Current rheumatology reviews最新文献

{"title":"Acroparesthesias: An Overview.","authors":"Maroua Slouma, Siwar Ben Dhia, Elhem Cheour, Imen Gharsallah","doi":"10.2174/0115733971254976230927113202","DOIUrl":"10.2174/0115733971254976230927113202","url":null,"abstract":"<p><p>Acroparesthesia is a symptom characterized by a subjective sensation, such as numbness, tingling, prickling, and reduced sensation, affecting the extremities (fingers and toes). Despite its frequency, data regarding its diagnostic approach and management are scarce. The etiological diagnosis of acroparesthesia is sometimes challenging since it can be due to abnormality anywhere along the sensory pathway from the peripheral nervous system to the cerebral cortex. Acroparesthesia can reveal several diseases. It can be associated with rheumatic complaints such as arthritis or myalgia. Further cautions are required when paresthesia is acute (within days) in onset, rapidly progressive, severe, asymmetric, proximal, multifocal, or associated with predominant motor signs (limb weakness) or severe dysautonomia. Acroparesthesia may reveal Guillain-Barré syndrome or vasculitis, requiring rapid management. Acroparesthesia is a predominant symptom of polyneuropathy, typically distal and symmetric, often due to diabetes. However, it can occur in other diseases such as vitamin B12 deficiency, monoclonal gammopathy of undetermined significance, or Fabry's disease. Mononeuropathy, mainly carpal tunnel syndrome, remains the most common cause of acroparesthesia. Ultrasonography contributes to the diagnosis of nerve entrapment neuropathy by showing nerve enlargement, hypoechogenic nerve, and intraneural vascularity. Besides, it can reveal its cause, such as space-occupying lesions, anatomical nerve variations, or anomalous muscle. Ultrasonography is also helpful for entrapment neuropathy treatment, such as ultrasound-guided steroid injection or carpal tunnel release. The management of acroparesthesia depends on its causes. This article aimed to review and summarize current knowledge on acroparesthesia and its causes. We also propose an algorithm for the management of acroparesthesia.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"115-126"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report of MPO+ ANCA Vasculitis with Pauci-immune GN Associated with Invasive Ductal Carcinoma of the Breast.","authors":"Biniyam Teka Mohammed, Nnenna Uzodi, Ashwini Gotimukul, Rediet Kokebie","doi":"10.2174/0115733971246438230924163114","DOIUrl":"10.2174/0115733971246438230924163114","url":null,"abstract":"<p><strong>Background: </strong>Malignancy-associated vasculitis usually presents in the form of polyarteritis nodosa or leukocytoclastic vasculitis. However, ANCA vasculitis associated with malignancy is rare. Here, we present a case of MPO+ ANCA vasculitis with pauci-immune GN associated with invasive ductal carcinoma of the breast.</p><p><strong>Case presentation: </strong>A 66-year-old female with a history of rheumatoid arthritis, Hashimoto's thyroiditis, and psoriasis presented with multiple joint pain, body aches, petechial rash, paresthesia and numbness, and deranged renal function a month after diagnosis of localized left breast invasive ductal carcinoma. Renal biopsy showed crescentic pauci-immune glomerulonephritis, and serology was positive for Perinuclear Antineutrophil Cytoplasmic Antibody (P-ANCA) and myeloperoxidase (MPO). The disease course was complicated by diverticulitis with peritonitis and intraperitoneal abscess collection, which required laparoscopic peritoneal lavage and additional interventional radiology-guided drainage of the abscess. We treated the patient successfully with steroids, rituximab, and mastectomy for left breast malignant lesions, resulting in the resolution of symptoms, normalization of inflammatory markers, and ANCA seroconversion.</p><p><strong>Conclusion: </strong>Treating ANCA-associated Vasculitis (AAV) in surgical emergencies like bowel perforation can be challenging. Individualized treatment strategy tailored to patients' acute needs is crucial. In this case, we considered malignancy-associated vasculitis and pursued treatment that fit the patient's clinical situation in a multidisciplinary approach.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"213-218"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Levels of Long Non-coding RNAs NEAT1, GAS5, and GAPLINC Altered in Rheumatoid Arthritis.","authors":"Roghayeh Tofigh, Mohammadali Hosseinpourfeizi, Reza Safaralizadeh, Sepideh Ghoddusifar, Behzad Baradaran","doi":"10.2174/0115733971251184230921042511","DOIUrl":"10.2174/0115733971251184230921042511","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA), an autoimmune joint inflammatory disease, presents a significant challenge due to its prevalence, particularly among women, affecting around 6% of individuals over the age of 65. Novel insights into disease mechanisms are crucial for improved diagnostic and therapeutic approaches.