This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 | Archive 4 | Archive 5 | → | Archive 10 |
I was looking for a recent review article, but this was the most recent one I could find. It's still pretty good, and it would fill in a lot of the gaps in this entry:
Review Article: Mechanisms of Disease
The Pathogenesis of Rheumatoid Arthritis
Iain B. McInnes, F.R.C.P., Ph.D., and Georg Schett, M.D.
N Engl J Med 2011; 365:2205-2219 December 8, 2011 DOI: 10.1056/NEJMra1004965
--
Nbauman (
talk)
06:48, 12 July 2015 (UTC)
Systematic review and meta-analysis doi:10.1016/S0140-6736(14)61704-9 JFW | T@lk 14:50, 17 July 2015 (UTC)
Biologics or Conventional Drugs for Managing RA? discussed recent study results and reviews on costs of using biologics earlier vs later. - Rod57 ( talk) 14:24, 28 January 2016 (UTC)
Triple Therapy Underused in RA: Why? says "the combination of methotrexate, sulfasalazine, and hydroxychloroquine is similar in efficacy to biologic therapy and is less costly," and rarely used despite the evidence. - Rod57 ( talk) 02:08, 25 February 2016 (UTC)
doi:10.1016/S0140-6736(16)30173-8 JFW | T@lk 08:30, 2 September 2016 (UTC)
Rheumatoid arthritis.
Smolen JS, Aletaha D, McInnes IB.
Lancet. 2016 May 3. pii: S0140-6736(16)30173-8.
doi: 10.1016/S0140-6736(16)30173-8. [Epub ahead of print] Review.
-- Nbauman ( talk) 22:22, 4 June 2016 (UTC)
I have moved here this paragraph, supported by an article from Frontiers in Immunology:
Content read: One theory is that infections may provoke the autoimmune response characteristic of rheumatoid arthritis. One example of this theory is that unique bacterial species associated with periodontitis may initiate an autoimmune response in genetically susceptible individuals by citrullinating self-proteins, thus leading to the production of ACPAs. A meta-analysis published in 2016 found an association between periodontal disease and RA]. [1]
It has been suggested that Frontiers journals are not WP:MEDRS. Opinions?
Best regards.
References
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
-- BallenaBlanca (Talk) 23:09, 22 January 2017 (UTC)
User:Drsoumyadeepb. Here and here, the following were added:
Additionally, the following:
Was replaced with:
Patients with RA do not have decreased fertility.
[8] Women of childbearing age having RA are recommended to use contraceptives to avoid pregnancy and to discontinue its use if pregnancy is planned.
[6]
[7] There is no evidence on increase in maternal and fetal deaths which can be attributed to RA .Cite error: The <ref>
tag has too many names (see the
help page).
Methotrexate and
leflunomide are teratogenic (harmful to foetus) and not used in pregnancy.Low dose of
prednisolone,
hydroxychloroquine and
sulfasalazine are considered safe in pregnant persons with rheumatoid arthritis.Biologics should be stopped as soon as pregnancy is discovered.
