Collin W Blackburn, Jerry Y Du, Randall E Marcus
BACKGROUND: Under Medicare's fee-for-service and bundled payment models, the basic unit of hospital payment for inpatient hospitalizations is determined by the Medicare Severity Diagnosis Related Group (MS-DRG) coding system. Primary total joint arthroplasties (hip and knee) are coded under MS-DRG code 469 for hospitalizations with a major complication or comorbidity and MS-DRG code 470 for those without a major complication or comorbidity. However, these codes do not account for the indication for surgery, which may influence the cost of care...
November 27, 2023: Clinical Orthopaedics and related Research
Meng Hsuan Kuo, Chih-Wei Tseng, Ping-Hung Ko, Sz-Tsan Wang, Ming-Chi Lu, Chien-Hsueh Tung, Kuo-Chih Tseng, Kuang-Yung Huang, Chi-Hui Lee, Ning-Sheng Lai
BACKGROUND: Rheumatoid arthritis (RA) patients seropositive for hepatitis B core antibody (HBcAb) and negative for hepatitis B surface antigen (HBsAg) are at risk of hepatitis B virus (HBV) reactivation when treated with biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs). The study aims to investigate the risk in this population. METHODS: From January 2004 through December 2020, 1068 RA patients undergoing b/tsDMARDs therapy and 416 patients with HBsAg-/HBcAb+ were enrolled...
November 27, 2023: Liver International: Official Journal of the International Association for the Study of the Liver
Flory T Muanda, Peter G Blake, Matthew A Weir, Fatemeh Ahmadi, Eric McArthur, Jessica M Sontrop, Brad L Urquhart, Richard B Kim, Amit X Garg
IMPORTANCE: Low-dose methotrexate is used to treat rheumatoid arthritis and psoriasis. Due to its kidney elimination, better evidence is needed to inform its safety in adults with chronic kidney disease (CKD). OBJECTIVES: To compare the 90-day risk of serious adverse events among adults with CKD who started low-dose methotrexate vs those who started hydroxychloroquine and to compare the risk of serious adverse events among adults with CKD starting 2 distinct doses of methotrexate vs those starting hydroxychloroquine...
November 1, 2023: JAMA Network Open
Ryan M Hum, Seema D Sharma, Michael Stadler, Sebastien Viatte, Pauline Ho, Nisha Nair, Chenfu Shi, Chuan Fu Yap, Mehreen Soomro, Darren Plant, Jenny H Humphreys, Alexander MacGregor, Max Yates, Suzanne Verstappen, Anne Barton, John Bowes
OBJECTIVES: There is growing evidence that genetic data is of benefit in the rheumatology outpatient setting by aiding early diagnosis. A genetic probability tool (G-PROB) has been developed to aid diagnosis has not yet been tested in a real-world setting. Our aim was to assess whether G-PROB could aid diagnosis in the rheumatology outpatient setting using data from the Norfolk Arthritis Register (NOAR), a prospective observational cohort of patients presenting with early inflammatory arthritis...
November 27, 2023: Arthritis & Rheumatology
Claire T Deakin, Geoffrey O Littlejohn, Hedley Griffiths, Sabina Ciciriello, Catherine O'Sullivan, Tegan Smith, Peter Youssef, Paul Bird
BACKGROUND AND AIMS: This study aimed to assess the comparative effectiveness of the etanercept (ETN) originator (Enbrel) and ETN biosimilar SB4 (Brenzys) as first-line treatment in patients with rheumatoid arthritis (RA), while also exploring the potential cost-savings associated with this approach in Australia. METHODS: Clinical data were obtained from the Optimising Patient outcomes in rheumatoLogy Australian real-world data set. Adult patients with RA who had initiated treatment with the ETN originator or biosimilar as their first-recorded biologic or targeted synthetic disease-modifying antirheumatic drug between 1 April 2017 and 31 December 2020 were included...
November 27, 2023: Internal Medicine Journal
Yoshinori Taniguchi, Hirotaka Yamamoto
No abstract text is available yet for this article.
November 27, 2023: International Journal of Rheumatic Diseases
Zhang Jingzhou, Zhou Xiong, Kong Qing Xin
Rheumatoid arthritis is systemic inflammatory disease, presenting as symmetrical polyarthritis, mainly affecting hands and feet. Female patients with rheumatoid arthritis have also decreased fertility and premature ovarian failure. Methotrexate is used in treatment of rheumatoid arthritis. However, single treatment of Methotrexate is not ideal and often needs to be combined with other drugs like Iguratimod for intensive treatment of refractory rheumatoid arthritis. We aim to explore efficacy of combined use of MTX and IGU for female patients with rheumatoid arthritis and its impact on ovarian reserve function...
