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1.
Kurume Med J ; 68(1): 1-8, 2023 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-36754380

RESUMO

Currently, there is no surgical assistance system that can perform a three-dimensional (3D) planned total hip arthroplasty (THA) by methods other than surgical assistance navigation or robots. However, they are expensive, cumbersome, and subject to additional invasiveness, so there is a need for a simpler and less expensive 3D surgical support system. In this study, THA was performed using the anterolateral approach (Watson-Jones) in the supine position in 23 subjects to examine the efficacy and safety of a patient-specific femoral guide linked to 3D surgery support software. In 48% of the subjects, the difference in anterior torsion angle from the preoperative plan was within ±5 degrees, while in 83% of the subjects, the difference was within ±10 degrees. The 95% confidence interval (4.61-8.70) of the absolute difference did not fall below the pre-defined threshold of 7.2 degrees (p = 0.293). No adverse events were observed other than 2 cases (8.7%) of hemorrhage that required a blood transfusion. We confirmed the efficacy and safety of the patient-specific femoral guide in anterolateral supine approach THA.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Cirurgia Assistida por Computador , Humanos , Artroplastia de Quadril/métodos , Fêmur/cirurgia , Software , Cirurgia Assistida por Computador/métodos
2.
Mod Rheumatol ; 33(2): 292-301, 2023 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-35289372

RESUMO

OBJECTIVES: The study aimed to investigate the effectiveness and tolerance of biological disease-modifying antirheumatic drugs (bDMARDs) therapy administered concomitantly with tacrolimus (TAC) treatment in patients with rheumatoid arthritis. METHODS: 2792 patients who underwent therapy with five bDMARDs (etanercept: ETN, adalimumab, golimumab, tocilizumab, and abatacept: ABT) were enrolled. Among the study subjects, 1582 were concomitant methotrexate (MTX group), 147 were concomitant TAC (TAC group), and 1063 were non-concomitant MTX and TAC (non-MTX/TAC group). The primary outcome was the incident rate of discontinuation of bDMARDs by adverse events (AEs) or loss of efficacy. RESULTS: Concerning the analysis for each reasons of discontinuation, including AEs and loss of efficacy, the hazards ratio (HR) was significantly lower in the TAC group than in non-MTX/TAC groups (AEs: HR = 0.39, 95% confidence interval, 0.23-0.68, loss of efficacy: HR = 0.49, 95% confidence interval, 0.30-0.78). The loss of efficacy with the use of ETN and ABT was lower in the TAC group than in non-MTX/TAC groups. Concomitant TAC did not induce elevated risk for discontinuation of AEs in all bDMARD analyses. CONCLUSIONS: Concomitant TAC with ABT or ETN showed higher retention rates than bDMARDs therapy without TAC or MTX. AEs did not increase over long-term observation.


Assuntos
Antirreumáticos , Artrite Reumatoide , Humanos , Antirreumáticos/efeitos adversos , Tacrolimo/efeitos adversos , Resultado do Tratamento , Artrite Reumatoide/tratamento farmacológico , Metotrexato/efeitos adversos , Etanercepte/uso terapêutico , Quimioterapia Combinada
3.
Mod Rheumatol ; 33(5): 891-898, 2023 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-35975317

RESUMO

OBJECTIVES: Patients with rheumatoid arthritis (RA) usually switch to a second biological disease-modifying antirheumatic drugs (bDMARDs) when the first has proven to be ineffective, although some may discontinue bDMARDs treatment altogether. We investigated the total rate of bDMARDs retention and the risk of bDMARDs discontinuation in patients with RA. METHODS: The study included 564 patients with RA who started bDMARDs treatment before 2008 (<65 years old, n = 413; ≥65, n = 151). The primary outcome was the incidence of bDMARDs discontinuation due to adverse events (AEs). Risk factors were examined using Fine and Gray regression models. RESULTS: Among 564 patients, 74 had discontinued bDMARDs treatment due to AEs. Male sex and Steinbrocker class 3-4 were more frequent, while rheumatoid factor and concomitant methotrexate treatment were less frequent, in those aged ≥65 years than in those aged <65 years, respectively. The subdistribution hazard ratio for discontinuation was significantly higher in the ≥65 group than in the <65 years group (hazard ratio = 3.53, 95% confidence interval = 2.07-6.03). Lack of concomitant treatment with MTX was risk factor for discontinuation in patients ≥65 years. Advanced Steinbrocker class was a risk factor in patients <65 years. CONCLUSIONS: Older patients are at higher risk of discontinuing bDMARDs treatment due to AEs than younger patients.