[8]
References
{{
cite journal}}
: Check |url=
value (
help)
{{
cite journal}}
: |access-date=
requires |url=
(
help); Cite journal requires |journal=
(
help)
None of this is OK. Jytdog ( talk) 17:34, 15 March 2017 (UTC)
You have also reverted without discussion.Editing wikipedia has become so much difficult because of editors who threaten without discussion and when the same is done to them they coerce citing rules. . I quit Wikipedia. Thanks Drsoumyadeepb ( talk) 18:00, 15 March 2017 (UTC)
Dear Jytdog, soupvector , Doc James I see that Wikipedia has successfully converted it into a rule-book throwing organisation without application of any common sense and etiquette. Rules exist to facilitate and not hinder and is not superseded by common-sense : 1. If a new patho-physiological mechanism is discovered which challenges previous dogma , do we wait for a decade till a review article comes up. (I hope everyone knows the pace at which science moves from bench to text book and then to implementation). This is what happened for the new "combined synovial IL-21 and TNF production mechanism ".. I have clearly stated that this is an emerging theory and readers would be smart enough to understand that. 2. I have edited the RA article extensively , including information almost all the secondary sources in this article which Jytdog is throwing at me now. I know the wiki rules well. I edit the article based on information needs of patients and so it is important to address information on - What is the evidence on this new drug Sirukumab (in this case only a single trial is available and systematic reviews are not likely to be available for next few years)? If I have RA does my fertility decrease ?If i get pregnant does it increase the risk of maternal death or foetal death ? Do I stop or not stopping drugs I am taking, how does it affect my symptom ? For pregnancy, a good editor would use his sense and either try to find better sources to refine the article.( Doc James mentions apparently there are plenty !) . Instead Wikipedia editors, revert edits(without discussion) and then "troll" other editors by posting weird notices declaring war on the talk page. I can clearly see a pattern and the motivation, is to increase edit counts without actually contributing to better quality information being available. Editors with high edit counts, treat wikipedia as their personal fiefdom , reverting and threatening others at their free will without any consequences .Why threaten banning ? Do I have to throw a rule book to stop online trolling ?By the way there is one which defines trolling as "nonconstructive edits to Wikipedia with the intent of provoking an angry reaction in other userss )" /info/en/?search=Wikipedia:Vandals_versus_Trolls#Trolls . So i am taking the advice "don't feed the trolls" and quitting wikipedia. Drsoumyadeepb ( talk) 05:57, 16 March 2017 (UTC)
User:Autoimmunity rev, about this and this -- there was already content in the Research section about this. And even the Smolen ref makes it clear that the association is suggested, not confirmed. It still belongs in research. I added the quote from Smolen and have moved the content to the Research section and blended it with what was already there, in these diffs. Jytdog ( talk) 00:18, 5 April 2017 (UTC)
This reversal of a Good faith edit with the rather pompous pluralis maiestatis editsummary "we do not empty sections" makes no sense to me. I am restoring it. -- Wuerzele ( talk) 14:52, 19 July 2017 (UTC)
There are issues with these edits [6]
Doc James ( talk · contribs · email) 17:20, 19 July 2017 (UTC)
I am not editing the article on this aspect because I have a COI (consultant to clients that sell fish oil dietary supplements) but want to offer for consideration meta-analyses that are more recent than what is currently cited in the article (Ruggiero 2009 and Miles 2012). David notMD ( talk) 15:19, 27 October 2017 (UTC)
References
{{
cite web}}
: Unknown parameter |deadurl=
ignored (|url-status=
suggested) (
help)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
Removed vague preliminary content and sources below per WP:PRIMARY and WP:CRYSTAL. "theory" and "is thought" reflect conjecture = unencyclopedic content. -- Zefr ( talk) 14:03, 1 October 2017 (UTC)
One theory is that infections may provoke the autoimmune response characteristic of rheumatoid arthritis. One example of this theory is that unique bacterial species associated with periodontitis may initiate an autoimmune response in genetically susceptible individuals by citrullinating self-proteins, thus leading to the production of ACPAs. PMID 25534621 PMID 22274780 Porphyromonas gingivalis expresses a bacterial PAD that is thought to citrullinate alpha-enolase. PMID 20820197 The bacterial virulence factor leukotoxin A from Aggregatibacter actinomycetemcomitans was shown to induce hypercitrullination in neutrophils, and exposure to leukotoxin A is associated with ACPA and mediates the genetic risk conferred by HLA-DRB1 shared epitope alleles. PMID 28292977
Per my undo (of the deletion), the reviews provided specifically refer to EGCG (not just Green Tea Extracts) and even name it as such in their titles. Here's another separate review on EGCG for RA again that can be added too: [1]. I'm fine for the text to be modified to "Green tea extract and EGCG" if preferred, since EGCG is one of the components of green tea extracts. There's no point in just deleting it, since there's a vast number of studies and reviews all showing the same thing. Just update the wording if it's so concerning. The vast majority of other non-EGCG specific studies of GTEs contain EGCG as well anyway, having most of the same effect (although higher EGC to EGCG ratios result in a bit lower EGCG absorption/bioavailability). Anyway, here's also example of long-term (10 year), repeatedly NIH-funded research programs, where the grants started off on green tea polyphenols and then moved to EGCG specifically for some years (searched by one of the principle investigators in the field as example). If the U.S. NIH alone has spent at least 10 years renewing funding to RA research programs (apart from all the international work), then it's notable enough for an "RA Research" section: [2]. 14.200.91.233 ( talk) 09:58, 1 October 2017 (UTC)
I'm re-adding this as after several days, nobody has substantiated their claims, or made any argument here for why it shouldn't be in Wikipedia.
