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  1. Article: Depression-, Pain-, and Health-Related Quality of Life in Patients with Systemic Lupus Erythematosus.

    Chalhoub, Nathalie E / Luggen, Michael E

    International journal of rheumatology

    2022  Volume 2022, Page(s) 6290736

    Abstract: Objectives: A significant number of patients with systemic lupus erythematosus (SLE) have depression, and many are untreated. We aim to assess the frequency of moderate to severe depression (MSD) in a multiethnic group of SLE patients with different ... ...

    Abstract Objectives: A significant number of patients with systemic lupus erythematosus (SLE) have depression, and many are untreated. We aim to assess the frequency of moderate to severe depression (MSD) in a multiethnic group of SLE patients with different sociodemographic backgrounds, identify modifiable factors associated with depression, and determine the impact of depression, disease activity, damage, cognitive function, and pain severity on health-related quality of life (HRQoL).
    Methods: Ninety-nine patients with SLE were evaluated in a cross-sectional study. Sociodemographic data, Beck Depression Inventory (BDI II), SLE disease activity index (SLEDAI-2K), SLICC Damage Index (SLICC-DI), pain severity (10 cm visual analogue scale), cognitive function (Automated Neuropsychologic Assessment Metrics (ANAM)), and the physical (PCS) and mental (MCS) component scores of the Short Form Health Survey (SF-36) were recorded. Bivariate analysis identified potential associations of relevant variables with BDI II and SF-36. Regression analysis determined independent correlates with MSD, PCS, and MCS.
    Results: Over 50% of subjects (50.5%) were African-American, 37.1% had a family income of ≤$20,000, and 31.3% had MSD. In the bivariate analysis, family income, SLEDAI-2K, cognitive function, and pain severity were associated with MSD. Using binary logistic regression, SLEDAI-2K and pain severity remained independently correlated with MSD (
    Conclusion: Pain severity and disease activity are associated with MSD in our unique population, are potentially modifiable, and deserve further attention in the clinic. Depression and pain significantly affect HRQoL and should be aggressively managed.
    Language English
    Publishing date 2022-05-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2503284-7
    ISSN 1687-9279 ; 1687-9260
    ISSN (online) 1687-9279
    ISSN 1687-9260
    DOI 10.1155/2022/6290736
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  2. Article ; Online: Olokizumab, a monoclonal antibody against interleukin-6, in combination with methotrexate in patients with rheumatoid arthritis inadequately controlled by tumour necrosis factor inhibitor therapy: efficacy and safety results of a randomised controlled phase III study.

    Feist, Eugen / Fatenejad, Saeed / Grishin, Sergey / Korneva, Elena / Luggen, Michael E / Nasonov, Evgeniy / Samsonov, Mikhail / Smolen, Josef S / Fleischmann, Roy M

    Annals of the rheumatic diseases

    2022  Volume 81, Issue 12, Page(s) 1661–1668

    Abstract: Objectives: To assess the efficacy and safety of olokizumab (OKZ), a monoclonal antibody against the interleukin-6 (IL-6) cytokine, versus placebo (PBO) in patients with prior inadequate response to tumour necrosis factor inhibitors (TNFi-IRs).: ... ...

