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Objective To explore the association of suprapatellar pouch effusion with knee pain and serum levels of interleukin (IL)-6,IL-17,IL-23 in patients with knee osteoarthritis measured by magnetic resonance imaging (MRI).Methods 204 patients with knee osteoarthritis were enrolled into the study.Suprapatellar pouch effusion was measured by OSIRIS in both grade (0-3) and maximum area (cm2).Serum IL-6,IL-17,IL-23 were measured.Knee pain was assessed by Western Ontario and McMasters osteoarthritis index (WOMAC) questionnaire and Lequesne index.Characteristics of patients were recorded and body mass index (BMI) was calculated.Student t test or Chi-square test was used to compare means or proportions.Multivariable linear regression or logistic regression was used to determine risk factors (α=0.05).Results ① In the 204 patients [mean age (55±8) years,86.3％ were females],the prevalence of physiologic effusion (≤ 1) was 47.9％ while moderate or larger (≥2) effusion was 52.1％.② The age,labour intensity,serum levels of uric acid (sUA) and Lequesne index of higher grade effusion group were higher (P＜0.05) compared with lower grade effusion group.③ Suprapatellar pouch effusion maximum area was positively correlated with age (r=0.208,P=0.006),BMI (r=0.171,P=0.027) and labour intensity (r=0.189,P=0.013).④ Adjusted for age,gender and BMI,the results of Logistic regression analysis showed that:suprapatellar pouch effusion grades were positively correlated with Lequesne index [OR=1.120,95％CI(1.011,1.241),P=0.029] and negatively correlated with IL-23 [OR=0.768,95％CI (0.598,0.986),P=0.038].Suprapatellar pouch effusion was not independently associated with WOMAC index,IL-6 and IL-17.Conclusion The prevalence of suprapatellar pouch pathological effusion is 52.1％ in knee osteoarthritis.Suprapatellar pouch effusions is positively correlated with knee pain (Lequesne index) and negatively conrelated with IL-23.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) on patients with rheumatoid arthritis (RA) in China.</p><p><b>METHODS</b>Five hundred and sixty-six patients with active rheumatoid arthritis were randomly assigned to receive leflunomide at 20 mg once daily or MTX at 15 mg once weekly in a controlled trial. Five hundred and four patients completed the 12-week treatment and some patients continued the treatment for 24 weeks.</p><p><b>RESULTS</b>Both leflunomide and MTX could improve the symptoms, signs, and joint function, but there were no changes in X-ray observations of patients with rheumatoid arthritis. In the leflunomide group, the overall rates of effectiveness at 12 weeks and 24 weeks were 86.94% and 92.31% respectively; the rates of remarkable improvement were 64.95% and 79.81% respectively. In the MTX group, the overall rates of effectiveness at 12 weeks and 24 weeks were 84.04% and 83.15% respectively; the rates of remarkable improvement were 56.81% and 75.28% respectively. According to intent-to-treat analysis, the ACR 20% response rates at 12 weeks and 24 weeks in the leflunomide group were 62.54% and 67.18% respectively, compared with 60.08% and 61.32% respectively in MTX group. No statistical differences were shown in the efficacy between the two groups (P > 0.05). The adverse events in the leflunomide group were gastrointestinal symptoms, skin rash, alopecia, nervous system symptoms, decreased leukocyte count, and elevation of alanine aminotransferase (ALT). Most of these side effects were mild and transient. The incidence of adverse events in the leflunomide group was 16.84%, significantly lower than that in MTX group (28.17%, P = 0.002).</p><p><b>CONCLUSIONS</b>Leflunomide is effective in the treatment of RA with less adverse events than MTX. Its efficacy is similar to MTX, but the incidence of adverse events and the rate of withdrawal due to adverse events were lower in the leflunomide group than in MTX group.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Antirheumatic Agents , Therapeutic Uses , Arthritis, Rheumatoid , Drug Therapy , Growth Inhibitors , Therapeutic Uses , Immunosuppressive Agents , Therapeutic Uses , Isoxazoles , Therapeutic Uses , Methotrexate , Therapeutic UsesABSTRACT
Objective To assess the effectiveness and safety of oral administration of type Ⅱ collagen(C Ⅱ) versus placebo in patients with active rheumatoid arthritis(RA).Methods Seventy patients with active RA were randomly divided into receive placebo(n=35) or bovine CⅡ(n=35) at 0 1mg/day for 12 weeks,in a double-blind study.The cumulative response rates were analyzed by utilizing the American College of Rheumatology(ACR) criteria for improvement in RA,and the requirement for ≥50% improvement of outcome measures in ACR criteria.Results After the 12-week course of treatment,much more outcome was significantly improved in C Ⅱ group than in placebo group.The rates of improvement and remarkable improvement in CⅡ group were increased significantly,as compared with placebo group(54 55% vs 12 12% and 18 18% vs 3 13%,respectively,P0 05).Conclusions Oral administration of CⅡ in treating RA was significantly effective and has slight side effects.Further investigation in the field is worthwhile.
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AIM To study the therapeutic action of leflunomide(Lef) on adjuvant arthritis (AA) rats and its mechanisms. METHODS To observe the change of secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Lef and to detect the effect of A771726—the active product of Lef on T cell subgroup in mice in vitro.RESULTS Lef(2,6,18 mg*kg-1×12 d) intragastric injection(ig) could signifcantly inhibit secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats.Lef couldnt effect the lowed response of Con A-induced splenolytes, and the decreased IL-2 synthesis in AA rats. But lef(2,6,18 mg*kg-1) could inhibit the elevated IL-1 released from peritoneal macrophage (PMΦ) in AA rats. A771726—the active product of Lef(0.1，0.5，2.5，12.5，25，100 μmol*L-1) could inhibit Con A-induced Th cells but has no effect in Con A-induced Ts cells in vitro.CONCLUSION Lef has therapeutic action on AA rats which could be related to its immunosuppressory activities——mainly through inhibit cell-mediated immunity.
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AIM To study the therapeutic action of leflunomide(Lef) on adjuvant arthritis (AA) rats and its mechanisms. METHODS To observe the change of secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Lef and to detect the effect of A 771726 —the active product of Lef on T cell subgroup in mice in vitro .RESULTS Lef(2,6,18 mg?kg -1 ?12 d) intragastric injection(ig) could signifcantly inhibit secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats.Lef couldnt effect the lowed response of Con A induced splenolytes, and the decreased IL 2 synthesis in AA rats. But lef(2,6,18 mg?kg -1 ) could inhibit the elevated IL 1 released from peritoneal macrophage (PM?) in AA rats. A 771726 —the active product of Lef(0 1,0 5,2 5,12 5,25,100 ?mol?L -1 ) could inhibit Con A induced T h cells but has no effect in Con A induced T s cells in vitro .CONCLUSION Lef has therapeutic action on AA rats which could be related to its immunosuppressory activities——mainly through inhibit cell mediated immunity.
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Pinealectomy (PX), zymosan-in-duced-luminol-dependent-chemiluminescence (CL) and PGE2 radioimmunoassay were used to determine the effects of the pineal gland and melatonin ( MT ) on CL of peritoneal macrophages (PM?s) and PGE2 content in the hypothalamus and spleen in rats. It was suggested that the CL value of PM?s was decreased and PGE2 contents in the hypothalamus and spleenwere increased significantly after PX, which could be restored respectively by 10~ 1 000 ?g? kg-1MT and 10 ?g?kg-1MT. 10 ?g?kg-1MT could also inhibit PGE2 in the hypothalamus and spleen in normal rats.