Combination therapy with pulsed methylprednisolone in rheumatoid arthritis.

Abstract:

:Pulsed methylprednisolone (PMP) has been shown to produce clinical improvement and reduction in the ESR and acute phase protein concentrations in patients with active rheumatoid arthritis and has been advocated for use either as an alternative to slow-acting antirheumatoid drugs (SAARDs) or in conjunction with SAARDs to accelerate the response to treatment. To test these potential roles for PMP 45 patients with active RA were randomly allocated to treatment with PMP alone, PMP + sulphasalazine (SAS - at a maintenance dose of 2.0 g/day), or PMP + D-penicillamine (DPA - at a maintenance dose of 500 mg/day). In each case three 1 g intravenous infusions were given on alternate days during the first week of the trial. Patients were monitored for 24 weeks by standard clinical and laboratory measurements. All three treatment groups showed significant clinical and laboratory improvements at two weeks. With PMP + DPA and PMP + SAS these improvements were sustained and were not significantly different in these two treatment groups. However, in the 'PMP only' group ESR and CRP rose to pretreatment values by eight weeks. Twelve patients withdrew from the study owing to a relapse of the RA. No serious adverse effects were seen in the 'PMP only' group. Both combination regimens were well tolerated; adverse effects seen were attributable to either DPA or SAS. We conclude that PMP alone is insufficient for treatment of RA but can be used successfully in combination with either DPA or SAS. A comparison between these results obtained from two previous groups of 15 patients treated with DPA alone and SAS alone (using the same study design) shows that PMP accelerated the response to therapy by at least six weeks.

journal_name

Ann Rheum Dis

authors

Neumann V,Hopkins R,Dixon J,Watkins A,Bird H,Wright V

doi

10.1136/ard.44.11.747

subject

Has Abstract

pub_date

1985-11-01 00:00:00

pages

747-51

issue

11

eissn

0003-4967

issn

1468-2060

journal_volume

44

pub_type

临床试验,杂志文章,随机对照试验
  • Bone anabolic changes progress in psoriatic arthritis patients despite treatment with methotrexate or tumour necrosis factor inhibitors.

    abstract:OBJECTIVES:To investigate whether methotrexate or tumour necrosis factor inhibitors (TNFi) affect osteophyte formation in patients with psoriatic arthritis (PsA). METHODS:41 patients with PsA were examined for the presence of osteophytes and erosions at the metacarpophalangeal joints by high-resolution micro-CT imagin...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/annrheumdis-2012-201580

    authors: Finzel S,Kraus S,Schmidt S,Hueber A,Rech J,Engelke K,Englbrecht M,Schett G

    更新日期:2013-07-01 00:00:00

  • Assessment of anti-inflammatory drugs in the rat using subcutaneous implants of polyurethane foam impregnated with dead tubercle bacilli.

    abstract::The fluid and cellular phases of inflammatory resonse have been measured using a technique employing subcutaneous implantation of polyurethane foam cubes impregnated with heat-killed Mycobacterium tuberculosis. Phenylbutazone, azathioprine, aspirin, cyclophosphamide, and prednisolone suppressed fluid response, whereas...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.34.4.326

    authors: Clarke AK,Vernon-Roberts B,Currey HL

    更新日期:1975-08-01 00:00:00

  • Relationship between serum hyaluronic acid level and disease activity in early rheumatoid arthritis.

    abstract:OBJECTIVES:To measure hyaluronic acid (HA) levels, which are raised in active rheumatoid arthritis (RA), in patients with early RA, and to assess the correlation with clinical and laboratory indices of disease activity and with subsequent radiographic erosive status. PATIENTS AND METHODS:Patients fulfilling ACR criter...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.2003.010942

    authors: Majeed M,McQueen F,Yeoman S,McLean L

    更新日期:2004-09-01 00:00:00

  • Intra-articular corticosteroids are effective in osteoarthritis but there are no clinical predictors of response.

    abstract:OBJECTIVES:To show whether intra-articular steroid injections are effective in osteoarthritis; to determine factors that predict response; and to determine whether injection has a beneficial effect on muscle strength. METHODS:Double blind, placebo controlled, crossover study in 59 patients with symptomatic osteoarthri...

