Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRAK
Artritis rematoid merupakan penyakit otoimun sistemik yang paling sering ditemukan di dunia pada berbagai populasi dan ras, ditandai oleh inflamasi menetap pada jaringan sendi yang meliputi sendi perifer, distribusi simetris, dengan atau tanpa kerusakan rawan sendi dan erosi tulang. Pemantauan aktivitas penyakit diperlukan untuk menentukan keberhasilan terapi. Selama ini, pemantauan aktivitas penyakit menggunakan Disease Activity Score 28 (DAS28), meskipun terdapat kekurangan berupa parameter klinis yang bersifat subjektif, menggunakan perhitungan yang rumit, dan terdapat ketidakseragaman nilai titik potong derajat aktivitas penyakit pada berbagai penelitian.

Penelitian ini merupakan penelitian potong lintang untuk menilai korelasi antara kadar anti-CCP serum dan cairan sendi dengan aktivitas penyakit (DAS28) pada 30 subjek dengan artritis rematoid. Subjek yang memenuhi kriteria masukan dan tidak ada kriteria tolakan dilakukan penentuan skor DAS28 serta pemeriksaan anti-CCP serum dan cairan sendi.

Median (rentang) kadar anti-CCP serum secara keseluruhan, pada tingkat aktivitas penyakit sedang, dan berat adalah 112.23 (1.02-1853.07), 70.98 (1.02-1224.07), dan 157.59 (1.07-1853.07) RU/mL. Median (rentang) kadar anti-CCP cairan sendi secara keseluruhan, pada tingkat aktivitas penyakit sedang dan berat adalah 85.54 (0.90-4150.58), 58.90 (1.03-2477.81), dan 110.23 (0.90-4150.58) RU/mL. Median (rentang) skor DAS28 pada keseluruhan subjek ditemukan 5.04 (4.04-7.10). Uji korelasi Spearman didapatkan korelasi positif lemah namun tidak bermakna secara statistik antara kadar anti-CCP serum dan DAS28 dengan rs = 0.296, p = 0.056, korelasi positif lemah yang bermakna secara statistik antara anti- CCP cairan sendi dan DAS28 dengan rs = 0.331, p = 0.037, sedangkan korelasi antara anti-CCP serum dengan cairan sendi ditemukan kuat yang bermakna secara statistik dengan rs = 0.907, p <0.01.

Kami menyimpulkan kadar anti-CCP cairan sendi berkorelasi lemah dengan aktivitas penyakit (DAS28). Tidak ditemukan korelasi yang bermakna secara statistik antara kadar anti-CCP serum dengan aktivitas penyakit (DAS28). Terdapat korelasi kuat antara kadar anti-CCP serum dengan kadar anti-CCP dalam cairan sendi.

---

ABSTRACT
Rheumatoid arhtritis is the most common chronic systemic autoimmune disease worldwide among many populations and races, characterized by persistent joint inflammation affecting peripheral joints, symmetrical distribution, with or without joint damage or bone erosion. Disease activity monitoring is needed to determine treatment response. Nowadays, Disease Activity Score 28 (DAS28) is used to monitor disease activity, although it uses subjective clinical parameter, complicated calculation, and ununiformity cut-off value for disease activity stages on various researches.

This study was a cross sectional study to assess wheter there was any correlation between anti-CCP serum and synovial fluid concentration with disease activity (DAS28) in 30 rheumatoid arhtritis subject. Blood and synovial fluid specimen collection and DAS28 determination was performed on subjects who fulfill inclusion and exclusion criteria, followed by anti-CCP assay on each specimen.

Median (range) anti-CCP serum concentration in overall, moderate, and severe disease activity were 112.23 (1.02-1853.07), 70.98 (1.02-1224.07), and 157.59 (1.07-1853.07) RU/mL, respectively. Median (range) anti-CCP synovial fluid concentration in overall, moderate, and severe disease activity were 85.54 (0.90-4150.58), 58.90 (1.03-2477.81), and 110.23 (0.90-4150.58) RU/mL, respectively. Median (range) of DAS28 were 5.04 (4.04-7.10). A weak but not statistically significant correlation was found between serum anti-CCP concentration and DAS28 with rs = 0.296 (p = 0.056). A weak and significant correlation was found between synovial fluid anti-CCP concentration and DAS28 with rs = 0.331 (p = 0.037). A strong and significant correlation are found between serum and synovial fluid anti-CCP concentration, with rs = 0.907 (p <0.01) using Spearman correlation test.