</p><p><strong>Objective: </strong>Long non-coding RNAs (lncRNAs) have emerged as potential contributors to the pathogenesis of various autoimmune diseases, including RA. This study aims to investigate the unique roles of four lncRNAs-NEAT1, GAS5, TMEVPG1, and GAPLINC-in the etiology of RA.</p><p><strong>Methods: </strong>Leveraging isolated serum samples from RA patients and healthy controls, we comprehensively evaluated the expression profiles of these lncRNAs.</p><p><strong>Results: </strong>Notably, our findings unveil a distinctive landscape of lncRNA expressions in RA. Among them, GAPLINC exhibited a significantly elevated average expression in the serum samples of RA patients, suggesting a potential biomarker candidate for disease stratification. Importantly, reduced expression of NEAT1 and GAS5 was observed in RA patients, highlighting their possible roles as diagnostic and prognostic markers. Conversely, TMEVPG1 displayed unaltered expression levels in RA samples.</p><p><strong>Conclusion: </strong>Our study introduces a novel dimension to RA research by identifying NEAT1, GAS5, and GAPLINC as promising serological biomarkers. These findings hold significant clinical implications, offering potential avenues for improved diagnosis, disease monitoring, and therapeutic interventions in RA.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"182-190"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Scleroderma\" and \"Scleroderma-like\" Capillaroscopic Pattern-Differences and Similarities.","authors":"Sevdalina Nikolova Lambova, Ulf Müller-Ladner","doi":"10.2174/0115733971265291231212045931","DOIUrl":"https://doi.org/10.2174/0115733971265291231212045931","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The \"scleroderma\" type capillaroscopic pattern is a reference pattern in rheumatology that is a diagnostic sign for systemic sclerosis (SSc) in an appropriate clinical context and is observed in more than 90% of scleroderma patients. Similar microvascular changes, the so-called \"scleroderma-like\", have been described albeit in a lower proportion of patients with other rheumatic diseases, such as dermatomyositis (DM), undifferentiated connective tissue diseases (UCTD), systemic lupus erythematosus (SLE), etc. Three distinct stages of \"scleroderma\" pattern have been suggested by Cutolo &lt;i&gt;et al., i.e&lt;/i&gt;., \"early\", \"active\", and \"late\". However, disease duration is just one of the factors that contributes to the progression of microvascular changes, and in this regard, \"active\" or even \"late\" pattern could be observed in patients with shorter disease duration. In addition, stable microvascular changes could be found for long periods in other cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the study was to assess the presence of differentiating features between \"scleroderma\" pattern in SSc and \"scleroderma-like\" pattern in other rheumatic diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;684 capillaroscopic images demonstrating a \"scleroderma\" and \"scleroderma-like\" pattern have been analysed in the current retrospective cross-sectional study. 479 capillaroscopic pictures were obtained from 50 SSc patients, 105 from 7 DM patients, 38 from 10 rheumatoid arthritis (RA) patients, 36 images from 5 patients with SLE, and 26 images from 9 patients with UCTD. All capillaroscopic images used in the current analysis have fulfilled the criteria for \"sclerderma/scleroderma-like\" pattern, as the pathological changes in the capillaroscopic parameters have also been confirmed by quantitative measurement of capillary diameters, capillary density, and intercapillary distance. All the images have been categorized into one of the following groups, i.e., \"early\", \"active\" and \"late\" phases (according to the definition of Cutolo &lt;i&gt;et al&lt;/i&gt;.), or \"other\" findings, the latter being specifically described as they could not be attributed to one of the other three categories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;479 capillaroscopic pictures were obtained from 50 scleroderma patients. 