Serum amylase activity was found to be an independent predictor of mortality in ESRD patients. Relatively low serum pancreatic enzyme levels in CKD may be regarded as a novel component of the malnutrition-inflammation-atherosclerosis syndrome.
Background Early arthritis (EA) is one of the difficult patient groups with the right timing of disease modifying anti-rheumatismal drugs (DMARDs). Objectives To assess long term outcome, drug free remission rates of patients with EA and classification based on 1987 ACR (1) or 2010 ACR/EULAR (2) rheumatoid arthritis (RA) criteria. Methods Patients with arthritis with symptom duration of at least 3 months were assessed. Unclassified arthritis (UA) or patients classified as RA were included. Steroids were given if NSAİDs failed to induce remission. Patients were interviewed with telephone and those accepted were admitted to the outpatient clinic. Patients were telephoned for 3 times if first 2 call was missed. Among 135 EA patients, 82 were interviewed; only one did not want to participate. 36 (27%) were admitted to outpatient clinic. Results Demographic features were as follows: 57 (71%) were woman, mean age was 50 (19-82) (baseline). Mean swollen and joint count was 5 (1-22) and 8 (1-36) respectively. Most frequently affected joints were MCP (54%), wrist (48%), and PIP (31%). Laboratory findings were as follows: RF positivity 22%, anti-CCP 25%. Mean age of disease at the last assessment was 4 years (6 months- 8 years). Patients were classified as RA according to 1987 ACR (6,7%) and 2010 ACR/EULAR (18, 22%) criteria. Steroids were given 75%. Mean steroid dosage was 10 mg (5-40) to induce remission. Drug free remission was induced with NSAIDs and steroids in 14 (17%) and 16 (20%) patients respectively. DMARDS were given in 51 (62%) patient (39 (48%) hdroxycloroquine, 37 (45%) methotrexate, 14 (17)% sulfasalazine, 10 (12) leflunomide). Twelve of the patients voiced that although they were given DMARD, they stopped to take DMARDs and they were symptom free for approximately 3 years. Conclusions Patients with the diagnosis of unclassified arthritis and RA were assessed. Drug free remission was achieved in approximately 40% of the patients. These patients were still symptom free after about three years. More than half of the patients were given DMARD although only 20% of the patients fulfilled either 1987 or 2010 criteria. There are contradictory results about the benefit of MTX in probable RA in disease progression (3, 4). Along with these results, we are still in the need of criteria that would indicate the early arthritis patients to start with DMARDs. References Arnet FC, Edworhy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31:315-24. Aletaha D. Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: An American College of Rheumatology European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010:69;1580-8. van Akemans L, Gillet-van Dongen H, et al. Five-year outcomes of probable rheumatoid arthritis treated with methotrexate or placebo during the first year (PROMPT study). Ann Rheum Dis 2014:73:396-400. van Dongen H, van Aken j, Lard LR, et al. Efficacy of m...
BackgroundReal life experience of early arthritis; remission or evolving to rheumatoid arthritisObjectivesTo assess long term outcome, drug free remission rates of patients with early arthritis and classification based on 1987 ACR1 or 2010 ACR/EULAR2 rheumatoid arthritis (RA) criteria.MethodsPatients with arthritis with symptom duration within the first 3 months at first visit were assessed after disease age of at least 6 months. Patients with unclassified arthritis (UA) and classified as RA were included. Patients using drugs other than non-steroidal anti-inflammatory drugs (NSAID) at first visit were excluded. Glucocorticoids were given if NSAIDs failed to induce remission. Patients were interviewed with telephone and those accepted were admitted to the outpatient clinic. Patients were telephoned for 3 times if first 2 call were missed. There were 135 patients. Among 92 patients interviewed only one refused to participate. 37 (27%) were admitted to outpatient clinics, 54 (40%) were interviewed with telephone. Patients were classified as RA according to either 1987 ACR or 2010 ACR/EULAR criteria.ResultsDemographic features were as follows: 66 (73%) were woman, mean age was 50 (19–85) (first admission). Mean swollen and tender joint count was 5 (1–22) and 8 (1–36) respectively. Most frequently affected joints were MCP (50%), wrist (48%), and PIP (32%). Morning stiffness was longer than 30 minutes in 67%. RF and anti-CCP were positive 20%, 17%, respectively. Mean age of disease at the last assessment was 4 years (6 months- 8 years). Patients were classified as RA according to 1987 ACR (8%) and 2010 ACR/EULAR (20%) criteria. Glucocorticoids were given 75%. Mean glucocorticoid dosage was 10 mg (5–50) and 8% patients were given 50 mg equivalent of prednisolon for 3 days in order to induce remission. Drug free remission was induced with NSAIDs and glucocorticoids in 18% and 20% patients respectively. DMARDS were given in 44 (48%) patients (HQ, 45%; MTX, 44%; SSZ 17%; LEF 11%; only 1 patient TNF inhibitors). 13 patients (14%) voiced that although they were given DMARD, they stopped to take DMARDs and they were symptom free for approximately 3 years.ConclusionsEarly arthritis patients with the diagnosis of unclassified arthritis or RA were assessed. Drug free remission was achieved in approximately 40% of the patients. These patients were still symptom free after about four years. Nearly half of the patients were given DMARD although only 20% of the patients fulfilled either 1987 or 2010 criteria. About 10% of the patients stopped taking DMARDs although given and they were symptom free. There are contradictory results about efficacy of MTX in probable RA and UA in disease progression. Along with these results, we are still in the need of criteria that would indicate the early arthritis patients to start with DMARDs so that we would neither be late nor avoid any unnecessary prescription.ReferencesArnet FC, Edworhy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheu...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.