Arthritis and rheumatism
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Arthritis and rheumatism · May 2004
Randomized Controlled Trial Multicenter Study Clinical TrialRadiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled, 52-week trial.
Tumor necrosis factor (TNF) is an important proinflammatory cytokine that mediates inflammatory synovitis and articular matrix degradation in rheumatoid arthritis (RA). We investigated the ability of adalimumab, a human anti-TNF monoclonal antibody, to inhibit the progression of structural joint damage, reduce the signs and symptoms, and improve physical function in patients with active RA receiving concomitant treatment with methotrexate (MTX). ⋯ In this 52-week trial, adalimumab was more effective than placebo at inhibiting the progression of structural joint damage, reducing the signs and symptoms, and improving physical function in patients with active RA who had demonstrated an incomplete response to MTX.
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Arthritis and rheumatism · May 2004
Randomized Controlled Trial Clinical TrialExercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial.
The Arthritis, Diet, and Activity Promotion Trial (ADAPT) was a randomized, single-blind clinical trial lasting 18 months that was designed to determine whether long-term exercise and dietary weight loss are more effective, either separately or in combination, than usual care in improving physical function, pain, and mobility in older overweight and obese adults with knee osteoarthritis (OA). ⋯ The combination of modest weight loss plus moderate exercise provides better overall improvements in self-reported measures of function and pain and in performance measures of mobility in older overweight and obese adults with knee OA compared with either intervention alone.
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Arthritis and rheumatism · May 2004
Mechanical injury and psychosocial factors in the work place predict the onset of widespread body pain: a two-year prospective study among cohorts of newly employed workers.
Mechanical injury has been postulated as a risk factor for widespread pain, although to date, the evidence is weak. The aim of this study was to determine whether repeated exposure to mechanical trauma in the work place predicts the onset of widespread pain and to determine the relative contribution of mechanical trauma compared with psychosocial factors. ⋯ Our findings demonstrate that the prevalence of new-onset widespread pain was high, but among this young, newly employed work force, both physical and psychosocial factors played an important role.
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Arthritis and rheumatism · May 2004
Comparative StudyDistribution of radiographic osteoarthritis between the right and left hands, hips, and knees.
To investigate whether radiographic osteoarthritis (OA) is asymmetric and greater on the right side than on the left side in the hands, hips, and knees. ⋯ This discordance in symmetry suggests that the relative importance of biomechanical factors in the pathogenesis of OA is site-specific and may be discordant for cartilage and bone.
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Arthritis and rheumatism · May 2004
Expression of Toll-like receptor 2 on CD16+ blood monocytes and synovial tissue macrophages in rheumatoid arthritis.
CD16 (IgG Fcgamma receptor type IIIA [FcgammaRIIIA])-expressing CD14+ monocytes express high levels of Toll-like receptor 2 (TLR-2) and are able to efficiently produce proinflammatory cytokines such as tumor necrosis factor alpha (TNFalpha). To understand the role of CD16 and TLR-2 in monocyte and macrophage activation in rheumatoid arthritis (RA), we investigated the expression of TLR-2 on CD16+ blood monocytes and synovial tissue macrophages and the effect of CD16 and TLR-2 activation on cytokine production. ⋯ These results suggest that CD16+ monocytes and synovial tissue macrophages with high TLR-2 expression may be induced by M-CSF and IL-10, and their production of TNFalpha could be simulated by endogenous TLR ligands such as Hsp60 and FcgammaRIIIA ligation by small immune complexes in RA joints.