References of "Rheumatology"
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See detailClinically meaningful effect of strontium ranelate on symptoms in knee osteoarthritis: a responder analysis
Bruyère, Olivier ULg; Reginster, Jean-Yves ULg; Bellamy, Nicholas et al

in Rheumatology (2014), 53

Objectives. The aim of this study was to assess the efficacy of strontium ranelate in improving symptoms in knee OA. Methods. Symptoms were assessed over 3 years in patients with primary knee OA receiving ... [more ▼]

Objectives. The aim of this study was to assess the efficacy of strontium ranelate in improving symptoms in knee OA. Methods. Symptoms were assessed over 3 years in patients with primary knee OA receiving strontium ranelate 2 g/day (n = 454), 1 g/day (n = 445) or placebo (n = 472) in the Strontium Ranelate Efficacy in Knee Osteoarthritis Trial. Clinical response was evaluated using WOMAC subscores, minimal perceptible clinical improvement (MPCI), minimal clinically important improvement (MCII) and a modified OMERACT Osteoarthritis Research Society International (OARSI) responder definition. Patients who withdrew prematurely from the study were considered non-responders. Results. There was no significant effect on symptoms for strontium ranelate 1 g/day. At the dosage of 2 g/day, strontium ranelate was associated with greater response than placebo in terms of 520% improvement in WOMAC pain from baseline to the last visit (58% vs 47%, P = 0.002) and 550% improvement in WOMAC pain (42% vs 36%, P = 0.083). Significant differences were found in MPCI response for WOMAC pain (52% vs 40%, P<0.001), stiffness (47% vs 39%, P = 0.009) and physical function (46% vs 37%, P = 0.009) and in MCII response for WOMAC physical function (46% vs 37%, P = 0.013). There were also more OMERACT-OARSI-like responders with strontium ranelate (44% vs 35%, P = 0.004). The treatment placebo difference in MPCI response for WOMAC pain was significant after 6 months (P = 0.024), while that in MPCI and MCII response for WOMAC physical function reached significance after 12 months (P = 0.027 and P = 0.019, respectively). Conclusion. Treatment with strontium ranelate 2 g/day over 3 years is associated with a clinically meaningful improvement in pain from 6 months as well as physical function and stiffness as assessed by the number of responders above thresholds of clinical relevance. [less ▲]

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See detailSerum Vascular Endothelial Growth Factor is Selectively Upregulated in Patients with Biopsy-Proven Giant Cell Arteritis
Morlet, Julien; Mahoney, David; Zarei, Ali et al

in Rheumatology (2014), 53(1), 188-188

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See detailImpact of components of the metabolic syndrome on progression of knee osteoarthritis in the SEKOIA study
Edwards, MH; Parsons, C; Eymard, F et al

in Rheumatology (2014), 53(1), 31

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See detailImpact of bone marrow lesion on the progression of knee osteoarthritis in the SEKOIA study
Parsons, C; Edwards, MH; Bruyère, Olivier ULg et al

in Rheumatology (2014), 53(1), 130

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See detailRheumatoid arthritis and pregnancy: evolution of disease activity and pathophysiological considerations for drug use
Hazes, Johanna M.W.; Coulie, Pierre G.; Geenen, Vincent ULg et al

in Rheumatology (2011)

It has long been known that pregnancy and childbirth have a profound effect on the disease activity of rheumatic diseases. For clinicians, the management of patients with RA wishing to become pregnant ... [more ▼]

It has long been known that pregnancy and childbirth have a profound effect on the disease activity of rheumatic diseases. For clinicians, the management of patients with RA wishing to become pregnant involves the challenge of keeping disease activity under control and adequately adapting drug therapy during pregnancy and post-partum. This article aims to summarize the current evidence on the evolution of RA disease activity during and after pregnancy and the use of anti-rheumatic drugs around this period. Of recent interest is the potential use of anti-TNF compounds in the preconception period and during pregnancy. Accumulating experience with anti-TNF therapy in other immune-mediated inflammatory diseases, such as Crohn’s disease, provides useful insights for the use of TNF blockade in pregnant women with RA, or RA patients wishing to become pregnant. [less ▲]

