Rheumatoid Arthritis: Anderson J

Wells G, Anderson J, Boers M, Felson D, Heiberg T, Hewlett S, Johnson K, Kirwan J, Lassere M, Robinson V, Shea B, Simon L, Strand V, van Riel P, Tugwell P. · Department of Clinical Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada. · J Rheumatol. · Pubmed #12734920 No free full text.

Abstract: The OMERACT 6 Minimal Clinically Important Difference/Low Disease Activity Workshop was organized with the aim of meeting the many challenges that exist in determining a low disease activity in rheumatoid arthritis (RA). This article presents an overview of that workshop, including results of the voting, a summary of associated discussions, recommendations, and a proposed research agenda.

Wells G, Boers M, Shea B, Anderson J, Felson D, Johnson K, Kirwan J, Lassere M, Robinson V, Simon L, Strand V, van Riel P, Tugwell P. · Department of Clinical Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada. · J Rheumatol. · Pubmed #12734918 No free full text.

Abstract: The MCID (minimal clinically important difference) module of OMERACT 5 developed a research agenda that led to the conclusion that a state of low disease activity for rheumatoid arthritis (RA) would need to be defined. To develop such a definition the various concepts and terminologies, the process for developing an operational definition, and the availability and design of longitudinal datasets for validation needed to be considered. This article describes the process of the MCID/Low Disease Activity State Workshop at OMERACT 6 to develop such a definition.

Kavanaugh A, Genovese M, Baughman J, Kivitz A, Bulpitt K, Olsen N, Weisman M, Matteson E, Furst D, van Vollenhoven R, Anderson J, Cohen S, Wei N, Meijerink J, Jacobs C, Mocci S. · Division of Rheumatology, Allergy and Immunology, University of California, San Diego, San Diego, CA 92037-0943, USA. · J Rheumatol. · Pubmed #12610799 No free full text.

Abstract: OBJECTIVE: Human cartilage glycoprotein 39 (HC gp-39) appears to be a relevant autoantigen in patients with rheumatoid arthritis (RA). Administration of major histocompatibility complex (MHC) Class II complexed antigens without requisite costimulatory signals can induce immunologic tolerance. We evaluated the safety, pharmacokinetics, and preliminary efficacy of AG4263 in patients with RA. AG4263 is a soluble complex of native HLA-DR4 (beta*0401) complexed to Org 36601, a 13-mer peptide derived from HC gp-39 (also referred to as CDP263). METHODS: Thirty-one HLA-DRB1*0401 positive patients with persistent RA disease activity despite concurrent methotrexate were randomized to 7 infusions of AG4263 (n = 24) or placebo (n = 7) over 6 weeks. The initial dose of 0.5 micro g/kg was escalated in subsequent cohorts to a maximum of 150 micro g/kg. Safety analyses included recording of adverse events and measurement of CD4/CD8 counts, reactivity to recall antigens, and development of antibodies to HLA-DR4. Efficacy was assessed using the Paulus 20 criteria. RESULTS: Treatment was well tolerated, with injection site reaction the most common adverse event. There was no loss of reactivity to recall antigens, change in cell counts, or antibodies to HLA-DR. The mean half-life of AG4263 was 12.5 h. Some evidence of clinical response was seen; responses were more common among patients receiving the highest doses of AG4263 and among those with baseline T cell reactivity to CDP263. CONCLUSION: AG4263 was safe, well tolerated, and without evidence of generalized immune suppression. Along with the observed trend toward clinical efficacy, the results suggest that this therapeutic approach warrants further investigation in patients with RA.

