Rheumatoid Arthritis Research Today is a free monthly online journal that collates and summarizes the latest research about Rheumatoid Arthritis, including details on treatment, symptoms, causes, medication.

Dynamics of body composition and bone in patients with juvenile idiopathic arthritis treated with growth hormone.

Bechtold S, Ripperger P, Dalla Pozza R, Roth J, Häfner R, Michels H, Schwarz HP

Division of Pediatric Endocrinology, University Children's Hospital, D-80337 Munich, Germany. Susanne.Bechtold@med.uni-muenchen.de

INTRODUCTION: GH has a positive impact on growth, bone, and muscle development. The objectives of this study were to demonstrate the effects of GH treatment on regional body composition and bone geometry at final height in patients with juvenile idiopathic arthritis (JIA). PATIENTS AND METHODS: In this longitudinal study, parameters of bone mineral density and geometry as well as muscle and fat cross-sectional area (CSA) in the nondominant forearm were recorded using peripheral quantitative computed tomography at yearly intervals until final height in 12 patients (seven females) receiving GH treatment. Data at final height were compared with 13 patients (nine females) with JIA not treated with GH. RESULTS: Patients were treated with GH for a mean of 5.35 +/- 0.7 yr. Correcting for height, total bone CSA (+0.89 +/- 0.5 sd) and muscle CSA (+1.14 +/- 0.6 sd) increased significantly and normalized at final height. Compared with JIA patients without GH at final height, there was a significantly higher muscle CSA and a lower fat CSA in GH-treated patients. Additionally, in relation to total bone CSA, there was significantly more cortical and less marrow CSA in boys with GH treatment. CONCLUSION: During GH treatment, there was a significant increase and normalization of total bone and muscle CSA at final height. In accordance with an anabolic effect of GH, fat mass stabilized at the lower limit of healthy children. At final height, cortical and marrow CSA, relative to total bone CSA, were normalized in GH-treated patients.

Published 8 January 2010 in J Clin Endocrinol Metab, 95(1): 178-85.
Full-text of this article is available online (may require subscription).

Articles on Rheumatoid Arthritis published 6 January 2010:

A case of sclerosing mesenteritis with rheumatoid arthritis.   South Med J, 103(1): 96-7.

Sclerosing mesenteritis (SM) is an uncommon disorder characterized by chronic nonspecific inflammation involving the adipose tissue of the mesentery. The etiology remains unclear. It has been reported in association with and as an initial presentation in some autoimmune diseases. Its clinical presentation and laboratory findings are typically nonspecific and definitive diagnosis usually requires biopsy or surgical excision. We report a patient with a history of rheumatoid arthritis who was ... [Abstract] [Full-text]

Articles on Rheumatoid Arthritis published 5 January 2010:

Conjunctival in vivo confocal scanning laser microscopy in patients with Sjögren syndrome.   Invest Ophthalmol Vis Sci, 51(1): 144-50.

PURPOSE: To demonstrate the conjunctival alterations in patients with Sjögren's (SSDE) and non-Sjögren's syndrome dry eye (NSSDE) using a new generation confocal microscope (HRTII/ RCM; Heidelberg Engineering, Heidelberg, Germany), in a prospective controlled study. METHODS: Twenty-eight right eyes of 28 patients with SSDE (28 women; mean age, 58.2 +/- 14.3 years), 7 right eyes of patients with NSSDE (7 women; mean age, 66.1 +/- 14.4 years), and 14 right eyes of 14 age- and sex-matched ... [Abstract] [Full-text]

Articles on Rheumatoid Arthritis published 23 December 2009:

Autoimmunity against fibrinogen mediates inflammatory arthritis in mice.   J Immunol, 184(1): 379-90.

Rheumatoid arthritis (RA) is an autoimmune synovitis characterized by the presence of anticitrullinated protein Abs, although the exact targets and role of anticitrullinated protein autoimmunity in the pathogenesis of RA remain to be defined. Fibrinogen, which can be citrullinated, has recently emerged as a candidate autoantigen. To determine whether autoimmunity against fibrinogen can mediate inflammatory arthritis, we immunized a variety of common mouse strains with fibrinogen and found that ... [Abstract] [Full-text]

Revision total knee arthroplasty for aseptic and septic causes in patients with rheumatoid arthritis.   Clin Orthop Relat Res, 468(1): 82-9.

Revision total knee arthroplasty in patients with rheumatoid arthritis can be challenging. We asked whether we could confirm previously reported high failure rates following revision total knee arthroplasty in patients with rheumatoid arthritis. We therefore determined the Knee Society knee score and function scores, radiographic evidence of failure, and overall survival of the revision procedure in these patients. We retrospectively reviewed 39 patients with rheumatoid arthritis who underwent ... [Abstract] [Full-text]

Articles on Rheumatoid Arthritis published 16 December 2009:

A new design for registration trials in rheumatoid arthritis allowing secondary head-to-head comparisons with standard of care treatment including biologicals.   Ann Rheum Dis, 69(1): 4-6.

Current drug development programs produce high quality data on the efficacy of new drugs, substantial data on safety, but little data on actual applicability of the new product compared to standard of care. After successful registration and launch, such data require years to accumulate and often remain incomplete. This viewpoint proposes a new trial design for phase 2 and 3 drug trials in rheumatoid arthritis. In this design the trial starts conventionally: patients that are inadequate ... [Abstract] [Full-text]

The time has come to limit the placebo period in rheumatoid arthritis trials to 3 months: a systematic comparison of 3- and 6-month response rates in trials of biological agents.   Ann Rheum Dis, 69(1): 186-92.

BACKGROUND: Most registration trials in rheumatoid arthritis (RA) include a placebo arm in the setting of an incomplete response to disease-modifying antirheumatic treatment (DMARD-IR). A minimum duration of 6 months is required despite serious methodological and ethical shortcomings. OBJECTIVE: To study whether a 3-month placebo period is sufficient to prove efficacy. METHODS: Meta-analysis of placebo- or active control trials of biological agents in DMARD-IR RA, comparing the contrast in ACR ... [Abstract] [Full-text]

Major improvements in health-related quality of life during the use of etanercept in patients with previously refractory juvenile idiopathic arthritis.   Ann Rheum Dis, 69(1): 138-42.

OBJECTIVE: To evaluate changes in health-related quality of life (HRQoL) in patients with refractory juvenile idiopathic arthritis (JIA) who are being treated with etanercept. METHODS: 53 patients with JIA from seven Dutch centres were included. HRQoL was measured by the Childhood Health Assessment Questionnaire (CHAQ), Child Health Questionnaire (CHQ) and Health Utilities Index mark 3 (HUI3) at the start and after 3, 15 and 27 months of treatment. At the same time points the following JIA ... [Abstract] [Full-text]

Patients with rheumatoid arthritis treated with tumour necrosis factor antagonists increase their participation in the workforce: potential for significant long-term indirect cost gains (data from a population-based registry).   Ann Rheum Dis, 69(1): 126-31.

OBJECTIVE: To investigate the effect of tumour necrosis factor (TNF) antagonist treatment on workforce participation in patients with rheumatoid arthritis (RA). METHODS: Data from the Stockholm anti-TNFalpha follow-up registry (STURE) were used in this observational study. Patients with RA (n = 594) aged 18-55 years, (mean (SD) 40 (9) years) followed for up to 5 years were included with hours worked/week as the main outcome measure. Analyses were performed unadjusted and adjusted for baseline ... [Abstract] [Full-text]

© 2004-2010 Rheumatoid Arthritis Research Today. All Rights Reserved.