September 2023: Pakistan Journal of Pharmaceutical Sciences
Jin-Mei You, Yao-Chen Zhang, Ke-Yi Fan, Shang-Kai Bai, Zi-Yu Zhang, He-Yi Zhang, Ting Cheng, Yue-Hong Huo, Cai-Hong Wang, Xiao-Feng Li, Sheng-Xiao Zhang
Rheumatoid arthritis (RA) is an autoimmune disease characterized by the accumulation of leukocytes and inflammatory mediators within the synovial tissue. Leukocyte counts are proposed to play a role in the pathogenesis of RA. However, the causality remains unclear. To investigate the causal relationship between various leukocytes and RA by implementing two-sample univariable Mendelian Randomization (MR) and multivariable MR. MR analysis was performed using respective genome-wide association study (GWAS) summary statistics for the exposure traits (eosinophil counts, neutrophil counts, lymphocyte counts, monocyte counts, basophil counts, and white blood cell counts) and outcome trait (RA)...
November 26, 2023: Scientific Reports
Hans Ulrich Scherer
BACKGROUND: The generation and persistence of autoreactive B and plasma cells is crucial to the pathogenesis of many human autoimmune diseases. Secreted autoantibodies frequently serve as biomarkers in clinical practice and, in some cases, function as pathogenic effector molecules. Nonetheless, the primary break of B cell tolerance against autoantigens, the triggers that maintain autoreactive B cell memory, and the phenotype that autoreactive B cells adopt during the disease course are poorly understood...
November 22, 2023: Seminars in Arthritis and Rheumatism
Myles J Lewis
BACKGROUND: Although targeted biological treatments have transformed the outlook for patients with rheumatoid arthritis (RA), 40% of patients show poor clinical response, and there is an imperative to unravel the molecular pathways and mechanisms underlying non-response and disease progression. 5-20% of RA individuals do not respond to all current medications including biologic and targeted therapies, which suggests that distinct pathogenic processes underlie multi-drug refractoriness...
November 22, 2023: Seminars in Arthritis and Rheumatism
Jinxiang Liu, Dan Fei, Jie Xing, Juan Du
No abstract text is available yet for this article.
November 25, 2023: Biomedicine & Pharmacotherapy
Alejandro Balsa, Petra Díaz Del Campo Fontecha, Lucía Silva Fernández, José Valencia Martín, Virginia Nistal Martínez, Fernando León Vázquez, M Vanesa Hernández Hernández, Héctor Corominas, Rafael Cáliz Cáliz, José María Aguado García, Gloria Candelas Rodríguez, Nora Ibargoyen Roteta, Arturo Martí Carvajal, M Nieves Plana Farras, Janet Puñal Riobóo, Hye Sang Park, Yolanda Triñanes Pego, Virginia Villaverde García
OBJECTIVE: To present recommendations based on the available evidence and the consensus of experts, for risk management of biological treatment and JAK inhibitors in patients with rheumatoid arthritis. METHODS: Clinical research questions relevant to the purpose of the document were identified. These questions were reformulated in PICO format (patient, intervention, comparison, outcome or outcome) by a panel of experts, selected based on their experience in the area...
November 25, 2023: Reumatología clinica
Taro Horino, Hiroshi Ohnishi, Masahiro Komori, Yoshio Terada
No abstract text is available yet for this article.
November 27, 2023: Internal Medicine
Yifan Zhou, Tianyu Cao, Zhiguo Li, Hongjiang Qiao, Erle Dang, Shuai Shao, Gang Wang
As one of the most abundant stromal cells, fibroblasts are primarily responsible for the production and remodeling of the extracellular matrix. Traditionally, fibroblasts have been viewed as quiescent cells. However, recent advances in multi-omics technologies have demonstrated that fibroblasts exhibit remarkable functional diversity at the single-cell level. Additionally, fibroblasts are heterogeneous in their origins, tissue locations, and transitions with stromal cells. The dynamic nature of fibroblasts is further underscored by the fact that disease stages can impact their heterogeneity and behavior, particularly in immune-mediated inflammatory diseases such as psoriasis, inflammatory bowel diseases, and rheumatoid arthritis, etc...
November 24, 2023: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Xiaoqian Lv, Xiaoyu Wang, Xuelei Wang, Yunna Han, Haoyue Chen, Yuwen Hao, Hao Zhang, Chao Cui, Qiang Gao, Zuncheng Zheng
Arthritis is a group of diseases characterized by joint pain, swelling, stiffness, and limited movement. Osteoarthritis, rheumatoid arthritis, and gouty arthritis are the most common types of arthritis. Arthritis severely affects the quality of life of patients and imposes a heavy financial and medical burden on their families and society at large. As a widely used traditional Chinese medicine, Herba siegesbeckiae has many pharmacological effects such as anti-inflammatory and analgesic, anti-ischemic injury, cardiovascular protection, and hypoglycemic...
