J Rheumatol
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Clinical Trial Controlled Clinical Trial
Nicardipine for the treatment of Raynaud's phenomena: a double blind crossover trial of a new calcium entry blocker.
Fifteen patients with Raynaud's phenomenon [systemic lupus erythematosus (6), progressive systemic sclerosis (8) and rheumatoid arthritis (1)] and 12 patients with Raynaud's disease participated in a parallel, 4-week/arm, double blind, crossover study of nicardipine, an experimental calcium channel blocker. Nicardipine significantly improved pain (p = 0.03), decreased number of Raynaud's attacks (p less than 0.03), and was preferred over placebo (p less than 0.05) in the patients with Raynaud's disease, but showed an effect only in the number of attacks (p = 0.049) among the group with Raynaud's phenomenon. ⋯ Nonlimiting toxicity occurred more commonly with drug than placebo (15 vs 9 times, p less than 0.05). Our study demonstrated that nicardipine improves symptoms in Raynaud's disease, but is not effective in Raynaud's phenomenon.
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Clinical Trial Controlled Clinical Trial
Psoriatic arthritis treated with oral colchicine.
We investigated the use of colchicine in psoriatic arthritis to determine if we could confirm the good results obtained in an earlier, uncontrolled study. Twelve of 15 patients with psoriatic skin lesions and arthritis completed a 16-week placebo controlled double blind crossover study. ⋯ The few side effects observed were related to gastrointestinal intolerance, which were usually controlled by temporarily reducing the dose of the drug. Our results indicate that 1.5 mg colchicine daily is an effective treatment for psoriatic arthritis.
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We studied 14 cases of polymyositis-dermatomyositis (PM-DM) and found roentgenographic evidence of interstitial lung disease in 9 patients with DM (64.3%). Serum anti-Jo-1 antibody was demonstrated in only one case. ⋯ Response to corticosteroid therapy was poor, and 6 cases (67%) succumbed to respiratory failure and died. We conclude that interstitial lung disease in DM occurs more frequently than previously reported and may be an important prognostic factor.
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Sleep physiology, pain and mood symptoms of 8 patients with idiopathic osteoarthritis of the hands who complained of morning symptoms were compared to 7 age and sex matched subjects with similar joint pathology, but who did not complain of morning symptoms. The "AM Symptoms" group had sleep related (nocturnal) myoclonus, associated with increased morning peripheral joint tenderness and decreased grip strength, whereas the "No Complaint" group had improved mood in the morning.