31 of them showed an \"early\", 391 an \"active\" phase, and 57 a \"late\" phase \"scleroderma\" type microangiopathy. In 69 images assessed as an \"active\" pattern, neoangiogenesis was found. In 43 out of 105 capillaroscopic pictures from DM patients, an \"active\" phase was detected; in 2 of the images, a \"late\" pattern was found, and in 60 capillaroscopic pictures, neoangiogenesis in combination with giant capillary loops was observed. Early microangiopathy was not found in this group. Among capillaroscopic images from SLE patients, \"late\" phase microangiopathy was not found. \"Early\" phase was present in 3 images, \"active\" phase in 29, neoangiogenesis in \"active\" phase in 4 p","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":"20 3","pages":"304-316"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Postmenopausal Osteoporosis by Moroccan General Practitioners: A Cross-Sectional Survey.","authors":"Ahmed Mougui, Imane El Bouchti","doi":"10.2174/1573397119666230731122645","DOIUrl":"10.2174/1573397119666230731122645","url":null,"abstract":"<p><strong>Background: </strong>Despite the existence of effective treatments and prescribed therapeutic protocols, there is a lack of management of osteoporosis, resulting in increased secondary morbidity and mortality. The general practitioner (GP) is the first-line practitioner for the detection and management of osteoporosis.</p><p><strong>Objective: </strong>This study was conducted to explore the practices, knowledge, and difficulties in postmenopausal osteoporosis management reported by GPs.</p><p><strong>Methods: </strong>An anonymous questionnaire (19 questions) was created via Google Forms and distributed to 300 GPs via social networks (WhatsApp, Facebook, and Gmail). The survey results were automatically calculated on \"Google Forms\" and checked using SPSS.20 software.</p><p><strong>Results: </strong>A total of 129 responses were received, representing a response rate of 43%. The majority of respondents were women (67.2%). The definition of osteoporosis was variable, with 51.6% defining it as a T-score of ≤-2.5 SD, 25.8% defining it as diffuse bone demineralization, and 12.1% defining it as a fracture after falling with low energy. Prolonged corticosteroid therapy was the most commonly indicated reason for measuring bone mineral density (BMD) (81.39%). The calcium phosphate balance was the most requested (90.1%). Vitamin D and calcium supplementation were reported by 74.41% and 54.26% of GPs, respectively. Fracture of the upper end of the femur was the main therapeutic indication (65.11%). Most GPs surveyed (73.3%) were unfamiliar with the fracture risk assessment tool (FRAX). Most of the GPs gave advice on fall prevention to their patients (83.72%), and 62.5% of GPs monitored their patients' height. Anti-osteoporosis treatment was maintained for 3 to 5 years by 44.96% of GPs.</p><p><strong>Conclusion: </strong>Our survey found that the practices and knowledge of GPs on osteoporosis vary widely and often deviate from the recommended standards. This highlights the need for more excellent education of GPs, due to their vital role in the management of osteoporosis.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"100-106"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Benefits of Psilocybin for Lupus Pain: A Case Report.","authors":"Sofia Audrey B Gonzales, Christine Alexopoulos, Daniel G Arkfeld","doi":"10.2174/1573397119666230904150750","DOIUrl":"10.2174/1573397119666230904150750","url":null,"abstract":"<p><strong>Introduction: </strong>Outcomes of treatment for patients with Lupus have shown overall improvement and benefit from the more aggressive use of immunosuppressants and biological agents through a treat-to-target approach. However, chronic musculoskeletal pain can be refractory to treatment despite the use of non-steroidal anti-inflammatory drugs, corticosteroids, and other analgesic agents, leading to patient dissatisfaction. The concept of new neural pathways from psilocybin usage has been proposed in a variety of pain syndromes; however, it is not trialed for patients with Lupus pain.</p><p><strong>Case presentation: </strong>The patient was a 67-year-old male with positive anti-dsDNA antibody Lupus with a predominance of chronic polyarticular joint pain treated with hydroxychloroquine and non-steroidal anti-inflammatory drugs without pain relief. Pain dramatically improved after a one-time macro-dosing of 6 grams of Psilocybin cubensis in Oregon, which he expected would only provide a sense of enlightenment. After 12 months, he continued without debilitating joint pain.