Disease modifying anti-rheumatic drugs in people with cystic fibrosis-related arthritis

Abstract

Although it is generally recognised that cystic fibrosis-related arthritis can be episodic and resolve spontaneously, treatment with analgesics and anti-inflammatory agents may be needed. But when episodic symptoms progress to persistent disease, disease-modifying anti-rheumatic drugs may be needed to limit the course of the disease. It is disappointing that no randomised controlled trials to rigorously evaluate these drugs could be found. This systematic review has identified the need for a well-designed adequately powered randomised controlled trial to assess the efficacy and safety of disease-modifying anti-rheumatic drugs for the management of cystic fibrosis-related arthropathy and hypertrophic osteoarthropathy in adults and children with cystic fibrosis. However, given the infrequency of cystic fibrosis-related arthritis and the range of symptoms and severity, randomised controlled trials may not be feasible and well-designed non-randomised observational studies may be more appropriate. Studies should also better define the two conditions.

Osteoarticular infection by Candida albicans in an infant with cystic fibrosis

“…Differential diagnosis of osteoarticular infections includes idiopathic rheumatoid arthritis and, in CF, CF-related arthropathy, which may also present with pain, swelling, tenderness and limitation of movement of joint as well as fever (Thornton & Rangaraj, 2009). …”

Cistinės Fibrozės Artropatijos: Klinikinis Atvejis

“…Sąnarių simptomai gali būti tiesiogiai susiję su cistine fibroze, gali pasireikšti kaip gydymo vaistais komplikacija arba stebimi kaip atskira liga. Nustatyta, kad artropatijos išsivystymas sergantiesiems cistine fibroze didina mirties riziką [5].…”

“…ir 7 proc. sergančiųjų CF [5]. Artropatija gali atsirasti bet kuriame amžiuje, tačiau dažniausiai nustatoma jauno amžiaus ligoniams antrajame gyvenimo dešim-tmetyje [6].…”

Ultrasound and magnetic resonance imaging assessment of joint disease in symptomatic patients with cystic fibrosis arthropathy

“…Despite CFA becoming an increasing cause of morbidity in an ageing population, there is little data available about the spectrum of disease, underlying mechanism of the disease process, imaging and effectiveness of treatment (6)(7)(8)(9).…”