We concluded that synovial fluid anti-CCP concentration weakly correlated with disease activity. No significant correlation was found between serum anti-CCP concentration with disease activity. Strong correlation was found between serum and synovial fluid anti-CCP concentration.

Abstrak :
ABSTRAK
Background Aim of this research is to assess the efficacy and safety of tocilizumab in combination with methotrexate in Indonesian patients with moderate to severe active rheumatoid arthritis who have an inadequate response to non biologic DMARDs.Methods This was a interventional, prospective, single arm, multicenter, study in Indonesian male or female patients aged > 18 years old, with a diagnosis of RA for > 6 months based on ACR 1987 revised criteria with moderate to severe disease activity DAS28 score > 3.2 after > 12 weeks of non biologic DMARDs treatment. The treatment consisted of tocilizumab, 8 mg/kg, intravenous, every 4 weeks for a total of 6 infusion in combination with oral MTX 10 until 25 mg every week. Efficacy was assessed based on the percentage of patients achieving low disease activity state DAS28 < 3.2, percentage of patients achieving reduction > 1.2 point of DAS28, percentage of patients achieving remission DAS28 < 2.6, and percentage of patients with ACR20, ACR50, and ACR70 responses. Descriptive statistics will be used for presentation of results.Results 100 percent patients reached low disease activity DAS28 < 3.2 at last study visit week 24 and clinically significant improvement reduction at least 1.2 units at every visit in DAS28, both for ITT or PP patients. Remission DAS28 < 2.6 was observed in 82.1 percent ITT patients and 93.1 percent PP patients on last study visit. ACR20, ACR50, and ACR70 were achieved in 20 percent, 34 percent, and 34 percent ITT patients, and 7 percent, 24 percent, and 62 percent PP patients on week 24. There were 3 out of 39 patients 7.69 percent with adverse events and serious adverse events that resulted in discontinuation of TCZ treatment, consisting of 1 patient with SAE of sepsis ec acquired community pneumonia, 1 patient with SAE of pneumonia tuberculosis, and 1 patient with AE of candidiasis. Most common adverse events were hepatic dysfunction 30.7 percent, hypercholesterolemia 23.1 percent, followed by arthralgia 20.5 percent Twelve percent of patients needed dose modification due to elevated liver enzyme elevated ALT/SGPT level. Conclusion Tocilizumab seems to be efficacious and likely to have good safety profile in non biologic DMARD nonresponsive RA patients of PICTURE INA study.

Abstrak :
Artritis Reumatoid AR merupakan salah satu penyakit yang berhubungan dengan sistem imun yang menyebabkan kerusakan sendi dan mengakibatkan terjadi penurunan kualitas hidup pasien. Nilai DAS28 CRP menggambarkan aktivitas penyakit AR. Titer Anti-CCP merupakan pemeriksaan yang sangat spesifik digunakan untuk memberikan gambaran prognosis penyakit pasien AR. Penelitian tentang korelasi titer Anti-CCP dengan nilai DAS28 CRP belum pernah dilakukan di Indonesia. Oleh karena itu, penelitian ini bertujuan untuk mengetahui korelasi antara titer Anti-CCP dengan nilai DAS28 CRP di RSCM. Pada peneltian ini desain penelitian yang digunakan adalah cross-sectional dengan sampel berjumlah 43 data. Data mengenai titer Anti-CCP dan DAS28 CRP didapatkan melalui rekam medis pasien. Hasil menyatakan bahwa tidak terdapat korelasi p=0,582 antara titer Anti-CCP dengan DAS28 CRP dengan nilai r yang menunjukkan korelasi sangat lemah r=0,086.

---

Rheumatoid arthritis is one of a disease relating with immunity that causes destruction in joints which affects quality of life of its patients. DAS28 CRP score represents the activity of the disease. Anti CCP titer is a specific test to portray the prognosis for the patients. Study about correlation between DAS28 CRP score and Anti CCP titer has not been done in Indonesia. Therefore, this study rsquo s done to understand the correlation between DAS28 CRP score and Anti CCP titer in RSCM. The design of this study is cross sectional study with 43 samples. Data of Anti CCP score and DAS28 CRP score are collected from patients rsquo medical records. The result of this study shows that there is no correlation between Anti CCP titer and DAS 28 CRP score in Rheumatoid Arthritis patients in RSCM with a very low correlation p 0,582 r 0,086.