    Abstract Objectives: To assess the efficacy and safety of olokizumab (OKZ), a monoclonal antibody against the interleukin-6 (IL-6) cytokine, versus placebo (PBO) in patients with prior inadequate response to tumour necrosis factor inhibitors (TNFi-IRs).
    Methods: In this 24-week multicentre, placebo-controlled, double-blind study, the patients were randomised in a 2:2:1 ratio to receive subcutaneously administered OKZ 64 mg once every 2 weeks (q2w), OKZ 64 mg once every 4 weeks (q4w) or PBO plus methotrexate. At week 16, the patients on PBO were randomised to receive either OKZ regime. The primary endpoint was the proportion of patients achieving an American College of Rheumatology 20% (ACR20) response at week 12. Disease Activity Score 28-joint count C-reactive protein (DAS28 (CRP))<3.2 at week 12 was the major secondary efficacy endpoint. Safety and immunogenicity were assessed.
    Results: In 368 patients randomised, ACR20 response rates were 60.9% in OKZ q2w, 59.6% in OKZ q4w and 40.6% in PBO (p<0.01 for both comparisons). Achievement of DAS28 (CRP) <3.2 was significantly different, favouring the OKZ arms. Improvements in efficacy and patient-reported outcomes were maintained throughout 24 weeks and were noted after week 16 in patients who switched from PBO.Dose-related treatment-emergent serious adverse events were 7% in OKZ q2w, 3.2% in OKZ q4w and none in the PBO group.
    Conclusions: Direct inhibition of IL-6 with OKZ resulted in significant improvements in the signs and symptoms of rheumatoid arthritis compared with PBO in TNF-IR patients with a similar safety profile as observed for monoclonal antibodies to the IL-6 receptor.
    Trial registration number: NCT02760433.
    MeSH term(s) Humans ; Antibodies, Monoclonal/therapeutic use ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; C-Reactive Protein/metabolism ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug Therapy, Combination ; Interleukin-6 ; Methotrexate/therapeutic use ; Treatment Outcome ; Tumor Necrosis Factor Inhibitors/therapeutic use
    Chemical Substances Antibodies, Monoclonal ; Antirheumatic Agents ; C-Reactive Protein (9007-41-4) ; Interleukin-6 ; Methotrexate (YL5FZ2Y5U1) ; olokizumab (PAI71R1D2W) ; Tumor Necrosis Factor Inhibitors
    Language English
    Publishing date 2022-09-15
    Publishing country England
    Document type Randomized Controlled Trial ; Multicenter Study ; Clinical Trial, Phase III ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/ard-2022-222630
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  3. Article: Trials are short, disease long: measuring drug utility beyond clinical trials.

    Luggen, Michael L

    The Journal of rheumatology

    2004  Volume 31, Issue 2, Page(s) 205–206

    MeSH term(s) Antirheumatic Agents/therapeutic use ; Clinical Trials as Topic/methods ; Humans ; Rheumatic Diseases/drug therapy
    Chemical Substances Antirheumatic Agents
    Language English
    Publishing date 2004-02
    Publishing country Canada
    Document type Comment ; Editorial ; Review
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
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  4. Article ; Online: Efficacy and safety of tildrakizumab in patients with active psoriatic arthritis: results of a randomised, double-blind, placebo-controlled, multiple-dose, 52-week phase IIb study.

    Mease, Philip J / Chohan, Saima / Fructuoso, Ferran J Garcia / Luggen, Michael E / Rahman, Proton / Raychaudhuri, Siba P / Chou, Richard C / Mendelsohn, Alan M / Rozzo, Stephen J / Gottlieb, Alice

    Annals of the rheumatic diseases

    2021  Volume 80, Issue 9, Page(s) 1147–1157

    Abstract: Objectives: To evaluate efficacy and safety of the anti-interleukin-23p19 monoclonal antibody tildrakizumab in patients with psoriatic arthritis (PsA).: Methods: In this randomised, double-blind, placebo-controlled, phase IIb study, patients with ... ...

