Treatment of Rheumatoid Arthritis with Oral Type II Collagen / 대한류마티스학회지

OBJECTIVE: To investigate the efficacy and safety of oral bovine type II collagen (C II) in the treatment of rheumatoid arthritis (RA). METHODS: Forty-five patients with active RA were enrolled and randomized to receive placebo or oral C II for 3 months. Efficacy parameters were assessed monthly. Cumulative response rates (percentages of patients meeting the criteria for response at anytime during the study) were analyzed utilizing 3 set of composite criteria : Paulus criteria, ACR criteria for improvement in RA, and a requirement for > or = 30% reduction in both swollen and tender joint counts. RESULTS: The C II-treated group (n=25) showed significant higher response rate by the Paulus criteria compared to placebo group (n=20, p=0.04), and MHAQ scores between baseline and 3 months of treatment were also significantly decreased in the C II-treated group (p<0.05). However, there were no significant differences in tender and swollen joint count, and physician and patient global scores between C II-treated and placebo groups. Only one patient treated with C II had a urticaria 1 week after administration, but no serious side effects were found in the two groups. Patients treated with C II (n=15) showed the decreased levels of circulating IgG antibodies to bovine C II 3 months after treatment (p=0.02), whereas significant changes of IgG antibodies to C II were not found in placebo group (n=12). CONCLUSION: Oral administration of C II was safe and effective for the treatment of rheumatoid arthritis. The finding that serum IgG antibodies to bovine C II was decreased in patients who treated with C II suggest that autoimmune response to C II could be decreased by repetitive administration of C II.

The Clinical Characteristics of Male Patients with Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVES: To document the clinical characteristics of Korean male patients with rheumatoid arthritis that are different from those of female counterparts. METHODS: Six hundred and seventy-five patients who had met the ACR criteria for rheumatoid arthritis were included in the study. Clinical and laboratory data were retrospectively reviewed and radiologic features of hands and feet were graded by Steinbroker's method. RESULTS: The female : male ratio in the total patients studied is 567 : 108 (5.25). The symptom onset age was 39.5 +/- 11.8 in woman and 44.0 +/- 11.3 in men. The functional class at the time of diagnosis and the incidence of anemia showed little significant difference. Among the extraarticular manifestations, only interstitial lung disease was more common in males. There were significant differences between both sexes on positivity of antiperinuclear factor, C-reactive protein, and titer of rheumatoid factor in the seropositive groups, but not on rheumatoid factor positivity. Radiologically there was no significant difference in the hands and feet joints between males and females. Higher dosage of steroid was initially prescribed for male patients. CONCLUSIONS: The males seem to have slightly more active disease and to show significant differences in antiperinuclear factor positivity, the titer of rheumatoid factor and C-reactive protein, and lung involvement. However, we failed to demonstrate that the disease in males was more severe than compared to that of their female counterparts.