Abstrak :
Background. Rheumatoid Arthritis (RA) is one of the diseases associated with the immune system which causes joint damage and effect to the quality of patients life. DAS28 CRP value describes RA disease activity. The antiCCP titer is a very specific examination which provide an overview prognosis of RA patients illness. The research on the correlation of anti CCP Titers with DAS28 CRP values has never been done in Indonesia. Therefore, this research aims to determine the correlation between anti CCP Titer and DAS28 CRP value in RA patient in Cipto Mangunkusumo hospital with DAS28 CRP value in RSCM. Method. The research design is crosssectional with the sample amounted to 34. anti CCP and DAS28 CRP were obtained through patients medical records. Result. The result of this correlationstudy is (p = 0,582) and r = 0,086. Conclusion. In conclusion, there is no correlation between antiCCP and DAS28 in Cipto Mangunkusumo hospital.

Abstrak :
Background rheumatoid arthritis (RA) is one of the diseases associated with the immune system which causes joint damage and effect to the quality of patients life. DAS28 CRP value describes RA disease activity. The anti ccp titer is a very specific examination which provoide an overview progonosis of RA pantients illness. the research on the corellation of anti ccp titers with DAAS28 CRP values has never been done in Indonesia.

Abstrak :
ABSTRACT
Artritis Reumatoid AR merupakan penyakit inflamasi kronis sistemik yang ditandai dengan pembengkakan dan nyeri sendi, serta kerusakan dari membran sinovial pada persendian. Dalam memonitor penyakit ini, digunakan Disease Activity Score-28 DAS28 yang dapat menunjukkan aktivitas penyakit AR dari waktu ke waktu. DAS28 bermanfaat untuk mengevaluasi pengobatan serta menentukan keputusan klinis lainnya. DAS28 dapat dihitung menggunakan beberapa komponen seperti jumlah sendi yang nyeri, bengkak, nilai Visual Analogue Scale VAS , serta penanda inflamasi berupa nilai Laju Endap Darah LED atau C-Reactive Protein CRP . DAS28-LED dan DAS28-CRP digunakan secara luas dan keduanya ekuivalen. Namun, nilai LED dapat dipengaruhi berbagai faktor lain, seperti kejadian infeksi, yang angkanya cukup tinggi di Indonesia. Oleh karena itu, penelitian ini bertujuan untuk melihat apakah terdapat perbedaan antara nilai DAS28-CRP dengan DAS28-LED di Indonesia. Data ini belum diketahui sebelumnya. Data mengenai jenis kelamin, usia, jumlah sendi nyeri dan bengkak, nilai VAS, LED, dan CRP diperoleh dari 40 rekam medis pasien AR yang berobat di RSCM pada tahun 2015. Dari hasil penelitian, didapatkan bahwa terdapat perbedaan bermakna rerata antara nilai DAS28-CRP dan DAS28-LED sebesar 1,0107.

---

ABSTRACT
Rheumatoid Arthritis RA is a systemic chronic inflammation disease marked by swollen and tender joint, also destruction of joint rsquo s synovial membrane. To monitoring this disease, Disease Activity Score 28 DAS28 used to show disease activity of RA in times to times. DAS28 is useful to evaluate disease rsquo s treatment and guide clinician to take a decision for the treatment itself. There are some component needed to count DAS28 score, they are number of tender and swollen joint, Visual Analogue Scale, and inflammatory marker such as Erythrocyte Sedimentation Rate ESR or C Reactive Protein CRP . Either DAS28 ESR or DAS28 CRP are used widely and are said to be equivalent to each other. Otherwise, ESR influenced by many other factors, one of them is infection disease, whose the incident number in Indonesia is relatively high. Therefore, the objective of this stuy is to know the comparison between DAS28 ESR and DAS28 CRP in Indonesia, which is still unknown. Data about gnder, age, number of tender and swollen joint, VAS, ESR, and CRP are obtained from 40 RSCM RA patients rsquo medical record in 2015. From this research known that there are significant mean difference between DAS28 CRP and DAS28 ESR which is 1,0107.

