Speciality
Spotlight

       




 


Medicine


   

 




Rheumatoid
Arthritis

  

  • ME
    Weinblatt, JM Kremer, et al (Brigham and Women’s
    Hosp, Boston; Albany Med College, NY; Univ of New
    Mexico, Albuquerque; et al)

    A
    Trial of Etanercept, a Recombinant Tumor Necrosis
    Factor Receptor:Fc Fusion Protein, in Patients With
    Rheumatoid Arthritis Receiving Methotrexate.

    N
    Engl J Med 340: 253-259, 1999

     

    A Recombinant human tumor necrosis factor (TNF)
    given along with methotrexate produces excellent
    response in rheumatoid arthritis giving significant
    and sustained benefit.

         

  • DT
    Felson, LaVelley, et al (Boston Univ; St Louis Univ;
    Rush-Presbyterian-St Luke’s Med Ctr, Chicago; et al
    )

    The
    Prosorba Column for Treatment of Refractory
    Rheumatoid Arthritis: 
    A Randomized, Double-blind, Sham-controlled
    Trial.

    Arthritis
    Rheum 42: 2153-2159, 1999.

      

    In
    patients with rheumatoid arthritis resistant to all
    other treatments and which is severe and rapidly
    progressive, Prosorba column has proved effective.

      

    Prosorba
    column is a device containing highly purified
    staphylococcal protein in a silica matrix. It combines with IgG and IgM, rheumatoid factor and allows these
    complexes to be removed.

       

  • JR
    O’Dell, G Paulsen, et al (Univ of Nebraska, Omaha;
    Platte Valley Med Group, Kearney, Neb; Omaha, Neb;
    et al)

    Treatment
    of Early Seropositive Rheumatoid Arthritis with
    Minocycline: Four Year Followup of a Double-blind,
    Placebo-controlled Trial.

    Arthritis
    Rheum  2:
    1691-1695, 1999.

     

    In
    early patients with rheumatoid arthritis, treatment
    with minocycline increases the periods of remission.

       

  • X
    Puechal, J-N Fiessinger, et al (Hopital Broussais,
    Paris)

    Rheumatic Manifestations in
    Patients with Thromboangiitis Obliterans (Buerger’s
    Disease)

    J
    Rheumatol 26:1764-1768, 1999.

     

    Thromboangiitis 
    obliterans (TAO) should be considered in the
    differential diagnosis of all smokers with
    rheumatic symptoms. 
    Sometimes rheumatic symptoms may predate the
    vascular change by more than a decade.

         

  • JD
    O’Duffy, WL Griffing, et al (Mayo Clinic, Rochester,
    Minn)

    Arthritis
    Rheum  42:
    812-817, 1999.

        

    Whipple’s
    disease or Whipple’s arthritis is a due to infection
    with Tropheryma
    whippeli. The
    common clinical diagnosis typical in a middle age
    man is because of malabsorption syndrome, chronic
    diarrhoea and weight loss.
    There is lymphadenopathy, fever of unknown
    origin, dementia, uveitis, anemia, hyperpigmentation,
    ascites and arthritis.
    Diagnosis is by a PCR test.

        

  • F C Breedveld

    Commentary – Is There a Place for Leflunomide in the Treatment of Rheumatoid Arthritis? 

    The Lancet October 13, 2001, Vol.358 (9289) Pg. 1198-1200

         


    The manufacturer of leflunomide was alerting prescribers to changes in the summary of product characteristics and package leaflet made because of reports of 15 cases of severe liver injury (including hepatitis and a few cases of acute hepatic necrosis), some of which were fatal.

         


    Randomised clinical trials of leflunomide for the treatment of rheumatoid arthritis showed that it was superior to placebo and similar to sulphasalazine or methotrexate in most measures.

        


    The frequency of side-effects leading to the discontinuation of leflunomide was similar to that for the control drugs in the trials. Diarrhoea, reversible alopecia, allergic reactions, and increased serum concentrations of hepatic enzymes are known side-effects, and special care should be taken in patients who drink alcohol or have a history of liver disease.