Assuntos
Antirreumáticos , Artrite Reumatoide , Produtos Biológicos , Humanos , Masculino , Idoso , Antirreumáticos/efeitos adversos , Resultado do Tratamento , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/epidemiologia , Fatores de Risco , Estudos Longitudinais , Produtos Biológicos/uso terapêutico
4.
Adv Orthop ; 2022: 7223534, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36016995

RESUMO

Background: This study aimed to investigate factors, such as differences in femoral shape, that could affect the femoral valgus correction angle (VCA) for the intramedullary alignment rod (IM rod) by using a three-dimensional (3D) measurement system in patients with varus knee osteoarthritis undergoing total knee arthroplasty (TKA). Methods: A total of 305 knees in 233 Japanese patients with varus knee osteoarthritis who underwent primary TKA by using Jig Engaged 3D Pre-Operative Planning Software for the TKA operation support system was examined. We retrospectively analysed factors, such as the shape of the proximal, middle, and distal femur in the coronal plane, all of which could affect the VCA for the IM rod, by multiple linear regression analyses. Results: The VCA for the IM rod was 5.9° ± 1.6° (range: 1.7° to 10.7°), and the femoral lateral bowing angle (FBA) was 3.5° ± 3.2°. Major factors independently associated with the VCA for the IM rod were the FBA (ß: 0.75), femoral offset (ß: 0.38), and the medial angle between the mechanical femoral axis and the line that connects the distal margins of the medial and lateral femoral condyles (ß: -0.16). The model was created by stepwise multiple linear regression (F = 266.6, p < 0.001, and estimated effect size = 4.4) explained 85% of the variance in the VCA for the IM rod (R 2 = 0.85). Conclusions: The VCA for the IM rod was most strongly associated with femoral lateral bowing in patients with varus knee osteoarthritis undergoing TKA. Our findings suggest that preoperatively measuring the VCA for the IM rod in patients with femoral lateral bowing by using a 3D measurement system could be useful for accurate coronal alignment of the femoral component in TKA.

5.
J Orthop Sci ; 27(3): 658-664, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-33867199

RESUMO

BACKGROUND: The femoral anterior tangent (FAT) line refers to a line parallel to the anterior surface of the distal femur in the axial plane. This study aimed to evaluate the effectiveness of a new operation support system which uses the FAT line to set the femoral component rotational alignment in total knee arthroplasty (TKA). METHODS: A total of 170 consecutive knees in 139 patients undergoing primary TKA with the JIGEN (Jig Engaged Three-dimensional (3D) Pre-Operative Planning Software for TKA) operation support system was examined. The JIGEN system creates 3D models of bones using computed tomography data, allowing for surgical simulations such as positioning of implants while calculating positions of the intramedullary alignment rod (IM rod) and surgical jig. We retrospectively analyzed the FAT line angle relative to the surgical epicondylar axis (SEA) on the axis plane perpendicular to the IM rod and evaluated the accuracy of the femoral component alignment after TKA with the 3D measurement system. RESULTS: The FAT line was 9.6° ± 3.7° (range, 1.4°-20.4°) internally rotated relative to the SEA. The average absolute error was 1.4° ± 1.1° in the coronal plane, 2.0° ± 1.5° in the sagittal plane, and 1.6° ± 1.3° in the axial plane. The femoral component outliers (i.e., >3° away from the goal alignment) were 7.7% in the coronal plane, 20.6% in the sagittal plane, and 10.3% in the axial plane. CONCLUSIONS: Our findings suggest that the FAT line is a reliable and reproducibly identifiable axis for the accurate determination of proper rotational alignment in TKA. An operation support system which uses the FAT line for determining intraoperative femoral component rotation can effectively achieve highly accurate positioning of the femoral component in TKA.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/métodos , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Estudos Retrospectivos
6.
Kurume Med J ; 67(1): 31-40, 2022 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-34840202

