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Rheumatoid Arthritis: HELP
Articles from Seoul area
Based on 823 articles published since 2008
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These are the 823 published articles about Arthritis, Rheumatoid that originated from Seoul area during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline The importance of assessment and management of morning stiffness in Asian patients with rheumatoid arthritis: Recommendations from an expert panel. 2016

Mok, Chi Chiu / Cha, Hoon Suk / Hidayat, Rudy / Nguyen, Lan Thi Ngoc / Perez, Emmanuel C / Ramachandran, Raveendran / Tsay, Gregory J / Yoo, Dae Hyun / Anonymous4900843. ·Department of Medicine, Tuen Mun Hospital, Hong Kong, China. · Sungkyunkwan University, Seoul, South Korea. · Dr Ciptomangunkusumo Hospital, Jakarta, Indonesia. · Hanoi Medical University, Hanoi, Vietnam. · De la Salle University Medical Center, Health Science Institute, Cavite, Philippines. · Sime Darby Medical Centre, Subang Jaya, Malaysia. · Chung Shan Medical University, Taichung, Taiwan. · Hanyang University, Seoul, South Korea. ·Int J Rheum Dis · Pubmed #26403254.

ABSTRACT: OBJECTIVE: In patients with rheumatoid arthritis (RA), morning stiffness is linked more to functional disability and pain than disease activity, as assessed by joint counts and markers of inflammation. As part of the Asia Pacific Morning Stiffness in Rheumatoid Arthritis Expert Panel, a group of eight rheumatologists met to formulate consensus points and develop recommendations for the assessment and management of morning stiffness in RA. METHODS: On the basis of a systematic literature review and expert opinion, a panel of Asian rheumatologists formulated recommendations for the assessment and medical treatment of RA. RESULTS: The panel agreed upon 10 consensus statements on morning stiffness, its assessment and treatment. Specifically, the panel recommended that morning stiffness, pain and impaired morning function should be routinely assessed in clinical practice. Although there are currently no validated tools for these parameters, they should be assessed as part of the patients' reported outcomes in RA. The panel also agreed on the benefits of low-dose glucocorticoids in RA, particularly for the improvement of morning stiffness. CONCLUSIONS: These recommendations serve to guide rheumatologists and other stakeholders on the assessment and management of morning stiffness, and help implement the treat-to-target principle in the management of RA.

2 Guideline APLAR rheumatoid arthritis treatment recommendations. 2015

Lau, Chak Sing / Chia, Faith / Harrison, Andrew / Hsieh, Tsu-Yi / Jain, Rahul / Jung, Seung Min / Kishimoto, Mitsumasa / Kumar, Ashok / Leong, Khai Pang / Li, Zhanguo / Lichauco, Juan Javier / Louthrenoo, Worawit / Luo, Shue-Fen / Nash, Peter / Ng, Chin Teck / Park, Sung-Hwan / Suryana, Bagus Putu Putra / Suwannalai, Parawee / Wijaya, Linda Kurniaty / Yamamoto, Kazuhiko / Yang, Yue / Yeap, Swan Sim / Anonymous4880841. ·Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, University of Hong Kong, Hong Kong. · Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore City, Singapore. · Department of Medicine, University of Otago Wellington, Wellington South, New Zealand. · Section of Allergy, Immunology and Rheumatology, and Section of Clinical Skills Training, Taichung Veterans General Hospital, Taichung, Taiwan. · Narayana Hospital, Jaipur, India. · Division of Rheumatology, Department of Internal Medicine, The Catholic University of Korea, St. Mary's Hospital, Seoul, South Korea. · Immuno-Rheumatology Center, St Luke's International Hospital, Tokyo, Japan. · Department of Rheumatology, Fortis Flt. Lt Rajan Dhall Hospital, New Delhi, India. · Department of Rheumatology, Peking University People's Hospital, Beijing, China. · St. Luke's Medical Center, Quezon City, Philippines. · Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. · Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan. · Department of Medicine, University of Queensland, Brisbane, Queensland, Australia. · Department of Rheumatology and Immunology, Singapore General Hospital, Singapore City, Singapore. · Rheumatology Division, Department of Internal Medicine, Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia. · Allergy, Immunology and Rheumatology Division, Internal Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. · Division of Rheumatology, Department of Internal Medicine, University of Indonesia, Jakarta, Indonesia. · Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. · Subang Jaya Medical Centre, Selangor, Malaysia. ·Int J Rheum Dis · Pubmed #26334449.