</p><p><strong>Conclusion: </strong>The serotonin-2A receptor's activation triggers an array of neurophysiological reactions that disrupt the functional connections in areas of the brain that are associated with chronic pain. These neuroplastic effects can generate healthy connections, resulting in long-lasting pain relief. However, this is a process that has not been fully analyzed. While there is anecdotal evidence to suggest the therapeutic benefits for autoimmune diseases, including rheumatoid arthritis and psoriasis, there is no specific research that explores its use for lupus-related pain. Since this is the first case that shows the benefit of psilocybin in a patient with Lupus, further studies on macro-dosing psilocybin to treat Lupus pain are warranted.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"97-99"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10162596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Short Course Low-dose Prednisolone in Patients with Clinically Suspected Seronegative Inflammatory Arthritis - A Retrospective Study.","authors":"Sam Shan, Mueed Mian","doi":"10.2174/0115733971273652231213092458","DOIUrl":"10.2174/0115733971273652231213092458","url":null,"abstract":"<p><strong>Objective: </strong>We aim to establish the utility of a trial of low-dose systemic glucocorticoid therapy in the assessment of new clinically suspected inflammatory arthritis patients.</p><p><strong>Methods: </strong>We retrospectively identified patients from a private rheumatology practice in Melbourne, Australia between January 1st, 2019, and December 31st, 2021, who presented with clinically suspected inflammatory arthritis and subsequently underwent a trial of low-dose prednisolone (15 mg daily weaned over three weeks in 5 mg increments). We excluded patients with known autoimmune/ inflammatory disorders or concurrent immunosuppression at presentation. We collected basic participant demographic details and clinical details of their presentation, glucocorticoid response, investigations, and treatment.</p><p><strong>Results: </strong>We recruited 177 participants with a median age of 52, and 69.5% were female gender. The median symptom time to presentation was 12 months. Hands were the most affected joint in 63.3% and 85% had bilateral disease. Among the participants, 29.4% had synovitis on clinical review and 75.7% had imaging performed as part of the initial assessment. At presentation, the median CRP was 11 and the median ESR was 16. 79.7% of the cohort experienced significant improvement in their arthritis symptoms from low-dose glucocorticoids and 83.6% of the cohort required long-term immunosuppression for an underlying inflammatory condition. Of those who responded to glucocorticoids, 92.1% were diagnosed with an inflammatory condition. Rheumatoid arthritis was the most common overall diagnosis in 28%.</p><p><strong>Conclusion: </strong>An initial trial of low-dose glucocorticoids in undifferentiated arthritis patients is useful in predicting the diagnosis of inflammatory arthritis. It is also a predictor of further long-term steroid-sparing therapy.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"296-303"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139086334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet and Lifestyle Modifications for Fibromyalgia.","authors":"Caroline Metyas, Tun Tun Aung, Jennifer Cheung, Marina Joseph, Andrew M Ballester, Samy Metyas","doi":"10.2174/0115733971274700231226075717","DOIUrl":"10.2174/0115733971274700231226075717","url":null,"abstract":"<p><p>Fibromyalgia (FM) is a complex, widespread pain disorder characterized by symptoms such as fatigue, sleep deprivation, mental fog, mood swings, and headaches. Currently, there are only three FDA-approved medications for FM patients: duloxetine, milnacipran, and pregabalin, with outcomes frequently being inadequate. This research team aims to investigate the effects of diet and lifestyle modifications on FM, with emphasis on anti-inflammatory diet, antioxidants, and gluten-free diets, as well as supplementation with Magnesium, CQ10, and Vitamin D, microbiome, sleep, exercise, and cognitive behavioral therapy. We reviewed the pathophysiology of certain foods that can be proinflammatory with the release of cytokines leading to activation of pain, fatigue and aggravation of the majority of Fibromyalgia symptoms. A literature review was performed by identifying FM articles published between 1994 and 2022 <i>via</i> PubMed and EMBASE databases, with particular emphasis on randomized controlled trials, meta-analysis, and evidence-based treatment guidelines. This review article was completed by a comprehensive narrative review process, in which our team systematically examined relevant scientific literature to provide a comprehensive overview of the significant role that diet and other lifestyle modifications play in mediating symptoms of Fibromyalgia. We propose that diet modifications and lifestyle changes, such as sleep, exercise, and weight loss, can be important steps in managing FM.