scholarly journals Association between Serum 25-Hydroxyvitamin D Level and Rheumatoid Arthritis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Xiaomin Cen ◽  
Yuan Liu ◽  
Geng Yin ◽  
Min Yang ◽  
Qibing Xie

The objective of this study is to examine and evaluate whether serum 25(OH)D is associated with disease activity in patients with rheumatoid arthritis (RA). Our results suggested that serum 25(OH)D in RA groups has significant lower level (35.99±12.59 nmol/L) than that in the normal groups (54.35±8.20 nmol/L,P<0.05). Based on the DAS28, patients with RA were divided into four subgroups, and no differences were found in the four groups (P>0.05). The 25(OH)D levels in complete remission, low disease activity, middle disease activity, and high disease activity group were32.86±12.26,33.97±13.28,38.41±10.64, and38.94±13.35 nmol/L, respectively. Based on the serum 25(OH)D levels, patients with RA were divided into inadequate group and normal group, and there were no significant differences in baseline characteristics and disease activity in the two groups. Our results showed that serum 25(OH)D levels in the inadequate group are significantly lower than those in the normal group. However, no correlations were found between 25(OH)D levels and disease activity among 116 patients with RA. The present findings will help to understand the association between 25(OH)D and disease activity of RA.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 516.1-516
Author(s):  
S. H. Chang ◽  
J. S. Lee ◽  
J. S. Lee ◽  
C. H. Park ◽  
M. U. Kim ◽  
...  

Background:Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). However, the effect of RA disease activity on the course of ILD is not yet known.Objectives:To assess the natural course of lung physiology of RA-ILD and the relation between arthritis activity and pulmonary physiology in patients with RA-ILD.Methods:The Korean Rheumatoid Arthritis ILd (KORAIL) cohort is the prospective observational cohort and aims to investigate the natural course of RAILD. Based on either 1987 or 2020 ACR criteria, patients diagnosed with RA and ILD based on CT scan were recruited from six tertiary medical hospitals in Korea since January 2015. RA disease activity was assessed using disease activity (DAS)28-ESR and CRP, annually. Pulmonary function tests (PFT), including FVC and DLCO were conducted annually. According to the transition of DAS28-ESR status, we classified patients into four groups: Group A. persistent remission or low disease activity, Group B. improvement, Group C. worsening, Group D. persistent moderate to high disease activity.Results:We analyzed 143 patients who completed a 2-year follow-up (visit 2) or had died with available PFT results at least twice. Mean duration since RA diagnosis and since ILD diagnosis was 7.6±8.0 and 2.7±3.1 years, respectively. Twenty-four patients were Group A, 33 Group B, 10 Group C and 30 Group D. The mean of FVC (mL) and % of the predicted value in FVC was significantly lower in Group D than in other groups (Table 1). The annual rate of decline in FVC was -42 (95% CI -93~10) mL·year-1 in Group B while -113 (95% CI -206~-21) mL·year-1 in Group C (Figure 1A). The annual decline rate in Group C was further exaggerated in patients with ≥ 80% of FVC predicted (-141, 95% CI -251~-32 mL·year-1). During two years of follow-up, patients ever experienced a relative decline of ≥10% from the enrollment in FVC predicted was 27.3%(n-9/33) in Group B whereas 30.0% (3/10) in Group C. The annual rate of decline in % of DLco predicted value was also the largest in Group C (-4.6 %·year-1, 95%CI -8.5~-0.7), which further exaggerated in patients with ≥ 80% of FVC predicted (-4.9%·year-1, 95 %CI -8.3~-1.5, Figure 1B). Of note, about half of patients with maintained not only low disease activity (Group A) but also moderate to severe disease activity (Group D) improved in DLco at least 10% or more from the enrollment of DLco predicted value (Group A: 54.2%, n=13/24, Group D: 46.7%, n=14/30).Conclusion:RA disease activity is associated with the change of lung physiology in patients with RA-ILD; worsening disease activity associated with a further decrease of annual change in FVC and maintaining low disease activity associated with a further increase of annual change in % of DLco predicted value.Table 1.The analysis of forced vital capacity (FVC) according to disease activity transition group.Group AGroup BGroup CGroup DFVC (mL), mean±SD2810.0±771.12528.8±735.32801.0±952.72048.3±575.7FVC % of predicted, mean±SD87.5±14.586.5±16.693.0±15.677.2±17.3Rate of FVC decline, mL·year-1 (95% CI)-52 (-112,7)-42 (-93,10)-113 (-206, -21)1 (-52, 54)A 10-point decline from V1 in predicted FVC value, n (%)29 (20.3)6 (25.0)6 (18.2)3 (30.0)Relative decline of 10% from the enrollment in predicted FVC value, n (%)35 (24.5)5 (20.8)9 (27.3)3 (30.0)Figure 1.The annual change of pulmonary physiology according to disease activity transition group.Acknowledgements:This work was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant no.HI14C1277).Disclosure of Interests:None declared


