bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of intraarticular infliximab in patients with chronic or recurrent gonarthritis: A clinical randomized trial
Authors: van der Bijl A. E. , Teng Y. K. O. , van Oosterhout M. , Breedveld F. C. , Allaart C. F. , Huizinga T. W. J. 
Published: June 2009

AbstractObjectiveTo evaluate the efficacy and safety of intraarticular infliximab compared with intraarticular methylprednisolone in patients with gonarthritis.MethodsIn 23 patients with recurrent gonarthritis despite previous intraarticular corticosteroid therapy, a total of 41 intraarticular injections (20 infliximab and 21 methylprednisolone) were performed in 28 knees. Initial therapy was randomly assigned, and crossover therapy was eligible within 3 months. The clinical effect was assessed during 6 months of followup. The primary outcome was event‐free survival, defined as the time after treatment until local retreatment was performed and/or nonimprovement of the knee joint score. Adverse effects were recorded during followup.ResultsAll patients treated with intraarticular infliximab had an insufficient response. In contrast, 8 of the 21 intraarticular methylprednisolone injections were effective (P = 0.004). Between groups, no differences in the patients' age, disease duration, number of disease‐modifying antirheumatic drugs, or previous intraarticular methylprednisolone were observed. Reported adverse effects were not related to therapy.ConclusionTreatment with intraarticular infliximab injection was not effective in patients with a chronically inflamed knee joint. Intraarticular injection with methylprednisolone was superior despite previous intraarticular corticosteroid therapy. Further investigation is needed to provide these patients with a better alternative.
Validation of whole‐body against conventional magnetic resonance imaging for scoring acute inflammatory lesions in the sacroiliac joints of patients with spondylarthritis
Authors: Weber Ulrich , Maksymowych Walter P. , Jurik Anne G. , Pfirrmann Christian W. A. , Rufibach Kaspar , Kissling Rudolf O. , Khan Muhammad A. , Lambert Robert G. W. , Hodler Juerg 
Published: June 2009

AbstractObjectiveTo compare the performance of whole‐body magnetic resonance imaging (MRI) versus conventional MRI in assessing acute inflammatory lesions of the sacroiliac (SI) joints in patients with established and active spondylarthritis (SpA) using the Spondyloarthritis Research Consortium of Canada (SPARCC) MRI index. This study is validating whole‐body MRI against the current MRI standard for assessing active inflammatory lesions of the SI joints in patients with SpA.MethodsThirty‐two SpA patients with clinically active disease (Bath Ankylosing Spondylitis Disease Activity Index score ≥4) fulfilling the modified New York criteria were scanned by whole‐body and conventional MRI of the SI joints. The MRIs were scored independently in random order by 3 readers blinded to patient identity. Active inflammatory lesions of the SI joints were recorded on a Web‐based SPARCC index. Pearson's correlation coefficients were used to compare scores for whole‐body and conventional MRI for each reader, whereas intraclass correlation coefficients (ICCs) were used to compare interobserver reliability.ResultsThe Pearson's correlation coefficients between whole‐body and conventional MRI per rater were 0.94, 0.87, and 0.93. The mean sum scores for conventional versus whole‐body MRI were statistically significantly higher for all 3 readers, although all patients showing inflammatory lesions on conventional MRI also demonstrated them on whole‐body MRI. The ICCs(2,1) were 0.69, 0.78, and 0.95 for conventional MRI, and 0.79, 0.85, and 0.96 for whole‐body MRI for the 3 possible reader pairs.ConclusionWhole‐body and conventional MRI scores show a strong correlation and comparable reliability for the detection of inflammatory lesions of the SI joints.
Targeted ultrasound of the fifth metatarsophalangeal joint in an early inflammatory arthritis cohort
Authors: Sheane Barry J. , Beddy Peter , O'Connor Michelle , Miller Stanley , Cunnane Gaye 
Published: June 2009

