Key Points The Johns Hopkins Arthritis Center conducted a study to determine the presence of gum disease in patients who have Rheumatoid Arthritis (RA). Oral health exams were performed on patients who have RA and healthy volunteers for comparison. Data was collected from 100 RA patients and 40 healthy volunteers. 70% of the RA patients […]
Vaccinations are a critical component of RA clinical management, and their importance in preventing infection cannot be stressed enough. The majority of patients with RA are on immunosuppressive treatment, and a data driven approach to vaccinations in this high-risk population is essential.
On January 8, 2010, the U.S. Food and Drug Administration approved tocilizumab (to be marketed under the trade name of Actemra) for the treatment of patients with moderate to severe rheumatoid arthritis who have had inadequate clinical responses to treatment with TNF inhibitors. Tocilizumab is a humanized monoclonal antibody directed against the receptor for IL-6, […]
Initial combination therapy has been shown to be superior to step-up combination therapy in groups of RA patients; however, these findings are difficult to reconcile with the observation that many RA patients will have complete remission of disease on methotrexate alone. Practice patterns tend to emphasize initial treatment with methotrexate monotherapy, followed by the addition of other agents in combination for those with inadequate responses.
Approval for golimumab (which will by marketed under the trade name Simponi) was granted this week by the U.S. Food and Drug Administration. The drug received approval for the treatment of moderate to severe RA (in conjunction with methotrexate), active psoriatic arthritis (as monotherapy or with methotrexate), and active ankylosing spondylitis at a dose of […]
Cases of new onset psoriasis in patients receiving TNF inhibitors for the treatment of rheumatoid arthritis (RA) have been reported; however, case reports do not permit the calculation of drug-associated incidence rates. Here, Harrison et al (Ann Rheum Dis 2009; 68: 209) compare incident psoriasis in TNF inhibitor treated vs. untreated patients enrolled in the […]
RA patients who use methotrexate have been shown to have lower cardiovascular mortality compared to non-users; however, the mechanism underlying this protection is unclear. Here, Reiss et al (Arthritis Rheum 2008; 58(12): 3675) explore the atheroprotective effects of methotrexate in an experimental model of atherogenesis. Methods THP-1 monocytes/macrophages and human donor peripheral blood mononuclear cells […]
Type II collagen is abundant in the joint and is a major target of immune-mediated damage in RA. As suggested in studies of experimental animals, induction of immune tolerance at the level of the cartilage may be a way of reducing the signs and symptoms of RA and prevent joint destruction. However, whether oral administration of Type II collagen is an efficacious treatment for humans with established active RA has not been established.
Bone erosions in response to inflammation in RA are driven by osteoclasts which are in turn activated by RANKL (Receptor Activator for Nuclear Factor κ B Ligand) binding to its receptor RANK. Inhibition of RANKL has the potential to retard bone erosions in RA patients, thereby limiting progressive joint damage and destruction.
Estrogens are known to modify immunologic responses and the modulation of rheumatoid arthritis (RA) disease activity during pregnancy is well documented. However, whether physiologic replacement of estrogen and other hormones after menopause adversely affects RA outcomes is controversial.