Clin Exp Rheumatol
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The Disease Activity Score including 28 joints (DAS28) and the Clinical Disease Activity Index (CDAI) were developed in order to provide a quantifiable measure of rheumatoid arthritis (RA) activity. The aim of this study was to evaluate the validity and internal consistency reliability for DAS28 and CDAI in patients with RA seen by rheumatologists in usual clinical care. We also compared proposed categories of high, moderate, and low activity and remission according to both scores. ⋯ DAS28 and CDAI are valid and simple acceptable ways to measure RA activity in the clinical practice, but disease activity categorized by these indices differ considerably. Further research is needed to resolve this issue.
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Non-steroidal anti-inflammatory drugs (NSAIDs) play different roles in the management of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). In RA there is minimal evidence that NSAIDs are able to alter the course of disease or prevent joint destruction and, therefore, they should mostly be used as a short-term bridging therapy. In contrast to RA, in AS NSAIDs are considered as a cornerstone of the treatment not only because of a high symptomatic efficacy, but also because they might even retard osteoproliferation and radiographic progression. Considering younger age of AS patients and lower prevalence of comorbidities, they are probably at lower risk for cardiovascular and gastrointestinal side effects of short- and long-term NSAID therapy in comparison to RA.
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To examine effects of the COX-2 inhibitor market withdrawals on NSAID utilization among patients at increased risk of gastrointestinal (GI) and cardiovascular (CV) toxicities. ⋯ The COX-2 inhibitor withdrawals resulted in a rapid decline in NSAID gastroprotection prescribed by participating U.S. rheumatologists despite the availability of other gastroprotective options. Channeling toward nsNSAID use was widespread, including among patients at increased CV risk. Longer term follow-up is required to determine the clinical significance of these changes in NSAID prescribing, particularly for NSAID-related GI and CV-related toxicities.
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To retrospectively evaluate the role of the various imaging techniques in the study of the sternocostoclavicular joint, in patients with spondyloarthropathies and other rheumatic conditions and to assess potential pitfalls in the radiological diagnosis. ⋯ The radiological evaluation of the anterior chest wall in patients with different rheumatic disorders represents a problem of difficult diagnostic evaluation both for the anatomic region complexity and for the variability of the radiographic findings. The integrated use of X-ray, CT, MRI and nuclear medicine is suggested to avoid misdiagnosis.
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To assess the clinical features of nervous system (NS) involvement in patients with ANCA-associated vasculitides (AAV), including microscopic polyangiitis (MPA), Wegener's granulomatosis (WG), and Churg-Strauss syndrome (CSS). ⋯ NS involvement was common in AAVs and the characteristic of NS involvement was different among MPA, WG and CSS patients. DAH and infection instead of NS damage remained the leading causes of death in AAVs.