| Lower extremity ulcers in rheumatoid arthritis: features and response to immunosuppression. | |
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MedLine Citation:
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PMID: 21340497 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Lower extremity ulcers are a recognized complication of rheumatoid arthritis (RA). Their prevalence has not been assessed since the advent of more aggressive disease modifying antirheumatic therapies. The purpose of this study was to establish the period prevalence of lower extremity ulcers in a modern-day unselected cohort of patients with RA, and to report the features associated with ulcer development and response to therapy. Between June 2007 and June 2010, 366 RA patients were evaluated at the Georgetown Division of Rheumatology. Data were collected and analyzed retrospectively on demographics, antibody and prothrombotic profile, comorbidities, disease activity, and outcomes. The period prevalence of ulcers in this cohort of 366 patients with RA followed over 3 years was 4.37%. Patients with ulcers were predominantly female (81.25%) and more commonly African American (56.2%). The mean disease duration at ulcer development was 25.9 years. All patients with ulcers had erosive disease and 63% were seropositive. Only five patients (31.25%) healed over a mean follow-up of 22.8 months. However, in this small sample, treatment with anti-tumor necrosis factor-α (anti-TNFα) therapy was associated with significantly higher likelihood of healing (p = 0.039). In this modern-day cohort of patients with RA, we found a prevalence of lower extremity ulcers of 4.37% over 3 years. Only 31.25% of patients healed after a mean 22.8 months of follow-up. However, treatment with a biologic agent was associated with a significant increased likelihood of healing (RR 3.27, 95% CI 0.59-18.29, p = 0.039). |
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Authors:
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Victoria K Shanmugam; David M DeMaria; Christopher E Attinger |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2011-02-22 |
Journal Detail:
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Title: Clinical rheumatology Volume: 30 ISSN: 1434-9949 ISO Abbreviation: Clin. Rheumatol. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-05-25 Completed Date: 2011-09-22 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 8211469 Medline TA: Clin Rheumatol Country: Germany |
Other Details:
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Languages: eng Pagination: 849-53 Citation Subset: IM |
Affiliation:
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Division of Rheumatology, Immunology and Allergy, Georgetown University Hospital, NW Washington, DC 20007, USA. vks4@gunet.georgetown.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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African Continental Ancestry Group Aged Antibodies, Anticardiolipin / blood Antibodies, Antiphospholipid / blood Antirheumatic Agents / pharmacology, therapeutic use* Arthritis, Rheumatoid / blood, complications*, ethnology Biopsy Cohort Studies European Continental Ancestry Group Female Follow-Up Studies Humans Immunosuppressive Agents / pharmacology, therapeutic use* Leg Ulcer / drug therapy*, epidemiology, etiology* Male Middle Aged Prevalence Retrospective Studies Treatment Outcome Tumor Necrosis Factor-alpha / antagonists & inhibitors* Wound Healing / drug effects |
| Grant Support | |
ID/Acronym/Agency:
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KL2 RR031974-01/RR/NCRR NIH HHS; KL2RR031974/RR/NCRR NIH HHS; UL1 RR031975-01/RR/NCRR NIH HHS; UL1RR031975/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Anticardiolipin; 0/Antibodies, Antiphospholipid; 0/Antirheumatic Agents; 0/Immunosuppressive Agents; 0/Tumor Necrosis Factor-alpha |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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