ABSTRACT: AIMS: Rheumatoid arthritis is a chronic inflammatory condition that affects approximately 1% of the world's population. There are a wide number of guidelines and recommendations available to support the treatment of rheumatoid arthritis; however, the evidence used for these guidelines is predominantly based on studies in Caucasian subjects and may not be relevant for rheumatoid arthritis patients in the Asia-Pacific region. Therefore, the Asia Pacific League of Associations for Rheumatology established a Steering Committee in 2013 to address this issue. MATERIALS AND METHODS: The AGREE II instrument and the ADAPTE Collaboration framework were applied to systematically identify, appraise, synthesize, and adapt international rheumatoid arthritis guidelines for use in the Asia-Pacific region. RESULTS: Forty rheumatoid arthritis treatment recommendations, based on evidence and expert opinion, were drafted and are presented in this report. CONCLUSION: The Asia Pacific of Associations for Rheumatology rheumatoid arthritis treatment recommendations are intended to serve as a reference for best practice management of rheumatoid arthritis in Asia-Pacific, focusing on local issues to ensure the delivery of basic care for these patients, and to improve their outcomes. In addition, the document will serve as a reference for national rheumatology associations in Asia-Pacific for developing guidelines in their respective countries.

3 Editorial Rheumatology in East Asia. 2018

Yamamoto, Kazuhiko / Song, Yeong-Wook / Li, Zhan-Guo. ·RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa, 230-0045, Japan. kazuhiko.yamamoto@riken.jp. · Seoul National University Medical Research Center, Seoul, South Korea. · Peking University People's Hospital, Peking, China. ·Arthritis Res Ther · Pubmed #29566765.

ABSTRACT: Europe and North America have been leaders in rheumatology for many years. However, for more than a decade now the East Asian region has been catching up dramatically. Some aspects of rheumatology in East Asia are now almost comparable to those in the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). In this article, we describe recent progress in rheumatology in East Asia, focusing specifically on Japan, Korea, and China.

4 Editorial Editorial: Can Prevotella copri Be a Causative Pathobiont in Rheumatoid Arthritis? 2016

Kim, Donghyun / Kim, Wan-Uk. ·Center for Integrative Rheumatoid Transcriptomics and Dynamics, Seoul, Republic of Korea. · Center for Integrative Rheumatoid Transcriptomics and Dynamics and The Catholic University of Korea, Seoul, Republic of Korea. wan725@catholic.ac.kr. ·Arthritis Rheumatol · Pubmed #27390139.

ABSTRACT: -- No abstract --

5 Editorial Could tofacitinib, the first oral small-molecule inhibitor proven for use in active rheumatoid arthritis (RA) patients with insufficient response to methotrexate, be the breakthrough drug for RA? 2014

Kwok, Seung-Ki. ·Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ·Korean J Intern Med · Pubmed #25228832.

ABSTRACT: -- No abstract --

6 Editorial Proper time to initiate antiosteoporotic treatment in rheumatoid arthritis with or without glucocorticoid use. 2014

Lee, Sang-Won. ·Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ·Korean J Intern Med · Pubmed #25045290.

ABSTRACT: -- No abstract --

7 Editorial The rise of biosimilars: potential benefits and drawbacks in rheumatoid arthritis. 2014

Yoo, Dae Hyun. ·Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, College of Medicine, Seoul 133-792, Republic of Korea. ·Expert Rev Clin Immunol · Pubmed #24961712.

ABSTRACT: Although biologic agents are effective in the treatment of rheumatoid arthritis, the high price of drugs and restricted health care budgets have restricted easy access to biologics. Eventually, the use of biologic disease-modifying antirheumatic drugs might be inversely associated with disease activity in countries with low gross domestic product. The EMA approved an infliximab biosimilar for the first time in September 2013. The first approval of a biosimilar monoclonal antibody by a major regulatory authority provided a global standard for subsequent biosimilars and for biopharmaceutical companies developing biosimilars. Biosimilars with a highly similar quality and efficacy profile at an acceptable lower cost would significantly increase affordability of biologic disease-modifying antirheumatic drugs in the treatment of rheumatoid arthritis. Here, we will review the current status of first biosimilar antibody agent and the potential discussion points raised against biosimilars. In addition, the importance of awareness on biosimilars for stakeholders is discussed.

8 Review MiR-146a levels in rheumatoid arthritis and their correlation with disease activity: a meta-analysis. 2018

Bae, Sang-Cheol / Lee, Young H. ·Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. · Department of Rheumatology, Korea University College of Medicine, Seoul, Korea. ·Int J Rheum Dis · Pubmed #29968332.