2015 ◽  
Vol 42 (7) ◽  
pp. 1090-1098 ◽  
Author(s):  
Leslie R. Harrold ◽  
George W. Reed ◽  
Ashwini Shewade ◽  
Robert Magner ◽  
Katherine C. Saunders ◽  
...  

Objective.To characterize the real-world effectiveness of rituximab (RTX) in patients with rheumatoid arthritis.Methods.Clinical effectiveness at 12 months was assessed in patients who were prescribed RTX based on the Clinical Disease Activity Index (CDAI). Change in CDAI was calculated (CDAI at 12 mos minus at initiation). Achievement of remission or low disease activity (LDA; CDAI ≤ 10) among those with moderate/high disease activity at the time of RTX initiation was compared based on prior anti-tumor necrosis factor agent (anti-TNF) use (1 vs ≥ 2) using logistic regression models.Results.Patients (n = 265) were followed for 12 months with a mean change in CDAI of −8.1 (95% CI −9.8 – −6.4). Of the 218 patients with moderate/high disease activity at baseline, patients with 1 prior anti-TNF (baseline CDAI 25.0) demonstrated a mean change in CDAI of −10.1 (95% CI −13.2 – −7.0); patients with ≥ 2 prior anti-TNF (baseline CDAI 30.0) demonstrated a mean change of −10.5 (95% CI −12.9 – −8.0). The unadjusted OR for achieving LDA/remission in patients with moderate/high disease activity at baseline exposed to ≥ 2 versus 1 prior anti-TNF was 0.40 (95% CI 0.22–0.73), which was robust to 4 different adjusted models (OR range 0.38–0.44).Conclusion.A good clinical response was observed in all patients; however, patients previously treated with 1 anti-TNF, who had lower baseline CDAI and a greater opportunity for clinical improvement compared with patients previously treated with ≥ 2 anti-TNF, were more likely to achieve LDA/remission.


2019 ◽  
Vol 13 (2) ◽  
pp. 80-83
Author(s):  
I. V. Menshikova ◽  
V. V. Strogonova

Objective: to analyze the efficacy of tofacitinib (TOFA) in patients with an advanced stage of rheumatoid arthritis (RA) and previous methotrexate (MTX) failure according to comprehensive clinical and laboratory examination.Patients and methods. Nineteen patients (11 women and 8 men aged 29 to 71 years (mean age 53.47±10.53 years)) with a reliable diagnosis of RA according to the 2012 American College of Rheumatology (ACR) criteria were followed up. Due to a high disease activity (DAS28 averaged 5.84±0.89), the patients were prescribed TOFA 10 mg/day taken for 12 months. The disease activity indicators were assessed at baseline, 3, 6, and 12 months after the start of the study.Results and discussion. The effect of TOFA developed quite quickly: at 3 months of therapy, there were positive clinical, laboratory, and instrumental changes in most patients; 5 (26.3%) patients achieved the goal of treatment. At 12 months of therapy, 8 patients achieved DAS28 remission and 3 patients had a low disease activity; moderate RA activity persisted in 7 patients; and a high disease activity was seen in 1 patient; these SDAI activity indicators were observed in 2, 8, 7, and 2 patients, respectively. According to the ACR criteria, 20, 50, and 70% improvements were achieved by 8, 6, and 3 patients, respectively. No serious adverse reactions were recorded. The findings confirm the good efficacy and safety of TOFA in the treatment of patients with an advanced stage of RA.Conclusion. The innovative mechanism of TOFA allows a significant number of patients, in whom MTX therapy was not effective enough, to achieve the goal of treatment. 


2021 ◽  
Author(s):  
Bilin Chen ◽  
Qing Zhu ◽  
Shu Li ◽  
Yan Ge ◽  
Peijun Wu ◽  
...  