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See detailUpdating the 2003 European regulatory requirements for registering disease-modifying drugs to be used in the treatment of rheumatoid arthritis.
Smolen, Josef S.; Boers, Maarten; Abadie, Eric ULg et al

in Rheumatology (2011), 50(10), 1732-6

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See detailIncrease in type II collagen turnover after iron depletion in patients with hereditary haemochromatosis.
Richette, Pascal; Eymard, Claire; Deberg, Michelle ULg et al

in Rheumatology (2010), 49(4), 760-6

OBJECTIVE: To determine the effects of iron depletion on serum levels of joint biomarkers and on joint symptoms in patients with hereditary haemochromatosis (HH). METHODS: Levels of biomarkers were ... [more ▼]

OBJECTIVE: To determine the effects of iron depletion on serum levels of joint biomarkers and on joint symptoms in patients with hereditary haemochromatosis (HH). METHODS: Levels of biomarkers were measured in 18 patients with HH at the time of diagnosis and after iron depletion. The markers were type II collagen degradation (Coll2-1) and its nitrated form (Coll2-1NO(2)), type II procollagen synthesis (CPII), MPO, COMP and HA. For each patient, demographic data were collected and the global joint pain (visual analogue scale) was assessed before and after iron depletion by phlebotomy. RESULTS: A total of 18 patients [10 males; mean (s.d.) age 48 (11) years] were homozygous for the C282Y mutation. No patient had liver dysfunction. Ferritin level before iron removal was 627.5 (range 133-3276) microg/l, and duration of the iron depletion phase was 295 (70-670) days. Serum levels of both Coll2-1 and CPII were significantly increased from diagnosis after iron depletion: 80.1 (55.6-113.5) vs 96.0 (48.8-136.3) nM (P = 0.004) and 731.4 (374.2-1012.3) vs 812.8 (535.8-1165.6) ng/ml (P = 0.03), respectively. Levels of other biomarkers were not modified by iron depletion. Ferritin level, which at baseline was correlated with body iron store (r = 0.63; P = 0.008), was significantly correlated with HA level measured before iron depletion (r = 0.60; P = 0.01). Global joint pain was not correlated with ferritin concentration and did not significantly decrease after iron depletion: 43 (19-73) vs 36 (16-67) mm (P = 0.07). CONCLUSIONS: In patients with HH, cartilage homoeostasis is modified by iron excess and an increase in type II collagen turnover occurs after excess iron removal. [less ▲]

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See detailVaccinations in patients with immune-mediated inflammatory diseases.
Rahier, Jean-Francois; Moutschen, Michel ULg; Van Gompel, Alfons et al

in Rheumatology (2010), 49(10), 1815-27

Patients with immune-mediated inflammatory diseases (IMID) such as RA, IBD or psoriasis, are at increased risk of infection, partially because of the disease itself, but mostly because of treatment with ... [more ▼]

Patients with immune-mediated inflammatory diseases (IMID) such as RA, IBD or psoriasis, are at increased risk of infection, partially because of the disease itself, but mostly because of treatment with immunomodulatory or immunosuppressive drugs. In spite of their elevated risk for vaccine-preventable disease, vaccination coverage in IMID patients is surprisingly low. This review summarizes current literature data on vaccine safety and efficacy in IMID patients treated with immunosuppressive or immunomodulatory drugs and formulates best-practice recommendations on vaccination in this population. Especially in the current era of biological therapies, including TNF-blocking agents, special consideration should be given to vaccination strategies in IMID patients. Clinical evidence indicates that immunization of IMID patients does not increase clinical or laboratory parameters of disease activity. Live vaccines are contraindicated in immunocompromized individuals, but non-live vaccines can safely be given. Although the reduced quality of the immune response in patients under immunotherapy may have a negative impact on vaccination efficacy in this population, adequate humoral response to vaccination in IMID patients has been demonstrated for hepatitis B, influenza and pneumococcal vaccination. Vaccination status is best checked and updated before the start of immunomodulatory therapy: live vaccines are not contraindicated at that time and inactivated vaccines elicit an optimal immune response in immunocompetent individuals. [less ▲]

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See detailCurrent role of glucosamine in the treatment of osteoarthritis
Reginster, Jean-Yves ULg; Bruyère, Olivier ULg; Neuprez, Audrey

in Rheumatology (2007), 46(5), 731-735

Objectives. To evaluate the interest of using the various preparations of glucosamine for symptomatic and structural management of osteoarthritis (OA). Methods. A critical analysis of the literature based ... [more ▼]

