Wednesday, 17 Oct 2018

You are here

The Fate of Palindromic Rheumatism


Palindromic rheumatism (PR) is an intermittent inflammatory arthropathy with episodes of arthritis and/or periarticular inflammation that wax and wane over time. It is thought that up to one-third of such patients may go on to develop rheumatoid arthritis (RA).

A claims data study from the Taiwanese National Health Insurance Research Database identified 4,421 cases of PR over a 5 year span and compared PR patients to randomly chose 44,210 non-PR individuals who matched (1:10) for age, sex and the year of index date without prior history of  rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjogren's syndrome (SS), dermatomyositis (DM) and polymyositis (PM).

From this cohort, over time 12.9% developed RA, 6.1% developed SS, 2.6% developed SLE,  and less than 1% developed SSc, PM, or DM.

PR patients had an increased risk of RA (HR, 118.76; 95% CI, 89.81-157.04), SS (HR, 59.57; 95% CI, 43.87-80.88), SLE (HR, 51.56; 95% CI, 32.96-80.66) PM (HR, 57.38; 95% CI, 6.90-476.83), and SSc (HR, 13.42; 95% CI, 3.79-47.55) but not of DM (HR, 3.44; 95% CI, 0.34-34.59).

Patients with PR had an increased risk of developing RA, SS, SLE, PM, and SSc.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Predictive Risk Factors for Uveitis in JIA

Researchers from Germany have studied a large cohort of juvenile idiopathic arthritis (JIA) patients and shown that JIA disease activity scores and laboratory biomarkers could be used to better define the group of JIA patients at high risk of uveitis onset.

Elder Rheumatoids Less Likely to Receive Biologics

Multiple studies have shown that elderly rheumatoid arthritis (RA) patients tend to be under-treated and receive DMARD therapies less often than younger RA patients. Now a VAMC study shows that the elderly are less likely to receive biologic agents yet are as likely to be subjected to glucocorticoid use.

Long-Term Efficacy of Canakinumab in Systemic Juvenile Idiopathic Arthritis

Only inhibitors of IL-1 (canakinumab) and IL-6 (tocilizumab) are FDA approved for use in children with systemic onset juvenile idiopathic arthritis (sJIA). Now, long-term data from the extension studies from two phase III studies shows that canakinumab yields long-term improvements with reduced glucocorticoid dosing with no new safety findings with long-term use.

Defining Refractory Rheumatoid Arthritis

Researchers from the British Society for Rheumatology Biologics (BSRBR) set out to define under what circumstances will rheumatoid arthritis (RA) patients manifest biologic disease-modifying antirheumatic drugs (bDMARDs) refractory disease.

Using the patients from the BSRBR Register (2001 to 2014) they defined patients as bDMARD refractory when they initiated their third class of bDMARD.

Venous Thromboembolism Increased with Rheumatoid Arthritis, Not with TNF Inhibition

Venous thromboembolism (VTE) is a common adverse event throughout medicine and includes both pulmonary embolism (PE) and deep vein thrombosis (DVT).   The cost of diagnosing a thromboembolic event is approximately $4000 - $5550, while the annual cost of treating one case of VTE is between $17,000 and $19,000. The impact of VTE is substantial.