RESUMO

To improve component-placement accuracy in total knee arthroplasty, we developed two devices: an original extramedullary patient-specific guide for the femur and an original extramedullary universal guide for the tibia (EM-TIBIA). We also developed a new function in ZedView, a three-dimensional surgical assistive software, that provides the parameters necessary to install the EM-TIBIA. Compared with conventional manual methods based on X-ray two-dimensional images or ZedView, these newly developed devices function as an extramedullary intraoperative support guide in conjunction with ZedView, simplifying surgical procedures. We conducted a study to evaluate the efficacy and safety of the surgery using the new guides and software function. Nineteen patients underwent surgery. On the femoral side, the mean absolute difference of the installation alignment was within 3° for all parameters. On the other hand, on the tibial side, the mean absolute difference from the preoperative plan for the rotation was 5.26±5.30°. The proportion of patients whose difference fell within ±3° was 52.6% (95% confi dence interval: 28.9 to 75.6%), and did not meet the pre-specified criteria for efficacy (P=0.261). No serious adverse events were reported, and no excessive bleeding, thrombosis, infections, or intraoperative or postoperative fractures were noted. The two new guides can easily reproduce the preoperative plan as 3D intraoperative support jigs, but errors can occur on the tibia side due to soft tissue that is not recognized by CT, creating problems in installation accuracy.


Assuntos
Artroplastia do Joelho , Artroplastia do Joelho/efeitos adversos , Fêmur/cirurgia , Humanos , Articulação do Joelho/cirurgia , Software , Tíbia/cirurgia
7.
J Psychol ; 155(8): 717-737, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34424143

RESUMO

Previous research on the relationship between rumination and behavioral impulsivity has been limited because impulsivity was assessed by using individual tasks. This study examined the concurrent associations of a latent variable named impulsive action with rumination and depression to alleviate the task-impurity problem and the low reliability of laboratory tasks assessing impulsivity. This study also examined whether stressors mediated the association between impulsive action and rumination. University students in Japan (N = 176) conducted three laboratory tasks assessing impulsive action: the Go/No-Go Task, the Stop Signal Task, and the Conners Continuous Performance Test 3rd Edition. They also completed self-report measures of rumination, stressors, and depression. Results indicated that the latent variable named impulsive action constructed from the performance in these three tasks was positively associated with rumination. Moreover, stressors mediated this association. Also, impulsive action was positively associated with depression via the increase in stressors and rumination. These findings and those of previous studies examining associations between rumination and self-reported impulsivity suggest that impulsivity might be a determinant of rumination.


Assuntos
Depressão , Comportamento Impulsivo , Humanos , Japão , Reprodutibilidade dos Testes , Autorrelato
8.
Mod Rheumatol ; 31(1): 80-87, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32148143

RESUMO

OBJECTIVES: This study aimed to evaluate the efficacy of add-on iguratimod (IGU) in patients with rheumatoid arthritis (RA patients) who inadequately respond to either tocilizumab (TCZ) or tumor necrosis factor alpha inhibitors (TNFi). METHODS: Twenty-three RA patients treated with TCZ (the TCZ group) and 23 RA patients treated with TNFi (the TNFi group) were enrolled in this 24-week retrospective study from our multicenter registry. All inadequate responders to either TCZ or TNFi received add-on IGU. Baseline demographics and disease activity at 24 weeks after initiating add-on IGU were compared between the two groups. RESULTS: Baseline clinical disease activity index (CDAI) values in the TCZ group and TNFi group were 14.1 and 11.8 (p = .24 between the two groups). At 24 weeks, CDAI values in the TCZ group and TNFi group were 5.1 and 7.5 (p = .002 and .002 compared to baseline, respectively) and ΔCDAI values were -9.0 and -4.3 (p = .007 between the two groups). Multiple linear regression analysis revealed that add-on IGU in the TCZ group was associated with greater improvement in CDAI relative to the TNFi group. CONCLUSION: Add-on IGU was more effective in inadequate responders to TCZ than in inadequate responders to TNFi.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Cromonas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Sulfonamidas/uso terapêutico , Inibidores do Fator de Necrose Tumoral/uso terapêutico , Adulto , Idoso , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
9.
Joint Bone Spine ; 87(6): 596-602, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32534200

