Flares in Rheumatoid Arthritis Patients with Low Disease Activity: Predictability and Association with Worse Clinical Outcomes

Bechman, Katie; Tweehuysen, Lieke; Garrood, Toby; Scott, David; Cope, Andrew P.; Galloway, James; Ma, Margaret

doi:10.3899/jrheum.171375

Cited by 46 publications

(46 citation statements)

References 34 publications

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“…In a study to investigate predictors of flare in patients with RA who had LDA and to evaluate the effect of flare on 12-month clinical outcomes, it was found that at time of flare, although DAS28 and its components significantly correlated with MBDA, the correlation coefficients were low, and two-thirds of flares were not associated with a rise in biomarkers 10 .…”

mentioning

confidence: 99%

Value of the Multibiomarker Disease Activity Score to Predict Remission in RA: What Does the Evidence Show?

Fleischmann

2019

J Rheumatol

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confidence: 99%

Value of the Multibiomarker Disease Activity Score to Predict Remission in RA: What Does the Evidence Show?

Fleischmann

2019

J Rheumatol

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“…At each visit, a patient's disease activity was scored following the disease activity (DAS28) score, with 0 indicating no symptoms and 10 representing the greatest disease burden [7]. Besides, CDAI (clinical disease activity index), and SDAI (simplified disease activity index) were applied to RA cohort.…”

Section: Resultsmentioning

confidence: 99%

“…It has been reported that failure on methotrexate (MTX) and on a following disease modifying anti-rheumatic drugs (DMARD)/biologics treatment leads to an increased flare rate [6]. According to 2018 report, flares are common on a 12-month treatment span for the RA patients with low disease activity, which is not dependent on their biomarker status [7]. Importantly, patients who flared had significantly worse outcomes after a 12-month long treatment [7].…”

Section: Introductionmentioning

confidence: 99%

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Antibodies to synthetic citrullinated peptide epitope correlate with disease activity and flares in rheumatoid arthritis

2020

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Rheumatoid arthritis (RA), caused by the abnormal recognition of human joint cells by autoimmune antibodies, remains the world's most prevalent autoimmune disease, with over five million people affected and as much as 4% of the population at risk of RA. To prevent rapid disease development, hormonal and anti-inflammatory therapies require fast and reliable RA diagnosis. However, difficulty in detecting early specific biomarkers for RA means that it is unclear when treatment needs to begin. Here, we combined synthesis of citrullinated peptide epitopes with molecular diagnostics to verify a new specific biomarker for early RA diagnosis and flare prediction. A fibrinogen-derived 21-amino-acid-long citrullinated peptide showed high reactivity toward autoantibodies in RA samples. Additionally, the level of antibodies to this epitope was elevated prior to flares. In contrast, other citrullinated protein variants had lower reactivity and poorer sensitivity to disease activity. In conclusion, fibrinogenderived epitope E2 subjected to citrullination facilitated a reliable RA diagnosis with a strong correlation to disease activity. This is of a high value for the diagnosis and management of RA patients who respond poorly to treatment.

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“…TNF-α overexpression leads to excessive production of many cytokines, such as IL-6 [29,30] . TNF-α and IL-6 are also the two key in ammatory cytokines media in the process of RA sustainable development [31] .…”

Section: Discussionmentioning

confidence: 99%

Anti-inflammatory Activity of Formononetin in a Collagen-induced Arthritis Mouse Model ofRheumatoid Arthritis

Zhao

Wen-xue

et al. 2020

Preprint

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Background: Rheumatoid arthritis (RA) is a common autoimmune disease characterized by chronic inflammation of the joints, leading to bone erosion and joint dysfunction. Although there are options for the treatment of RA, safer and more effective drugs are still being sought. Formononetin (FMN) is an isoflavonoid compound found in various plants, such as Astragalus propinquus Schischkin and Spatholobus suberectus. It has anti-tumor, anti-bacterial, anti-lipid peroxidation, and estrogen-like activities，and is a noteworthy compound for screening of anti-RA drugs. Methods: To investigate the anti-inflammatory effects of FMN in a collagen-induced arthritis (CIA) mouse model, thirty-six C57BL/6 mice were randomly divided into 6 groups: a healthy control group and 5 CIA groups. Arthritis was induced the CIA groups using chicken collagen type II. The CIA groups were divided in a control group (RA), a tripterygium glycosides (10 mg/kg body weight) treated group (TG), a low-dose (50 mg/kg) FMN group (FMN-L), a middle-dose(100mg/kg) FMN group (FMN-M), and a high-dose (200 mg/kg) FMN group (FMN-H). The control mice and CIA mice in the RA group were treated with an equal volume of 5% carboxymethylcellulose sodium. Drugs were delivered three times a week for four weeks, and the bodyweight, food-uptake, and swelling of the paws were monitored during the treatment process. Inflammatory cytokines and other biochemical indexes in the serum and joint tissues were analyzed, along with the expression levels of NF-κB pathway-related proteins (IκBα, p65, p-p65, TIPE2, and PCNP) in the spleen. Histopathological examinations were processed for the hind limbs. Results: FMN-M dramatically reduced the arthritis index in the CIA mice, inhibited the inflammatory cell infiltration, and prevented damage to the synovium and cartilage. Mechanistic studies suggested that FMN might reduce inflammation by inhibiting IκB-α degradation and by regulating the expression and release of NF-κB p65. Conclusions: These data suggest that FMN might be an active therapeutic agent for RA by preventing bone destruction, regulating inﬂammatory mediators, and suppressing NF-κB signaling pathways.

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Flares in Rheumatoid Arthritis Patients with Low Disease Activity: Predictability and Association with Worse Clinical Outcomes

Cited by 46 publications

References 34 publications

Value of the Multibiomarker Disease Activity Score to Predict Remission in RA: What Does the Evidence Show?

Value of the Multibiomarker Disease Activity Score to Predict Remission in RA: What Does the Evidence Show?

Antibodies to synthetic citrullinated peptide epitope correlate with disease activity and flares in rheumatoid arthritis

Anti-inflammatory Activity of Formononetin in a Collagen-induced Arthritis Mouse Model ofRheumatoid Arthritis

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