ABSTRACT: OBJECTIVE: To evaluate the relationship between miR-146a levels and rheumatoid arthritis (RA), and the correlation with RA activity. METHODS: For the meta-analysis, we searched the PubMed, MEDLINE, EMBASE and Cochrane databases, comparing miR-146a levels in patients with RA and controls, and correlation coefficients between miR-146a levels and Disease Activity Score for 28 joints (DAS28) and erythrocyte sedimentation rate (ESR) in patients with RA. RESULTS: Fourteen studies, totaling 683 patients with RA and 477 controls, were available. miR-146a levels were significantly higher in the RA group than in the control group (standardized mean difference [SMD] = 0.546, 95% CI = 0.033-1.059, P = 0.037). Stratification by adjustment for age and/or sex revealed significantly higher miR-146a levels in the adjusted, but not in the non-adjusted group (SMD = 0.747, 95% CI = 0.094-1.400, P = 0.025; SMD = 0.431, 95% CI = -0.430-1.291, P = 0.326, respectively). Stratification by sample size showed significantly higher miR-146a levels in RA groups of large sample sizes (N ≥ 50), but not in those of small size. miR-146a levels in synovial tissue/fluid were significantly higher in the RA group than in the OA group (SMD = 1.305, 95% CI = 1010-1.639, P < 0.001). A significant positive correlation was found between miR-146a levels and ESR (correlation coefficient = 0.534, 95% CI = 0.029-0.822, P = 0.039). CONCLUSIONS: Circulating and synovial tissue/fluid miR-146a levels are high in patients with RA, and circulating miR-146a levels positively correlate with ESR.

9 Review Comparative efficacy and safety of biosimilar-infliximab and originator-infliximab in combination with methotrexate in patients with active rheumatoid arthritis: a meta-analysis of randomized controlled trials. 2018

Bae, Sang-Cheol / Lee, Young Ho. ·Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. · Department of Rheumatology, Korea University College of Medicine, Seoul, Korea. ·Int J Rheum Dis · Pubmed #29671942.

ABSTRACT: OBJECTIVE: We aimed to assess the relative efficacy and safety of biosimilar-infliximab and originator-infliximab in combination with methotrexate (MTX) compared to placebo plus MTX in active rheumatoid arthritis (RA). METHODS: We performed a Bayesian network meta-analysis to combine direct and indirect evidence from randomized controlled trials (RCTs) examining the efficacy and safety of biosimilar + MTX and infliximab + MTX and placebo + MTX (MTX group) in patients with active RA despite treatment with MTX. RESULTS: Seven RCts involving 2606 patients met the inclusion criteria. The American College of Rheumatology (ACR)20 response rate was significantly higher in the biosimilar + MTX group than in the MTX group (odds ratio [OR] 3.31, 95% credible interval [CrI] 1.74-6.06). Similarly, the ACR20 response rate was significantly higher in the infliximab + MTX group than in the MTX group (OR 3.15, 95% CrI 1.99-4.70). There was no difference in the ACR20 response rate between the biosimilar+ MTX and infliximab + MTX groups. Ranking probability based on surface under the cumulative ranking curve (SUCRA) indicated that treatment with biosimilar + MTX had the highest probability of achieving the ACR20 response rate (SUCRA = 0.7964), followed by infliximab + MTX (SUCRA = 0.7018) and MTX alone (SUCRA = 0.0018). The ACR50 and ACR70 response rates showed a similar distribution pattern to the ACR20 response rate. By contrast, the safety based on the number of serious adverse events (SAEs) did not differ significantly among the three interventions. CONCLUSIONS: Biosimilar- and originator-infliximab, in combination with MTX, represent effective interventions for active RA, with a low risk of SAEs. No significant difference between biosimilar- and originator-infliximab was found in terms of efficacy and safety.

10 Review Structural Biology of the TNFα Antagonists Used in the Treatment of Rheumatoid Arthritis. 2018

Lim, Heejin / Lee, Sang Hyung / Lee, Hyun Tae / Lee, Jee Un / Son, Ji Young / Shin, Woori / Heo, Yong-Seok. ·Department of Chemistry, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea. gmlwls454@naver.com. · Department of Chemistry, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea. dltkdgud92@naver.com. · Department of Chemistry, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea. hst2649@naver.com. · Department of Chemistry, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea. jaspersky@naver.com. · Department of Chemistry, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea. jieyson@hanmail.net. · Department of Chemistry, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea. woolishin@nate.com. · Department of Chemistry, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea. ysheo@konkuk.ac.kr. ·Int J Mol Sci · Pubmed #29518978.

ABSTRACT: The binding of the tumor necrosis factor α (TNFα) to its cognate receptor initiates many immune and inflammatory processes. The drugs, etanercept (Enbrel

11 Review Osteoporosis in Rheumatic Diseases: Anti-rheumatic Drugs and the Skeleton. 2018

Dubrovsky, Alanna M / Lim, Mie Jin / Lane, Nancy E. ·Center for Musculoskeletal Health, University of California at Davis Medical Center, Sacramento, CA, 95817, USA. · Division of Rheumatology, Department of Internal Medicine, Inha University Hospital, Incheon, South Korea. · Center for Musculoskeletal Health, University of California at Davis Medical Center, Sacramento, CA, 95817, USA. nelane@ucdavis.edu. · Department of Internal Medicine, University of California at Davis Medical Center, 4625 2nd Avenue, Suite 2000, Sacramento, CA, 95817, USA. nelane@ucdavis.edu. ·Calcif Tissue Int · Pubmed #29470611.