RESUMO

OBJECTIVE: To investigate predictors of disease flare after methotrexate discontinuation in Japanese rheumatoid arthritis (RA) patients with sustained low disease activity undergoing tocilizumab plus methotrexate combination therapy. METHODS: Participants of this multicenter, open-label, uncontrolled, prospective study were RA patients maintaining low disease activity (Clinical Disease Activity Index [CDAI]≤10) for≥12weeks with tocilizumab plus methotrexate. Methotrexate was discontinued after 12weeks of biweekly administration while continuing tocilizumab therapy. Disease flare was defined as either a CDAI score>10 or intervention with rescue treatments for any reason even if the CDAI score was≤10. The impact of baseline characteristics on disease flare at week 64 (52weeks after methotrexate discontinuation) was assessed with logistic regression models. RESULTS: Efficacy analyses were performed in 49 patients, of whom 15 had a disease flare by week 64. The proportion (95% confidence interval [CI]) of patients who maintained low disease activity without a flare at week 64 was 69.4% (54.6-81.8%). The dosing interval of tocilizumab was longer than that described on the drug label in Japan (i.e., intravenously every 4weeks, or subcutaneously every 2weeks) in 27% and 6% of patients with and without a flare, respectively. Multivariate analysis revealed that male sex (odds ratio [OR]: 18.00, 95% CI: 2.80-115.56) and extended dosing interval of tocilizumab (OR: 12.00, 95% CI: 1.72-83.80) were independent predictors of disease flare. CONCLUSION: Male patients and those receiving tocilizumab at an extended dosing interval are at high risk of disease flare after discontinuation of concomitant methotrexate. TRIAL REGISTRATION NUMBER: jRCTs041180071, UMIN000021247.


Assuntos
Antirreumáticos , Artrite Reumatoide , Anticorpos Monoclonais Humanizados , Antirreumáticos/efeitos adversos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Método Duplo-Cego , Quimioterapia Combinada , Humanos , Japão/epidemiologia , Masculino , Metotrexato/uso terapêutico , Estudos Prospectivos , Exacerbação dos Sintomas , Resultado do Tratamento
10.
Mod Rheumatol ; 30(3): 434-441, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31390271

RESUMO

Objectives: To evaluate the efficacy and safety of methotrexate (MTX) discontinuation in Japanese rheumatoid arthritis (RA) patients with sustained low disease activity undergoing combination therapy with tocilizumab (TCZ) plus MTX.Methods: This multicenter, open-label, uncontrolled, prospective study included RA patients maintaining low disease activity (Clinical Disease Activity Index (CDAI) ≤10) for ≥12 weeks with TCZ plus MTX. Methotrexate was discontinued following 12 weeks of biweekly administration while continuing TCZ therapy. The primary endpoint was the proportion of patients maintaining low disease activity with no flare at week 36.Results: A total of 49 patients completed 36 weeks of therapy. The proportion of patients maintaining low disease activity at week 36 was 75.5%. The lower limit of the 95% confidence interval exceeded the assumed threshold response rate of 60%, demonstrating the clinical feasibility of MTX discontinuation. The prevalence of gastroesophageal reflux disease, defined as a Frequency Scale for Symptoms of Gastroesophageal reflux disease score ≥8, significantly decreased from week 0 to 12 (27.1-18.4%; p= .025).Conclusion: Discontinuation of concomitant MTX is clinically feasible for maintaining low disease activity, and may be beneficial from the perspective of reducing gastrointestinal symptoms in Japanese RA patients treated with TCZ. Trial registration number: UMIN000021247.


Assuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Antirreumáticos/administração & dosagem , Artrite Reumatoide/tratamento farmacológico , Metotrexato/administração & dosagem , Adulto , Anticorpos Monoclonais Humanizados/uso terapêutico , Antirreumáticos/uso terapêutico , Esquema de Medicação , Feminino , Humanos , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade
11.
Clin Rheumatol ; 38(1): 181-187, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28940139

RESUMO

This study aimed to evaluate whether normal serum matrix metalloproteinase-3 (MMP-3) levels can be used to predict clinical remission and normal physical function at a single time point when treating patients with rheumatoid arthritis (RA) in daily practice settings. Subjects were all 1321 RA patients who were treated at our hospital. The accuracy of serum MMP-3 levels was larger than those of C-reactive protein (CRP) levels for predicting clinical remission [Simplified Disease Activity Index (SDAI) ≤ 3.3], normal function [Disability Index of the Health Assessment Questionnaire (HAQ-DI) ≤ 0.5], and both in clinical remission and with normal function (clinical remission + normal function) using receiver operating characteristic curve analysis. Serum MMP-3 levels were significantly correlated with CRP levels [r 0.229 (men), r 0.476 (women)] using Pearson's correlation coefficients. Among patients with normal CRP levels (n = 807), the percentage of patients in clinical remission, with normal function, and with clinical remission + normal function having normal serum MMP-3 levels was significantly higher than those with abnormal serum MMP-3 levels. In addition, among patients with the 28-point count Disease Activity Score-CRP (DAS28-CRP) remission (DAS28-CRP < 2.3), the percentage of patients in clinical remission, with normal function, and with clinical remission + normal function having normal serum MMP-3 levels was significantly higher than those with abnormal serum MMP-3 levels. Our findings suggest that normal serum MMP-3 levels, in combination with CRP levels or disease activity, are useful for predicting clinical remission and normal physical function in patients with RA.


Assuntos
Artrite Reumatoide/sangue , Proteína C-Reativa/análise , Metaloproteinase 3 da Matriz/sangue , Idoso , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Exame Físico , Desempenho Físico Funcional , Curva ROC , Indução de Remissão , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Sci Rep ; 8(1): 10117, 2018 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-29973601

RESUMO

We conducted two experiments to investigate the effects of word list consistency and group collaboration on false memory. Using the DRM (Deese-Roediger-McDermott) paradigm, the first experiment (n = 121) examined false memory in a group; participants collaborated to select keywords using a between-subject condition of a consistent or randomized word list. The proportion of false responses was larger than that of error responses, especially for the consistent word list condition (p < 0.001), and group collaboration increased false recognition for both word lists (p < 0.001). Using an applied within-subject word list condition, the second experiment (n = 119) confirmed the results of Experiment 1. Furthermore, individual differences Euclidean distance model analysis revealed a difference in the shared cognitive dimension related to group false memory.


Assuntos
Tomada de Decisões , Memória , Repressão Psicológica , Comportamento Social , Feminino , Humanos , Ilusões , Masculino , Distribuição Aleatória , Adulto Jovem
13.
J Clin Rheumatol ; 24(6): 308-312, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29742541

RESUMO

OBJECTIVE: This study aimed to examine anxiety and depression experienced by patients with rheumatoid arthritis (RA) using EuroQoL 5-Dimensional Descriptive System (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) scores. METHODS: We analyzed 1005 Japanese patients with RA. Stepwise multiple linear regression analysis was performed to evaluate the independent influence of variables on EQ-5D and HADS scores. Pearson correlation coefficients were also calculated to explore relationships between variables. RESULTS: The mean EQ-5D score was 0.74 for all patients (mean age, 63.2 years; mean disease duration, 13.6 years; mean Health Assessment Questionnaire Disability Index [HAQ-DI], 0.78; mean HADS total [HADS-T] score, 10.3; mean disease activity score assessed by 28 joints based on CRP [DAS28-CRP], 2.8). The EQ-5D score was strongly correlated with HAQ-DI and was moderately correlated with age, Steinbrocker functional class, HADS-T score, tender joint count assessed by 28 joints, pain on a visual analog scale (pain-VAS), patient's global assessment of disease activity (general-VAS), and DAS28-CRP. The HADS-T score was moderately correlated with HAQ-DI, pain-VAS, general-VAS, and DAS28-CRP. Factors that influenced the EQ-5D score included HAQ-DI (ß = -0.533), pain-VAS (ß = -0.128), HADS-T score (ß = -0.142), DAS28-CRP (ß = -0.187), and prednisolone use (ß = -0.056). Factors that influenced the HADS score included HAQ-DI (ß = 0.348), general-VAS (ß = 0.145), disease duration (ß = 0.094), and worklessness (ß = 0.083). CONCLUSIONS: The HADS score is an independent factor associated with EQ-5D in patients with RA. Our findings suggest that the assessment of anxiety and depression is essential in achieving better quality of life for patients with RA.