Abstrak :
ABSTRAK
Latar Belakang : Strategi terapi Artritis Reumatoid (AR) menggunakan strategi terapi untuk mencapai target sehingga membutuhkan suatu intrumen yang valid dan akurat dalam menilai aktivitas penyakit AR. Instrumen yang paling banyak digunakan adalah DAS28, yang dikembangkan dari DAS namun tidak melibatkan pemeriksaan pada persenidan kaki dan pergelangan kaki. Telah terdapat banyak kritikan mengenai akurasi DAS28 dalam mengklasifikasikan kondisi aktivitas penyakit AR, terutama bila suatu kondisi aktivitas penyakit aktif diklasifikasikan sebagai tidak aktif (negatif palsu) karena hal ini dapat menyebabkan terapi yang tidak optimal dan pada akhirnya menyebabkan terjadinya disabilitas. Perbedaan utama antara DAS28 dan DAS terletak pada eksklusi persendian kaki dan pergelangan kaki, karena itu suatu instrumen baru DAS28-squeeze telah diajukan. Instrumen ini memeriksa 28 sendi yang ada pada DAS28 ditambah dengan tes penekanan pada sendi metatarsofalangeal. Namun instrumen baru ini belum pernah divalidasi secara radiologis. Tujuan : Menilai nilai diagnostic DAS28 dan DAS28-squeeze. Metode : Studi potong menggunakan USG Power Doppler sebagai acuan untuk mengevaluasi nilai diagnostik DAS28 dan DAS28-squeeze. Studi ini menggunakan kriteria USG paling ketat untuk mendefinisikan kondisi aktivitas penyakit aktif, yaitu sinyal Doppler positif disertai dengan hipertrofi synovium sedang pada B-mode. Hasil : Lima puluh enam subyek dilakukan pemeriksaan DAS28, DAS28-squeeze dan USG Power Doppler. Terdapat 4 kasus negatif palsu pada DAS28 dan 1 kasus pada DAS28-squeeze. Sensitivitas DAS28 dan DAS28-squeeze untuk mendeteksi kondisi aktivitas penyakit aktif masing-masing sebesar 73.3% dan 93.3%. Spesifisitas masing-masing sebesar 36.6% dan 34.1%, dan likelihood ratio negatif sebesar 0.73 dan 0.19. Simpulan : Studi ini adalah studi pertama yang memvalidasi DAS28-squeeze secara radiologis. Nilai negatif palsu DAS28-squeeze lebih rendah daripada DAS28 dan memiliki sensitivitas dan likelihood ratio negatif yang lebih baik daripada DAS28 untuk menentukan kondisi aktivitas penyakit AR.

---

ABSTRACT
Background : Rheumatoid Arthritis (RA) treatment is based on ?treat to target? strategy which requires a valid and accurate tool in assessing disease activity. The most widely used tool is DAS28, which was developed from DAS with the omission of ankle and foot joints. Misclassification of disease state in DAS28, most importantly when an active disease state misclassified as unactive could lead to undertreatment and subsequently to disability. The main difference between DAS28 and DAS is the exclusion of ankle and foot joints, thus DAS28- squeeze has been proposed. It comprises the same 28 joints in DAS28 added with squeeze test on both metatarsophalangeal joints. Objective : To assess the diagnostic values of DAS28 and DAS28-squeeze. Methods : This is a cross-sectional diagnostic study using Power Doppler sonography as a reference standard in evaluating the diagnostic value of DAS28 and DAS28-squeeze. Results : Over the study period, 56 subjects underwent diagnostic tests using DAS28, DAS28- squeeze and Power Doppler sonography. There were 4 false negative in DAS28 and 1 in DAS28-squeeze. The sensitivities of DAS28 and DAS28-squeeze to identify active disease using Power Doppler sonography as reference standard were 73.3% and 93.3% respectively. While the specificities were 36.6% and 34.1% respectively. Furthermore the negative likelihood ratio were 0.73 and 0.19 respectively. Conclusion : This study is the first to validate DAS28-squeeze using imaging techniques. DAS28-squeeze false negative rate is much lower than DAS28. DAS28-squeeze has better sensitivity and negative likelihood ratio than DAS28 in identifying RA active disease state.

