Background. Cardiovascular risk assessment in patients with rheumatoid arthritis (RA) is often a real challenge and requires the search for new indicators to reveal the potential threat of developing atherosclerotic vascular lesions in the early stages. The study aimed to analyse the association between von Willebrand factor (vWF), disease activity, and intima-media thickness (IMT) score in RA patients. Materials and Methods. The study involved 60 RA patients divided into three groups based on the Disease Activity Score 28 (DAS-28) activity index and 20 individuals as healthy controls. Clinical and laboratory assessments included determining the number of swollen (SJ) and painful joints (PJ), the visual analogue scale (VAS) score, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fibrinogen. The concentration of vWF in blood plasma was determined by an enzyme-linked immunosorbent assay (ELISA). The IMT was measured at the bifurcation of the external and internal carotid arteries. Asymptomatic vascular damage was identified as the IMT > 0.9 mm; an atherosclerotic plaque was verified when a focal structure encroached ≥ 0.5 mm or 50% of the adjacent IMT value into the carotid lumen or the IMT > 1.5 mm. Results. Most RA patients (39/60; 65.0%) showed an increase in the IMT (> 0.9 mm); atherosclerotic plaques (IMT > 1.5 mm) were confirmed in 16 (26.7%) individuals, which was significantly more as compared to the control group. VWF was positively associated with the IMT [OR 1.1 (1.06-1.2), p < 0.001]. In addition, elevated levels of vWF were associated with disease activity. The highest values of vWF were found in patients with moderate RA activity (43.3 [21.2-56.9]). There was a positive correlation between vWF and ESR, CRP, DAS-28 (0.564, 0.455, and 0.573, respectively). Conclusions. There was a positive correlation between vWF, inflammatory markers, and disease activity. VWF appeared to be a reliable predictor of the IMT score in RA patients.
Background:The Coronavirus disease 2019 (COVID-19) outbreak spread rapidly among the whole world, becoming the greatest pandemic for the decades. It triggered the enormous challenges for the global health system, forcing doctors and patients to adapt to new realities and the field of rheumatology was not an exclusion.Objectives:The aim of this study was to analyze articles covering interconnection between COVID-19 and rheumatic diseases; to investigate the common features of papers in this category and indicate the most influential among them; to determine which rheumatic nosologies were most represented.Methods:For retrieving of literature data, we applied the bibliometric database Scopus and conducted our search on 12th of January using following keywords: “rheumatoid arthritis” OR “systemic lupus erythematosus” OR “systemic sclerosis” OR “vasculitis” OR “myositis” OR “rheumatology” AND “COVID-19”. All selected articles were analyzed according to various aspects: type of document, authorship, journal, citations score, rheumatology field, country of origin, language, and keywords. We have built the visualizing keywords network (Figure 1) with the help of software tool VOSviewer version 1.6.15 (the minimum keyword occurrence threshold was set at 5).Figure 1.Results:A total of 844 literature items were obtained. After screening of title, abstract and keywords we excluded 106 records as they were not emphasized the rheumatological perspective on COVID-19 and as a result were inapplicable for this study. The 738 retrieved articles were mostly (86.8%) open access publications. The top five journals that contributed most to the coverage of this topic were: Annals Of The Rheumatic Diseases (n=59), Clinical Rheumatology (n=41), Lancet Rheumatology (n=24), Arthritis And Rheumatology (n=20) and Rheumatology International (n=19). The origin of most studies was not surprisingly from those countries, which belong to the top ten according to the total cases of COVID-19 [1] (USA – 167; Italy – 148; UK – 76; India – 60 and Spain – 58). Most items were written in English but articles in German (n=12), Spanish (n=11), Russian (n=5) and Chinese (n=2) could also be found. Analyzed studies were designed in the form of Original Articles (41.2%), Reviews (23.7%), Letters (21.8), Notes (6.9%), Editorials (5.1%). According to the citations scores, articles of highest interest were dedicated to clinical course of COVID-19 in patients with autoimmune pathologies. The other highly cited studies were about cytokine storm and perspective usage of biological drugs for severe cases of COVID-19. Our analysis of keywords showed that the most widely discussed rheumatic disease in the view of COVID-19 was systemic lupus erythematosus (n=188), followed by vasculitis (n=132), rheumatoid arthritis (n=90), systemic sclerosis (n=32) and psoriatic arthritis (24). The liveliest discussion about disease-modifying antirheumatic drugs in COVID-19 revolved around hydroxychloroquine (n=305), corticosteroids (n=161), tocilizumab (n=83), methotrexate (n=46) and anakinra (n=34).Conclusion:As far as we know, it is the first bibliometric overview of studies dedicated to interrelation between COVID-19 and rheumatic pathology. The high number of open access items contributes to the increase of research visibility in this emergently developing research field and facilitates the process of scientific data sharing. The conducting of bibliographic studies may provide a valuable guide through this area of knowledge.References:[1]https://www.worldometers.info/coronavirus/ Accessed on January 12, 2021Disclosure of Interests:None declared.
BackgroundRheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by inflammatory changes in the synovial membranes of the joints, leading to their progressive damage and deformity. Inflammation occupies a prominent place in the pathogenesis of RA making it an essential target to improve the patient’s condition.ObjectivesThe purpose of this study was to evaluate the influence of lipid-lowering therapy on RA patients given its anti-inflammatory effect.MethodsWe involved 80 patients with established RA diagnosis based on 2010 ACR/EULAR Classification Criteria. The inclusion criteria for our study were the age of patients ≥18 years and the DAS28 index > 2,6. We have excluded from investigation individuals with any prior medical history of myopathies, liver diseases or increased transaminase levels, pregnant or breastfeeding women and patients taking lipid-lowering drugs. The accepted patients were randomized into 2 groups numbering 40 individuals each. The first group of subjects received just basic DMARDs and the second had atorvastatin 40 mg/day in addition. The atorvastatin admission lasted 3 months. To evaluate the possible anti-inflammatory effect of atorvastatin the ESR, CRP, Visual Analogue Scale (VAS), swollen joint count (SJC), tender joint count (TJC) and Disease Activity Score (DAS-28) were used. Moreover, the lipid panel indexes in both groups of patients were assessed. We used the Kolmogorov-Smirnov test for data distribution evaluation. Mann-Whitney U test and unpaired t test were employed for groups comparison, p-value <0.05 was considered as statistically significant.ResultsWe found that the administration of atovastatin had a positive effect on pro-inflammatory parameters of patients. In the atorvastatin group the levels of ESR (mm/h) and CRP (mg/L) were significantly lower in comparison with the controls (25.38±9.43 vs 31.85±10.54, p=0.02 and 12.26 [8.21-17.54] vs 15.89 [11.32-21.54], p=0.04 respectively). SJC (p<0.01) and TJC (p<0.05) and DAS-28 (p<0.05) indexes have been improved more significantly in the investigation group as well. The results of lipid panel assessment were better in the atorvastatin group as well. The LDL (mg/dl) level differed between the two groups the most significantly (143.7±23.2 in the control group and 109.8±21.4 in the atorvastatin group, p=0.02).ConclusionWith this study, we managed to demonstrate the beneficial effect of atorvastatin not only on the lipid profile but also on an inflammatory level and disease course in patients with RA.Disclosure of InterestsNone declared
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