Assuntos
Ansiedade , Artrite Reumatoide/psicologia , Depressão , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/fisiopatologia , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/terapia , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/fisiopatologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa , Índice de Gravidade de Doença
14.
Mod Rheumatol ; 28(1): 119-125, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28463029

RESUMO

OBJECTIVE: This study aimed to determine whether serum matrix metalloproteinase-3 (MMP-3) levels can predict remission in rheumatoid arthritis (RA) patients treated with adalimumab (ADA). METHODS: Subjects were 114 RA patients continuously treated with ADA for 52 weeks. Predictive factors at baseline and 4 weeks after initiation of ADA therapy for the achievement of remission (28-point count Disease Activity Score-CRP (DAS28-CRP) < 2.3) at 52 weeks were evaluated by multivariate logistic regression analysis. RESULTS: DAS28-CRP at 4 weeks (odds ratio (OR) 0.614, 95% confidence interval (CI) 0.382-0.988) and improvement in serum MMP-3 levels at 4 weeks (OR 1.057, 95% CI 1.002-1.032) were independent predictors of remission at 52 weeks. The best cut-off level of DAS28-CRP and improvement in serum MMP-3 levels at 4 weeks for predicting remission at 52 weeks was 3.73 (sensitivity: 90%, specificity: 50%, area under the receiver operating characteristic curve (AUC): 62%) and 39.93% (sensitivity: 47%, specificity: 83%, AUC: 64%), respectively. CONCLUSION: Our findings suggest that a high rate of improvement in serum MMP-3 levels at 4 weeks after initiation of ADA therapy can predict remission at 52 weeks in RA patients.


Assuntos
Adalimumab/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Metaloproteinase 3 da Matriz/sangue , Adulto , Idoso , Artrite Reumatoide/sangue , Proteína C-Reativa , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Fatores de Tempo , Resultado do Tratamento
16.
Mod Rheumatol ; 28(2): 242-248, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28756710

RESUMO

OBJECTIVE: This study aimed to evaluate whether the level of serum matrix metalloproteinase-3 (MMP-3), a marker of synovium inflammation, is affected by clinical characteristics of patients in rheumatoid arthritis (RA) patients. METHODS: We analyzed data from 1087 female patients with RA. Pearson's correlation coefficients were calculated to explore associations between variables. Stepwise multiple linear regression analysis was performed to evaluate patient background variables that could potentially affect serum MMP-3 levels. RESULTS: Serum MMP-3 was moderately correlated with C-reactive protein (CRP) (r: 0.478). Factors that independently influenced serum MMP-3 levels were CRP (ß: 0.450), prednisolone (PSL) use (ß: 0.100), estimated glomerular filtration rate (eGFR) (ß: -0.085), swollen joint count assessed on 28 joints (ß: 0.072), and body mass index (ß: -0.061) in female patients with RA. In RA patients with PSL use, factors that independently influenced serum MMP-3 levels were CRP (ß: 0.480), eGFR (ß: -0.175), and PSL dose (ß: 0.171). CONCLUSIONS: Our findings suggest that steroid therapy and renal dysfunction affect serum MMP-3 levels in patients with RA.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/sangue , Glucocorticoides/uso terapêutico , Metaloproteinase 3 da Matriz/sangue , Prednisolona/uso terapêutico , Adulto , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/patologia , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Feminino , Taxa de Filtração Glomerular , Humanos , Pessoa de Meia-Idade
17.
Clin Rheumatol ; 36(11): 2607-2612, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28823077

