Split vs single-dose oral methotrexate in rheumatoid arthritis: a randomized controlled trial (SMART study).

Objective: Pharmacokinetic evidence suggests split dose of oral methotrexate increases bioavailability, but unproven to improve efficacy. Thus, we planned to compare clinical response of split vs single-dose oral methotrexate in rheumatoid arthritis (RA).

Methods: This pragmatic, open-label (blinded assessor) randomized controlled trial was conducted across six university hospitals in India and enrolled patients with seropositive RA with active disease (TJC ≥ 4 and SJC ≥ 2).

Childhood rheumatic diseases: bites not only the joint, but also the heart.

Cardiovascular involvement in juvenile rheumatic diseases is the primary manifestation in paediatric vasculitis and a major organ manifestation in paediatric connective tissue diseases. Though coronary vasculitis is the prototypical manifestation of Kawasaki disease, it can also be seen in patients with polyarteritis nodosa. Pericarditis is the most common manifestation seen in juvenile rheumatic diseases like systemic onset JIA, and lupus.

MRI and Sonography of the Knee in Acute Reactive Arthritis: An Observational Cohort Study.

Introduction: Reactive arthritis (ReA) is a unique subgroup of spondyloarthritis with acute presentation and tendency to develop chronicity. Magnetic resonance imaging (MRI) has enabled identification of sensitive markers of response to therapy.

Methods: A longitudinal pilot study of acute ReA with knee joint involvement satisfying the Braun's criteria was undertaken.

Mechanisms of thrombosis in ANCA-associated vasculitis.

Patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have a two- to threefold greater risk of developing venous as well as arterial thrombotic events. Although such thrombotic events are more commonly seen during phases of active AAV, they are also recognized to occur during AAV in remission. Endothelial injury is a key pathogenic event in AAV.