− Multiple reviews of green tea extract and epigallocatechin gallate pre-clinical and animal studies have concluded that it has promising potential for inflammation and rheumatoid arthritis treatment [3] [4] [5], with one noting the lack of human clinical studies "despite promising pre-clinical findings and the thorough mechanistic insights", as "surprising" [6].
120.17.218.156 ( talk) 21:11, 4 October 2017 (UTC)
References
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
Perhaps add to Research rather than Lifestyle, given modest nature of the evidence for fasting and vegetarian diet. The existing citations in Lifestyle are all Cochrane Reviews. David notMD ( talk) 22:55, 4 November 2017 (UTC)
http://www.dailymail.co.uk/health/article-5337265/Drinking-milk-eating-beef-cause-arthritis.html Someone knowledgeable should look up the original study and see if it is worth adding to this Wiki article. Phantom in ca ( talk) 05:18, 1 February 2018 (UTC)
I removed the top image, which showed an advanced case of RA in an elderly patient who did not have access to the medications we have today. It is no longer reflective of the disease and its progression and its placement on this page means it's one of the first images that pops up when you search for RA on the internet. I can tell you from personal experience that's a very upsetting thing to see, so why subject people to it when there are more representative images to use? — Preceding unsigned comment added by Thisnotnpov ( talk • contribs)
Hello my group and I are hoping to edit other signs and symptoms to include those found in different body systems that increase with the the development of RA [1]
````
YooCo ( talk) 16:32, 6 August 2019 (UTC)
I just want to say that the opening section of this page reads like it was written 50 years ago. Splints, Braces, Painkillers as first line treatments? No diagnostic tests? Who wrote this? As someone who has RA this sort of nonsense is just frustrating. Especially when it comes to having new treatments funded (where I live), since everyone thinks it's "no big deal" or "everyone has it". Anti-CCP is a pretty good diagnostic blood test and first line treatment is csDMARDS, sometimes even biologics, not paracetamol and splints. Can someone who knows something please, please re-write it? Thanks.
References
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 | Archive 4 | Archive 5 | → | Archive 10 |
I was looking for a recent review article, but this was the most recent one I could find. It's still pretty good, and it would fill in a lot of the gaps in this entry:
Review Article: Mechanisms of Disease
The Pathogenesis of Rheumatoid Arthritis
Iain B. McInnes, F.R.C.P., Ph.D., and Georg Schett, M.D.
N Engl J Med 2011; 365:2205-2219 December 8, 2011 DOI: 10.1056/NEJMra1004965
--
Nbauman (
talk)
06:48, 12 July 2015 (UTC)
Systematic review and meta-analysis doi:10.1016/S0140-6736(14)61704-9 JFW | T@lk 14:50, 17 July 2015 (UTC)
Biologics or Conventional Drugs for Managing RA? discussed recent study results and reviews on costs of using biologics earlier vs later. - Rod57 ( talk) 14:24, 28 January 2016 (UTC)
Triple Therapy Underused in RA: Why? says "the combination of methotrexate, sulfasalazine, and hydroxychloroquine is similar in efficacy to biologic therapy and is less costly," and rarely used despite the evidence. - Rod57 ( talk) 02:08, 25 February 2016 (UTC)
doi:10.1016/S0140-6736(16)30173-8 JFW | T@lk 08:30, 2 September 2016 (UTC)
Rheumatoid arthritis.
Smolen JS, Aletaha D, McInnes IB.
Lancet. 2016 May 3. pii: S0140-6736(16)30173-8.
doi: 10.1016/S0140-6736(16)30173-8. [Epub ahead of print] Review.
-- Nbauman ( talk) 22:22, 4 June 2016 (UTC)
I have moved here this paragraph, supported by an article from Frontiers in Immunology:
Content read: One theory is that infections may provoke the autoimmune response characteristic of rheumatoid arthritis. One example of this theory is that unique bacterial species associated with periodontitis may initiate an autoimmune response in genetically susceptible individuals by citrullinating self-proteins, thus leading to the production of ACPAs. A meta-analysis published in 2016 found an association between periodontal disease and RA]. [1]
It has been suggested that Frontiers journals are not WP:MEDRS. Opinions?