RESUMO

This study aimed to evaluate whether targeting clinical remission is appropriate for suppressing physical dysfunction in patients with early rheumatoid arthritis (RA). Subjects were all 75 early RA patients (within 2 years of onset) who were continuously treated with biologics for 12 months at our hospital. We evaluated the Simplified Disease Activity Index (SDAI) and Disability Index of the Health Assessment Questionnaire (HAQ-DI) at 3, 6, and 12 months from the initiation of biologics therapy. Rates of functional remission (HAQ-DI ≤ 0.5) at 12 months in the clinical remission (SDAI ≤ 3.3) group and the low disease activity [LDA (3.3 < SDAI ≤11)] group were 97 and 86%, respectively. Multivariate logistic regression analysis revealed that duration of disease and SDAI at 6 months were significantly associated with the achievement of functional remission at 12 months. The best cut-off value of SDAI at 6 months for predicting functional remission at 12 months was 15.7 by receiver operating characteristic curve analysis. HAQ-DI scores in the LDA group were significantly higher than those in the clinical remission group at 6 and 12 months. The mean HAQ-DI score at 12 months in the clinical remission group improved significantly relative to the mean HAQ-DI score at 6 months in the LDA group. Our findings highlight the importance of achieving LDA at least by 6 months after initiating biologics therapy, and achieving clinical remission as soon as possible, in order to minimize physical dysfunction in patients with early RA.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/fisiopatologia , Produtos Biológicos/uso terapêutico , Indução de Remissão/métodos , Adulto , Idoso , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Avaliação da Deficiência , Progressão da Doença , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
18.
J Rheumatol ; 43(8): 1475-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27307531

RESUMO

OBJECTIVE: To evaluate the rates of retention and discontinuation of adalimumab (ADA) due to efficacy and safety in Japanese patients with rheumatoid arthritis (RA). METHODS: All patients with RA (n = 476) who were treated with ADA in the Tsurumai Biologics Communication Registry were enrolled. RESULTS: The retention rate of ADA was 46% at 5 years. When focusing on insufficient efficacy, previous biologics use and high baseline disease activity were significant risk factors for up to 1 year. Methotrexate (MTX) use was a significantly low risk factor after 1 year of treatment. CONCLUSION: Concomitant MTX contributes to the longterm efficacy of ADA therapy.


Assuntos
Adalimumab/efeitos adversos , Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Pacientes Desistentes do Tratamento , Adalimumab/uso terapêutico , Adulto , Idoso , Antirreumáticos/uso terapêutico , Feminino , Humanos , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Resultado do Tratamento
19.
Shinrigaku Kenkyu ; 87(4): 405-14, 2016 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-29620335

RESUMO

Intrusive thoughts and difficulty in controlling thoughts are common, not only for people with psychological disorders, but also for healthy people. Individual differences in thought control ability may underlie such problems. The Thought Control Ability Questionnaire (TCAQ), which consists of 25 items, was developed by Luciano et al. (2005) in order to measure individual differences in the perceived ability to control unwanted intrusive thoughts. The purpose of the present study was to develop the Japanese version of the TCAQ and evaluate its reliability and validity. We translated the English version of the TCAQ into Japanese. We also conducted confirmatory factor analysis with a one factor solution, similar to the previous study. Based on the analysis, we excluded items whose factor loadings were lower than .30, resulting in 22 items for the Japanese version of the TCAQ. The model exhibited acceptable goodness-of-fit. The Japanese version of the TCAQ also demonstrated good reliability as well as evidence of construct validity. Thus, the development of the Japanese version of the TCAQ was successful.


Assuntos
Pensamento , Adolescente , Cognição , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
20.
Shinrigaku Kenkyu ; 86(4): 340-6, 2015 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-26562943

RESUMO

The cognitive function to project oneself into the specific past or future is labeled mental time travel (MTT). MTT to the past is considered "episodic memory" and the future is termed "episodic future thinking". Remembering the past and imaging the future during MTT both draw on information stored in episodic memory: a process that enables integration of episodic information into a coherent event representation. Recent studies suggested that episodic information in past/future event representations varies with temporal distance from the present to the event. However, it is unclear whether the influence on temporal distance is actually caused by the function of episodic memory retrieval. The present study investigated the relationship between episodic memory and temporal concepts with a lexical decision task. The results indicate that remembering the past activated temporal concepts of the near future more than that of the far future. This finding suggests that the rich information derived from episodic memory modulates the subjective sense of time in episodic future thinking.


Assuntos
Memória Episódica , Adolescente , Previsões , Humanos , Adulto Jovem
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