[Efficacy and safety of infliximab in patients with rheumatoid arthritis].

OBJECTIVE: To investigate the efficacy and safety of Infliximab (IFX) plus methotrexate (MTX) combination therapy in patients with rheumatoid arthritis (RA). METHODS: Prospectively observe refractory RA patients who were treated with combination therapy of MTX and IFX. IFX was infused at the dosage of 3 mg/kg, in week 0, 2, 6, and then every 8 weeks. During treatment, clinical variables, disease activity and adverse effects were evaluated. RESULTS: After treatment, 69.8%, 52.4%, 29.5% and 7.2% RA patients achieved ACR20, ACR50, ACR70 and ACR90 respectively. There were significant statistical differences in the changes of swollen joint counts, tender joint counts, VAS scale, patient' s global assessment, and physician's global assessment before and after therapy. CONCLUSION: Infliximab plus MTX achieved significant efficacy and safety in refractory RA patients.

[Clinical analysis of 61 patients with antiphospholipid syndrome].

OBJECTIVE: To investigate the clinical manifestations, diagnosis and treatment of anti-phospholipid syndrome (APS). METHODS: 61 patients with defined APS admitted from Jan 1986 to Dec 2002 were analyzed retrospectively. RESULTS: 10 patients with primary APS and 51 patients with secondary APS were analyzed. Women were affected 3.1 times as that of men. 48 of the 51 (94.1%) patients with secondary APS were complicated with other autoimmune diseases, including 33 cases (64.7%) of systemic lupus erythematosus. Vascular thrombosis was presented in around 80.3% of the patients in this study. Thrombosis frequently involved the gastrointestinal system (21 cases, 22.6%), pulmonary system (19 cases, 20.4%), the cerebral vascular system (17 cases, 18.3%), lower limb deep venous system (16 cases, 17.2%), and infrequently coronary arteries or adrenal glands. The abnormal pregnancy rate in the 37 married women was 45.9%. The prevalence of anticardiolipin antibody (ACL) and lupus anticoagulant (LA) was 77.0% and 62.3% respectively. LA was associated with ACL. CONCLUSION: APS occurs most commonly among young women, is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with positive ACL or LA. Thrombosis frequently occurs in gastrointestinal system, pulmonary system, cerebral vascular system and deep venous system. The association between clinical features of APS and antiphospholipid antibody is significant. LA is a stronger risk factor for thrombosis and abnormal pregnancy than ACL. Antiplatelet with low-dosage aspirin and long-term anticoagulation are main therapeutics.