Wolfe F, Michaud K, Anderson J, Urbansky K. · National Data Bank for Rheumatic Diseases, Wichita, Kansas, and University of Kansas School of Medicine, Wichita, Kansas 67214, USA. · Arthritis Rheum. · Pubmed #14872478 links to  free full text

Abstract: OBJECTIVE: According to the Centers for Disease Control and Prevention, the 1999 and 2000 incidence rates for tuberculosis (TB) in the US population were 6.4 and 5.8, respectively, per 100,000 persons. Recently, reports of TB following infliximab administration have raised questions regarding the rate of TB in patients with rheumatoid arthritis (RA) generally and in those treated with infliximab in clinical practice. We undertook this study to determine the baseline rate of TB in RA prior to the introduction of infliximab and to determine the rate of TB among those currently receiving infliximab. METHODS: We surveyed patients with questionnaires, followed by detailed validation from medical records and physician reports. In study 1, we evaluated 10,782 RA patients in 1998-1999 prior to the widespread use of infliximab. In study 2, we evaluated 6,460 infliximab-treated patients in 2000-2002. RESULTS: In study 1, the lifetime rate of TB was 696 per 100,000 patients (95% confidence interval [95% CI] 547-872). Of these cases, 76.8% occurred prior to the onset of RA. During the period of prospective followup, 1 case of TB developed during 16,173 patient-years of followup, yielding a rate of 6.2 cases (95% CI 1.6-34.4) per 100,000 patients. In study 2, the TB incidence rate among infliximab-treated patients was 52.5 cases (95% CI 14.3-134.4) per 100,000 patient-years of exposure. Three of the 4 cases occurred in patients with a history of TB exposure, and no cases occurred in persons with recent TB skin tests or prophylaxis. CONCLUSION: The rate of TB is not increased in RA patients generally. Among infliximab-treated patients, the rate is 52.5 cases (95% CI 14.3-134.4) per 100,000 patient-years of exposure. A thorough medical history regarding TB, as well as tuberculin testing and radiographic examination (if indicated), should be an essential component of anti-tumor necrosis factor therapy.

Anderson J. · Center for Health Quality Outcomes and Economic Research, Veterans Administration Health Services Research, Bedford, MA 01730, USA. · J Rheumatol. · Pubmed #10685830 No free full text.

Abstract: Variance of an outcome that is the topic of a metaanalysis may be estimated in a variety of ways. Variances are also not used in the same way in every metaanalysis. The metaanalysis may be of a single measure expressed in its original units, or of several such measures simultaneously, or it may be done using unitless effect sizes. We present some observations and practical recommendations on the estimation and use of variances relating to these several approaches to metaanalysis, as they may apply in a metaanalysis of radiographic progression in rheumatoid arthritis.

Wolfe F, Anderson J. · Arthritis Research Center and University of Kansas School of Medicine, Wichita, KS 67214, USA. · J Rheumatol. · Pubmed #10493686 No free full text.

Abstract: OBJECTIVE: The symptoms of what has been called silicone implant associated syndrome (SIAS) and fibromyalgia (FM) are similar. It has been hypothesized that silicone (filled) breast implants (SBI) might be causally related to the development of FM. This hypothesis was investigated by comparing 508 patients with FM with 1228 control subjects. We also studied the relationship of SBI to the subsequent development of rheumatoid arthritis (RA). METHODS: Utilizing a longitudinal databank, implantation status was determined in 464 patients with RA, 508 with FM, 261 with osteoarthritis (OA) of the knee or hip, and in 503 randomly selected community controls. We obtained data on the type of implant and its temporal relationship to the onset of FM and RA. RESULTS: No association between SBI and RA was found (OR 1.66, 95% CI 0.33, 8.23, p = 0.538). No association between prior SBI and subsequent FM was found (OR 1.22, 95% CI 0.30, 4.89, p = 0.781). But one-third of the SBI in FM occurred after development of the syndrome. When all implants regardless of temporal relationship were considered, the overall relationship between any implant and the diagnosis of FM was significant at p = 0.095 (OR 2.45, 95% CI 0.86, 7.03). CONCLUSION: No relationship between prior SBI and the subsequent development of FM or RA was noted. But implants appear to be more common in patients with than in those without FM (p = 0.095). A common, predisposing set of psychosocial characteristics may be shared between those who have FM and those who undergo SBI.

Hamilton J, Dagg K, Sturrock R, Anderson J, Banham S. · No affiliation provided · Rheumatology (Oxford). · Pubmed #10461485 links to  free full text

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