AbstractObjectiveTo determine whether targeted ultrasonographic (US) imaging of the fifth metatarsophalangeal (MTP) joint, compared with radiographs, could aid in the early diagnosis of rheumatoid arthritis (RA) by identifying erosions sooner in early inflammatory arthritis. Radiographic erosion in RA is a late indication of poor prognosis. The earlier detection of erosion may facilitate the timely initiation of disease‐modifying antirheumatic drug therapy, particularly in patients with undifferentiated synovitis.MethodsPatients presenting with synovitis for the first time were invited to participate. Each patient underwent laboratory tests, radiographs of the hands and feet, and US imaging of both fifth MTP joints.ResultsThirty patients (22 women) took part in the study. Seventeen patients (57%) had RA, and 13 (43%) had undifferentiated arthritis (UA). The mean ± SD time taken to scan both fifth MTP joints was 10.9 ± 4.4 minutes. Ten patients (33%) had US evidence of synovitis associated with a positive power Doppler (PD) signal (P = 0.04). Seven patients (23%) had radiographic erosions of the fifth MTP joint, and 17 patients (57%) had US evidence of fifth MTP joint erosions (P = 0.01). A positive PD signal at the fifth MTP joint was seen in 9 of 17 patients with RA and 1 of 13 patients with UA (P = 0.02). Patients with a definite diagnosis of RA were more likely to have fifth MTP joint erosions (11 [65%] of 17) compared with UA (6 [46%] of 13).ConclusionTargeted US is a rapid and useful tool in detecting erosive disease in early inflammatory arthritis. It gives a better indication of disease severity and prognosis compared with routinely available laboratory tests, even in the absence of a definite diagnosis.
The safety and efficacy of a JAK inhibitor in patients with active rheumatoid arthritis: Results of a double‐blind, placebo‐controlled phase IIa trial of three dosage levels of CP‐690,550 versus placebo
Authors: Kremer Joel M. , Bloom Bradley J. , Breedveld Ferdinand C. , Coombs John H. , Fletcher Mark P. , Gruben David , Krishnaswami Sriram , Burgos‐Vargas Rubén , Wilkinson Bethanie , Zerbini Cristiano A. F. , Zwillich Samuel H. 
Published: June 2009

AbstractObjectiveTo determine the efficacy, safety, and tolerability of 3 different dosages of CP‐690,550, a potent, orally active JAK inhibitor, in patients with active rheumatoid arthritis (RA) in whom methotrexate, etanercept, infliximab, or adalimumab caused an inadequate or toxic response.MethodsPatients (n = 264) were randomized equally to receive placebo, 5 mg of CP‐690,550, 15 mg of CP‐690,550, or 30 mg of CP‐690,550 twice daily for 6 weeks, and were followed up for an additional 6 weeks after treatment. The primary efficacy end point was the American College of Rheumatology 20% improvement criteria (ACR20) response rate at 6 weeks.ResultsBy week 6, the ACR20 response rates were 70.5%, 81.2%, and 76.8% in the 5 mg, 15 mg, and 30 mg twice daily groups, respectively, compared with 29.2% in the placebo group (P < 0.001). Improvements in disease activity in CP‐690,550–treated patients compared with placebo were seen in all treatment groups as early as week 1. ACR50 and ACR70 response rates significantly improved in all treatment groups by week 4. The most common adverse events reported were headache and nausea. The infection rate in both the 15 mg twice daily group and the 30 mg twice daily group was 30.4% (versus 26.2% in the placebo group). No opportunistic infections or deaths occurred. Increases in mean low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels, and increases in mean serum creatinine level (0.04–0.06 mg/dl) were seen in all CP‐690,550 treatment arms.ConclusionOur findings indicate that CP‐690,550 is efficacious in the treatment of RA, resulting in rapid, statistically significant, and clinically meaningful reductions in the signs and symptoms of RA. Further studies of CP‐690,550 in RA are warranted.
Mail‐delivered arthritis self‐management tool kit: A randomized trial and longitudinal followup
Authors: Goeppinger Jean , Lorig Kate R. , Ritter Philip L. , Mutatkar Sonal , Villa Frank , Gizlice Ziya 
Published: June 2009

AbstractObjectiveTo determine the effectiveness of an intervention Tool Kit of arthritis self‐management materials to be sent once through the mail, and to describe the populations reached.MethodsSpanish speakers (n = 335), non‐Hispanic English‐speaking African Americans (n = 156), and other non‐Hispanic English speakers (n = 404) were recruited separately and randomized within each of the 3 ethnic/racial categories to immediately receive the intervention Tool Kit (n = 458) or to a 4‐month wait‐list control status (n = 463). At the end of 4 months, controls were sent the Tool Kit. All subjects were followed in a longitudinal study for 9 months. Self‐administered measures included health status, health behavior, arthritis self‐efficacy, medical care utilization, and demographic variables. Using analyses of covariance and t‐tests, analyses were conducted for all participants and for Spanish‐ and English‐language groups.ResultsAt 4 months, comparing all intervention subjects with randomized wait‐list controls, there were significant (P < 0.01) benefits in all outcomes except medical care utilization and self‐rated health. The results were maintained at 9 months compared with baseline. On average, the Tool Kit reached persons ages 50–56 years with 12–15 years of schooling. There were few differences between English‐ and Spanish‐language participants in either the effectiveness or reach variables.ConclusionA mailed Arthritis Self‐Management Tool Kit proved effective in improving health status, health behavior, and self‐efficacy variables for up to 9 months. It also reached younger persons in both English‐ and Spanish‐language groups and Spanish speakers with higher education levels than previous studies of the small‐group Arthritis Self‐Management Program.
Interleukin‐6 is a significant predictor of radiographic knee osteoarthritis: The Chingford study
Authors: Livshits Gregory , Zhai Guangju , Hart Deborah J. , Kato Bernet S. , Wang Huizhong , Williams Frances M. K. , Spector Tim D. 
Published: June 2009