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"405-413"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139566672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Excision of a Localized Tenosynovial Giant Cell Tumor of the Knee: A Case Report.","authors":"Hassan Zmerly, Maurizio Draghetti, Manuela Moscato, Ibrahim Akkawi","doi":"10.2174/0115733971272967231120114621","DOIUrl":"10.2174/0115733971272967231120114621","url":null,"abstract":"<p><strong>Background and aim: </strong>A tenosynovial giant cell tumor (TGCT) is a proliferative lesion of the synovial membrane of the joints, tendon sheaths and/or bursae. There are two described subtypes, including the localized and diffuse forms. A TGCT can also be intraarticular or extraarticular. An intraarticular localized tenosynovial giant cell tumor (L-TGCT) of the knee is characterized by nodular hyperplasic synovial tissue that can remain asymptomatic for a long time, but as the mass grows, it may cause mechanical symptoms that may require surgical treatment. The aim of our study is to present a rare case of an L-TGCT of the knee joint treated with an arthroscopic excision.</p><p><strong>Case report: </strong>We describe the case of a 17-year-old female with pain, swelling and knee locking in the absence of trauma. The magnetic resonance imaging (MRI) displayed a well-circumscribed small mass in the anterior medial compartment, adherent to the infrapatellar fat pad. The lesion presented the typical MRI characteristics of an intraarticular localized TGCT. The patient was treated with an arthroscopic mass removal and partial synovectomy. The gross pathology showed an ovoid nodule that was covered by a fibrous capsule; a histopathology examination confirmed the diagnosis. The patient was able to return to normal daily activities one month after surgery; at the three-year follow-up, she was free of symptoms with no evidence of disease on the MRI.</p><p><strong>Conclusion: </strong>In patients with a small-dimension L-TGCT in the anterior compartment of the knee that presents an MRI pattern and causes mechanical symptoms, an arthroscopic en-bloc excision can be performed that results in good outcomes and a rapid return to preinjury levels.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"459-464"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Frequency of Upper Gastrointestinal Bleeding Despite Non-Steroidal Anti-Inflammatory Drugs and Corticosteroids in Patients with Rheumatoid Arthritis.","authors":"Wilder Carvajal-Gutiérrez, María A Cisneros-Cisneros, Omar-Javier Calixto, Maria-Alejandra Meneses-Toro, Andrés Jesús Prada Rueda, Merardo A Vega-Báez, Duván A Álvarez-Vargas, Adriana C Uscátegui-Ruiz, Consuelo Romero-Sanchez, Juan-Manuel Bello-Gualtero","doi":"10.2174/0115733971290285240207080745","DOIUrl":"10.2174/0115733971290285240207080745","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic inflammatory disease. It has been identified that non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can be essential risk factors for developing complications such as upper gastrointestinal bleeding (UGIB).</p><p><strong>Objective: </strong>This study aimed to describe the safety profile of drugs used to treat RA focused in UGIB.</p><p><strong>Methods: </strong>A cross-sectional study of patients with RA between 2015 and 2021, a description of the population, and an evaluation of the relationship with UGIB through bivariate analysis and logistic regression.</p><p><strong>Results: </strong>Of 405 individuals, 16 presented UGIB (93.8% women, mean age was 65±13.6 years). No statistically significant differences were found regarding UGIB and medication use, except for the mean dose of corticosteroids. In the multivariate analysis, it was found that the presence of anemia in the last three months had an adjusted OR (AOR) of 16.1 (95% CI 2.74- 24.23) and higher HAQ values during the previous three months had an AOR of 6.17 (95% CI 1.79- 21.24).</p><p><strong>Conclusion: </strong>This study found a low frequency of UGIB in patients with RA. More significant disability and anemia in the previous months were independently associated with UGIB. The low frequency of NSAID use in this population is noteworthy. In general, reasonable medication use related to this complication is recommended.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"555-562"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}