Although autoimmune thyroid diseases have been associated with systemic lupus erythematosus (SLE), the prevalence of thyroid disorder is controversial. To clarify the prevalence of thyroid disorder in Korean patients with SLE, thyroid functions and diseases were evaluated in 63 SLE patients. Of these patients, Hashimoto's thyroiditis (9.5%) as well as euthyroid sick syndrome (14.3%) were more common than Graves' disease (4.8%). The prevalence of antithyroid autoantibodies (antimicrosomal and/or antithyroglobulin autoantibodies) in SLE was 27.0%. High titers of these autoantibodies were mainly detected in Hashimoto's thyroiditis. These results suggested that thyroid diseases are not uncommon in SLE and autoimmune thyroid diseases are possible manifestations in some patients with SLE. Antithyroid autoantibodies may be good predictors for the detection of Hashimoto's thyroiditis developing in SLE.
Activated protein C resistance (APCR), high tissue factor (TF) expression, and hyperhomocysteinemia are associated with thromboembolic diseases. Thromboembolism is a frequent complication of systemic lupus erythematosus (SLE). In this study, we evaluated the prevalence of APCR, high TF, and homocysteine with correlation of the thrombotic tendency in SLE. Ninety-four SLE patients and 28 normal controls were included. APC ratio and TF antigen were measured using commercial kits. Plasma homocysteine level was measured using HPLC. The prevalence of APCR, high TF antigen level, and hyper-homocysteinemia in our SLE patients were 21.3%, 66.0%, and 23.4%, respectively. The median plasma level of TF antigen in SLE patients was 145.23 pg/mL (range, 31.00-778.50 pg/mL), which was significantly higher than the control value of 39.83 pg/mL (range, 1.55-168.50 pg/mL). The median APC ratio in SLE patients was 2.76 (range, 1.48-13.47), which was significantly lower than the control value of 3.59 (range, 0.26-5.66). The plasma level of homocysteine was not significantly different from that of control. A significant association was observed between the presence of APCR (OR = 8.59, P < 0.0001) but not with the presence of high plasma TF antigen level (OR = 1.24, P = 0.67) and thrombotic complications in SLE patients. In conclusion, APCR and high plasma TF levels are common in SLE, but a significant association was observed only between the presence of APCR and thrombosis in SLE patients. Am. J. Hematol. 72:103-108, 2003.
Objective: To evaluate impact of age, gender, race and BMI on NSAID efficacy in OA. Methods: Pfizer Clinical Trials Registry was searched for studies meeting the following criteria: randomized parallel-group design; Ն1 treatment group receiving celecoxib Ն200 mg daily; Ն1 placebo, NSAID, or rofecoxib comparator group; planned duration of Ն6 weeks; study completed and report finalized by October 31, 2004; 1 primary OA efficacy end point and pain visual analog scale (VAS) of 100 mm collected. In analyzing efficacy, we used the minimal clinically important difference (MCID), which proposes that patients are unable to detect a small difference in efficacy. For MCID a change of Ն10 mm on the VAS from baseline to last observation was used to define responders. Percent responders and differences in responder rates were calculated for placebo and NSAIDs combined for age, gender, BMI, and race. For each treatment, responder rates were compared statistically for categorical data (gender and race) using a test of incidence rates within each treatment category, and CMH for overall association. For continuous variables (BMI and age), inference was calculated on the slope of the regression of VAS change on predictor variables. No adjustments in the nominal alpha level were made for the multiple analyses. Results: Fifteen studies were included: 21,798 OA patients received celecoxib (61%), diclofenac (19%), naproxen (10%), ibuprofen (1%), rofecoxib (2%), or placebo (8%). The majority of patients were female (73%) and Caucasian (78%). Median (range) for age and BMI were: 63 years (18 -96) and 29 (11-149), respectively. NSAID response was influenced significantly by age (P ϭ 0.0099), BMI (P ϭ 0.0002), gender and race (P Յ 0.0001); placebo response was influenced by age (P ϭ 0.0002) and race (P Յ 0.0001). Differential response between NSAIDs and placebo was significantly influenced by all variables (P Յ 0.0001). Conclusions: Age, gender, BMI, and race are important predictors of NSAID response, while only age and race influence placebo response. Predictors of the highest benefits of pain reduction with NSAIDs versus placebo are: older age, female sex, being overweight, and Caucasian race.
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