AbstractObjectiveThere is a great need for identification of biomarkers that could improve the prediction of early osteoarthritis (OA). We undertook this study to determine whether circulating levels of interleukin‐6 (IL‐6), tumor necrosis factor α (TNFα), and C‐reactive protein (CRP) can serve as useful markers of radiographic knee OA (RKOA) in a normal human population.MethodsRKOA data were obtained from the cohort of the Chingford Study, a prospective population‐based study of healthy, middle‐aged British women. The RKOA‐affected status of the subjects was assessed using the Kellgren/Lawrence (K/L) grade as determined on radiographs obtained at baseline (n = 908) and at 10 years and 15 years thereafter. Serum levels of CRP, IL‐6, and TNFα were assayed at 5, 8, and 15 years, using high‐sensitivity commercial assays. A K/L grade of ≥2 in either knee was used as the outcome measure. Statistical analyses included analysis of variance for repeated measurements and logistic regression models, together with longitudinal modeling of dichotomous responses.ResultsDuring 15 years of followup, the prevalence of RKOA (K/L grade ≥2) increased from 14.7% to 48.7% (P < 0.00001 versus baseline). The body mass index (BMI) and circulating levels of CRP and IL‐6 were consistently and significantly higher in subjects diagnosed as having RKOA. When multiple logistic regression was applied to the data, the variables of older age (P = 3.93 × 10−5), higher BMI at baseline (P = 0.0003), and increased levels of IL‐6 at year 5 (P = 0.0129) were determined to be independent predictors of the appearance of RKOA at year 10. The results were fully confirmed using longitudinal modeling of repeated measurements of the data obtained at 3 visits. The odds ratio for RKOA in subjects whose IL‐6 levels were in the fourth quartile of increasing levels (versus the first quartile) was 2.74 (95% confidence interval 1.94–3.87).ConclusionThis followup study showed that individuals were more likely to be diagnosed as having RKOA if they had a higher BMI and increased circulating levels of IL‐6. These results should stimulate more work on IL‐6 as a potential therapeutic target.
Subtype‐specific peripheral blood gene expression profiles in recent‐onset juvenile idiopathic arthritis
Authors: Barnes Michael G. , Grom Alexei A. , Thompson Susan D. , Griffin Thomas A. , Pavlidis Paul , Itert Lukasz , Fall Ndate , Sowders Dawn Paxson , Hinze Claas H. , Aronow Bruce J. , Luyrink Lorie K. , Srivastava Shweta , Ilowite Norman T. , Gottlieb Beth S. , Olson Judyann C. , Sherry David D. , Glass David N. , Colbert Robert A. 
Published: June 2009

AbstractObjectiveTo identify differences in peripheral blood gene expression between patients with different subclasses of juvenile idiopathic arthritis (JIA) and healthy controls in a multicenter study of patients with recent‐onset JIA prior to treatment with disease‐modifying antirheumatic drugs (DMARDs) or biologic agents.MethodsPeripheral blood mononuclear cells (PBMCs) from 59 healthy children and 136 patients with JIA (28 with enthesitis‐related arthritis [ERA], 42 with persistent oligoarthritis, 45 with rheumatoid factor [RF]–negative polyarthritis, and 21 with systemic disease) were isolated from whole blood. Poly(A) RNA was labeled using a commercial RNA amplification and labeling system (NuGEN Ovation), and gene expression profiles were obtained using commercial expression microarrays (Affymetrix HG‐U133 Plus 2.0).ResultsA total of 9,501 differentially expressed probe sets were identified among the JIA subtypes and controls (by analysis of variance; false discovery rate 5%). Specifically, 193, 1,036, 873, and 7,595 probe sets were different in PBMCs from the controls compared with those from the ERA, persistent oligoarthritis, RF‐negative polyarthritis, and systemic JIA patients, respectively. In patients with persistent oligoarthritis, RF‐negative polyarthritis, and systemic JIA subtypes, up‐regulation of genes associated with interleukin‐10 (IL‐10) signaling was prominent. A hemoglobin cluster was identified that was underexpressed in ERA patients but overexpressed in systemic JIA patients. The influence of JAK/STAT, ERK/MAPK, IL‐2, and B cell receptor signaling pathways was evident in patients with persistent oligoarthritis. In systemic JIA, up‐regulation of innate immune pathways, including IL‐6, Toll‐like receptor/IL‐1 receptor, and peroxisome proliferator–activated receptor signaling, were noted, along with down‐regulation of gene networks related to natural killer cells and T cells. Complement and coagulation pathways were up‐regulated in systemic JIA, with a subset of these genes being differentially expressed in other subtypes as well.ConclusionExpression analysis identified differentially expressed genes in PBMCs obtained early in the disease from patients with different subtypes of JIA and in healthy controls, providing evidence of immunobiologic differences between these forms of childhood arthritis.
Relationship between elevated cerebrospinal fluid levels of plasminogen activator inhibitor 1 and neuronal destruction in patients with neuropsychiatric systemic lupus erythematosus
Authors: Kwieciński Jakub , Kłak Marcin , Trysberg Estelle , Blennow Kaj , Tarkowski Andrej , Jin Tao 
Published: June 2009

