scholarly journals Rheumatoid Arthritis and its treatment: potential risk factors of osteonecrosis of the jaw besides bisphosphonates

2021 ◽  
Author(s):  
Carolina Teixeira Cidon ◽  
Thais Helena Bonini Gorayeb ◽  
Maria Eugênia Teixeira Bicalho ◽  
Renata Lys Pinheiro de Mello ◽  
Victor Caires Tadeu ◽  
...  
RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000700 ◽  
Author(s):  
Rebecca M Joseph ◽  
David W Ray ◽  
Brian Keevil ◽  
Tjeerd P van Staa ◽  
William G Dixon

BackgroundGlucocorticoids (GCs) suppress endogenous cortisol levels which can lead to adrenal insufficiency (AI). The frequency of GC-induced AI remains unclear. In this cross-sectional study, low morning salivary cortisol (MSC) levels were used as a measure of adrenal function. The study aim was to investigate the prevalence of low MSC in patients with rheumatoid arthritis (RA) currently and formerly exposed to oral GCs, and the association with potential risk factors.MethodsSample collection was nested within UK primary care electronic health records (from the Clinical Practice Research Datalink). Participants were patients with RA with at least one prescription for oral GCs in the past 2 years. Self-reported oral GC use was used to define current use and current dose; prescription data were used to define exposure duration. MSC was determined from saliva samples; 5 nmol/L was the cut-off for low MSC. The prevalence of low MSC was estimated, and logistic regression was used to assess the association with potential risk factors.Results66% of 38 current and 11 % of 38 former GC users had low MSC. Among former users with low MSC, the longest time since GC withdrawal was 6 months. Current GC dose, age and RA duration were significantly associated with increased risk of low MSC.ConclusionThe prevalence of low MSC among current GC users is high, and MSC levels may remain suppressed for several months after GC withdrawal. Clinicians should therefore consider the risk of suppressed cortisol and remain vigilant for symptoms of AI following GC withdrawal.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Wei-Lin Xie ◽  
Zhuo-Ling Li ◽  
Zhen Xu ◽  
Huan-Ru Qu ◽  
Luan Xue ◽  
...  

Objective. To analyse the potential risk factors of nosocomial infections in patients with active rheumatoid arthritis (RA). Methods. A total of 2452 active RA patients at Hospitals in Shanghai between January 2009 and February 2011 were analyzed. Their demographic and clinical characteristics were compared with those without infection, and the potential risk factors were determined by logistic regression analysis. Results. Multivariate analysis indicated the gender (OR=0.70, 95% CI 0.53–0.92), duration in hospital (OR=1.03, 95%CI 1.01–1.05), number of organs involved (OR=0.82, 95%CI 0.72–0.92), number of disease-modifying antirheumatic drugs ((DMARDs) (OR=1.22, 95%CI 1.061–1.40)), corticosteroid therapy (OR=1.02, 95%CI 1.01–1.03), peripheral white blood cell counts ((WBC) (OR=1.04, 95%CI 1.00–1.08)), levels of serum albumin (OR=0.98, 95%CI 0.97–0.99), and C-reactive protein ((CRP) (OR=1.03, 95%CI 1.01–1.04)) that were significantly associated with the risk of infections. Conclusion. The female patients, longer hospital stay, more organs involved, more DMARDs, corticosteroid usage, high counts of WBC, lower serum albumin, and higher serum CRP were independent risk factors of infections in active RA patients.


1990 ◽  
Vol 63 (01) ◽  
pp. 013-015 ◽  
Author(s):  
E J Johnson ◽  
C R M Prentice ◽  
L A Parapia

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.


Author(s):  
Syahrun Neizam Mohd Dzulkifli ◽  
◽  
Abd Halid Abdullah ◽  
Yee Yong Lee ◽  
Mohd Mahathir Suhaimi Shamsuri ◽  
...  

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