    journal_title:Annals of the rheumatic diseases

    pub_type: 临床试验,杂志文章

    doi:10.1136/ard.55.11.829

    authors: Jones A,Doherty M

    更新日期:1996-11-01 00:00:00

  • Arthritis and angioimmunoblastic lymphadenopathy.

    abstract::We report 2 contrasting cases of a seronegative polyarthritis associated with angioimmunoblastic lymphadenopathy (AILD). Both cases were nonerosive, with symmetrical involvement of the elbows, wrists, knees, and ankles. In one the arthritis appeared concurrently with the main systemic manifestations of AILD. The secon...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.42.5.516

    authors: Davies PG,Fordham JN

    更新日期:1983-10-01 00:00:00

  • Antibodies against cyclic citrullinated peptides of IgG, IgA and IgM isotype and rheumatoid factor of IgM and IgA isotype are increased in unaffected members of multicase rheumatoid arthritis families from northern Sweden.

    abstract:BACKGROUND:Rheumatoid factors (RFs) and antibodies against cyclic citrullinated peptides (CCPs) of IgG, IgA and IgM isotype have been shown to precede disease onset by years. OBJECTIVE:To evaluate serological risk markers in first-degree relatives from multicase families in relation to genetic and environmental risk f...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/annrheumdis-2011-200668

    authors: Ärlestig L,Mullazehi M,Kokkonen H,Rocklöv J,Rönnelid J,Dahlqvist SR

    更新日期:2012-06-01 00:00:00

  • Socioeconomic deprivation and rheumatoid disease: what lessons for the health service? ERAS Study Group. Early Rheumatoid Arthritis Study.

    abstract:OBJECTIVE:To assess how socioeconomic deprivation influences the presentation, treatment, and outcome of patients with rheumatoid arthritis (RA). METHODS:Three year follow up of 869 consecutive patients with RA from nine hospital rheumatology clinics, with patients categorised by the Carstairs deprivation score of the...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.59.10.794

    authors:

    更新日期:2000-10-01 00:00:00

  • Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids.

    abstract::Peripheral and axial bone mass and fracture incidence were studied in a group of 104 postmenopausal patients with rheumatoid arthritis (RA). Patients were divided into non-corticosteroid and low dose corticosteroid treated groups after elimination of patients with concomitant disease or therapy which might affect bone...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.45.10.852

    authors: Verstraeten A,Dequeker J

    更新日期:1986-10-01 00:00:00

  • Risk of diabetes mellitus associated with disease-modifying antirheumatic drugs and statins in rheumatoid arthritis.

    abstract:OBJECTIVE:To investigate the rate of incident diabetes mellitus (DM) in patients with rheumatoid arthritis (RA) and the impact of disease-modifying antirheumatic drug (DMARD) and statin treatments. METHODS:We studied patients with RA and ≥1 year participation in the National Data Bank for Rheumatic Diseases without ba...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/annrheumdis-2016-209954

    authors: Ozen G,Pedro S,Holmqvist ME,Avery M,Wolfe F,Michaud K

    更新日期:2017-05-01 00:00:00

  • Aggressive combination drug therapy in very early polyarticular juvenile idiopathic arthritis (ACUTE-JIA): a multicentre randomised open-label clinical trial.

    abstract:OBJECTIVES:In juvenile idiopathic arthritis (JIA), the efficacy of very early disease-modifying drug therapy, synthetic or biological, is not well known. Three alternative strategies were compared for treating recent-onset polyarticular JIA. METHODS:In a 54-week multicentre open-label clinical trial, 60 disease-modify...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/ard.2010.143347

    authors: Tynjälä P,Vähäsalo P,Tarkiainen M,Kröger L,Aalto K,Malin M,Putto-Laurila A,Honkanen V,Lahdenne P

    更新日期:2011-09-01 00:00:00

  • EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria.

    abstract::The aim of this report was to propose a definition for erosive disease in the context of inflammatory arthritis in light of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria for use in clinical practice and studies. A EULAR task force was form...

