Factors associated with mental illness in patients with rheumatoid arthritis initiating b/ts DMARDs: A population-based study.

AIM: Mental health is an essential issue in patients with rheumatoid arthritis (RA) but remains unclear among those receiving biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). We aim to assess the incidence and factors associated with mental illness among patients with RA who underwent b/tsDMARD therapy. METHOD: We used Taiwan's National Health Insurance Research Database for the period 2001-2020 to identify patients with RA receiving b/tsDMARDs. The primary outcome was newly developed mental illness, including anxiety and mood disorders. We performed a Cox regression analysis to determine factors associated with mental illness and presented as hazard ratios (HR) with 95% confidence interval (CI). RESULTS: We enrolled 10 852 patients, with 7854 patients receiving tumor necrosis factors inhibitors (TNFi), 1693 patients receiving non-TNFi bDMARDs, and 1305 patients treated with tsDMARD. We found that 13.62% of enrolled patients developed mental illness, with an incidence rate of 4054 per 100 000 person-year. Those receiving tocilizumab (aHR 0.64, 95% CI: 0.51-0.82), abatacept (aHR 0.69, 95% CI: 0.55-0.86), or tsDMARDs (aHR 0.58, 95% CI: 0.47-0.73) had a lower risk of mental illness compared with those receiving TNFi. We also found that old age, low income, diabetes mellitus, use of cyclosporine, and use of steroids were associated with incident mental illness. CONCLUSION: This population-based study investigated the incidence and factors associated with mental illness among patients with RA receiving b/tsDMARDs. Our findings highlight the need for vigilance with respect to the possibility of mental illness in patients with RA.

The combinative therapeutic effects of Mailuo Shutong Granules and synthetic medications on patients with superficial thrombophlebitis / 中成药

AIM To observe the combinative therapeutic effects of Mailuo Shutong Granules and routine synthetic medications on patients with superficial thrombophlebitis (STP).METHODS Seventy patients randomly and equally divided into control group and observation group were subjected to a two-week conventional treatment and a two-week intervention of Mailuo Shutong Granules on the basis of routine treatment,respectively,and they had the before and after the treatment assessment in terms of main clinical symptoms and signs,endothelial function indices (NO,ET-1,TXB2,6-Keto-PGF1α,VEGF,vWF),hemorheology indices (plasma viscosity,blood sedimentation,erythrocyte aggregation index,fibrous protein).RESULTS The observation group generally demonstrated significantly higher effective rate than the control group (P ＜ 0.05).Markedly decreased post-treatment scores for main clinical symptoms and signs,TXB2,ET-1,vWF,plasma viscosity,blood sedimentation,erythrocyte aggregation index,fibrous protein,and increased 6-Keto-PGF1 α,VEGF and NO (P ＜ 0.05) in both groups were observed,as well as the between-group variance showing the observation group's priority (P ＜ 0.05).The respective 8.57％ and 14.29％ incidence rates of adverse reactions in the observation group and control group were also noticed.CONCLUSION For patients with STP,a combination therapy of Mailuo Shutong Granules on the basis of synthetic medications contributes to an effective main clinical symptoms alleviation due to its vascular endothelial cells protection,cellular secretion function and hemorheological improvement.