https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(00)04046-0.pdf

Inflammation and cancer: back to Virchow?

Interleukin-10 (IL-10), first recognized for its ability to inhibit activation and effector function of T cells, monocytes, and macrophages, is a multifunctional cytokine with diverse effects on most hemopoietic cell types. The principal routine function of IL-10 appears to be to limit and ultimately terminate inflammatory responses. In addition to these activities, IL-10 regulates growth and/or differentiation of B cells, NK cells, cytotoxic and helper T cells, mast cells, granulocytes, dendritic cells, keratinocytes, and endothelial cells. IL-10 plays a key role in differentiation and function of a newly appreciated type of T cell, the T regulatory cell, which may figure prominently in control of immune responses and tolerance in vivo. Uniquely among hemopoietic cytokines, IL-10 has closely related homologs in several virus genomes, which testify to its crucial role in regulating immune and inflammatory responses. This review highlights findings that have advanced our understanding of IL-10 and its receptor, as well as its in vivo function in health and disease.

Interleukin-10 and the interleukin-10 receptor.

In this article, the 2010 European League against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) with synthetic and biological disease-modifying antirheumatic drugs (sDMARDs and bDMARDs, respectively) have been updated. The 2013 update has been developed by an international task force, which based its decisions mostly on evidence from three systematic literature reviews (one each on sDMARDs, including glucocorticoids, bDMARDs and safety aspects of DMARD therapy); treatment strategies were also covered by the searches. The evidence presented was discussed and summarised by the experts in the course of a consensus finding and voting process. Levels of evidence and grades of recommendations were derived and levels of agreement (strengths of recommendations) were determined. Fourteen recommendations were developed (instead of 15 in 2010). Some of the 2010 recommendations were deleted, and others were amended or split. The recommendations cover general aspects, such as attainment of remission or low disease activity using a treat-to-target approach, and the need for shared decision-making between rheumatologists and patients. The more specific items relate to starting DMARD therapy using a conventional sDMARD (csDMARD) strategy in combination with glucocorticoids, followed by the addition of a bDMARD or another csDMARD strategy (after stratification by presence or absence of adverse risk factors) if the treatment target is not reached within 6 months (or improvement not seen at