Best regards.
References
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
-- BallenaBlanca (Talk) 23:09, 22 January 2017 (UTC)
User:Drsoumyadeepb. Here and here, the following were added:
Additionally, the following:
Was replaced with:
Patients with RA do not have decreased fertility.
[8] Women of childbearing age having RA are recommended to use contraceptives to avoid pregnancy and to discontinue its use if pregnancy is planned.
[6]
[7] There is no evidence on increase in maternal and fetal deaths which can be attributed to RA .Cite error: The <ref>
tag has too many names (see the
help page).
Methotrexate and
leflunomide are teratogenic (harmful to foetus) and not used in pregnancy.Low dose of
prednisolone,
hydroxychloroquine and
sulfasalazine are considered safe in pregnant persons with rheumatoid arthritis.Biologics should be stopped as soon as pregnancy is discovered.
[8]
References
{{
cite journal}}
: Check |url=
value (
help)
{{
cite journal}}
: |access-date=
requires |url=
(
help); Cite journal requires |journal=
(
help)
None of this is OK. Jytdog ( talk) 17:34, 15 March 2017 (UTC)
You have also reverted without discussion.Editing wikipedia has become so much difficult because of editors who threaten without discussion and when the same is done to them they coerce citing rules. . I quit Wikipedia. Thanks Drsoumyadeepb ( talk) 18:00, 15 March 2017 (UTC)
Dear Jytdog, soupvector , Doc James I see that Wikipedia has successfully converted it into a rule-book throwing organisation without application of any common sense and etiquette. Rules exist to facilitate and not hinder and is not superseded by common-sense : 1. If a new patho-physiological mechanism is discovered which challenges previous dogma , do we wait for a decade till a review article comes up. (I hope everyone knows the pace at which science moves from bench to text book and then to implementation). This is what happened for the new "combined synovial IL-21 and TNF production mechanism ".. I have clearly stated that this is an emerging theory and readers would be smart enough to understand that. 2. I have edited the RA article extensively , including information almost all the secondary sources in this article which Jytdog is throwing at me now. I know the wiki rules well. I edit the article based on information needs of patients and so it is important to address information on - What is the evidence on this new drug Sirukumab (in this case only a single trial is available and systematic reviews are not likely to be available for next few years)? If I have RA does my fertility decrease ?If i get pregnant does it increase the risk of maternal death or foetal death ? Do I stop or not stopping drugs I am taking, how does it affect my symptom ? For pregnancy, a good editor would use his sense and either try to find better sources to refine the article.( Doc James mentions apparently there are plenty !) . Instead Wikipedia editors, revert edits(without discussion) and then "troll" other editors by posting weird notices declaring war on the talk page. I can clearly see a pattern and the motivation, is to increase edit counts without actually contributing to better quality information being available. Editors with high edit counts, treat wikipedia as their personal fiefdom , reverting and threatening others at their free will without any consequences .Why threaten banning ? Do I have to throw a rule book to stop online trolling ?By the way there is one which defines trolling as "nonconstructive edits to Wikipedia with the intent of provoking an angry reaction in other userss )" /info/en/?search=Wikipedia:Vandals_versus_Trolls#Trolls . So i am taking the advice "don't feed the trolls" and quitting wikipedia. Drsoumyadeepb ( talk) 05:57, 16 March 2017 (UTC)
User:Autoimmunity rev, about this and this -- there was already content in the Research section about this. And even the Smolen ref makes it clear that the association is suggested, not confirmed. It still belongs in research. I added the quote from Smolen and have moved the content to the Research section and blended it with what was already there, in these diffs. Jytdog ( talk) 00:18, 5 April 2017 (UTC)
This reversal of a Good faith edit with the rather pompous pluralis maiestatis editsummary "we do not empty sections" makes no sense to me. I am restoring it. -- Wuerzele ( talk) 14:52, 19 July 2017 (UTC)
There are issues with these edits [6]
Doc James ( talk · contribs · email) 17:20, 19 July 2017 (UTC)
I am not editing the article on this aspect because I have a COI (consultant to clients that sell fish oil dietary supplements) but want to offer for consideration meta-analyses that are more recent than what is currently cited in the article (Ruggiero 2009 and Miles 2012). David notMD ( talk) 15:19, 27 October 2017 (UTC)
References
{{