ABSTRACT: Osteoporosis in rheumatic diseases is a very well-known complication. Systemic inflammation results in both generalized and localized bone loss and erosions. Recently, increased knowledge of inflammatory process in rheumatic diseases has resulted in the development of potent inhibitors of the cytokines, the biologic DMARDs. These treatments reduce systemic inflammation and have some effect on the generalized and localized bone loss. Progression of bone erosion was slowed by TNF, IL-6 and IL-1 inhibitors, a JAK inhibitor, a CTLA4 agonist, and rituximab. Effects on bone mineral density varied between the biological DMARDs. Medications that are approved for the treatment of osteoporosis have been evaluated to prevent bone loss in rheumatic disease patients, including denosumab, cathepsin K, bisphosphonates, anti-sclerostin antibodies and parathyroid hormone (hPTH 1-34), and have some efficacy in both the prevention of systemic bone loss and reducing localized bone erosions. This article reviews the effects of biologic DMARDs on bone mass and erosions in patients with rheumatic diseases and trials of anti-osteoporotic medications in animal models and patients with rheumatic diseases.

12 Review Circulating adiponectin and visfatin levels in rheumatoid arthritis and their correlation with disease activity: A meta-analysis. 2018

Lee, Young Ho / Bae, Sang-Cheol. ·Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. · Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. ·Int J Rheum Dis · Pubmed #28205390.

ABSTRACT: AIM: This study aimed to evaluate the relationship between circulating adiponectin and visfatin levels and rheumatoid arthritis (RA) and to establish a correlation between serum adipokine levels and RA activity. METHODS: We conducted meta-analyses on serum/plasma adiponectin or visfatin levels in patients with RA and controls and correlation coefficients between circulating adiponectin and visfatin levels and Disease Activity Score of 28 joints (DAS28) in RA patients. RESULTS: Eleven studies comprising 813 RA patients and 684 controls were included in this meta-analysis. The meta-analysis revealed that adiponectin levels were significantly higher in the RA group than in the control group (standardized mean difference [SMD] = 1.529, 95% confidence interval [CI] = 0.354-2.704, P = 0.011). Circulating adiponectin level was not associated with RA activity based on DAS28 and C-reactive protein (CRP) levels. Visfatin levels were significantly higher in the RA group than in the control group (SMD = 2.575, 95% CI: = 0.963-4.189, P = 0.002). A trend of positive correlation among circulating visfatin levels and DAS28 and CRP levels was found (correlation coefficient = 0.416, 95% CI: = -0.917 to 0.795, P = 0.177; correlation coefficient = 0.366, 95% CI: = -0.074 to 0.687, P = 0.101, respectively). CONCLUSIONS: Our meta-analysis demonstrated that circulating adiponectin levels were significantly higher in patients with RA than in controls. Circulating visfatin levels were significantly higher in patients with RA than in controls and a positive correlation between circulating visfatin level and RA activity is suggested.

13 Review Arthroscopic Synovectomy of Wrist in Rheumatoid Arthritis. 2017

Shim, Jae Woo / Park, Min Jong. ·Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 06351, Republic of Korea. · Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 06351, Republic of Korea. Electronic address: mjp3506@skku.edu. ·Hand Clin · Pubmed #28991588.

ABSTRACT: Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting multiple joints. Wrist involvement is common. Patients with persistent symptoms despite medical management are candidates for surgery. Synovectomy can provide pain relief and functional improvement for rheumatoid wrist. Arthroscopic synovectomy is a safe and reliable method, with minimal postoperative morbidity. This article reviews the role, technique, and results of arthroscopic synovectomy in the rheumatoid wrist.

14 Review CT-P13 in the treatment of rheumatoid arthritis. 2017

Yoo, Dae Hyun. ·a Hanyang University Hospital for Rheumatic Diseases, College of Medicine , Hanyang University , Seoul , Republic of Korea. ·Expert Rev Clin Immunol · Pubmed #28571501.

ABSTRACT: INTRODUCTION: The first biosimilar infliximab, CT-P13 infliximab-dyyb was approved in 2013 by the European Medicines Agency (EMA) and in 2016 by the United States Food and Drug Administration (FDA) and has been used for the treatment of rheumatoid arthritis (RA) for 4 years. Areas covered: CT-P13 with the three brand names on the market has highly similar efficacy and safety profiles but lower price than originator infliximab and are approved in more than 80 countries. One of the most important determinants of the implementation of CT-P13 in the treatment of RA is scientific evidence from clinical studies and real-world pharmacovigilance data. Here, we review all available clinical data supporting the similarity of CT-P13 to originator infliximab in its clinical efficacy and safety for the treatment of RA and related arthritis. In addition, we consider the role of CT-P13 in therapeutic strategies for RA treatment. Expert commentary: With its highly similar efficacy and safety profile to originator infliximab and its lower price, CT-P13 is expected to be very useful in RA treatment, whether it is applied earlier or switched from originator infliximab or other biologics. Future educational initiatives will be important to overcome misunderstandings about biosimilars and to improve the implementation of CT-P13.

