What are the effects of short-term deactivation of methotrexate on disease activity in RA patients? Which type of RA patient is more likely to quit smoking?

A week of information, waiting for you to see! Which rheumatoid arthritis patients are more likely to quit smoking? What are the effects of short-term discontinuation of methotrexate on disease activity in patients with rheumatoid arthritis? Where does the complication of gout and hyperuricemia come from? Which rheumatoid arthritis patients are more likely to quit smoking? Rheumatoid arthritis (RA) is a common connective tissue disease, the pathogenesis has not been elucidated.environmental factors play a major role in the pathogenesis of RA, and smoking is one of the important environmental factors.after being ignited, tobacco will release different harmful chemicals, such as nicotine, tar and carbon monoxide.these harmful chemicals can make the human body gradually lose the resistance to RA disease through different ways.studies have shown that smokers are more likely to develop RA, and smoking can affect the therapeutic effect of RA.therefore, quitting smoking has become one of the preventive measures for RA.but how easy is it to quit smoking? Not every patient can listen to the doctor's advice and stay away from tobacco.so what kind of RA patients are more likely to quit smoking? Scholars have studied it.the researchers extracted electronic health data of RA patients in two health systems from 2005 to 2016.of the 3577 RA patients, 507 smoked, and 29% of them successfully quit smoking within an average of 4.75 years.compared with other patients, those who had just received rheumatic care were 60% more likely to quit smoking, RA patients in rural community health system were 66% more likely to quit smoking, and 43% less likely to quit smoking in serum positive patients.according to the researchers, medical care plays an important role in quitting smoking in RA patients, but patients with serum positive RA are less likely to quit smoking. It is suggested that intervention measures should be implemented as soon as possible for newly diagnosed smoking patients with serum positive RA, and the importance of quitting smoking should be emphasized.the reason why RA patients stop smoking may be that they do not realize the relationship between smoking and RA, and use smoking as a way to relieve pain.patients with RA may feel lonely due to difficulty in movement. I hope that family and friends can give more care to RA patients.we also hope that patients with RA can get good treatment regardless of smoking or not.2 what are the effects of short-term discontinuation of methotrexate on RA disease activity? What are the effects of short-term withdrawal of methotrexate on the disease activity of RA? The authors analyzed the changes of disease activity score (DAS28) and disease activity rate of RA patients during the withdrawal of methotrexate, and the disease activity of RA patients after the withdrawal of methotrexate.the study included 54 patients who continued to take methotrexate (group 1) and 44 patients who stopped taking methotrexate for 4 weeks (group 2). the results showed that the DAS28 score increased after 4 weeks of methotrexate withdrawal, and returned to the baseline level after the introduction of methotrexate. There was no significant difference in disease-free survival between the two groups (P = 0.142). However, during the 4-week methotrexate withdrawal period, the disease activity rate in the withdrawal group tended to increase (20.5% vs 7.4%, P = 0.058). there was no difference in disease activity rate between the two groups after methotrexate treatment was resumed in the withdrawal group. disease activity rate: withdrawal for 4 weeks may increase the disease activity rate of RA patients. What about 2 weeks' withdrawal? After comparison, the disease activity rates of 2-week group, 4-week group and non-stop group were 10.8%, 20.5% and 5.8% respectively. the researchers indicated that it was safe to discontinue methotrexate for 2 weeks, while withdrawal for 4 weeks might increase the risk of disease activity in RA patients. If methotrexate treatment is reopened within 4 weeks after drug withdrawal, the disease activity risk and disease activity can return to the baseline level. 3 where do the complications of gout and hyperuricemia come from? Hyperuricemia is a necessary condition for gout, but gout does not occur when blood uric acid increases. gout can involve the kidney, often accompanied by 4-5 complications, such as chronic hyperuricemia nephropathy, acute uric acid nephropathy, uric acid kidney stones, etc. but so far, no relevant research has clearly demonstrated the causal relationship between serum uric acid and gout, hyperuricemia complications. observational studies have shown that the complications of gout and hyperuricemia are mainly related to metabolic syndrome, chronic kidney disease and renal function. although there is strong evidence for the association between serum uric acid and gout and hyperuricemia complications, the causal relationship between various complications is still unclear. according to the researchers, body mass index (BMI) has an effect on blood uric acid levels, which may explain the relationship between gout, hyperuricemia and metabolic syndrome and chronic kidney disease, as BMI is a characteristic known cause of some metabolic diseases, such as diabetes. how to choose drugs for patients with hyperuricemia and gout with complications? "Chinese guidelines for the diagnosis and treatment of hyperuricemia and gout (2019)" suggests: when patients with hyperuricemia and gout are combined with hypertension, losartan and / or calcium channel blockers are recommended as the first choice of antihypertensive drugs, while thiazides and loop diuretics are not recommended for antihypertensive treatment; fenofibrate is recommended as the first choice for patients with Hypertriglyceridemia; fenofibrate is recommended as the first choice for patients with hypercholesterolemia, Atorvastatin calcium is the first choice; when complicated with diabetes, hypoglycemic drugs are recommended to be the drugs with the effect of lowering uric acid. References: [1] Maria schletzbaum et al, predictors of smoking cession in patients with rheumatoid arthritis in two cohorts: healthcare factors most predictive, arthritis care & amp; Research (2020). [2] Park, J.K., Kim, M.J., Choi, Y. et al. Effect of short-term methotrexate discontinuation on rheumatoid arthritis disease activity: post-hoc analysis of two randomized trials. Clin Rheumatol 39, 375–379 (2020).[3] Nicholas A. Sumptera, Kenneth G. Saag， et.al.Comorbidities in gout and hyperuricemia: causality or epiphenomena?Current Opinion in Rheumatology.First published:03 March 2020. [4] endocrinology branch of Chinese Medical Association, Chinese guidelines for diagnosis and treatment of hyperuricemia and gout (2019), Chinese Journal of Endocrinology and metabolism, 2020,36 (1): 1-13