    Abstract Objectives: To evaluate efficacy and safety of the anti-interleukin-23p19 monoclonal antibody tildrakizumab in patients with psoriatic arthritis (PsA).
    Methods: In this randomised, double-blind, placebo-controlled, phase IIb study, patients with active PsA were randomised 1:1:1:1:1 to tildrakizumab 200 mg every 4 weeks (Q4W); tildrakizumab 200, 100 or 20 mg Q12W; or placebo Q4W. Patients receiving tildrakizumab 20 mg or placebo switched to tildrakizumab 200 mg Q12W at W24; treatment continued to W52. The primary efficacy endpoint was proportion of patients with ACR20 response (≥20% improvement by American College of Rheumatology criteria) at W24. Secondary efficacy endpoints were assessed without adjustment for multiplicity. Safety was evaluated from treatment-emergent adverse events (TEAEs).
    Results: 391/500 patients screened were randomised and treated. At W24, 71.4%-79.5% of tildrakizumab-treated versus 50.6% of placebo-treated patients achieved ACR20 (all p<0.01). Patients receiving tildrakizumab versus placebo generally achieved higher rates of ACR50, Disease Activity Score in 28 joints with C reactive protein <3.2, minimal disease activity and 75%/90%/100% improvement from baseline Psoriasis Area and Severity Index responses at W24 and through W52. Improvement in dactylitis and enthesitis was not observed; results were mixed for other outcomes. Responses in patients switched to tildrakizumab 200 mg at W24 were consistent with treatment from baseline. TEAEs and serious TEAEs occurred in 64.5% and 3.3%, respectively, of all patients through W52 and were comparable among treatment arms.
    Conclusions: Tildrakizumab treatment significantly improved joint and skin manifestations of PsA other than dactylitis and enthesitis. Treatment was generally well tolerated through W52. Clinicaltrials.gov NCT02980692.
    Language English
    Publishing date 2021-05-13
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/annrheumdis-2020-219014
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  5. Book ; Online: Non-Parametric Class Completeness Estimators for Collaborative Knowledge Graphs -- The Case of Wikidata

    Luggen, Michael / Difallah, Djellel / Sarasua, Cristina / Demartini, Gianluca / Cudré-Mauroux, Philippe

    2019  

    Abstract: Collaborative Knowledge Graph platforms allow humans and automated scripts to collaborate in creating, updating and interlinking entities and facts. To ensure both the completeness of the data as well as a uniform coverage of the different topics, it is ... ...

    Abstract Collaborative Knowledge Graph platforms allow humans and automated scripts to collaborate in creating, updating and interlinking entities and facts. To ensure both the completeness of the data as well as a uniform coverage of the different topics, it is crucial to identify underrepresented classes in the Knowledge Graph. In this paper, we tackle this problem by developing statistical techniques for class cardinality estimation in collaborative Knowledge Graph platforms. Our method is able to estimate the completeness of a class - as defined by a schema or ontology - hence can be used to answer questions such as "Does the knowledge base have a complete list of all {Beer Brands|Volcanos|Video Game Consoles}?" As a use-case, we focus on Wikidata, which poses unique challenges in terms of the size of its ontology, the number of users actively populating its graph, and its extremely dynamic nature. Our techniques are derived from species estimation and data-management methodologies, and are applied to the case of graphs and collaborative editing. In our empirical evaluation, we observe that i) the number and frequency of unique class instances drastically influence the performance of an estimator, ii) bursts of inserts cause some estimators to overestimate the true size of the class if they are not properly handled, and iii) one can effectively measure the convergence of a class towards its true size by considering the stability of an estimator against the number of available instances.
    Keywords Computer Science - Databases ; Computer Science - Social and Information Networks
    Subject code 004
    Publishing date 2019-09-03
    Publishing country us
    Document type Book ; Online
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  6. Article ; Online: Anti-NR2 antibodies, blood-brain barrier, and cognitive dysfunction.

    Gulati, Gaurav / Iffland, Philip H / Janigro, Damir / Zhang, Bin / Luggen, Michael E

    Clinical rheumatology

    2016  Volume 35, Issue 12, Page(s) 2989–2997

    Abstract: Cognitive dysfunction (CD) is one of the most common neuropsychiatric manifestations of systemic lupus erythematosus (SLE). In animal models, antibodies to NR2 subunit of N-methyl D-aspartate receptor (anti-NR2) cause memory impairment, but only with ... ...