    journal_title:Annals of the rheumatic diseases

    pub_type: 共识发展会议,杂志文章

    doi:10.1136/annrheumdis-2012-202779

    authors: van der Heijde D,van der Helm-van Mil AH,Aletaha D,Bingham CO,Burmester GR,Dougados M,Emery P,Felson D,Knevel R,Kvien TK,Landewé RB,Lukas C,McInnes I,Silman AJ,Smolen JS,Stanislawska-Biernat E,Zink A,Combe B

    更新日期:2013-04-01 00:00:00

  • Osteoarthritis of the knee in Nigerians.

    abstract::Eighty-one patients with 116 osteoarthritic knees were seen by the author at the University College Hospital (UCH), Ibadan in six years. Below the age of 50 the disease was significantly commoner among Nigerians than Caucasians; 39.5% of our patients were less than 50 years old, compared with 1.1% of Caucasians. In co...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.44.10.682

    authors: Ebong WW

    更新日期:1985-10-01 00:00:00

  • An open label, single dose study to evaluate the safety, efficacy, and effects on CD25 expression of ciclosporin in patients with active rheumatoid arthritis despite treatment with methotrexate and infliximab.

    abstract:OBJECTIVE:To explore the safety, efficacy, and lymphocyte activation of a triple therapeutic regimen with infliximab, methotrexate (MTX), and ciclosporin A (CsA) by an open label, pilot study. PATIENTS AND METHODS:19 patients (mean age 52.9 years) with active rheumatoid arthritis (mean DAS28 7.3) after a mean of 16.8 ...

    journal_title:Annals of the rheumatic diseases

    pub_type: 临床试验,杂志文章

    doi:10.1136/ard.2005.036152

    authors: Sidiropoulos PI,Siakka P,Raptopoulou A,Mamoulaki M,Choulaki C,Koutala H,Kouroumali H,Kritikos H,Boumpas DT

    更新日期:2006-04-01 00:00:00

  • A case of weak muscles.

    abstract:BACKGROUND:Gut involvement in inflammatory myositis is rare but causes significant morbidity and mortality. CASE REPORT:A case of eosinophilic gastroenteritis and polymyositis occurring in the same patient is described. The interface of visceral and striated muscle involvement is discussed. The pathophysiology of eosi...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.61.1.10

    authors: Sofat N,Pitcher M,Price A,El-Jabbour JN,Higgens CS

    更新日期:2002-01-01 00:00:00

  • Triple crystal disease: monosodium urate monohydrate, calcium pyrophosphate dihydrate, and basic calcium phosphate in a single joint.

    abstract::A 49 year old man is described with a polyarticular arthritis. Synovial fluid aspirated from the knee joint showed monosodium urate monohydrate and calcium pyrophosphate dihydrate by polarised light microscopy. Additionally, diphosphonate binding and scanning electron microscopy with energy dispersive analysis showed ...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.47.10.864

    authors: Halverson PB,Ryan LM

    更新日期:1988-10-01 00:00:00

  • Disability in adults with hip and knee arthroplasty: a French national community based survey.

    abstract:OBJECTIVES:To compare levels of disability of people with and without hip and knee arthroplasty in a random national sample. METHODS:In 1999 a screening questionnaire to classify people into groups of increasing probabilities of disability was sent to 417 500 people; response rate 86%. The study population was obtaine...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.62.8.748

    authors: Boutron I,Poiraudeau S,Ravaud JF,Baron G,Revel M,Nizard R,Dougados M,Ravaud P

    更新日期:2003-08-01 00:00:00

  • Male sex predominance in Chlamydia trachomatis sexually acquired reactive arthritis: are women more protected by anti-chlamydia antibodies?

    abstract:OBJECTIVE:To determine whether the humoral anti-chlamydia antibody response might be related to the ineffective bacterial elimination seen in patients with Chlamydia trachomatis reactive arthritis, particularly in men, who have a higher prevalence of the disease than women. METHODS:The number and specificity of the an...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.60.6.605

    authors: Bas S,Scieux C,Vischer TL

    更新日期:2001-06-01 00:00:00

  • The unclosing premature mortality gap in gout: a general population-based study.

