Article
Pharmacology & Pharmacy
Ana Socorro Rodriguez-Baez, Ana Patricia Huerta-Garcia, Susanna Edith Medellin-Garibay, Cristian Jazmin Rodriguez-Pinal, Marco Ulises Martinez-Martinez, David Herrera-Van Oostdam, Carlos Abud-Mendoza, Silvia Romano-Moreno, Rosa del Carmen Milan-Segovia
Summary: The safety and efficacy of low-dose methotrexate administered daily or weekly in rheumatoid arthritis patients were investigated in this study. The results showed a good response to methotrexate treatment in both daily and weekly dosage regimens, with similar adherence patterns. Additionally, methotrexate polyglutamate 3 concentrations could serve as a useful tool for therapeutic drug monitoring.
BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY
(2022)
Article
Medicine, General & Internal
Alejandro Escudero-Contreras, Clementina Lopez-Medina, Eduardo Collantes-Estevez, Rafaela Ortega-Castro, Jerusalem Calvo-Gutierrez, Natalia Mena-Vazquez, Blanca Panero-Lamothe, Barbara Manzanares-Martin, Rafael Caliz-Caliz, Alberto Jimenez-Morales, Mayte Ruiz-Jimenez, Pilar Font-Ugalde
Summary: This study identified significant associations between the GGH-T401C genotype and MTX intolerance, and the ABCC2-C24T genotype and MTX intolerance. These findings may contribute to the development of new biomarkers and personalized medicine for patients with RA.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Rheumatology
Delila Singh, Nina Hesse, Alla Skapenko, Hendrik Schulze-Koops
Summary: Methotrexate is associated with rare bone lesions that are often misdiagnosed as osteoporotic fractures. Early diagnosis is crucial for treatment and prevention of further osteopathology. This case highlights the importance of raising awareness and taking appropriate therapeutic measures, including discontinuing methotrexate.
Article
Biochemical Research Methods
Duck Hyun Kim, Yeong Suk Yoo, Hee Jin Yoo, Yoon Ji Choi, Soon Ae Kim, Dong-Hyuk Sheen, Sang Kwang Lee, Mi Kyoung Lim, Kun Cho
Summary: The study developed a new LC-ESI-MS/MS method for accurately measuring MTX-Glu in hair cells, red blood cells, and serum. This method was both sensitive and precise within the clinically relevant range.
JOURNAL OF MASS SPECTROMETRY
(2021)
Article
Immunology
Shu-Lin Chen, Qiang Xu, Chang-Song Lin
Summary: A study found that the therapeutic drugs for rheumatoid arthritis (RA) are associated with thyroid function, with methotrexate being linked to decreased levels of total thyroxine (TT4) and glucocorticoids being linked to decreased levels of total triiodothyronine (TT3).
INFLAMMOPHARMACOLOGY
(2023)
Article
Rheumatology
Clement Triaille, Gaelle Tilman, Tatiana Sokolova, Axelle Loriot, Joelle Marchandise, Stephanie De Montjoye, Adrien Nzeusseu-Toukap, Laurent Meric de Bellefon, Caroline Bouzin, Christine Galant, Patrick Durez, Bernard R. Lauwerys, Nisha Limaye
Summary: This study used transcriptomic profiling to explore clinically relevant subgroups in early, untreated rheumatoid arthritis (RA) patients. The synovial transcriptome closely mirrored clinical disease activity, and the ratio of M2:M1 macrophages was inversely correlated with inflammation and disease activity, suggesting a protective role for tissue resident macrophages in RA.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Tate M. Johnson, Harlan R. Sayles, Joshua F. Baker, Michael D. George, Punyasha Roul, Cheng Zheng, Brian Sauer, Katherine P. Liao, Daniel R. Anderson, Ted R. Mikuls, Bryant R. England
Summary: In patients with RA, the use of MTX was associated with a reduced risk of cardiovascular events, particularly HF-related hospitalizations. However, this association was not mediated through reductions in RA disease activity, suggesting that MTX may modify CVD risk in this population through alternative mechanisms.