    Abstract Cognitive dysfunction (CD) is one of the most common neuropsychiatric manifestations of systemic lupus erythematosus (SLE). In animal models, antibodies to NR2 subunit of N-methyl D-aspartate receptor (anti-NR2) cause memory impairment, but only with blood-brain barrier (BBB) disruption or intrathecal administration. Several studies have failed to find association of aNR2 with CD, but none have assessed BBB integrity. S100B, an astrocyte-specific protein, has been used as biomarker of BBB disruption in traumatic brain injury and some neurodegenerative disorders. Antibodies to this immunologically privileged protein (anti-S100B) might indicate preceding BBB disruption. We hypothesized that aNR2 antibody is pathogenic in SLE patients only with BBB disruption. Demographic, clinical, and laboratory data was collected from patients with SLE. Total throughput score (TTS) of the Automated Neuropsychological Assessment Metrics (ANAM) was used as primary outcome measure. CD was defined as TTS < 1.5 SD below an age-, sex-, and race-matched RA population mean. Serum was analyzed by established ELISA techniques. Fifty-seven patients were evaluated and 12 had CD. Age, ethnicity, and family income were significantly different between the two groups (p < 0.05). In a multiple regression model adjusting for other variables, no significant effects of anti-NR2, S100B, or anti-S100B on TTS were found. Even at high levels of S100B and anti-S100B, no significant influence of anti-NR2 on TTS was found. The anti-NR2 was not associated with CD in SLE even in context of potential BBB disruption. This suggests that, if pathogenic, these antibodies may be produced intrathecally.
    MeSH term(s) Adult ; Aged ; Antibodies/blood ; Antibodies/chemistry ; Autoantibodies/immunology ; Biomarkers/blood ; Blood-Brain Barrier/immunology ; Cognitive Dysfunction/immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lupus Coagulation Inhibitor/immunology ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/immunology ; Male ; Middle Aged ; Receptors, N-Methyl-D-Aspartate/chemistry ; S100 Calcium Binding Protein beta Subunit/blood ; S100 Calcium Binding Protein beta Subunit/chemistry ; Severity of Illness Index ; Treatment Outcome
    Chemical Substances Antibodies ; Autoantibodies ; Biomarkers ; Lupus Coagulation Inhibitor ; Receptors, N-Methyl-D-Aspartate ; S100 Calcium Binding Protein beta Subunit ; S100B protein, human
    Language English
    Publishing date 2016-12
    Publishing country Germany
    Document type Journal Article ; Multicenter Study
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-016-3339-1
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  7. Article ; Online: Non-criteria anti-phospholipid antibodies and cognitive impairment in SLE.

    Luggen, Michael E / Gulati, Gaurav / Zhang, Bin / Willis, Rohan A / Gonzalez, Emilio B

    Clinical rheumatology

    2016  Volume 35, Issue 1, Page(s) 93–99

    Abstract: The pathogenesis of cognitive impairment (CI) in patients with systemic lupus erythematosus (SLE) is unknown. Anti-phospholipid antibodies (APL) have been implicated. The APL which have been evaluated have variably included anti-cardiolipin (ACL) ... ...

    Abstract The pathogenesis of cognitive impairment (CI) in patients with systemic lupus erythematosus (SLE) is unknown. Anti-phospholipid antibodies (APL) have been implicated. The APL which have been evaluated have variably included anti-cardiolipin (ACL) antibodies, lupus anticoagulant (LAC), and antibodies to beta-2 glycoprotein I (β2GPI). Few studies have examined other APL (so-called non-criteria APL). We evaluated the association of CI with a broad spectrum of non-criteria APL. Subjects meeting SLE classification criteria were recruited from three different patient populations. Cognitive function was assessed with the Automated Neuropsychologic Assessment Metrics (ANAM), a validated computer-based assessment tool. The total throughput score (TTS = number of correct responses/time) was used as the primary outcome measure. The following APL of all three isotypes were assessed by ELISA using standardized techniques: anti-β2GPI, anti-phosphatidyl ethanolamine (aPE), anti-phosphatidyl choline (aPC), anti-phosphatidyl inositol (aPI), anti-phosphatidyl serine (aPS), anti-phosphatidyl glycerol (aPG), anti-phosphatidic acid (aPA). Fifty-seven (57) patients were evaluated. Of the 57, 12 had definite CI (>1.5 SD below the mean of an age-, sex-, and race-matched RA population). The two groups were significantly different with regard to age, ethnicity, and family income. There was no significant difference between groups with regard to the presence of any non-criteria APL. When titers of specific non-criteria APL were compared with TTS, no significant correlations were found. Using multiple linear regression and adjusting for relevant covariates including age, ethnicity, and family income, neither the presence nor the titer of any non-criteria APL significantly influenced TTS. In this cross-sectional study, non-criteria APL were not associated with CI.
    MeSH term(s) Adult ; Antibodies, Antiphospholipid/blood ; Cognition Disorders/diagnosis ; Cross-Sectional Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Linear Models ; Lupus Erythematosus, Systemic/blood ; Lupus Erythematosus, Systemic/psychology ; Male ; Middle Aged ; Psychiatric Status Rating Scales
    Chemical Substances Antibodies, Antiphospholipid
    Language English
    Publishing date 2016-01
    Publishing country Germany
    Document type Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-015-3114-8
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  8. Article: T cell costimulation: a rational target in the therapeutic armamentarium for autoimmune diseases and transplantation.

