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Báo cáo y học: "Improvement in symptoms and signs in the forefoot of patients with rheumatoid arthritis treated with anti-TNF therapy"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Improvement in symptoms and signs in the forefoot of patients with rheumatoid arthritis treated with anti-TNF therapy. | Bowen et al. Journal of Foot and Ankle Research 2010 3 10 http www.jfootankleres.eom content 3 1 10 JOURNAL OF FOOT AND ANKLE RESEARCH RESEARCH Open Access Improvement in symptoms and signs in the forefoot of patients with rheumatoid arthritis treated with anti-TNF therapy Catherine J Bowen 41 7 Christopher J Edwards4 2 4 6 5 Lindsey Hooper41 5 Keith Dewbury43 Madeleine Sampson43 Sally Sawyer44 Jane Burridge41 and Nigel K Arden44 6 7 Abstract Background Inhibition of tumour necrosis factor TNF is an effective way of reducing synovitis and preventing joint damage in rheumatoid arthritis RA yet very little is known about its specific effect on foot pain and disability. The aim of this study was to evaluate whether anti-TNF therapy alters the presence of forefoot pathology and or reduces foot pain and disability. Methods Consecutive RA patients starting anti-TNF therapy infliximab etanercept adalimumab were assessed for presence of synovial hypertrophy and synovitis in the 2nd and 5th metatarso-phalangeal MTP joints and plantar forefoot bursal hypertrophy before and 12 weeks after therapy. Tender MTP joints and swollen bursae were established clinically by an experienced podiatrist and ultrasound US images were acquired and interpreted by a radiologist. Assessment of patient reported disease impact on the foot was performed using the Manchester Foot Pain and Disability Index MFPDI . Results 31 patients 24 female 7 male with RA 12 seronegative 19 seropositive completed the study mean age 59.6 SD 10.1 years disease duration 11.1 SD 10.5 years and previous number of Disease Modifying Anti Rheumatic Drugs 3.0 1.6 . Significant differences after therapy were found for Erythrocyte Sedimentation Rate t 4.014 p 0.001 C-reactive protein t 3.889 p 0.001 28 joint Disease Activity Score t 3.712 p 0.0001 Visual Analog Scale t 2.735 p 0.011 and Manchester Foot Pain and Disability Index t 3.712 p 0.001 . Presence of MTP joint synovial hypertrophy on US was noted in 67.5 of joints at