Cross sectional study evaluating the correlation of thyroid dysfunction with severity of disease in rheumatoid arthritis

Background: The present study was conducted to evaluate the correlation of disease severity in RA and thyroid dysfunction.Methods: The present cross-sectional descriptive study enrolled 164 participants aged 12 years and above diagnosed as having RA. Use of drugs causing thyroid dysfunction, malignancy, diabetes mellitus, systemic hypertension, pregnancy and prior thyroidectomy were the criteria for exclusion. Data was analyzed using R and tests of significance were Chi square test and independent sample t-test and Pearson correlation. Institutional ethics committee approved the study and written informed consent was obtained from all study participants.Results: Serum TSH positively correlated with DAS 28 (r=0.2, p=0.005), ESR (r=0.2, p=0.03), CRP (r=0.2, p=0.006), RA factor (r=0.2, p=0.003), subjective assessment (r=0.3, p= 0.001) and anti TPO antibodies (r=0.7, p=0.001). Free T4 negatively correlated with DAS28 (r=-0.2, p=0.006), ESR (r=-0.2, p=0.02), CRP (r=-0.2, p=0.01). RA factor (r=-0.2, p=0.01), subjective assessment (r=-0.2, p= 0.01), anti TPO (r=-0.6, p=0.001) and Free T3 negatively correlated with DAS28 score (r=-0.2, p=0.02) , ESR (r=-0.2, p=0.03), RA factor (r=-0.3, p=0.001) and anti TPO antibodies (r=- 0.3, p=0.001).Conclusions: Hypothyroidism was significantly associated with disease severity of RA with linear positive correlation of TSH with DAS28 score, ESR, CRP, RA factor, subjective assessment and anti TPO antibodies, linear negative correlation of serum free T4 with DAS 28 score, ESR, CRP, RA factor, subjective assessment and anti TPO antibody and linear negative correlation of free T3 with DAS28 score, ESR, RA factor and anti TPO antibody was observed.

Comparing Effectiveness Rituximab (Mabthera®) to Other Second-line Biologics for Rheumatoid Arthritis Treatment in Patients Refractory to or Intolerant of First-line Anti-tumor Necrosis Factor Agent: An Observational Study

OBJECTIVE: Failure of first-line anti-tumor necrosis factor (TNF) agents in in rheumatoid arthritis patients leads to decisions among second-line biologic agents. To better inform these decisions, the therapeutic effectiveness of rituximab is compared with other second-line biologic agents in this observational study. METHODS: Between November 2011 and December 2014, study subjects were observed for 12 month periods. Patients with an inadequate response to initial anti-TNF agent received either rituximab or alternative anti-TNF agents (adalimumab/etanercept/infliximab) based on the preference of patients and physicians. The efficacy end point of this study was the change in 28-joint count Disease Activity Score (DAS28) at six and 12 months from baseline. Safety data were also collected. RESULTS: Ninety patients were enrolled in the study. DAS28 at six months did not change significantly whether the patients were treated with rituximab or alternative anti-TNF agents in intention-to-treat analysis (n=34, −1.63±0.30 vs. n=31, −2.05±0.34) and standard population set analysis (n=31, −1.51±0.29 vs. n=24, −2.21±0.34). Similarly, the change in DAS28 at 12 months did not reach statistical significance (−1.82±0.35 in the rituximab vs. −2.34±0.44 in the alternative anti-TNF agents, p=0.2390). Furthermore, the incidences of adverse events were similar between two groups (23.5% for rituximab group vs. 25.8% for alternative anti-TNF agents group, p=0.7851). CONCLUSION: Despite the limitations of our study, switching to rituximab or alternative anti-TNF agents after failure of the initial TNF antagonist showed no significant therapeutic difference in DAS28 reduction.

Observations on the Efficacy of Warm Needling Moxibustion plus Medication for Rheumatoid Arthritis / 上海针灸杂志

Objective To investigate the efficacy of warm needling moxibustion plus medication for rheumatoid arthritis.Methods One hundred patients with rheumatoid arthritis were randomly allocated to two groups (treatment and control) by using random number table method, 50 cases each. The treatment group received warm needling moxibustion plus medication as combined therapy and the control group, oral administration of drugs alone. In both groups, treatment was given 10 times as a course, for a total of two courses. The DAS 28 score was recorded and rheumatoid factor (RF) was determined in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 100％ in the treatment group and 86.0％ in the control group; there was a statistically significant difference between the two groups (P<0.05). There were no statistically significant post-treatment differences in DAS 28 score and RF between the two groups (P>0.05). There were statistically significant differences in pre-/post-treatment DAS 28 score difference value and RF difference value in the two groups (P<0.05).Conclusion Warm needling moxibustion plus medication is clinically more effective than oral administration of drugs alone in treating rheumatoid arthritis.

Observations on the Efficacy of Warm Needling Moxibustion plus Medication for Rheumatoid Arthritis / 上海针灸杂志

Objective To investigate the efficacy of warm needling moxibustion plus medication for rheumatoid arthritis.Methods One hundred patients with rheumatoid arthritis were randomly allocated to two groups (treatment and control) by using random number table method, 50 cases each. The treatment group received warm needling moxibustion plus medication as combined therapy and the control group, oral administration of drugs alone. In both groups, treatment was given 10 times as a course, for a total of two courses. The DAS 28 score was recorded and rheumatoid factor (RF) was determined in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 100％ in the treatment group and 86.0％ in the control group; there was a statistically significant difference between the two groups (P<0.05). There were no statistically significant post-treatment differences in DAS 28 score and RF between the two groups (P>0.05). There were statistically significant differences in pre-/post-treatment DAS 28 score difference value and RF difference value in the two groups (P<0.05).Conclusion Warm needling moxibustion plus medication is clinically more effective than oral administration of drugs alone in treating rheumatoid arthritis.