joints, and the duration of morning stiffness. The grip strength of the left hand was increased. The ESR and serum uric acid level were not changed significantly. The titre of Waaler-Rose reaction in four patients was decreased, in two it was increased, and in four it remained unchanged. No side effects were observed during the treatment. In the light of these observations it seems worthwhile to continue further studies on the action of isoprinosine in early rheumatoid arthritis.
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PMID:Isoprinosine in the early pre-erosive stage of rheumatoid arthritis: a pilot study. 245 93

In 62 patients with seropositive rheumatoid arthritis, treated with gold compounds, the relationship between serological and clinical response was analysed, based on data on the rheumatoid factor (RF) titre, ESR, number of swollen joints and joint tenderness, through 3 years. Three groups were distinguished. The RF titre became normal in 19, remained elevated in 22, became normal and subsequently again elevated in 21. Responders and non-responders to chrysotherapy occurred in all 3 groups. The findings suggest involvement of pathogenetic mechanisms related to IgM-RF, and of pathogenetic mechanisms which are not related to IgM-RF, and which may be responsive or unresponsive to chrysotherapy.
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PMID:Waaler Rose titres may decrease but increase again during chrysotherapy. 323 60


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