Rheumatoid arthritis

The value of rheumatoid factor and anti-citrullinated protein antibodies as predictors of response to infliximab in rheumatoid arthritis: an exploratory study Klaasen, R. et al. Rheumatology (Oxford) doi:10.1093/rheumatology/ker010

A study of 101 patients with active rheumatoid arthritis explored whether the presence and levels of specific rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) isotypes at baseline were associated with the response to infliximab therapy. The presence of all three RF isotypes (IgM, IgG and IgA) and ACPA IgM and IgG isotypes was associated with decreased disease activity following treatment; however, these correlations were not strong enough to predict the response to infliximab in individual patients.

Rheumatoid arthritis

Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis Takeuchi, T. et al. Ann. Rheum. Dis. doi:10.1136/ard.2011.153023

In a study of patients with rheumatoid arthritis refractory to treatment with methotrexate, those with high baseline levels of tumor necrosis factor (TNF) were found to respond less well to low doses of infliximab (3 or 6 mg/kg per week) than to a higher dose (10 mg/kg per week), suggesting that a stronger infliximab dose might be required in order to compensate for a high baseline TNF level.

Fibromyalgia

Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life Fiz, J. et al. PLoS ONE 6, e18440

A study from Spain has suggested that cannabis use is associated with beneficial effects on some of the symptoms of fibromyalgia. Using visual analog scales and questionnaires, cannabis users reported statistically significant reductions in pain and stiffness and enhancements to relaxation, somnolence and feeling of well being compared with nonusers.

Crystal arthritis

Canakinumab reduces the risk of acute gouty arthritis flares during initiation of allopurinol treatment: results of a double-blind, randomised study Schlesinger, N. et al. Ann. Rheum. Dis. doi:10.1136/ard.2010.144063

Canakinumab, a fully human anti-IL-1β monoclonal antibody, has been shown to be an effective prophylactic treatment against flares of gouty arthritis in patients beginning urate-lowering allopurinol therapy. A single dose of canakinumab >50 mg or four 4-weekly, smaller doses showed superior protection against flares in comparison to daily colchicine 0.5 mg.