Rheumatoid Arthritis: Vicaut E

Schaeverbeke T, Vicaut E, Cohen A, Ravaud P. · Service de Rhumatologie, CHU Pellegrin, Bordeaux 33000. · Presse Med. · Pubmed #17078593 No free full text.

Abstract: The cardiovascular impact of the non-steroidal anti-inflammatory drugs and the higher cardiovascular mortality during treatment of inflammatory rheumatism impose a rigorous evaluation of the cardiovascular risk of rheumatic patients. Large epidemiological studies have identified risk factors for cardiovascular diseases such as the age, male gender, family history (infarct, stroke), tobacco consumption, systolic arterial pressure, renal insufficiency, hypercholesterolemia, diabetes mellitis, sedentariness, obesity and "electric" ventricular hypertrophy. Some equations make it possible to evaluate the absolute cardiovascular risk at the individual level, which corresponds to the onset risk of a stroke in the 10 years to come in a subject according to the number and importance of each of his risk factors. It has been demonstrated that the correction of one or more risk factors reduce the overall cardiovascular risk justifying the strategies for evaluating this risk to define therapeutic intervention thresholds. The impact of a long-term anti-inflammatory treatment or an inflammatory disease such as rheumatoid arthritis has not been the subject of specific epidemiological study allowing these elements to be included in an equation of the estimation of the cardiovascular risk. However, the introduction of on anti-inflammatory treatment, likely to increase the cardiovascular risk of a patient, certainly justifies an evaluation of the absolute cardiovascular risk.

Richette P, François M, Vicaut E, Fitting C, Bardin T, Corvol M, Savouret JF, Rannou F. · Université Paris 7, UFR médicale, Assistance Publique-Hôpitaux de Paris, Paris, France. · J Rheumatol. · Pubmed #18597398 No free full text.

Abstract: OBJECTIVE: To assess the interleukin 1 receptor antagonist (IL-1Ra)/IL-1beta ratio in synovial fluid (SF) of patients with knee osteoarthritis (OA) or rheumatoid arthritis (RA) to determine a possible relation between cytokine level and disease activity. METHODS: IL-1beta and IL-1Ra concentrations were measured by ELISA in knee SF from patients with OA (n = 42) or RA (n = 11). For OA patients, pain and disability were assessed by a visual analog scale (VAS) and the Lequesne index. RA disease activity was assessed using the Disease Activity Score 28 Joint Count (DAS28). RESULTS: Patients with OA showed lower median levels of IL-1beta and IL-1Ra in SF than patients with RA (p < 0.001) but a higher IL-1Ra/IL-1beta ratio: 1793 (584-6221) versus 773.5 (187.64-1570.5) (p = 0.05). For patients with OA, the IL-1Ra/IL-1beta ratio was not associated with pain or disability. For patients with RA, the IL-1Ra/IL-1beta ratio and IL-1Ra and IL-1beta levels were related to SF white blood cell count. CONCLUSION: High endogenous IL-1Ra/IL-1beta ratio occurs in SF from knee OA and does not correlate with pain or Lequesne index. Our results suggest that intraarticular injection of IL-1Ra might be self-limited in patients with knee OA and a naturally high SF ratio.