Abstrak :
Latar Belakang: Aktivitas penyakit Artritis Reumatoid (AR) merupakan ekspresi dari kaskade inflamasi. Inflamasi jaringan sinovium yang disertai pembentukan pannus memerlukan asupan nutrisi dan oksigen melalui angiogenesis. Peningkatan penanda angiogenik menunjukkan inflamasi sendi yang progresif dan peningkatan aktivitas penyakit. Salah satu faktor pertumbuhan yang memiliki peran pada angiogenesis adalah nerve growth factor (NGF). Beberapa penelitian terdahulu mendapatkan kadar NGF yang meningkat baik pada serum maupun pada cairan sinovium pasien AR. Nerve growth factor (NGF) dapat menginduksi faktor-faktor pro-angiogenik dan faktor pertumbuhan lain yang berperan pada AR. Saat ini belum ada penelitian yang menghubungkan kadar serum NGF terhadap aktivitas penyakit AR. Tujuan: Mengetahui korelasi antara kadar NGF dengan aktivitas penyakit (yang dinilai dengan DAS28 LED dan DAS28 CRP) pada pasien AR di Rumah Sakit Cipto Mangunkusumo. Metode: Penelitian potong lintang yang mengevaluasi kadar NGF menggunakan two site immunoenzymatic assay (ELISA) pada 50 pasien (47 orang perempuan dan 3 orang laki-laki) AR di poliklinik Reumatologi Rumah Sakit Cipto Mangunkusumo pada Oktober sampai Desember 2015. Aktivitas penyakit AR pada penelitian ini dinilai menggunakan skor DAS28 LED dan DAS28 CRP melalui kalkulator yang diakses dari internet pada http://www.das-score.nl/. Analisis statistik bivariat digunakan untuk mendapatkan korelasi antara NGF dengan aktivitas penyakit AR. Hasil: Rerata usia subjek penelitian ini adalah 43,44 tahun. Median kadar serum NGF adalah 4,33 pg/mL (2,35-20,83). Hasil analisis memperlihatkan korelasi antara kadar serum NGF dengan skor DAS28 LED (r = +0,427; p = 0,002) dan DAS28 CRP (r =+0.407; p = 0,003). Kesimpulan: Terdapat korelasi positif sedang antara kadar serum NGF dengan aktivitas penyakit AR. ...... Background: Disease activity of Rheumatoid Arthritis (RA) is an expression of the inflammatory cascade. Disease activity of a given joint is correlated with the synovial vascularization. Synovial tissue inflammation accompanied by pannus formation requires intake of nutrients and oxygen through angiogenesis. Angiogenesis plays an integral part of the development of the pannus formation. Increased angiogenic markers shows a progressive increase of joint inflammation and disease activity. One of the contributing factors to angiogenesis is the nerve growth factor (NGF). Several previous studies show increased NGF concentrations in both the serum and synovial fluid of RA. Nerve growth factor can induce pro-angiogenic factors and other growth factors contribute in RA. Currently, there has not been any studies yet that correlates the NGF serum concentration with RA disease activity. Objective: To determine the correlation between the serum concentration of NGF and disease activity of RA patients at Cipto Mangunkusumo General Hospital (using DAS28 ESR and DAS28 CRP score). Methods: A cross-sectional study was used. Recruited were 50 RA patients (47 women and 3 men) of outpatient clinic of Rheumatology at Cipto Mangunkusumo General Hospital from October to December 2015. Concentrations of NGF were evaluated with a two site immunoenzymatic assay (ELISA). Disease activity in this study was assessed using DAS28 ESR and DAS28 CRP score using a calculator accessible from the internet on http://www.das-score.nl/. The correlation between NGF with disease activity was analyzed by bivariate analysis. Results: The mean age of the study subjects was 43.44 years. Median serum NGF was 4.33 pg / mL (2.35 to 20.83). The results shows correlation between serum NGF with DAS28 ESR (r = +0.427; p = 0.002) and DAS28 CRP (r = + 0407; p = 0.003). Conclusion: Significant positive correlation between serum concentration of NGF with diesease activity in patient with AR was found.