    abstract:OBJECTIVE:Gout, the most common inflammatory arthritis, is associated with premature mortality. Whether this mortality gap has improved over time, as observed in rheumatoid arthritis (RA), is unknown. METHODS:Using an electronic medical record database representative of the UK general population, we identified inciden...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/annrheumdis-2016-210588

    authors: Fisher MC,Rai SK,Lu N,Zhang Y,Choi HK

    更新日期:2017-07-01 00:00:00

  • Polymorphisms of the mannose binding lectin gene in patients with Sjögren's syndrome.

    abstract:OBJECTIVE:To investigate polymorphisms of both codon 54 allele and promoter variants of the mannose binding lectin (MBL) gene in patients with primary Sjögren's syndrome (SS). METHODS:Polymorphisms of codon 54 allele and promoter variants of the MBL gene in 104 patients with SS and 143 healthy controls were determined...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.60.5.483

    authors: Wang ZY,Morinobu A,Kanagawa S,Kumagai S

    更新日期:2001-05-01 00:00:00

  • Therapeutic value of arthroscopy.

    abstract::Thermography before and after joint irrigation at arthroscopy showed no significant improvement of inflammation in 14 patients. Subjectively, those with chondrocalcinosis did best. ...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.37.1.78

    authors: Bird HA,Ring EF

    更新日期:1978-02-01 00:00:00

  • Metric properties of advanced imaging methods in osteoarthritis of the hand: a systematic review.

    abstract:OBJECTIVE:To assess the value of advanced imaging techniques in the detection of hand osteoarthritis (OA) and hand OA progression. METHODS:PubMed/Medline and Embase were searched until April 2012 for studies on imaging of hand OA that presented quantitative data on validity, reliability or responsiveness. Articles pre...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章,评审

    doi:10.1136/annrheumdis-2012-202515

    authors: Saltzherr MS,Selles RW,Bierma-Zeinstra SM,Muradin GS,Coert JH,van Neck JW,Luime JJ

    更新日期:2014-02-01 00:00:00

  • Early effects of tumour necrosis factor alpha blockade on skin and synovial tissue in patients with active psoriasis and psoriatic arthritis.

    abstract:BACKGROUND:Tumour necrosis factor alpha (TNFalpha) blockade using infliximab, a chimeric anti-TNFalpha antibody, is an effective treatment for both psoriasis and psoriatic arthritis (PsA). OBJECTIVE:To analyse the early effects of infliximab treatment on serial skin and synovial tissue biopsy samples. METHODS:Twelve ...

    journal_title:Annals of the rheumatic diseases

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/ard.2003.018085

    authors: Goedkoop AY,Kraan MC,Teunissen MB,Picavet DI,de Rie MA,Bos JD,Tak PP

    更新日期:2004-07-01 00:00:00

  • Oxidative response of polymorphonuclear leucocytes to synovial fluids from patients with rheumatoid arthritis.

    abstract::Only a minority (7/35, 20%) of synovial fluids from patients with rheumatoid arthritis (RA) and none from patients with other arthritides stimulated the oxidative response of polymorphonuclear leucocytes (PMNs). Superoxide anion generation was measured by superoxide dismutase inhibitable reduction of cytochrome c. The...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.49.9.661

    authors: Dularay B,Badesha JS,Dieppe PA,Elson CJ

    更新日期:1990-09-01 00:00:00

  • Further evidence that a cartilage-pannus junction synovitis predilection is not a specific feature of rheumatoid arthritis.

    abstract:BACKGROUND:Qualitative differences in synovitis between the cartilage-pannus junction (CPJ) region and the adjoining suprapatellar pouch (SPP) have been reported in rheumatoid arthritis and the spondyloarthropathies. OBJECTIVE:To determine if the distribution of synovitis is the same in osteoarthritis (OA) using sensi...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.2004.033688

    authors: Rhodes LA,Conaghan PG,Radjenovic A,Grainger AJ,Emery P,McGonagle D

    更新日期:2005-09-01 00:00:00

  • Do knee abnormalities visualised on MRI explain knee pain in knee osteoarthritis? A systematic review.

