Individuals with rheumatoid arthritis (RA) are at an increased risk for lymphoma compared to the general population, with the risk increasing in proportion to cumulative exposure to systemic inflammation. Whether RA therapies, such as biologic and non-biologic DMARDs, contribute to this risk is controversial.
A strong association between chondrocalcinosis, resulting from calcium pyrophosphate dihydrate (CPPD) deposition, and knee osteoarthritis (OA) is firmly established. However, despite the association, a causative pathogenic role for CPPD crystals on the progression of articular degeneration in the knee has not been definitively demonstrated.
Although compelling, no clear-cut links between dietary factors and the risk of developing rheumatoid arthritis (RA) have been confirmed. Recent investigations have implicated increased consumption of red meat as a risk factor for incident inflammatory arthritis.
Oral vs. subcutaneous (sq) administration of methotrexate is generally considered equivalent in rheumatoid arthritis (RA) treatment. However, the enhanced bioavailability of sq methotrexate may make this route of administration preferable to the oral route in certain patients.
Safety data obtained from randomized clinical trials designed to evaluate the efficacy of rheumatoid arthritis (RA) drugs can be misleading for several reasons. Often, the studies are short term (6 months or less), and are highly selective of the subjects included (usually subjects with very active disease and with few medical comorbidities). In addition, background DMARDs are usually restricted to methotrexate.
The molecular mechanisms leading to erosive joint damage in some, but not all, patients with rheumatoid arthritis (RA) are incompletely understood. Downstream effects of inflammatory cytokines produced by rheumatoid synovium include the induction of RANKL, a powerful osteoclast activator, the action of which is physiologically opposed by its naturally occurring antagonist osteoprotegerin (OPG).
The Food and Drug Administration (FDA) has approved automated delivery systems for both Humira® (adalimumab) and Enbrel® (etanercept). The Humira Pen and Enbrel SureClickTM will be available for patient use in the first week of August 2006. In both systems, the medication is in a prefilled pen-like device and the needle is not visible to […]
Changes in disease activity during pregnancy and the peri-partum period have long been recognized features of systemic autoimmune disease. Moreover, as certain autoimmune diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), frequently affect women of childbearing age, there is the potential for the disease to affect pregnancy outcomes. However, despite the frequency […]
Hematologic malignancies, particularly lymphomas, are more prevalent in RA patients. Case reports have suggested an association between RA therapeutics and the development of lymphoma, although it has been problematic using conventional epidemiologic methods to disassociate the potential for the RA disease process, presumably mediated through chronic systemic inflammation, to contribute to this risk. These concerns have limited the use of RA therapies in some patients.
RA patients are at an increased risk for cardiovascular events and death from cardiovascular disease. In the general population, and in RA patients (Jane, link to ACR2005 abstract 1901), carotid atherosclerosis (defined by identification of a thickened intima-medial or plaque using ultrasound) is highly predictive of cardiovascular events. Despite this, previous studies have not identified a clear-cut increased risk for carotid plaque in individuals with RA compared to non-RA controls.