November 25, 2023: Biomedicine & Pharmacotherapy
Kyoko Yamazaki, Nobuhiko Kamada
The oral cavity harbors a diverse microbiota that plays a significant role in maintaining homeostasis. Disruption of this balance can lead to various oral diseases, including periodontitis. Accumulating evidence suggests a connection between periodontitis and extra-oral diseases such as cardiovascular disease, rheumatoid arthritis, obesity, and diabetes. During periodontitis, oral bacteria enter the bloodstream directly, impacting extra-oral organs. Furthermore, recent studies have uncovered another pathway, the direct oral-gut axis, where oral bacteria translocate to the gut through an enteral route, influencing gut microbiota and metabolism...
November 23, 2023: Mucosal Immunology
Keisuke Yasuda, Shieri Shimodan, Natsumi Maehara, Aika Hirota, Ruka Iijima, Akemi Nishijima, Haruka Mori, Ran Toyama, Atsumi Ito, Yuri Yoshikawa, Satoko Arai, Toru Miyazaki
The hallmark of autoimmune arthritis is the preceding autoantibody production and the following synovial inflammation with hyperplasia and tissue destruction of the joints. The joint inflammation is mediated not only by effector lymphocytes and auto-antibodies but also chronic activation of innate immunity, particularly promoted by the danger-associated molecular patterns (DAMPs). Here we show that apoptosis inhibitor of macrophage (AIM, also called CD5L) protein regulates arthritis by promoting removal of lesional DAMPs both physiologically and therapeutically...
November 24, 2023: Journal of Autoimmunity
Afsaneh Shamsi, Seyed Askar Roghani, Parviz Soufivand, Mehran Pournazari, Fatemeh Khoobbakht, Fariborz Bahrehmand, Mahdi Taghadosi
INTRODUCTION: Cardiovascular disease (CVD) is the most critical extra-articular manifestation of rheumatoid arthritis, and inflammatory molecules contribute to its pathogenesis. Recently, CXCL9 has been considered an inflammatory chemokine associated with the pathogenesis of CVD. Here, we evaluated the association of plasma CXCL9 with well-established cardiac biomarkers, including HS-CRP (High sensitivity C-reactive protein) and NT-ProBNP (N-terminal pro-B-type natriuretic peptide), in newly diagnosed and under-treatment RA patients...
November 25, 2023: Clinical Rheumatology
Max M H Teuwen, Salima F E van Weely, Thea P M Vliet Vlieland, Thom Douw, Dirkjan van Schaardenburg, Alfons A den Broeder, Astrid M van Tubergen, Maria A T van Wissen, Cornelia H M van den Ende, Maaike G J Gademan
The objective of the study is to describe the nature of functional limitations in activities and participation in people with Rheumatoid Arthritis (RA) or axial SpondyloArthritis (axSpA) with severe functional disability. Baseline data from people with RA (n = 206) or axSpA (n = 155) and severe functional disability participating in an exercise trial were used. Their three most limited activities were derived from the Patient Specific Complaint (PSC) instrument and linked to the International Classification of Functioning and Health (ICF)...
November 25, 2023: Rheumatology International
Andrea Picchianti-Diamanti, Assunta Navarra, Alessandra Aiello, Bruno Laganà, Gilda Cuzzi, Andrea Salmi, Valentina Vanini, Fabrizio Maggi, Silvia Meschi, Giulia Matusali, Stefania Notari, Chiara Agrati, Simonetta Salemi, Roberta Di Rosa, Damiano Passarini, Valeria Di Gioia, Giorgio Sesti, Fabrizio Conti, Francesca Romana Spinelli, Angela Corpolongo, Maria Sole Chimenti, Mario Ferraioli, Gian Domenico Sebastiani, Maurizio Benucci, Francesca Li Gobbi, Anna Paola Santoro, Andrea Capri, Vincenzo Puro, Emanuele Nicastri, Delia Goletti
Objectives : We aimed to analyse the incidence and severity of breakthrough infections (BIs) in rheumatoid arthritis (RA) patients after a COronaVIrus Disease 2019 (COVID-19) vaccination booster dose. Methods : We enrolled 194 RA patients and 1002 healthcare workers (HCWs) as controls. Clinical, lifestyle and demographic factors were collected at the time of the third dose, and immunogenicity analyses were carried out in a subgroup of patients at 4-6 weeks after the third dose. Results: BIs were experienced by 42% patients (82/194) with a median time since the last vaccination of 176 days...
November 2, 2023: Vaccines
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