Lege Artis Medicinae

[The effect of biological therapy on generalised osteoporosis in patients with rheumatoid arthritis]

JUHÁSZ Péter

JUNE 20, 2014

Lege Artis Medicinae - 2014;24(05-06)

[In rheumatoid arthritis, the inflammation and damage of multiple joints can lead to generalised osteoporosis. This process is mostly mediaated by cells and cytokines that are also important for maintaining inflammation, by inhibiting bone formation as well as stimulating bone resorption. Data from the literature show that biological therapies that effectively decrease inflammation can also stimulate bone formation and inhibit bone resorption. This results in an increased bone density and bone protection, which is highly important to prevent subseqent fractures.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Dada and the Surrealism ]

NAGY Zsuzsanna

Lege Artis Medicinae

[A Traveller’s Diary – Curiosities in Il Gesù, Rome]

KRUTSAY Miklós

Lege Artis Medicinae

[Eating and Body Image Disorders in the Early 21st Century – What will the Future Bring? ]

TÚRY Ferenc, HAYRIYE Güleç, MEZEI Ágnes

Lege Artis Medicinae

[Failures of Géza Csáth: Self-Remedy and Women ]

BARNA Bianka, GEREVICH József

Lege Artis Medicinae

[The age of barbarism]

NAGY Zsuzsanna

All articles in the issue

Related contents

Clinical Oncology

[Cancer-treatment induced peripheral neuropathy]

DEMETER Gyula

[Peripheral neuropathy is caused by structural or functional damage of nervous system. The pathophysiology is not well known. Its clinical features are established but there is a need to standardize CIPN assessment, also considering that health care providers and patients frequently have a different perception of CIPN severity. Neurotoxicity caused by traditional chemotherapy is widely recognized in patients with cancer. The adverse effects of newer therapeutics, such as targeting and immunotherapeutic agents, need more information for the proper management. This review addresses the main neurotoxicities of cancer treatments with a focus on the newer therapeutics. Recognition of these patterns of toxicity is important because drug discontinuation or dose adjustment might prevent further neurological injury. Treatment is symptomatic. For prevention or treatment there is need for further basic research outcomes.]

Lege Artis Medicinae

[Infectious diseases associated with biological therapy]

KÁDÁR János

[The use of biological therapeutic agents increases the risk of certain infectious diseases. The greatest hazards are the reactivation of tuberculosis or hepatitis B infection and the development of sepsis. The degree of risk is comparable to that experienced with the use of routine DMARD therapy: in case of an adequate choice of treatment the risk is equal to or slightly higher than that of conventional treatment. However, this hazard is definitely smaller than that associated with the use of corticosteroids at doses necessary to reach the required immunosuppressive effect. This article provides a brief summary of potential infectious illnesses on the basis of the literature.]

Lege Artis Medicinae

[Efficiency and safety of the vaccination against H1N1 influenza virus in inflammatory bowel disease]

FARKAS Klaudia, JANKOVICS István, MELLES Márta, NAGY Ferenc, SZEPES Zoltán, WITTMANN Tibor, MOLNÁR Tamás

[INTRODUCTION - Inactivated influenza and H1N1 vaccination is recommended yearly for patients with inflammatory bowel disease receiving immunosuppressive therapy; however, immunomodulator and biological therapy might impair the immune response to the vaccination. In our study, we assessed whether immunity can develop in response to H1N1 influenza vaccination in patients receiving immunomodulator and/or biological therapy. We also assessed the occurrence of side effects after the immunisation in these patients. PATIENTS AND METHODS - In our prospective study, blood samples were obtained from 24 patients (12 Crohn’sdisease, 12 ulcerative colitis) one month after immunisation against influenza A/California/ 07/2009 (H1N1) virus. At the time of vaccination, all patients have been receiving immunomodulator and/or biological therapy for at least three month. Antiviral antibodies were detected by using microneutralisation assay. The safety of the vaccination was assessed by questionnaires. RESULTS - Every patient developed complete immunity against influenza A (H1N1) virus, independently from the type of immunosuppressive therapy. Regarding side effects, local symptoms occurred in six patients and systemic symptoms in another six patients. Mild diarrhea occurred in five patients. Moderate exacerbation of the disease was observed in 2 patients with Crohn’s disease and in one patient with ulcerative colitis. CONCLUSIONS - According to our results, immunocompromised patients with IBD can be safely advised to receive the vaccination. In our study, all patients developed adequate immunity according to microneutralisation titers.]

Hungarian Radiology

[A paradox of articular protective phenomenon: more serious-damaged rudimentary hand in rheumatoid arthitis]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

[INTRODUCTION - The joints have been secured from rheumatoid arthritis by diminution of biomechanical effeciency. This effect was analyzed and named articular protective phenomenon three decades ago. CASE REPORT - A case of bilateral rheumatoid arthritis associated with unilateral developmental abnormality hand and bronchial asthma in a 35 year old female patient is presented. Her left 2nd, 3rd, 4th and 5th metacarpal bones moreover her fingers had not evolved. The patient has been treated by antiasthmatic steroid drugs for five years. Rheumatoid disorders of the affected left hand were more severe, than the abnormality of the normal upper limb. Eight years later the most severe bony lesions (ankylosis and mutilation) appeared on this side, only. CONCLUSION - The patient's hand was not saved by inborn bone defect in rheumatoid arthritis. The absence of articular protective phenomenon can be explained by the undisturbed innervation of limb, the motility of hypotrophic carpus besides to steroid-induced suppression.]

Lege Artis Medicinae

[Hip joint involvement in rheumatoid arthritis: pathological features and orthopaedic treatment]

LAKATOS Tamás, KORÁNYI Ágnes, GUNTHER Tibor, RÁCZ Dénes, UDVARHELYI Iván

[The authors review the orthopaedic surgical treatment possibilities of the hip joint affected by rheumatoid arthritis. In the first part, they draw the attention to the characteristic features of the disease. They describe a possible pathological interpretation of rheumatoid arthritis and emphasize the specific features of the rheumatoid hip joint. Different surgical interventions and treatment possibilities are analyzed. Because of the multiple joint involvement in these patients, the possibility of sequential operations has to be considered. The importance of close cooperation between rheumatologists and orthopaedic surgeons is emphasized. According to the authors, one of the most effective long term treatment possibility of the rheumatoid hip is the total hip arthroplasty.]