Abstract Objective: This study aimed to study and evaluate the value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers to predict the disease activity and severity in patients with rheumatoid arthritis (RA).Methods: A total of 139 inpatients with RA were divided into two groups: moderate activity group (3.2<DAS28-CRP score<5.1) and high activity group (≥5.1). The correlation of routine hematological indices with DAS28 and joint ultrasound score (gray-scale ultrasound score, GS-US; power Doppler ultrasound score, PD-US; total ultrasound score, T-US) were analyzed by Pearson's correlation and logistic regression analyses. Receiver operating characteristics (ROC) analysis was performed to compare the efficacy of blood indices, ESR, or CRP in reflecting the disease activity and severity of RA.Results: The values of PLR, NLR, PD-US, and T-US were significantly different between moderate and high disease activity groups (p<0.001), and PLR was significantly correlated with PD-US and DAS28. Logistic regression analyses showed that PLR was an independent risk factor for disease activity by DAS 28 and joint damage severity by PD-US and T-US. ROC analysis showed that the efficacy of using PLR alone to evaluate the disease activity and joint severity of RA was similar to that of using combined CRP and ESR. The best cut-off value of PLR for predicting high disease activity and high joint severity was determined as 236.6.Conclusions: PLR can be used as a marker to predict activity and severity in patients with moderate and high RA disease activity.


2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Baochen Li ◽  
Qiaoling Guo ◽  
Yanyan Wang ◽  
Rui Su ◽  
Chong Gao ◽  
...  

Objective. To investigate the relationship between serum interleukin-2 (IL-2) levels and disease activity, absolute numbers of peripheral lymphocyte subsets, autoantibodies, and associated cytokines in patients with rheumatoid arthritis (RA). Methods. This study included 106 patients with RA, evaluated their disease activity (DAS28 score), and divided them into disease remission (DAS28≤2.6), low disease activity (DAS28≤3.2), and moderate-high disease activity (DAS28>3.2) groups. Flow cytometry was used to detect the absolute numbers of peripheral lymphocyte subpopulations and CD4+ T cell subsets in each group, and serum cytokine levels were measured using cytometric bead array. Results. Serum IL-2 levels in RA patients were positively correlated with disease activity and rheumatoid factor titers (p<0.001 and p=0.045, respectively), and multiple regression analysis revealed that serum IL-2 levels were an independent factor affecting disease activity. Serum IL-2 levels were positively correlated with Th17/Treg ratios (p=0.013). Compared with the remission group, peripheral lymphocyte and CD4+ T lymphocyte subsets in patients with active RA decreased to varying degrees; however, the numbers of peripheral natural killer (NK) cells were significantly higher in the moderate-high disease activity group than in the remission (p=0.046) and low disease activity (p=0.020) groups; the percentages of NK cells had the same trend. In addition, the number and percentage of NK cells were positively correlated with serum IL-2 levels (p=0.018 and p=0.006, respectively). Conclusions. In RA patients, serum IL-2 levels were not only correlated with patients’ disease activity and autoantibody levels but were also involved in their Th17/Treg immune imbalance. In addition, in patients with active RA, NK cell levels were abnormally elevated, possibly due to high serum levels of IL-2.


2021 ◽  
Author(s):  
Bilin Chen ◽  
Qing Zhu ◽  
Shu Li ◽  
Yan Ge ◽  
Peijun Wu ◽  
...  

Abstract Objective: This study aimed to study and evaluate the value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers to predict the disease activity and severity in patients with rheumatoid arthritis (RA).Methods: A total of 139 inpatients with RA were divided into two groups: moderate activity group (3.2<DAS28-CRP score<5.1) and high activity group (≥5.1). The correlation of routine hematological indices with DAS28 and joint ultrasound score (gray-scale ultrasound score, GS-US; power Doppler ultrasound score, PD-US; total ultrasound score, T-US) were analyzed by Pearson's correlation and logistic regression analyses. Receiver operating characteristics (ROC) analysis was performed to compare the efficacy of blood indices, ESR, or CRP in reflecting the disease activity and severity of RA.Results: The values of PLR, NLR, PD-US, and T-US were significantly different between moderate and high disease activity groups (p<0.001), and PLR was significantly correlated with PD-US and DAS28. Logistic regression analyses showed that PLR was an independent risk factor for disease activity by DAS 28 and joint damage severity by PD-US and T-US. ROC analysis showed that the efficacy of using PLR alone to evaluate the disease activity and joint severity of RA was similar to that of using combined CRP and ESR. The best cut-off value of PLR for predicting high disease activity and high joint severity was determined as 236.6.Conclusions: PLR can be used as a marker to predict activity and severity in patients with moderate and high RA disease activity.


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