Seminars in arthritis and rheumatism
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Semin. Arthritis Rheum. · Dec 2009
Randomized Controlled TrialRandomized controlled trial of diclofenac sodium gel in knee osteoarthritis.
Nonsteroidal anti-inflammatory drugs have dose-related adverse effects. Topical nonsteroidal anti-inflammatory drugs may offer local efficacy with low systemic drug levels. This study assessed the efficacy and safety of topical diclofenac sodium 1% gel (DSG) in mild to moderate symptomatic knee osteoarthritis. ⋯ Over a 3-month treatment period, topical treatment with DSG achieved statistically and clinically significant improvements of pain and measures of physical function in patients with knee osteoarthritis.
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Semin. Arthritis Rheum. · Oct 2009
Review Meta AnalysisTreatment with infliximab plus methotrexate improves anemia in patients with rheumatoid arthritis independent of improvement in other clinical outcome measures-a pooled analysis from three large, multicenter, double-blind, randomized clinical trials.
To evaluate the effect of antitumor necrosis factor-alpha monoclonal antibody infliximab treatment on anemia in patients with rheumatoid arthritis (RA). ⋯ Treatment with infliximab plus MTX significantly improved hemoglobin level among anemic RA patients when compared with treatment with placebo plus MTX, even after adjusting for improvement in disease activity.
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Semin. Arthritis Rheum. · Oct 2009
ReviewSystemic nonarticular manifestations of rheumatoid arthritis: focus on inflammatory mechanisms.
Extra-articular ("nonarticular") manifestations of rheumatoid arthritis (RA) are common and greatly affect physical and emotional health, as well as prognosis, including survival. Several plausible mechanisms have been advanced for many nonarticular manifestations but there is increasing evidence that pro-inflammatory cytokines (eg, tumor necrosis factor-alpha [TNF-alpha], interleukin [IL]-1, and IL-6) are also involved. The purpose of this review is to provide a concise appraisal of recent studies investigating the involvement of inflammatory cytokines in the pathogenesis of nonarticular RA manifestations. ⋯ Overall, further research in this area will add to our understanding of the mechanisms of extra-articular manifestations in RA patients. These insights should allow clinicians to select therapies to better match the spectrum of joint disease and nonarticular manifestations in individual patients. This may be particularly relevant for newer biologic agents with specific inhibitory effects on cytokines such as TNF-alpha and IL-6.
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Semin. Arthritis Rheum. · Aug 2009
Randomized Controlled Trial Multicenter StudyA double-blind, randomized, saline-controlled study of the efficacy and safety of EUFLEXXA for treatment of painful osteoarthritis of the knee, with an open-label safety extension (the FLEXX trial).
To report the FLEXX trial, the first well-controlled study assessing the safety and efficacy of Euflexxa (1% sodium hyaluronate; IA-BioHA) therapy for knee osteoarthritis (OA) at 26 weeks. ⋯ IA-BioHA therapy resulted in significant OA knee pain relief at 26 weeks compared with IA-SA. Subjects treated with IA-BioHA also experienced significant improvements in joint function, treatment satisfaction, and HRQoL.
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Semin. Arthritis Rheum. · Jun 2009
ReviewSelective costimulation modulation with abatacept: a look at quality-of-life outcomes in patients with rheumatoid arthritis.
To highlight the importance of improving quality of life (QoL) in patients with rheumatoid arthritis (RA) and to provide a summary of the QoL benefits provided by abatacept in patients who have an inadequate response to disease-modifying antirheumatic drugs (DMARDs) and/or tumor necrosis factor (TNF) antagonists. ⋯ Improvements in QoL are rated by patients as 1 of the most important benefits of an effective treatment; however, inclusion of QoL measurements in clinical trials as a measure of efficacy is a relatively recent event. Abatacept has been shown to alleviate both the physical and the emotional/social burdens that RA imposes on the patient, including improvements in day-to-day activity and reducing sleep problems and fatigue in patients with RA who have an inadequate response to DMARDs and/or TNF antagonists.