    Vincenti, Flavio / Luggen, Michael

    Annual review of medicine

    2007  Volume 58, Page(s) 347–358

    Abstract: T cells are central mediators of adaptive immunity. As such, they are involved in both normal immune responses (e.g., rejection of a transplanted organ) and abnormal ones (e.g., rheumatoid arthritis). T cells require both antigen-specific and ... ...

    Abstract T cells are central mediators of adaptive immunity. As such, they are involved in both normal immune responses (e.g., rejection of a transplanted organ) and abnormal ones (e.g., rheumatoid arthritis). T cells require both antigen-specific and costimulatory signals for their full activation. Advances in protein engineering and an increased understanding of the immune response have culminated in the evolution and creation of protein therapeutics that target specific costimulatory molecules. The selective costimulation modulator abatacept (CTLA-4Ig) binds to CD80 and CD86, blocking interaction with CD28, and is approved for the treatment of moderate to severe rheumatoid arthritis. Belatacept, currently enrolling phase III trials in renal transplantation, was rationally designed from abatacept to bind with more avidity to CD86, providing the more potent immunosuppressive properties required for immunosuppression in transplantation. This review describes the relevant immunology and summarizes recent clinical findings on these two molecules. Although both inhibit the CD28 costimulatory pathway, they are tailored for specific disease states--abatacept for autoimmune diseases and belatacept for transplantation.
    MeSH term(s) Abatacept ; Antigens, CD/drug effects ; Arthritis, Rheumatoid/immunology ; Arthritis, Rheumatoid/prevention & control ; Graft Rejection/immunology ; Graft Rejection/prevention & control ; Humans ; Immunoconjugates/pharmacology ; Immunoconjugates/therapeutic use ; Immunosuppressive Agents/pharmacology ; Immunosuppressive Agents/therapeutic use ; Lymphocyte Activation/drug effects
    Chemical Substances Antigens, CD ; Immunoconjugates ; Immunosuppressive Agents ; Abatacept (7D0YB67S97)
    Language English
    Publishing date 2007
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 207930-6
    ISSN 0066-4219
    ISSN 0066-4219
    DOI 10.1146/annurev.med.58.080205.154004
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  9. Article: Cognitive dysfunction in patients with systemic lupus erythematosus: a controlled study.

    Antonchak, Marc A / Saoudian, Mahnaz / Khan, Amber R / Brunner, Hermine I / Luggen, Michael E

    The Journal of rheumatology

    2011  Volume 38, Issue 6, Page(s) 1020–1025

    Abstract: Objective: To determine the extent to which cognitive dysfunction (CD) observed in patients with systemic lupus erythematosus (SLE) exceeds that seen in a matched control group of patients with rheumatoid arthritis (RA), and to estimate the prevalence ... ...

