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  • Electronic Resource  (3)
  • 1985-1989  (3)
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  • Electronic Resource  (3)
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  • 1
    Electronic Resource
    Electronic Resource
    Progressive joint damage during penicillamine therapy for rheumatoid arthritis (1988)
    Springer
    Rheumatology international 8 (1988), S. 135-139 
    Details
    ISSN: 1437-160X
    Keywords: Rheumatoid arthritis ; Penicillamine ; Radiological assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Progressive joint damage characterises rheumatoid arthritis despite treatment with slowacting drugs such as penicillamine. We examined a cohort of 145 RA patients, treated with 250 or 500 mg penicillamine daily for 18 months to study progressive joint damage measured using Larsen's standard radiographs. Overall damage increased significantly over 18 months at both doses of penicillamine. Radiological changes between 6–18 months were studied in detail in 55 cases. They were divided into rapidly progressive (increases in Larsen score of more than 5) or slowly progressive (increases in Larsen score of 5 or less). Overall clinical response, visual analogue pain score, ESR, haemoglobin and platelet count were significantly lower in the slowly progressive patients; articular index and duration of morning stiffness were slightly lower; latex titre, RAHA titre, joint size and white cell count showed no differences between groups. There is an indirect relationship between progressive joint damage and some clinical and laboratory measures. The reasons underlying our failure to control progression in some cases need further definition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00272436
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Rheumatoid inflammation and joint destruction: cause and effect or parallel phenomena? (1986)
    Springer
    Inflammation research 18 (1986), S. 538-543 
    Details
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Joint damage is a characteristic and important consequence of rheumatoid arthritis; it is usually considered to be a direct result of the inflammatory synovitis. This view implies that by treating actively the synovial inflammation subsequent joint damage will be reduced and the long-term outlook of patients with rheumatoid arthritis thus improved. However, there is relatively little clinical evidence that suppressing inflammation reduces rheumatoid joint damage. An alternative view is that the mechanisms causing inflammation and those leading to joint destruction are parallel processes related only indirectly. Considerable evidence supports such a concept. Clinical studies show radiological progression of the disease occurs despite improvements in measures of joint inflammation and a reduction in the levels of acute phase proteins. Damage can progress in either actively inflamed hot joints or cool swollen joints. Histopathologically the features of rheumatoid synovitis are non-specific, while the radiological pattern of joint damage is very characteristic. There is evidence that lymphocytic infiltration is not a poor prognostic finding, despite it being a typical feature of inflamed joints. Experimental studies also fail to show a close correlation between inflammation and cartilage damage: this is seen in experimental arthritis, coculturein vitro systems, and the air pouch model of cartilage damage. We suggest that attempts to improve the outcome of rheumatoid arthritis should not merely concentrate on controlling inflammation but should also seek to modify the associated connective tissue changes of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01964961
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The clinical value of measuring immunoglobulins when assessing penicillamine therapy in rheumatoid arthritis (1988)
    Springer
    Clinical rheumatology 7 (1988), S. 347-353 
    Details
    ISSN: 1434-9949
    Keywords: Rheumatoid Arthritis ; Penicillamine ; Immunoglobulins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Immunoglobulins are often high in active rheumatoid arthritis and fall when treatment with a slow-acting anti-rheumatic drug is instituted. We assessed the value of monitoring immunoglobulins during penicillamine therapy; 145 patients were followed for up to 5 years, IgA, IgM and IgG levels were compared to 12 other clinical and laboratory variables on 903 occasions. Mean levels of IgA and IgG fell by 10–30%. These changes were less than with ESR or clinical measures such as articular index and duration of morning stiffness. Immunoglobulin levels showed weak correlations with other variables. Only a small number of patients had hypogammuglobulineamia. Initially, 5 cases had low IgA with subsequent falls in 3 more. Initially, 2 cases had low IgG with subsequent falls in 5 more. No patients had low IgM levels. These changes seemed clinically irrelevant. Radiological progression was related to IgA levels. Patients with persistently high rates of radiological progression had persistently higher serum IgA. We conclude that IgM gives the most “acute phase” pattern of response. IgA gives more theoretically interesting information, especially concerning radiological progression. There is only a limited amount of clinically valuable information gained from measuring immunoglobulins.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02239191
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    Paper (German National Licenses)
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