15 Review Microbiota in T-cell homeostasis and inflammatory diseases. 2017

Lee, Naeun / Kim, Wan-Uk. ·Center for Integrative Rheumatoid Transcriptomics and Dynamics, College of Medicine, The Catholic University of Korea, Seoul, Korea. · Division of Rheumatology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. ·Exp Mol Med · Pubmed #28546563.

ABSTRACT: The etiology of disease pathogenesis can be largely explained by genetic variations and several types of environmental factors. In genetically disease-susceptible individuals, subsequent environmental triggers may induce disease development. The human body is colonized by complex commensal microbes that have co-evolved with the host immune system. With the adaptation to modern lifestyles, its composition has changed depending on host genetics, changes in diet, overuse of antibiotics against infection and elimination of natural enemies through the strengthening of sanitation. In particular, commensal microbiota is necessary in the development, induction and function of T cells to maintain host immune homeostasis. Alterations in the compositional diversity and abundance levels of microbiota, known as dysbiosis, can trigger several types of autoimmune and inflammatory diseases through the imbalance of T-cell subpopulations, such as Th1, Th2, Th17 and Treg cells. Recently, emerging evidence has identified that dysbiosis is involved in the progression of rheumatoid arthritis, type 1 and 2 diabetic mellitus, and asthma, together with dysregulated T-cell subpopulations. In this review, we will focus on understanding the complicated microbiota-T-cell axis between homeostatic and pathogenic conditions and elucidate important insights for the development of novel targets for disease therapy.

16 Review The interplay between host immune cells and gut microbiota in chronic inflammatory diseases. 2017

Kim, Donghyun / Zeng, Melody Y / Núñez, Gabriel. ·Center for Integrative Rheumatoid Transcriptomics and Dynamics, The Catholic University of Korea, Seoul, Korea. · Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA. · Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA. ·Exp Mol Med · Pubmed #28546562.

ABSTRACT: Many benefits provided by the gut microbiota to the host rely on its intricate interactions with host cells. Perturbations of the gut microbiota, termed gut dysbiosis, affect the interplay between the gut microbiota and host cells, resulting in dysregulation of inflammation that contributes to the pathogenesis of chronic inflammatory diseases, including inflammatory bowel disease, multiple sclerosis, allergic asthma and rheumatoid arthritis. In this review, we provide an overview of how gut bacteria modulates host metabolic and immune functions, summarize studies that examined the roles of gut dysbiosis in chronic inflammatory diseases, and finally discuss measures to correct gut dysbiosis as potential therapeutics for chronic inflammatory diseases.

17 Review Treatment of adult-onset still's disease: up to date. 2017

Yoo, Dae Hyun. ·a Department of Rheumatology, College of Medicine , Hanyang University Hospital for Rheumatic Diseases , Seoul , Korea. ·Expert Rev Clin Immunol · Pubmed #28540751.

ABSTRACT: INTRODUCTION: Adult onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology, and approximately 60-70% of patients may develop a chronic polyphasic form of the disease or a chronic polyarthritis. Due to rarity of disease, treatment of AOSD is not based on controlled study, but on case based experiences. Areas covered: Recently, the application of anti-cytokine therapy based on pathophysiology has resulted in significant progress in the treatment of AOSD. Here, we review current knowledge of the pathogenesis, disease progression, currently available biomarkers of disease activity, standard therapeutic agents, utility of biologic agents, future perspectives for treatment and treatment of macrophage activation syndrome. Expert commentary: Accumulated clinical data suggest that chronic disease can be classified into two subsets: dominant systemic disease, and the arthritis subgroup. IL-1 inhibitors may be more efficient for systemic manifestations and IL-6 inhibitor for both joint involvement and systemic manifestations. TNF inhibitors must be reserved for patients with purely chronic articular manifestations. For ideal management of patients, it is very important to measure disease activity accurately during follow up, but no single biomarker has been classified as ideal. New therapeutic agents and composite biomarkers are needed to improve the outcome of patients with AOSD by identifying disease activity properly.