    Abstract Objective: To determine the extent to which cognitive dysfunction (CD) observed in patients with systemic lupus erythematosus (SLE) exceeds that seen in a matched control group of patients with rheumatoid arthritis (RA), and to estimate the prevalence of CD in SLE in a community-based sample.
    Methods: A random subsample of 31 patients with SLE was compared to patients with RA matched by age, sex, and race and derived from the same patient population. Cognitive function was assessed by the Automated Neuropsychological Assessment Metrics (ANAM). The primary outcome was the total throughput score (number of correct responses divided by the time taken for those responses averaged over all subtests), adjusted for premorbid intelligence, neuromuscular efficiency, disease activity, damage, depression, fatigue, and health-related quality of life.
    Results: There were no statistically significant differences in mean throughput scores between patients in the SLE and RA groups in any subtest of the ANAM or in the total throughput score. The frequency of CD, defined as either total scores > 1.5 SD below the mean of the RA population, or 4 or more ANAM subtests each > 1.5 SD below the RA mean, was similar in patients with SLE and in RA controls.
    Conclusion: We found no differences in cognitive function between patients with SLE and RA, suggesting that the CD found in some patients with SLE may represent the consequences of a chronic and/or inflammatory disease rather than SLE-related central nervous system damage.
    MeSH term(s) Adult ; Arthritis, Rheumatoid/psychology ; Case-Control Studies ; Cognition Disorders/epidemiology ; Cohort Studies ; Female ; Humans ; Lupus Erythematosus, Systemic/psychology ; Middle Aged ; Neuropsychological Tests ; Outcome Assessment (Health Care) ; Prevalence ; Severity of Illness Index
    Language English
    Publishing date 2011-06
    Publishing country Canada
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.100560
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  10. Article: Monitoring methotrexate toxicity in juvenile idiopathic arthritis.

    Kocharla, Lakshmi / Taylor, Janalee / Weiler, Tracey / Ting, Tracy V / Luggen, Michael / Brunner, Hermine I

    The Journal of rheumatology

    2009  Volume 36, Issue 12, Page(s) 2813–2818

    Abstract: Objective: To determine the frequency of laboratory abnormalities with methotrexate (MTX) use in patients with juvenile idiopathic arthritis (JIA); to identify potential risk factors for MTX toxicity requiring medical interventions; and to compare the ... ...

    Abstract Objective: To determine the frequency of laboratory abnormalities with methotrexate (MTX) use in patients with juvenile idiopathic arthritis (JIA); to identify potential risk factors for MTX toxicity requiring medical interventions; and to compare the frequency of liver function abnormalities in patients treated with MTX to those not treated with MTX.
    Methods: Results of MTX surveillance laboratory testing (SLT) available in clinical databases were reviewed for 588 children with JIA. Information on demographics, JIA features, and factors previously associated with increased frequency of SLT abnormalities was obtained.
    Results: Results of SLT performed in at least 4-month intervals were available for 138 JIA patients whose JIA was not treated with MTX, and for 198 JIA patients treated with MTX plus folic acid. On SLT of the MTX-treated patients, there were 44 of 2650 (1.7%) AST tests and 90 of 2647 (3.4%) ALT tests that exceeded 2 times the upper limit of normal (> 2 ULN) in 30 children (15%). AST or ALT tests at > 2 ULN occurred more often with systemic JIA (p = 0.04), macrophage activation syndrome, during infections, in systemic antibiotic use, and after intensifying JIA drug regimens. AST or ALT results at > 2 ULN were as frequent among MTX-treated children as those not treated with MTX. Renal and hematological abnormalities with MTX were uncommon.
    Conclusion: Liver enzyme abnormalities > 2 ULN are rare in JIA, irrespective of MTX exposure. These data suggest that the adult standard of SLT every 4-8 weeks may not be necessary in children treated with MTX, especially if certain risk factors are absent.
    MeSH term(s) Adolescent ; Adult ; Antirheumatic Agents/therapeutic use ; Antirheumatic Agents/toxicity ; Arthritis, Juvenile/drug therapy ; Chemical and Drug Induced Liver Injury/physiopathology ; Child ; Databases, Factual ; Drug Monitoring ; Female ; Humans ; Liver/drug effects ; Liver/enzymology ; Male ; Methotrexate/therapeutic use ; Methotrexate/toxicity ; Risk Factors
    Chemical Substances Antirheumatic Agents ; Methotrexate (YL5FZ2Y5U1)
    Language English
    Publishing date 2009-11-16
    Publishing country Canada
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.090482
    Database MEDical Literature Analysis and Retrieval System OnLINE

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