    abstract:OBJECTIVE:To systematically evaluate the association between MRI findings (cartilage defects, bone marrow lesions (BML), osteophytes, meniscal lesion, effusion/synovitis, ligamentous abnormalities, subchondral cysts and bone attrition) and pain in patients with knee osteoarthritis (OA) in order to establish the relevan...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章,评审

    doi:10.1136/ard.2010.131904

    authors: Yusuf E,Kortekaas MC,Watt I,Huizinga TW,Kloppenburg M

    更新日期:2011-01-01 00:00:00

  • Genetic studies on components of the Wnt signalling pathway and the severity of joint destruction in rheumatoid arthritis.

    abstract:BACKGROUND:Progression of joint destruction in rheumatoid arthritis (RA) is partly heritable; knowledge of genetic factors may increase our understanding of the mechanisms underlying joint destruction. The activity of the Wnt/β-catenin pathway influences osteoblast differentiation. Dickkopf-1 (Dkk-1) and sclerostin (So...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章,meta分析

    doi:10.1136/annrheumdis-2012-202184

    authors: de Rooy DP,Yeremenko NG,Wilson AG,Knevel R,Lindqvist E,Saxne T,Krabben A,Leijsma MK,Daha NA,Tsonaka S,Zhernakova A,Houwing-Duistermaat JJ,Huizinga TW,Toes RE,Baeten DL,Brouwer E,van der Helm-van Mil AH

    更新日期:2013-05-01 00:00:00

  • Clinical and ultrasonographic predictors of joint replacement for knee osteoarthritis: results from a large, 3-year, prospective EULAR study.

    abstract:OBJECTIVES:To determine clinical and ultrasonographic predictors of joint replacement surgery across Europe in primary osteoarthritis (OA) of the knee. METHODS:This was a 3-year prospective study of a painful OA knee cohort (from a EULAR-sponsored, multicentre study). All subjects had clinical evaluation, radiographs ...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章,多中心研究

    doi:10.1136/ard.2008.099564

    authors: Conaghan PG,D'Agostino MA,Le Bars M,Baron G,Schmidely N,Wakefield R,Ravaud P,Grassi W,Martin-Mola E,So A,Backhaus M,Malaise M,Emery P,Dougados M

    更新日期:2010-04-01 00:00:00

  • IFI44L promoter methylation as a blood biomarker for systemic lupus erythematosus.

    abstract:OBJECTIVE:Systemic lupus erythematosus (SLE) is a clinically heterogeneous disease with limited reliable diagnostic biomarkers. We investigated whether gene methylation could meet sensitivity and specificity criteria for a robust biomarker. METHODS:IFI44L promoter methylation was examined using DNA samples from a disc...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/annrheumdis-2015-208410

    authors: Zhao M,Zhou Y,Zhu B,Wan M,Jiang T,Tan Q,Liu Y,Jiang J,Luo S,Tan Y,Wu H,Renauer P,Del Mar Ayala Gutiérrez M,Castillo Palma MJ,Ortega Castro R,Fernández-Roldán C,Raya E,Faria R,Carvalho C,Alarcón-Riquelme ME,Xiang Z

    更新日期:2016-11-01 00:00:00

  • Association of inflammation with raised serum IgA in ankylosing spondylitis.

    abstract::Serum immunoglobulins were measured in 122 patients with ankylosing spondylitis (AS) during various phases of disease activity and compared to those in 58 healthy subjects. The mean serum IgA was 38% higher in patients (306.9 mg/dl) than in controls (222.7 mg/dl) (P < 0.005), but there was no significant difference in...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.39.6.545

    authors: Cowling P,Ebringer R,Ebringer A

    更新日期:1980-12-01 00:00:00

  • A novel gene variation of TNFalpha associated with ankylosing spondylitis: a reconfirmed study.

    abstract:BACKGROUND:A great deal of evidence has shown that non-human leucocyte antigen (HLA)-B27 genes may play crucial roles in the aetiology of ankylosing spondylitis (AS), but there is little evidence of a relationship with tumour necrosis factor (TNF)alpha gene variation. One functional single-nucleotide polymorphism (SNP)...

    journal_title:Annals of the rheumatic diseases

    pub_type: 杂志文章

    doi:10.1136/ard.2006.068528

    authors: Zhu X,Wang Y,Sun L,Song Y,Sun F,Tang L,Huo Z,Li J,Yang Z

    更新日期:2007-11-01 00:00:00