18 Review A comparison of discontinuation rates of tofacitinib and biologic disease-modifying anti-rheumatic drugs in rheumatoid arthritis: a systematic review and Bayesian network meta-analysis. 2017

Park, Sun-Kyeong / Lee, Min-Young / Jang, Eun-Jin / Kim, Hye-Lin / Ha, Dong-Mun / Lee, Eui-Kyung. ·School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea. · Department of Information Statistics, Andong National University, Gyeongsangbuk-do, South Korea. · College of Pharmacy, Sahmyook University, Seoul, South Korea. · School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea. ekyung@skku.edu. ·Clin Exp Rheumatol · Pubmed #28079510.

ABSTRACT: OBJECTIVES: The purpose of this study was to compare the discontinuation rates of tofacitinib and biologics (tumour necrosis factor inhibitors (TNFi), abatacept, rituximab, and tocilizumab) in rheumatoid arthritis (RA) patients considering inadequate responses (IRs) to previous treatment(s). METHODS: Randomised controlled trials of tofacitinib and biologics - reporting at least one total discontinuation, discontinuation due to lack of efficacy (LOE), and discontinuation due to adverse events (AEs) - were identified through systematic review. The analyses were conducted for patients with IRs to conventional synthetic disease-modifying anti-rheumatic drugs (cDMARDs) and for patients with biologics-IR, separately. Bayesian network meta-analysis was used to estimate rate ratio (RR) of a biologic relative to tofacitinib with 95% credible interval (CrI), and probability of RR being <1 (P[RR<1]). RESULTS: The analyses of 34 studies showed no significant differences in discontinuation rates between tofacitinib and biologics in the cDMARDs-IR group. In the biologics-IR group, however, TNFi (RR 0.17, 95% CrI 0.01-3.61, P[RR<1] 92.0%) and rituximab (RR 0.20, 95% CrI 0.01-2.91, P[RR<1] 92.3%) showed significantly lower total discontinuation rates than tofacitinib did. Despite the difference, discontinuation cases owing to LOE and AEs revealed that tofacitinib was comparable to the biologics. CONCLUSIONS: The comparability of discontinuation rate between tofacitinib and biologics was different based on previous treatments and discontinuation reasons: LOE, AEs, and total (due to other reasons). Therefore, those factors need to be considered to decide the optimal treatment strategy.

19 Review Update on the genetic architecture of rheumatoid arthritis. 2017

Kim, Kwangwoo / Bang, So-Young / Lee, Hye-Soon / Bae, Sang-Cheol. ·Department of Biology, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea. · Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea. ·Nat Rev Rheumatol · Pubmed #27811914.

ABSTRACT: Human genetic studies into rheumatoid arthritis (RA) have uncovered more than 100 genetic loci associated with susceptibility to RA and have refined the RA-association model for HLA variants. The majority of RA-risk variants are highly shared across multiple ancestral populations and are located in noncoding elements that might have allele-specific regulatory effects in relevant tissues. Emerging multi-omics data, high-density genotype data and bioinformatic approaches are enabling researchers to use RA-risk variants to identify functionally relevant cell types and biological pathways that are involved in impaired immune processes and disease phenotypes. This Review summarizes reported RA-risk loci and the latest insights from human genetic studies into RA pathogenesis, including how genetic data has helped to identify currently available drugs that could be repurposed for patients with RA and the role of genetics in guiding the development of new drugs.

20 Review Toll-like receptors: promising therapeutic targets for inflammatory diseases. 2016

Achek, Asma / Yesudhas, Dhanusha / Choi, Sangdun. ·Department of Molecular Science and Technology, Ajou University, Suwon, 443-749, Korea. · Department of Molecular Science and Technology, Ajou University, Suwon, 443-749, Korea. sangdunchoi@ajou.ac.kr. ·Arch Pharm Res · Pubmed #27515048.

ABSTRACT: The health of living organisms is constantly challenged by bacterial and viral threats. The recognition of pathogenic microorganisms by diverse receptors triggers a variety of host defense mechanisms, leading to their eradication. Toll-like receptors (TLRs), which are type I transmembrane proteins, recognize specific signatures of the invading microbes and activate a cascade of downstream signals inducing the secretion of inflammatory cytokines, chemokines, and type I interferons. The TLR response not only counteracts the pathogens but also initiates and shapes the adaptive immune response. Under normal conditions, inflammation is downregulated after the removal of the pathogen and cellular debris. However, a dysfunctional TLR-mediated response maintains a chronic inflammatory state and leads to local and systemic deleterious effects in host cells and tissues. Such inappropriate TLR response has been attributed to the development and progression of multiple diseases such as cancer, autoimmune, and inflammatory diseases. In this review, we discuss the emerging role of TLRs in the pathogenesis of inflammatory diseases and how targeting of TLRs offers a promising therapeutic strategy for the prevention and treatment of various inflammatory diseases. Additionally, we highlight a number of TLR-targeting agents that are in the developmental stage or in clinical trials.