         

 



 

           

Speciality Spotlight

       

 
Medicine
   

 

Rheumatoid Arthritis
  

  • ME Weinblatt, JM Kremer, et al (Brigham and Women’s Hosp, Boston; Albany Med College, NY; Univ of New Mexico, Albuquerque; et al)
    A Trial of Etanercept, a Recombinant Tumor Necrosis Factor Receptor:Fc Fusion Protein, in Patients With Rheumatoid Arthritis Receiving Methotrexate.
    N Engl J Med 340: 253-259, 1999
     
    A Recombinant human tumor necrosis factor (TNF) given along with methotrexate produces excellent response in rheumatoid arthritis giving significant and sustained benefit.
         

  • DT Felson, LaVelley, et al (Boston Univ; St Louis Univ; Rush-Presbyterian-St Luke’s Med Ctr, Chicago; et al )
    The Prosorba Column for Treatment of Refractory Rheumatoid Arthritis:  A Randomized, Double-blind, Sham-controlled Trial.
    Arthritis Rheum 42: 2153-2159, 1999.
      
    In patients with rheumatoid arthritis resistant to all other treatments and which is severe and rapidly progressive, Prosorba column has proved effective.
      
    Prosorba column is a device containing highly purified staphylococcal protein in a silica matrix. It combines with IgG and IgM, rheumatoid factor and allows these complexes to be removed.
       

  • JR O’Dell, G Paulsen, et al (Univ of Nebraska, Omaha; Platte Valley Med Group, Kearney, Neb; Omaha, Neb; et al)
    Treatment of Early Seropositive Rheumatoid Arthritis with Minocycline: Four Year Followup of a Double-blind, Placebo-controlled Trial.
    Arthritis Rheum  2: 1691-1695, 1999.
     
    In early patients with rheumatoid arthritis, treatment with minocycline increases the periods of remission.
       

  • X Puechal, J-N Fiessinger, et al (Hopital Broussais, Paris)
    Rheumatic Manifestations in Patients with Thromboangiitis Obliterans (Buerger’s Disease)
    J Rheumatol 26:1764-1768, 1999.
     
    Thromboangiitis  obliterans (TAO) should be considered in the differential diagnosis of all smokers with rheumatic symptoms.  Sometimes rheumatic symptoms may predate the vascular change by more than a decade.
         

  • JD O’Duffy, WL Griffing, et al (Mayo Clinic, Rochester, Minn)
    Arthritis Rheum  42: 812-817, 1999.
        
    Whipple’s disease or Whipple’s arthritis is a due to infection with Tropheryma whippeli. The common clinical diagnosis typical in a middle age man is because of malabsorption syndrome, chronic diarrhoea and weight loss. There is lymphadenopathy, fever of unknown origin, dementia, uveitis, anemia, hyperpigmentation, ascites and arthritis. Diagnosis is by a PCR test.
        

  • F C Breedveld
    Commentary – Is There a Place for Leflunomide in the Treatment of Rheumatoid Arthritis? 
    The Lancet October 13, 2001, Vol.358 (9289) Pg. 1198-1200
         
    The manufacturer of leflunomide was alerting prescribers to changes in the summary of product characteristics and package leaflet made because of reports of 15 cases of severe liver injury (including hepatitis and a few cases of acute hepatic necrosis), some of which were fatal.
         
    Randomised clinical trials of leflunomide for the treatment of rheumatoid arthritis showed that it was superior to placebo and similar to sulphasalazine or methotrexate in most measures.
        
    The frequency of side-effects leading to the discontinuation of leflunomide was similar to that for the control drugs in the trials. Diarrhoea, reversible alopecia, allergic reactions, and increased serum concentrations of hepatic enzymes are known side-effects, and special care should be taken in patients who drink alcohol or have a history of liver disease.
         

 

 

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