Objectives. To evaluate the interest of using the various preparations of glucosamine for symptomatic and structural management of osteoarthritis (OA). Methods. A critical analysis of the literature based on an exhaustive search (Medline, PubMed and manual search within the bibliography of retrieved manuscripts) from 1980 to 2005. Results. Despite multiple controlled clinical trials of the use of glucosamine in OA (mainly of the knee), controversy on efficacy related to symptomatic improvement continues. Differences in results originate from the differences in products, study design and study populations. Symptomatic efficacy described in multiple studies performed with glucosamine sulphate (GS) support continued consideration in the OA therapeutic armamentarium. The most compelling evidence of a potential for inhibiting the progression of OA is also obtain with GS. Conclusions. GS has shown positive effects on symptomatic and structural outcomes of knee OA. These results should not be extrapolated to other glucosamine salts [hydrochloride or preparations (over-the-counter or food supplements)] in which no warranty exists about content, pharmacokinetics and pharmacodynamics of the tablets. [less ▲]

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See detailA dose adjustment in patients with rheumatoid arthritis not optimally responding to a standard dose of infliximab of 3 mg/kg every 8 weeks can be effective: a Belgian prospective study
Durez, P.; Van den Bosch, F.; Corluy, L. et al

in Rheumatology (2005), 44(4), 465-468

Objectives. To analyse the effect of a dose increase in patients with severe rheumatoid arthritis (RA) with insufficient clinical response to 3 mg/kg infliximab every 8 weeks. Methods. Patients suffering ... [more ▼]

Objectives. To analyse the effect of a dose increase in patients with severe rheumatoid arthritis (RA) with insufficient clinical response to 3 mg/kg infliximab every 8 weeks. Methods. Patients suffering from active refractory RA despite methotrexate, were treated with i.v. infusions of infliximab (3 mg/kg) on week 0, 2, 6 and every 8 weeks thereafter. Based on the clinical judgement at week 22, patients received a dose increase of 100 mg from week 30 on. The American College of Rheumatology (ACR) core set for disease activity measures was regularly assessed. Results. Five hundred and eleven RA patients were included. At week 22, 61.4, 34 and 14.1% of all patients met ACR 20, ACR 50 and ACR 70 criteria, respectively, and 6.1% of patients were in remission. A low swollen joint count at baseline was correlated with improvement at week 22 for ACR 20 (P < 0.06), ACR 50 (P < 0.06) and ACR 70 (P < 0.005). The change in HAQ score between weeks 0 and 22 was predictive for response at week 54 (P < 0.01). The dose of infliximab was increased by 100 mg in 22% of the patients. Most baseline values of patients requiring dose increase were higher (P <= 0.001) than the baseline values of the remaining patients. Increasing the dose of infliximab by one vial from week 30 on could circumvent the partial loss of response in these patients. Conclusion. Infliximab use in this large out-patient cohort resulted in a significant clinical improvement. A subgroup that partially lost response during the first 22 weeks could regain response by adding 100 mg of infliximab to the subsequent doses. Due to the current study design, however, a regression to the mean like effect could not be ruled out. [less ▲]

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See detailIntroduction and WHO perspective on the global burden of musculoskeletal conditions
Reginster, Jean-Yves ULg; Khaltaev, N. G.

in Rheumatology (2002), 41(Suppl. 1), 1-2

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See detailThe prevalence and burden of arthritis
Reginster, Jean-Yves ULg

in Rheumatology (2002), 41(Suppl. 1), 3-7

The prevalence of arthritis is high, with osteoarthritis (OA) being one of the most frequent disorders in the population. In England and Wales, between 1.3 and 1.75 million people have OA and a further 0 ... [more ▼]

The prevalence of arthritis is high, with osteoarthritis (OA) being one of the most frequent disorders in the population. In England and Wales, between 1.3 and 1.75 million people have OA and a further 0.25 0.5 million have rheumatoid arthritis (RA), while in France some 6 million new diagnoses of OA Lire made each year. In 1997, similar to16%, of the US population had some form of arthritis. This prevalence is expected to increase in the coining years, as arthritis more often affects the elderly, a proportion of the population that is increasing. The economic burden of such musculoskeletal diseases is also high, accounting for up to 1-2.5%, of the gross national product of western nations. This burden comprises both the direct costs of medical interventions and indirect costs, such as premature mortality and chronic and short-term disability. The impact of arthritis on quality of life is of particular importance. Musculoskeletal disorders are associated with some of the poorest quality-of-life issues, particularly in terms of bodily pain (mean score from the MOS 36-item Short Form Health Survey of 52.1) and physical functioning (49.9), where quality of life is lower than that for gastrointestinal conditions (bodily pain 52.9, physical functioning 55.4), chronic respiratory diseases (72.7, 65.4) and cardiovascular conditions (64.7, 59.3). [less ▲]