21 Review Association of the ATIC 347 C/G polymorphism with responsiveness to and toxicity of methotrexate in rheumatoid arthritis: a meta-analysis. 2016

Lee, Young Ho / Bae, Sang-Cheol. ·Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Korea University Anam Hospital, 73, Inchon-ro, Seongbuk-gu, Seoul, Korea. lyhcgh@korea.ac.kr. · Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. ·Rheumatol Int · Pubmed #27379764.

ABSTRACT: This study investigated whether the 5-aminoimidazole-4-carboxamide ribonucleotide transformylase gene (ATIC) 347 C/G polymorphism can predict the response to or toxicity of methotrexate (MTX) in patients with rheumatoid arthritis (RA). We conducted a meta-analysis of studies on the association between ATIC 347 C/G polymorphism and non-responsiveness to or toxicity of MTX in RA patients, using PUBMED, EMBASE, and COCHRANE. Nine comparative studies from 6 articles including 1056 RA patients met our inclusion criteria. This final group of studies comprised 5 studies on response to MTX and 4 on toxicity of MTX in RA patients in relation to the ATIC 347 C/G polymorphism status. Meta-analysis showed association between the ATIC 347 GG + GC genotype and non-response to MTX therapy (OR = 1.572, 95 % CI 1.146-2.156, p = 0.005). Stratification by ethnicity indicated significant association between the ATIC 347 GG + GC genotype and non-response to MTX in Caucasians (OR = 1.884, 95 % CI 1.236-2.873, p = 0.003), but not in Asian patients. Similarly, associations were noted for the ATIC 347 C/G polymorphism through analysis using recessive and overdominant models. Meta-analysis revealed association between the ATIC 347 GG + GC genotype and MTX toxicity (OR = 1.454 95 % CI 1.034-2.044, p = 0.032). Stratification by ethnicity indicated significant association between the ATIC 347 GG + GC genotype and MTX toxicity in Caucasians (OR = 1.741, 95 % CI 1.080-2.806, p = 0.023), but not in Asian patients. The ATIC 347 C/G polymorphism may be associated with non-responsiveness to and or toxicity of MTX in Caucasian RA patients.

22 Review Rheumatoid Arthritis: The Stride from Research to Clinical Practice. 2016

Chung, Ill-Min / Ketharnathan, Sarada / Thiruvengadam, Muthu / Rajakumar, Govindasamy. ·Department of Applied Bioscience, College of Life and Environmental Science, Konkuk University, Seoul 143-701, Korea. imcim@konkuk.ac.kr. · Department of Pathology, University of Otago, Dunedin 9016, New Zealand. sarada.biotech@gmail.com. · Department of Applied Bioscience, College of Life and Environmental Science, Konkuk University, Seoul 143-701, Korea. thiruv30@yahoo.com. · Department of Applied Bioscience, College of Life and Environmental Science, Konkuk University, Seoul 143-701, Korea. microlabsraj@gmail.com. ·Int J Mol Sci · Pubmed #27338350.

ABSTRACT: Over 70 different genetic variants with a significant association with rheumatoid arthritis (RA) have been discovered. Anti-citrullination protein antibodies (ACPA)-positive RA variants are more well-defined than their ACPA-negative counterparts. The human leukocyte antigen, HLA-DRB1 locus remains the prime suspect in anti-citrullination protein antibodies (ACPA)-positive RA. Different HLA-DRB1 alleles are linked to RA susceptibility across different ethnicities. With evolving techniques, like genome-wide association studies (GWAS) and single nucleotide polymorphism (SNP) arrays, more non-HLA susceptibility loci have been identified for both types of RA. However, the functional significance of only a handful of these variants is known. Their roles include increasing susceptibility to RA or in determining the speed at which the disease progresses. Additionally, a couple of variations are associated with protection from RA. Defining such clear-cut biological functions can aid in the clinical diagnosis and treatment of RA. Recent research has focused on the implication of microRNAs, with miR-146a widely studied. In addition to disease susceptibility, genetic variations that influence the efficacy and toxicity of anti-RA agents have also been identified. Polymorphisms in the MTHFR gene influence the effectiveness of methotrexate, the first line of therapy in RA. Larger studies are, however, needed to identify potential biomarkers for early disease identification and monitoring disease progression.

23 Review Macrophage migration inhibitory factor: a potential therapeutic target for rheumatoid arthritis. 2016

Kim, Kyoung-Woon / Kim, Hae-Rim. ·Convergent Research Consortium for Immunologic Disease, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. · Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea. ·Korean J Intern Med · Pubmed #27169879.

