Rheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition, ongoing advancements in therapeutic development have resulted in the production of medications that exhibit enhanced efficacy and safety characteristics. However, further investigation is required before RA can be deemed a manageable pathology. This review presents an analysis of the utilization of adalimumab for the treatment of RA by synthesizing information from relevant literature and emphasizing its effectiveness and safety to improve overall outcomes along with potential cost reductions for patients with RA.
Background: Rheumatiod factor in patients with Rheumatoid arthritis (RA) could be of IgM, IgG, or IgG isotypes.
Aim: To study the occurance of each or all these isotypes in RA patients .
Methods: Enzyme linked Immune Sorbent Assay (ELISA) & Latex agglutination test were used to asses RF in 74 patients with RA.
Results: Using ELISA, 58 (78.4%) patients had positive RF (IgM 48.6%, IgG in 47.3% & IgA in 54.1% ), while only 43 (58.1) patients were positive by AG .
Conclusion All RF isotypes should be assessed in patients with RA.
Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.
Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient
... Show MoreBackground: Pulmonary hypertension (PH) is a hemodynamic and pathophysiological condition
defined as an increase in mean pulmonary arterial pressure (PAP) ≥25 mmHg at rest as assessed by
right heart catheterization (RHC). Although there is some underestimation and overestimation of PAP
between transthoracic Doppler echo (DE) and RHC, Doppler echo remains an indispensable screening
tool for the assessment of PH.
Objective: clinical evaluation of patients with primary pulmonary hypertension (PPH) and assess
vasoreactivity testing to identify patients who may benefit from long term therapy with calcium channel
blockers (CCBs).
Patients and methods: This prospective study was performed in the cardiac catheterization
Reactive arthritis (ReA) is an incendiary joint inflammation that occurs few days to weeks after a gastrointestinal or genitourinary infection. The etiology of the disease is not well-known. Therefore, the present study included 80 females and 25 males, divided into 51 patients with reactive arthritis and 54 healthy individuals as control group. The study involved the detection of serum levels of anti-rheumatoid factor and anti-cyclic citrullinated peptide antibodies (anti-CCP) as well as those of CRP and C3 in all subjects. In addition, EBV levels were detected by Real Time-PCR technique. The results showed significantly increased levels (P < 0.05) of CRP, C3 and anti-CCP Ab in ReA patients’ group compared to th
... Show MoreABSTRACT Background: chronic periodontitis and rheumatoid arthritis are widely prevalent diseases and are characterized by tissue destruction due to chronic inflammation. Recently, there is growing evidence that the two diseases share many pathological features the aims of the study To determine the periodontal health status in patient have chronic periodontitis with rheumatoid arthritis and compare it with those having chronic periodontitis without Rheumatoid arthritis and determine the serum levels of interleukin -17(IL-17), tumor necrosis factor- alpha (TNF-α ) in both groups and compare with the control group (subject samples neither have periodontitis nor arthritis ) and correlate these immunological markers with the periodontal p
... Show MoreBackground: Patients who have both neurological impairment and kyphotic deformity can be treated medically, and this treatment can be achieved with anti-tuberculous drugs alone.
Objective: To evaluate conservative medical management of patients with tuberculosis of the spine (Pott disease). The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated.
Methods: Between January 2009 and January 2018 data were collected prospectively at The Neurosciences Hospital/ Baghdad/ Iraq in 44 patients with Pott disease in the thoracic and lumbar spine. These patients had no major neurological deficits or
... Show MoreBackground: Indeterminate colitis (IC), a term
originated by pathologists to characterize confounding
histopathlogic appearance of resected mucosa, has
become catch phrase for cases in which diagnostic
criteria at all levels elude classification as Crohn's
disease (CD) or ulcerative colitis (UC).
OBJECTIVES: evaluate the prevalence of pANCA
expression in the sera and its isotypes.
Patients and methods: PATIENTS GROUP
consisted of 60 patients (40 males and 20 females)
with indeterminate colitis and their age range was (19-
84 years). CONTROL GROUP consisted of 30 (15
males and 15 females) healthy volunteers and their
age range was (20- 66 years).
Antineutrophil cytoplasmic ( pANCA and cANCA)
te
Background: Significant numbers of patients with spinal tuberculosis (TB), especially in developing countries, still present late after disease onset with severe neurological deficits.
Objective:This study was conducted to assess the outcome of surgery in patients with tuberculosis of the spine with motor deficits.
Type of the study: Retrospective study.
Methods: We retrospectively analyzed data obtained in all the patients with severe motor deficits due to spinal TB admitted to and surgically treated in four hospitals in Baghdad/Iraq during the period from January 2012 to January 2014. History, examination, imaging, histological, postoperative, a
... Show MoreABSTRACTBackground: dyslipidemia plays a crucial rule in the development of cardiovascular disease, which has become the leading cause of death in most developed countries as well as in developing countries (1). The effects of reducing low density lipoprotein – C (LDL-C) concentrations on the prevention of cardiovascular events and stroke have been well reported in many clinical trials.Objectives: Evidence supports the use of statins for lipid modifications in the primary prevention of coronary artery disease, morbidity and mortality. This study aims to determine the effectiveness of atorvastatin in treating dyslipidemia in Iraqi obese patients.Methods: 200 overweight and obese patients with hypercholesterolemia, according to NCEP ATP
... Show MoreThe clinical spectrum of cutaneous leishmaniasis (CL), an intracellular parasitic pathogen, ranges from a single sore healing to chronic crusty lesions with a manifestation of treatment resistance. The complicated interaction between Leishmania bodies and the early immune response, including innate and adaptive mechanisms, determines the evolution of nodules. This study examined the levels of the chemoattractant interleukin 8 (IL-8), pro-inflammatory nitric oxide (NO), and immunoregulatory macrophage inhibitory factor (MIF) in the serum of subjects recently diagnosed with cutaneous leishmaniasis, in parallel with patients being monitored during consecutive sodium stibogluconate (Pentostam) treatment. A total of 161 serum samples of newly di
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