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See detailWHO Collaborating Centre consensus meeting on anti-cytokine therapy in rheumatoid arthritis
Emery, P.; Reginster, Jean-Yves ULg; Appelboom, T. et al

in Rheumatology (2001), 40(6), 699-702

Severe adult rheumatoid arthritis is a cause of progressive disability and increased mortality across Europe. A cure for the disease remains elusive, but control of symptoms and maintenance of individual ... [more ▼]

Severe adult rheumatoid arthritis is a cause of progressive disability and increased mortality across Europe. A cure for the disease remains elusive, but control of symptoms and maintenance of individual independence is possible. Anti-cytokine therapies offer a new approach to disease management. They are effective after the failure of full doses of methotrexate, and are at least as effective as methotrexate in retarding the progression of radiological changes. Until more is known about the long-term safety and efficacy of these drugs they should be reserved for patients with severe disease who are progressing despite adequate doses of methotrexate or other disease-modifying anti-rheumatic drugs. They should be continued until therapeutic failure or intolerance. A comprehensive health economic evaluation is needed to optimally direct the use of these drugs. This should be undertaken when long-term safety and efficacy studies are completed. [less ▲]

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See detailOn Conducting Burden-of-Osteoporosis Studies: A Review of the Core Concepts and Practical Issues. A Study Carried out under the Auspices of a Who Collaborating Center
Ben Sedrine, Wafa ULg; Radican, L.; Reginster, Jean-Yves ULg

in Rheumatology (2001), 40(1), 7-14

Osteoporosis is a problem that is relevant to public health from the clinical, economic and social viewpoints. Except in a handful of industrialized countries, there is a considerable void in our ... [more ▼]

Osteoporosis is a problem that is relevant to public health from the clinical, economic and social viewpoints. Except in a handful of industrialized countries, there is a considerable void in our knowledge of the magnitude of the problem. By exploring both the epidemiological and the economic impact of osteoporosis and the fractures associated with it in a particular country, studies of the 'burden of illness' (BOI) can fill that void. BOI analysis raises many questions at both the conceptual and the practical level. The purpose of this paper is to review the methodology underlying analyses of this type, to discuss its limitations and to provide a general format to improve their implementation in the field of osteoporosis. Investigators involved in BOI analysis should be very clear and explicit regarding the methods they adopt, so that studies in different countries can be interpreted and compared appropriately by interested parties. [less ▲]

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See detailSynovial fluid matrix metalloproteinase-3 levels are increased in inflammatory arthritides whether erosive or not
Ribbens, Clio ULg; Andre, Béatrice ULg; Kaye, O. et al

in Rheumatology (2000), 39(12), 1357-1365

OBJECTIVE: To study the levels of matrix metalloproteinase-3 (MMP-3) in the knee synovial fluid (SF) of inflammatory arthropathies (rheumatoid arthritis whether erosive or not, reactive arthritis, acute ... [more ▼]

OBJECTIVE: To study the levels of matrix metalloproteinase-3 (MMP-3) in the knee synovial fluid (SF) of inflammatory arthropathies (rheumatoid arthritis whether erosive or not, reactive arthritis, acute crystal arthritis) and degenerative arthropathies [chronic crystal disease, osteoarthritis and (control) meniscus pathology] and to correlate them with the degree of joint destruction, local inflammatory and immune parameters and systemic markers of inflammation. METHODS: SF levels of MMP-3 (precursor, active and tissue inhibitor of MMP-bound forms), tumour necrosis factor (TNF) alpha, soluble TNF receptors I and II, interleukin (IL)-6 and soluble IL-6 receptor were measured by ELISA in 107 inflammatory and 53 degenerative arthropathies. RESULTS: MMP-3 levels in SF were (i) significantly higher in inflammatory than in degenerative arthropathies; (ii) not related to the degree of joint destruction; (iii) significantly correlated with the levels of all SF markers tested and with erythrocyte sedimentation rate and serum levels of C-reactive protein and fibrinogen. CONCLUSION: Increased MMP-3 levels in SF are found in inflammatory arthropathies and are not specific for erosive joint diseases. MMP-3 in SF is therefore a potential candidate for the assessment of the inflammatory process in joints. However, the exclusive determination of the active form could indicate the degree of joint destruction. [less ▲]

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