ABSTRACT: Macrophage migration inhibitory factor (MIF) is originally identified in the culture medium of activated T lymphocytes as a soluble factor that inhibits the random migration of macrophages. MIF is now recognized as a multipotent cytokine involved in the regulation of immune and inf lammatory responses. In rheumatoid arthritis (RA), MIF promotes inf lammatory responses by inducing proinflammatory cytokines and tissue-degrading molecules, promoting the proliferation and survival of synovial fibroblasts, stimulating neutrophil chemotaxis, and regulating angiogenesis and osteoclast differentiation. Expression of MIF in synovial tissue and synovial fluid levels of MIF are elevated in RA patients. Specifically, MIF levels correlate with RA disease activity and high levels are associated with bone erosion. In animal models of RA, the genetic and therapeutic inhibition of MIF has been shown to control inflammation and bone destruction. Based on the role of MIF in RA pathogenesis, small molecular inhibitors targeting it or its receptor pathways could provide a new therapeutic option for RA patients.

24 Review Associations between PTPRC rs10919563 A/G and FCGR2A R131H polymorphisms and responsiveness to TNF blockers in rheumatoid arthritis: a meta-analysis. 2016

Lee, Young Ho / Bae, Sang-Cheol. ·Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea. lyhcgh@korea.ac.kr. · The Hospital for Rheumatic Diseases, Hanyang University Medical Center, Seoul, Korea. ·Rheumatol Int · Pubmed #27074847.

ABSTRACT: We aimed to investigate whether the PTPRC rs10919563 A/G and Fc gamma receptor 2A (FCGR2A) R131H polymorphisms can predict the response to anti-TNF therapy in rheumatoid arthritis (RA) patients. We conducted a meta-analysis of studies on the association between the PTPRC rs10919563 A/G or the FCGR2A R131H polymorphism and responsiveness to anti-TNF therapy in RA patients. Eighteen studies (twelve on PTPRC and six on FCGR2A) from eight articles involving 3058 patients were considered in this meta-analysis. The meta-analysis showed a significant association between the PTPRC rs10919563 A allele and response to TNF-α blockers in RA. The OR of the PTPRC A allele was significantly lower in responders (OR = 0.584, 95 % CI = 0.409-0.835, P = 0.003). Meta-analysis revealed no association between the FCGR2A HH + HR genotype and responsiveness to TNF blockers in all study subjects (OR = 0.762, 95 % CI = 0.543-1.068, P = 0.115). However, stratification by TNF inhibitor type showed that the FCGR2A HH + HR genotype was associated with responsiveness to adalimumab (OR = 0.591, 95 % CI = 0.369-0.947, P = 0.029), but not infliximab and etanercept (OR = 0.929, 95 % CI = 0.354-2.440, P = 0.881; OR = 0.804, 95 % CI = 0.293-2.207, P = 0.673). The PTPRC rs10919563 A allele shows a poor response to anti-TNF therapy, and the FCGR2A HH + HR genotype shows a poor response to adalimumab for RA. Genotyping for these polymorphisms may be useful for predicting the response to TNF-α blockers with respect to personalized medicine.

25 Review Vitamin D level in rheumatoid arthritis and its correlation with the disease activity: a meta-analysis. 2016

Lee, Young Ho / Bae, Sang-Cheol. ·Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. lyhcgh@korea.ac.kr. · Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. ·Clin Exp Rheumatol · Pubmed #27049238.

ABSTRACT: OBJECTIVES: This study aimed to evaluate the relationship between the 25-hydroxyvitamin D [25(OH)D] level and rheumatoid arthritis (RA) and the correlation between serum vitamin D level and RA activity. METHODS: We searched the PUBMED, EMBASE, and Cochrane databases and performed a meta-analysis examining the vitamin D level and prevalence of vitamin D deficiency in patients with RA compared to healthy controls and the correlation coefficients between the vitamin D level and disease activity score 28 (DAS28) in RA patients. RESULTS: Fifteen studies that included a total of 1,143 RA patients and 963 controls were available for this meta-analysis. The meta-analysis showed that the serum vitamin D level in the RA group was significantly lower than that in the control group (SMD=-0.608, 95% CI=-1.105-[-0.017], p=0.017). In addition, the prevalence of vitamin D deficiency was significantly higher in the RA group than in the control group (55.2% vs. 33.2%; OR = 2.460, 95% CI = 1.135-5.332, p=0.023). Thirteen studies evaluated the correlation between the vitamin D level and its activity in 924 RA patients. Meta-analysis showed a significant inverse correlation between the vitamin D level and DAS28 (Correlation coefficient =-0.278, 95% CI =-0.393-[-0.153], p=1.8 x 10-5). CONCLUSIONS: Our meta-analysis demonstrates that serum vitamin D level is significantly low in patients with RA, vitamin D deficiency is prevalent in RA patients compared to controls, and the vitamin D level correlates inversely with RA activity. Our meta-analysis suggests that the vitamin D level is associated with susceptibility to RA and RA activity.

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