AbstractObjectiveA homeostatic imbalance between coagulation and fibrinolysis might occur intrathecally in neuropsychiatric systemic lupus erythematosus (NPSLE). However, there are no published data on levels of fibrinolytic factors in the cerebrospinal fluid (CSF) of patients with NPSLE. The present study was undertaken to assess CSF levels of fibrinolytic molecules, including urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA), D‐dimer, and plasminogen activator inhibitor 1 (PAI‐1), in SLE patients with clinically verified neuropsychiatric involvement and to compare these levels with those in SLE patients without neuropsychiatric involvement and in healthy subjects.MethodsLevels of uPA, tPA, and PAI‐1 were assessed in CSF from 94 patients with SLE (33 who had NPSLE, 56 who did not have NPSLE, and 5 who were positive for antiphospholipid antibody [not included in the NPSLE or non‐NPSLE group]) and from 53 age‐matched controls. Patients were evaluated clinically, with magnetic resonance imaging of the brain, analyses of neuronal/glial degradation products in CSF, and neuropsychiatric testing.ResultsIn the group of patients with NPSLE, intrathecal PAI‐1 levels were significantly elevated compared with levels in SLE patients without overt neuropsychiatric involvement (P < 0.05) and in healthy controls (P < 0.001). In contrast, intrathecal levels of uPA did not differ significantly. Intrathecal levels of PAI‐1 correlated significantly with CSF levels of interleukin‐6 (IL‐6) (r = 0.34, P < 0.001) and IL‐8 (r = 0.33, P < 0.001). Importantly, increased PAI‐1 and D‐dimer levels were observed in SLE patients who had pathologically elevated levels of glial fibrillary acidic protein, neurofilament triplet protein, and tau protein in CSF.ConclusionIntrathecal release of PAI‐1 is increased in patients with NPSLE. This results in impaired fibrinolysis, which might contribute to neuronal and astrocytic damage in NPSLE.
Effectiveness of an early cognitive–behavioral treatment in patients with work disability due to musculoskeletal disorders
Authors: Leon Leticia , Jover Juan A. , Candelas Gloria , Lajas Cristina , Vadillo Cristina , Blanco Margarita , Loza Estibaliz , Perez Miguel Angel , Redondo Marta , Abasolo Lydia 
Published: June 2009

AbstractObjectiveTo evaluate whether an early cognitive–behavioral treatment complementary to a rheumatologic care program, for patients with recent‐onset temporary work disability caused by musculoskeletal disorders (MSDs) is effective.MethodsPatients with an MSD‐related temporary work disability episode from 3–8 weeks' duration who were in a rheumatologic care program were randomized into a control group (rheumatologic care program) or an intervention group (rheumatologic care program plus cognitive–behavioral treatment). Enrollment lasted 24 months and followup lasted 6–24 months. Efficacy variables included duration of temporary work disability episodes, total number of work days saved, relative efficacy, and relative rate to return to work. An economic evaluation was also performed.ResultsOne hundred eighty‐one patients were included (66 control and 115 intervention patients), generating 222 episodes of MSD‐related temporary work disability. Episodes tended to be shorter in the intervention group than in the control group (mean 98 versus 127 days; P = 0.053), with a relative efficacy of 22.9%. There were no differences in duration of the first episode between groups (mean 105 versus 110 days; P = 0.79), but relapse episodes were significantly shorter in the intervention group (mean 63 days versus 197 days; P = 0.0002). Costs were also lower in the intervention group. To save 1 day of temporary work disability, $13.50 had to be invested in the program. Each dollar invested generated a benefit of $4.08. The program had a net benefit of $172,607.ConclusionEarly cognitive–behavioral treatment complementary to a rheumatologic care program is cost‐effective, adds >20% efficacy to the rheumatologic care program, and reduces the duration of relapses.
Does the use of ordered values of subregional change in cartilage thickness improve the detection of disease progression in longitudinal studies of osteoarthritis?
Authors: Buck Robert J. , Wyman Bradley T. , Le Graverand Marie‐pierre hellio , Hudelmaier Martin , Wirth Wolfgang , Eckstein Felix ,   A9001140 Investigators
Published: June 2009