ANNALS OF THE RHEUMATIC DISEASES
(2021)
Article
Rheumatology
Katriona Goldmann, Athina Spiliopoulou, Andrii Iakovliev, Darren Plant, Nisha Nair, Cankut Cubuk, Paul McKeigue, Michael R. Barnes, Anne Barton, Costantino Pitzalis, Myles J. Lewis
Summary: This study conducted expression quantitative trait locus (eQTL) analysis using RNA-Sequencing to explore the link between genetic variants and gene expression in rheumatoid arthritis (RA) patients. The analysis identified 898 eQTL genes in synovium and blood, with 232 genes in common. A specific eQTL at HLA-DPB2 was found to be associated with clinical severity and the lympho-myeloid pathotype.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Paul Studenic, Daniel Aletaha, Maarten de Wit, Tanja A. Stamm, Farideh Alasti, Diane Lacaille, Josef S. Smolen, David T. Felson
Summary: This study aimed to externally validate a revised Boolean remission criteria using a higher patient global assessment (PtGA) threshold and validate the provisionally endorsed index-based criteria. The results showed that using the higher PtGA threshold increased the proportion of patients classified as achieving remission under the "Boolean2.0" criteria, improved agreement with index-based criteria, and did not compromise predictive value for radiographic or functional outcomes. The study findings were endorsed by ACR and EULAR.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Renske C. F. Hebing, Marry Lin, Maja Bulatovic Calasan, Ittai B. Muller, Sohaila Mahmoud, Sandra Heil, Eduard A. Struys, Bart J. F. van den Bemt, Jos W. R. Twisk, Willem Lems, Michael T. Nurmohamed, Gerrit Jansen, Robert de Jonge
Summary: This study investigates the pharmacokinetics of methotrexate polyglutamate (MTX-PG) accumulation in red blood cells (RBCs) and peripheral blood mononuclear cells (PBMCs) in patients with early rheumatoid arthritis (RA) after oral and subcutaneous MTX treatment. The results show that there are disparate pharmacokinetic profiles between PBMCs and RBCs, with higher accumulation of MTX-PG in PBMCs. The distribution profile of MTX-PG in PBMCs remains constant over 6 months, while in RBCs, the main PG-moiety changes from MTX-PG(1) to MTX-PG(3).
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Chemistry, Analytical
Junqing He, Junyan Wang, Min Zhang, Guoyue Shi
Summary: As a folate antagonist, methotrexate (MTX) has been widely used in clinics for treating various tumors and inflammatory diseases. However, the dosage and clearance of MTX vary between individuals, and it may cause life-threatening side effects at high doses. Therefore, a convenient and simple method for MTX sensing is highly demanded.
Article
Health Care Sciences & Services
Amanda J. Eakin, Tahanver Ahmed, Cathy M. McGeough, Stephen Drain, H. Denis Alexander, Gary D. Wright, Philip Gardiner, Dawn Small, Anthony J. Bjourson, David S. Gibson
Summary: This study investigates the relationship between disease activity in rheumatoid arthritis (RA) and the numbers and phenotypes of circulating regulatory T cells (Tregs) and monocytes. It also explores the potential sialic acid link between Tregs and monocytes and the effects of sialic acid on Treg activation and cytokine release.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Chemistry, Analytical
Jingjing Wu, Song Zhang, Jiali Li, Xiaoli Zhong, Guiping Feng, Liangqing Hu, Fan He, Hanjing Cen, Yilu Chen, Yanling He, Huasong Zeng, Xiao Chen, Xiaolan Mo
Summary: A new method using high-performance liquid chromatography-tandem mass spectrometry was developed to measure methotrexate polyglutamates in erythrocytes, allowing for accurate and stable monitoring of individualized treatment in patients.
JOURNAL OF SEPARATION SCIENCE
(2021)
Article
Rheumatology
Eva Vermeer, Renske C. F. Hebing, Maartje M. van de Meeberg, Marry Lin, Tim G. J. de Meij, Eduard A. Struys, Gerrit Jansen, Michael T. Nurmohamed, Maja Bulatovic Calasan, Robert de Jonge
Summary: There is no conclusive evidence supporting the superiority of either oral or subcutaneous administration of methotrexate (MTX) in immune-mediated inflammatory disorders (IMIDs). Subcutaneous administration leads to higher plasma bioavailability and initial accumulation of MTX-polyglutamates (MTX-PGs) in red blood cells (RBCs), but the difference seems to disappear over time. The choice of administration route may be based on shared decision-making, offering patients the option of either oral or subcutaneous administration of MTX based on individual preferences and tolerability.