cite web}}
: Unknown parameter |deadurl=
ignored (|url-status=
suggested) (
help)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
Removed vague preliminary content and sources below per WP:PRIMARY and WP:CRYSTAL. "theory" and "is thought" reflect conjecture = unencyclopedic content. -- Zefr ( talk) 14:03, 1 October 2017 (UTC)
One theory is that infections may provoke the autoimmune response characteristic of rheumatoid arthritis. One example of this theory is that unique bacterial species associated with periodontitis may initiate an autoimmune response in genetically susceptible individuals by citrullinating self-proteins, thus leading to the production of ACPAs. PMID 25534621 PMID 22274780 Porphyromonas gingivalis expresses a bacterial PAD that is thought to citrullinate alpha-enolase. PMID 20820197 The bacterial virulence factor leukotoxin A from Aggregatibacter actinomycetemcomitans was shown to induce hypercitrullination in neutrophils, and exposure to leukotoxin A is associated with ACPA and mediates the genetic risk conferred by HLA-DRB1 shared epitope alleles. PMID 28292977
Per my undo (of the deletion), the reviews provided specifically refer to EGCG (not just Green Tea Extracts) and even name it as such in their titles. Here's another separate review on EGCG for RA again that can be added too: [1]. I'm fine for the text to be modified to "Green tea extract and EGCG" if preferred, since EGCG is one of the components of green tea extracts. There's no point in just deleting it, since there's a vast number of studies and reviews all showing the same thing. Just update the wording if it's so concerning. The vast majority of other non-EGCG specific studies of GTEs contain EGCG as well anyway, having most of the same effect (although higher EGC to EGCG ratios result in a bit lower EGCG absorption/bioavailability). Anyway, here's also example of long-term (10 year), repeatedly NIH-funded research programs, where the grants started off on green tea polyphenols and then moved to EGCG specifically for some years (searched by one of the principle investigators in the field as example). If the U.S. NIH alone has spent at least 10 years renewing funding to RA research programs (apart from all the international work), then it's notable enough for an "RA Research" section: [2]. 14.200.91.233 ( talk) 09:58, 1 October 2017 (UTC)
I'm re-adding this as after several days, nobody has substantiated their claims, or made any argument here for why it shouldn't be in Wikipedia.
− Multiple reviews of green tea extract and epigallocatechin gallate pre-clinical and animal studies have concluded that it has promising potential for inflammation and rheumatoid arthritis treatment [3] [4] [5], with one noting the lack of human clinical studies "despite promising pre-clinical findings and the thorough mechanistic insights", as "surprising" [6].
120.17.218.156 ( talk) 21:11, 4 October 2017 (UTC)
References
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)
Perhaps add to Research rather than Lifestyle, given modest nature of the evidence for fasting and vegetarian diet. The existing citations in Lifestyle are all Cochrane Reviews. David notMD ( talk) 22:55, 4 November 2017 (UTC)
http://www.dailymail.co.uk/health/article-5337265/Drinking-milk-eating-beef-cause-arthritis.html Someone knowledgeable should look up the original study and see if it is worth adding to this Wiki article. Phantom in ca ( talk) 05:18, 1 February 2018 (UTC)
I removed the top image, which showed an advanced case of RA in an elderly patient who did not have access to the medications we have today. It is no longer reflective of the disease and its progression and its placement on this page means it's one of the first images that pops up when you search for RA on the internet. I can tell you from personal experience that's a very upsetting thing to see, so why subject people to it when there are more representative images to use? — Preceding unsigned comment added by Thisnotnpov ( talk • contribs)
Hello my group and I are hoping to edit other signs and symptoms to include those found in different body systems that increase with the the development of RA [1]
````
YooCo ( talk) 16:32, 6 August 2019 (UTC)
I just want to say that the opening section of this page reads like it was written 50 years ago. Splints, Braces, Painkillers as first line treatments? No diagnostic tests? Who wrote this? As someone who has RA this sort of nonsense is just frustrating. Especially when it comes to having new treatments funded (where I live), since everyone thinks it's "no big deal" or "everyone has it". Anti-CCP is a pretty good diagnostic blood test and first line treatment is csDMARDS, sometimes even biologics, not paracetamol and splints. Can someone who knows something please, please re-write it? Thanks.
References