AbstractObjectiveTo propose a novel strategy for more efficiently measuring changes in cartilage thickness in osteoarthritis (OA) using magnetic resonance imaging, and to hypothesize that determining the magnitude of thickness change independent of the anatomic location provides improved discrimination between healthy subjects and OA participants longitudinally.MethodsA total of 148 women were imaged; 90 were Kellgren/Lawrence (K/L) grade 0, 30 were K/L grade 2, and 28 were K/L grade 3. Magnetic resonance images (3T) were acquired at baseline and at 24 months. Changes in femorotibial cartilage thickness were determined in 5 tibial and 3 femoral medial and lateral subregions, respectively (conventional approach). The new strategy provided ordered values of subregional change in each compartment, ranked according to the direction and magnitude of change.ResultsUsing the new ordered values approach, the minimal P value for the differences in 2‐year change in medial cartilage thickness of K/L grade 3 and K/L grade 0 participants was 0.001 (Wilcoxon test), with 4 ordered medial subregions differing significantly between both groups. With the conventional approach, only 1 medial subregion differed significantly between K/L grade 3 and K/L grade 0 (P = 0.037). Cartilage thickening was significantly greater in K/L grade 2 versus K/L grade 0 participants in 1 medial subregion using the conventional approach (P = 0.016), and in 2 medial subregions (minimal P = 0.007) using the ordered values approach.ConclusionThe novel ordered values approach is more sensitive in detecting cartilage thinning in K/L grade 3 and cartilage thickening in K/L grade 2 versus K/L grade 0 participants. The new method may be particularly useful in the context of other comparisons, e.g., a group treated with a disease‐modifying OA drug versus one treated with a placebo.
Sociodemographic, disease, and symptom correlates of fatigue in systemic sclerosis: Evidence from a sample of 659 Canadian Scleroderma Research Group Registry patients
Authors: Thombs Brett D. , Hudson Marie , Bassel Marielle , Taillefer Suzanne S. , Baron Murray ,   Canadian Scleroderma Research Ggroup
Published: June 2009

AbstractObjectiveTo assess fatigue levels and demographic, socioeconomic, disease, and psychosocial correlates of fatigue in patients with systemic sclerosis (SSc).MethodsWe conducted a cross‐sectional, multicenter study of 659 patients with SSc from the Canadian Scleroderma Research Group Registry. Fatigue was assessed during annual Registry visits with the Short Form 36 (SF‐36) health survey vitality subscale. Patients completed measures of depressive symptoms and pain and underwent clinical histories and medical examinations. Kendall's tau was used to assess bivariate association of sociodemographic, medical, and psychosocial variables with fatigue. Multivariable associations of demographic (step 1), socioeconomic (step 2), global disease (step 3), specific disease and lifestyle (step 4), and psychosocial (step 5) factors with fatigue were assessed using hierarchical multiple linear regression.ResultsThe mean ± SD score of the patients on the SF‐36 vitality subscale was 45.6 ± 10.8, substantially lower (indicating more fatigue) than the mean ± SD score for the Canadian general population (65.8 ± 18.0). In multivariate analysis, higher fatigue was significantly associated with the number of medical comorbidities (standardized β = −0.11, P = 0.004), breathing problems (standardized β = −0.23, P < 0.001), the number of gastrointestinal (GI) symptoms (standardized β = −0.27, P < 0.001), and current smoking (standardized β = −0.08, P = 0.018). As a group, specific symptom and lifestyle variables predicted the most incremental variance in fatigue (▵R2 = 21.6%, P < 0.001), despite being added to the model after demographic, socioeconomic, and global disease duration/severity indicators. Symptoms of depression (β = −0.42) and pain (β = −0.21) were also independently associated with fatigue (P < 0.001).ConclusionHigh levels of fatigue are common in patients with SSc and are independently associated with clinical variables, including number of comorbidities, breathing problems, GI symptoms, and smoking.