CURRENT RHEUMATOLOGY REPORTS
(2023)
Article
Rheumatology
Carlo Scognamiglio Renner Araujo, Ana Cristina Medeiros-Ribeiro, Carla G. S. Saad, Karina Rossi Bonfiglioli, Diogo Souza Domiciano, Andrea Yukie Shimabuco, Matheus Santos Rodrigues Silva, Emily Figueiredo Neves Yuki, Sandra Gofinet Pasoto, Tatiana Pedrosa, Leonard de Vinci Kanda Kupa, Gioanna Zou, Rosa M. R. Pereira, Clovis Artur Silva, Nadia Emi Aikawa, Eloisa Bonfa
Summary: This study evaluated the effect of discontinuing methotrexate (MTX) for 2 weeks after each dose of the Sinovac-CoronaVac vaccine on immunogenicity and safety in patients with rheumatoid arthritis (RA). The results showed that the group that discontinued MTX had a higher rate of seroconversion and higher antibody titers compared to the group that continued MTX. However, there was an increased risk of flare after the second MTX withdrawal.
ANNALS OF THE RHEUMATIC DISEASES
(2022)
Article
Rheumatology
Nathalie Luurssen-Masurel, Elise van Mulligen, Angelique Elisabeth Adriana Maria Weel-Koenders, Johanna Maria Wilhelmina Hazes, Pascal Hendrik Pieter de Jong
Summary: This study compared the long-term clinical outcomes of three clinical arthritis phenotypes: undifferentiated arthritis (UA), autoantibody-negative (RA-) and autoantibody-positive RA (RA+). The results showed that there were differences in remission rates and sustained remission rates between these phenotypes. The data confirm that rheumatoid arthritis can be subdivided based on clinical phenotypes and that treatment should be stratified accordingly.
Article
Rheumatology
Henriette M. Y. de Jong, Janneke J. H. de Winter, Irene E. van der Horst-Bruinsma, Dirk-Jan van Schaardenburg, Floris A. van Gaalen, Astrid M. van Tubergen, Angelique E. A. M. Weel, Robert B. M. Landewe, Dominique L. P. Baeten, Marleen G. H. van de Sande
Summary: Features associated with SpA or imaging abnormalities were found in up to 32% of seemingly healthy FDRs, with an equal distribution between HLA-B27-positive and -negative FDRs. Progression to clinical axial SpA within 1 year of follow-up was mainly observed in HLA-B27-positive FDRs.
ARTHRITIS CARE & RESEARCH
(2022)
Article
Rheumatology
Elke Theodora Antonia Maria van Delft, Deirisa Lopes Barreto, Annette Helena Maria van der Helm-van Mil, Celina Alves, Johanna Maria Wilhelmina Hazes, Tjallingius Martijn Kuijper, Angelique Elisabeth Adriana Maria Weel-Koenders
Summary: The aim of this study was to evaluate the performance of the REACH and CARE referral rules in diagnosing inflammatory arthritis and IRD in a primary care population. The results showed that CARE had a higher area under the curve compared to REACH and had greater clinical value compared to usual care. Additionally, the composite referral rule for IRD using 10 parameters also demonstrated good diagnostic performance.
ARTHRITIS CARE & RESEARCH
(2022)
Article
Rheumatology
Marijke van den Dikkenberg, Nathalie Luurssen-Masurel, Tjallingius Martijn Kuijper, Marc-Redwart Kok, Johanna Maria Wilhelmina Hazes, Pascal Hendrik Pieter de Jong, Deirisa Lopes-Barreto, Angelique Elisabeth Adriana Maria Weel-Koenders
Summary: This systematic review aims to evaluate the effects of disease-modifying antirheumatic drugs (DMARDs) on patient-reported outcomes in rheumatoid arthritis. The results showed that DMARDs reduce the burden of pain, fatigue, and activity limitation compared to placebo and methotrexate.
ARTHRITIS CARE & RESEARCH
(2023)
Article
Rheumatology
E. T. A. M. van Delft, D. Lopes Barreto, K. H. Han, I Tchetverikov, A. Evertse, T. M. Kuijper, J. M. W. Hazes, A. E. A. M. Weel-Koenders
Summary: Introducing rheumatologists for triaging in primary care improves the accuracy of referrals, reduces healthcare utilization, and improves patient quality of life.
