1,721,055 research outputs found
The fate of the patient with musculoskeletal disorders in Italy: an epidemiological insight
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Best practice & research clinical rheumatology. Imaging and musculoskeletal conditions. Preface
No full textPotency on lowering serum uric acid in gout patients: a pooled analysis of registrative studies comparing febuxostat vs. allopurinol.
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Dissecting the inflammatory response in polymyalgia rheumatica: the relative role of IL-6 and its inhibition
No full textThe efficacy of tocilizumab (TCZ), a monoclonal antibody to the interleukin (IL)-6 receptor, in suppressing disease activity in glucocorticoid-naïve patients with new-onset polymyalgia rheumatica (PMR) was studied. Its effect on a panel of cytokines and growth factors was evaluated. Three patients, fulfilling the PMR ACR/EULAR criteria, received TCZ at the dosage of 8 mg/kg every 4 weeks for three times followed by prednisone 0.2 mg/kg in case of inefficacy. Concentrations of IL-10, IL-6, tumour necrosis factor (TNF)-α, IL-1β, IL-10, IL-17, interferon (IFN)-γ, vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and leukaemia inhibitory factor (LIF) were measured at baseline, after 72 h of the first TCZ infusion and then at weeks 1, 4, 5, 8, 9, 12, 13, 14, 16, and 22. A slight clinical improvement was seen only after the first TCZ infusion, but was largely inferior to that of conventional doses of GC administered subsequently. An ischaemic visual accident suggestive of GCA occurred in one patient during TCZ treatment. IL-6 was increased at baseline compared to controls, further increased after the first TCZ infusion, and was suppressed by GC. IL-17 production decreased during TCZ treatment and reverted to pre-treatment levels after GC. VEGF e PDGF showed a less constant pattern, but an increase of VEGF concentration antedated visual symptoms. The other cytokines were not detectable in patients and controls. In our small sample, TCZ was not able to suppress inflammation at the same degree as GC. As a result, monotherapy with TCZ in PMR cannot be recommended, although its efficacy as adjunctive treatment in GC-resistant patients should be further evaluate
Disease activity assessment of rheumatoid arthritis in daily practice: validity, internal consistency, reliability and congruency of the Disease Activity Score including 28 joints (DAS28) compared with the Clinical Disease Activity Index (CDAI)
No full textDAS28 and CDAI are valid and simple acceptable ways to measure RA
activity in the clinical practice, but disease activity categorized by these
indices differ considerabl
Glucocorticoid treatment of polymyalgia rheumatica
No full textGlucocorticoids are the mainstay of treatment in patients with polymyalgia rheumatica (PMR). Moreover, lower serum cortisol levels have been reported in patients with PMR, suggesting an important role of impaired hypothalamus-pituitary-adrenal (HPA) axis in the pathogenesis of the disease. Therefore, a good response to glucocorticoids has been recognised as a feature of PMR, even if disagreement remains concerning an exact starting dose, duration of treatment and schedule of administration. The role of glucocorticoids in the pathogenesis of PMR, as well as the available evidence concerning different schedules of glucocorticoid treatment, including administration according to circadian rhythms, are discussed
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