SCANDINAVIAN JOURNAL OF RHEUMATOLOGY
(2023)
Article
Medicine, Research & Experimental
P. N. d'Ailly, C. Deugd, N. W. L. Schep, T. M. Kuijper, M. R. Kok, A. Willemze, J. H. Coert, P. H. P. de Jong, W. K. Lam-Tse, A. H. M. van der Helm-van Mil, I. Tchetverikov, A. E. A. M. Weel-Koenders, R. J. Bisoendial
Summary: This study aims to evaluate the effect of arthroscopic synovectomy and intra-articular corticosteroid injections (IACSI) on wrist function in patients with therapy-resistant rheumatoid arthritis (RA) and psoriatic arthritis (PsA). A prospective randomized controlled trial will be conducted, recruiting 80 eligible patients who will be randomly assigned to two different treatment groups. The primary outcome measure is the improvement of wrist function.
Article
Economics
Fiona Koster, Marc R. Kok, Jaco van der Kooij, Geeke Waverijn, Angelique E. A. M. Weel-Koenders, Deirisa Lopes Barreto
Summary: Time-driven activity-based costing (TDABC) using fuzzy logic (FL-TDABC) provides a more precise and efficient estimate of healthcare cycle costs, considering the subjective nature of time estimates. The FL-TDABC methodology estimated the annual costs of the rheumatoid arthritis (RA) care cycle to be euro1497 per patient, with a 22% cost variation. The main cost drivers were consultations with rheumatologists and pharmacy costs. FL-TDABC offers insights for transitioning from a volume-based system to a value-based healthcare (VBHC) system.
PHARMACOECONOMICS-OPEN
(2023)
Article
Rheumatology
Luuk van Esveld, Juul M. Cox, T. Martijn Kuijper, Tessa M. Bosch, Angelique E. A. M. Weel-Koenders
Summary: Currently lacking guidelines, this study aims to evaluate the long-term cost-effectiveness of various bDMARD tapering strategies in Dutch patients with RA from a societal perspective. The results showed that the 50% tapering approach had the highest cost per QALY lost.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
M. Jamal, T. M. Kuijper, J. M. W. Hazes, D. Lopes Barreto, A. E. A. M. Weel
Summary: This study assessed the cost-utility of the digital CaFaSpA referral strategy for axSpA in primary care patients with CLBP. The results showed that the CS group had lower total costs and did not decrease the overall healthcare status of patients, indicating that CS is a cost-effective primary care referral model.
SCANDINAVIAN JOURNAL OF RHEUMATOLOGY
(2023)
Article
Rheumatology
Fiona Koster, Pieter L. H. Bakx, Marc R. Kok, Deirisa Lopes Barreto, Angelique E. A. M. Weel-Koenders
Summary: The prevalence of multimorbidity is increasing among patients with rheumatoid arthritis (RA) and is associated with worse outcomes. This study examines the importance of a multidisciplinary, integrated approach in managing multimorbid patients and assesses the association between expenditures and multimorbidity using real-life data.
RHEUMATOLOGY INTERNATIONAL
(2023)
Review
Rheumatology
Maha Jamal, Elke Theodora Antonia Maria van Delft, Hannah den Braanker, Tjallingius Martijn Kuijper, Johanna Mieke Wilhelmina Hazes, Deirisa Lopes Barreto, Angelique Elisabeth Adriana Maria Weel
Summary: This study aimed to investigate the proportion of axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) diagnoses among newly referred patients visiting rheumatology outpatient clinics, as well as the impact of ASAS and CASPAR classification criteria. The study found that the proportion of newly referred patients with axSpA was 19% and with PsA was 18%. However, due to high heterogeneity, the findings should be interpreted with caution.
RHEUMATOLOGY INTERNATIONAL
(2023)
Article
Rheumatology
Fiona Koster, Deirisa Lopes Barreto, Sandhya C. Nair, Marc R. Kok, Angelique E. A. M. Weel-Koenders
Summary: The study aimed to establish a validated process map of the care cycle for patients with Rheumatoid Arthritis (RA) in order to improve the quality of care and identify areas for improvement. By systematically documenting activities and resources and conducting interviews with medical staff, a comprehensive process map was created. This approach increased transparency, optimized care delivery, and resulted in improvement actions on both outcome and process levels.
RHEUMATOLOGY INTERNATIONAL
(2023)
Meeting Abstract
Economics
F. Koster, Lopes D. Barreto, M. R. Kok, A. E. A. M. Weel-Koenders
Meeting Abstract
Rheumatology
Marijke Van den Dikkenberg, Martijn Kuijper, Marc Kok, Deirisa Lopes Barreto, Angelique Weel
ARTHRITIS & RHEUMATOLOGY
(2022)
Meeting Abstract
Economics
F. Koster, M. R. Kok, A. E. A. M. Weel-Koenders, Lopes D. Barreto