/pdf/eular-recommendations-for-the-management-of-rheumatoid-4fujp4paik.pdf

EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update

99mTc
: technetium-99m
201TI
: thallium 201
ABCB1
: ATP-binding cassette sub-family B member 1
ABI
: ankle-brachial index
ACC
: American College of Cardiology
ACCF
: American College of Cardiology Foundation
ACCOMPLISH
: Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension
ACE
: angiotensin converting enzyme
ACIP
: Asymptomatic Cardiac Ischaemia Pilot
ACS
: acute coronary syndrome
ADA
: American Diabetes Association
ADP
: adenosine diphosphate
AHA
: American Heart Association
ARB
: angiotensin II receptor antagonist
ART
: Arterial Revascularization Trial
ASCOT
: Anglo-Scandinavian Cardiac Outcomes Trial
ASSERT
: Asymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial
AV
: atrioventricular
BARI 2D
: Bypass Angioplasty Revascularization Investigation 2 Diabetes
BEAUTIFUL
: Morbidity-Mortality Evaluation of the If Inhibitor Ivabradine in Patients With Coronary Artery Disease and Left Ventricular Dysfunction
BIMA
: bilateral internal mammary artery
BMI
: body mass index
BMS
: bare metal stent
BNP
: B-type natriuretic peptide
BP
: blood pressure
b.p.m.
: beats per minute
CABG
: coronary artery bypass graft
CAD
: coronary artery disease
CAPRIE
: Clopidogrel vs. Aspirin in Patients at Risk of Ischaemic Events
CASS
: Coronary Artery Surgery Study
CCB
: calcium channel blocker
CCS
: Canadian Cardiovascular Society
CFR
: coronary flow reserve
CHARISMA
: Clopidogrel for High Atherothrombotic Risk and Ischaemic Stabilization, Management and Avoidance
CI
: confidence interval
CKD
: chronic kidney disease
CKD-EPI
: Chronic Kidney Disease Epidemiology Collaboration
CMR
: cardiac magnetic resonance
CORONARY
: The CABG Off or On Pump Revascularization Study
COURAGE
: Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation
COX-1
: cyclooxygenase-1
COX-2
: cyclooxygenase-2
CPG
: Committee for Practice Guidelines
CT
: computed tomography
CTA
: computed tomography angiography
CV
: cardiovascular
CVD
: cardiovascular disease
CXR
: chest X-ray
CYP2C19*2
: cytochrome P450 2C19
CYP3A
: cytochrome P3A
CYP3A4
: cytochrome P450 3A4
CYP450
: cytochrome P450
DANAMI
: Danish trial in Acute Myocardial Infarction
DAPT
: dual antiplatelet therapy
DBP
: diastolic blood pressure
DECOPI
: Desobstruction Coronaire en Post-Infarctus
DES
: drug-eluting stents
DHP
: dihydropyridine
DSE
: dobutamine stress echocardiography
EACTS
: European Association for Cardiothoracic Surgery
EECP
: enhanced external counterpulsation
EMA
: European Medicines Agency
EASD
: European Association for the Study of Diabetes
ECG
: electrocardiogram
Echo
: echocardiogram
ED
: erectile dysfunction
EF
: ejection fraction
ESC
: European Society of Cardiology
EXCEL
: Evaluation of XIENCE PRIME or XIENCE V vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization
FAME
: Fractional Flow Reserve vs. Angiography for Multivessel Evaluation
FDA
: Food & Drug Administration (USA)
FFR
: fractional flow reserve
FREEDOM
: Design of the Future Revascularization Evaluation in patients with Diabetes mellitus: Optimal management of Multivessel disease
GFR
: glomerular filtration rate
HbA1c
: glycated haemoglobin
HDL
: high density lipoprotein
HDL-C
: high density lipoprotein cholesterol
HR
: hazard ratio
HRT
: hormone replacement therapy
hs-CRP
: high-sensitivity C-reactive protein
HU
: Hounsfield units
ICA
: invasive coronary angiography
IMA
: internal mammary artery
IONA
: Impact Of Nicorandil in Angina
ISCHEMIA
: International Study of Comparative Health Effectiveness with Medical and Invasive Approaches
IVUS
: intravascular ultrasound
JSAP
: Japanese Stable Angina Pectoris
KATP
: ATP-sensitive potassium channels
LAD
: left anterior descending
LBBB
: left bundle branch block
LIMA
: Left internal mammary artery
LDL
: low density lipoprotein
LDL-C
: low density lipoprotein cholesterol
LM
: left main
LMS
: left main stem
LV
: left ventricular
LVEF
: left ventricular ejection fraction
LVH
: left ventricular hypertrophy
MACE
: major adverse cardiac events
MASS
: Medical, Angioplasty, or Surgery Study
MDRD
: Modification of Diet in Renal Disease
MERLIN
: Metabolic Efficiency with Ranolazine for Less Ischaemia in Non-ST-Elevation Acute Coronary Syndromes
MERLIN-TIMI 36
: Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndromes: Thrombolysis In Myocardial Infarction
MET
: metabolic equivalents
MI
: myocardial infarction
MICRO-HOPE
: Microalbuminuria, cardiovascular and renal sub-study of the Heart Outcomes Prevention Evaluation study
MPI
: myocardial perfusion imaging
MRI
: magnetic resonance imaging
NO
: nitric oxide
NSAIDs
: non-steroidal anti-inflammatory drugs
NSTE-ACS
: non-ST-elevation acute coronary syndrome
NYHA
: New York Heart Association
OAT
: Occluded Artery Trial
OCT
: optical coherence tomography
OMT
: optimal medical therapy
PAR-1
: protease activated receptor type 1
PCI
: percutaneous coronary intervention
PDE5
: phosphodiesterase type 5
PES
: paclitaxel-eluting stents
PET
: positron emission tomography
PRECOMBAT
: Premier of Randomized Comparison of Bypass Surgery vs. Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease
PTP
: pre-test probability
PUFA
: polyunsaturated fatty acid
PVD
: peripheral vascular disease
QoL
: quality of life
RBBB
: right bundle branch block
REACH
: Reduction of Atherothrombosis for Continued Health
RITA-2
: Second Randomized Intervention Treatment of Angina
ROOBY
: Veterans Affairs Randomized On/Off Bypass
SAPT
: single antiplatelet therapy
SBP
: systolic blood pressure
SCAD
: stable coronary artery disease
SCORE
: Systematic Coronary Risk Evaluation
SCS
: spinal cord stimulation
SES
: sirolimus-eluting stents
SIMA
: single internal mammary artery
SPECT
: single photon emission computed tomography
STICH
: Surgical Treatment for Ischaemic Heart Failure
SWISSI II
: Swiss Interventional Study on Silent Ischaemia Type II
SYNTAX
: SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery
TC
: total cholesterol
TENS
: transcutaneous electrical neural stimulation
TERISA
: Type 2 Diabetes Evaluation of Ranolazine in Subjects With Chronic Stable Angina
TIME
: Trial of Invasive vs. Medical therapy
TIMI
: Thrombolysis In Myocardial Infarction
TMR
: transmyocardial laser revascularization
TOAT
: The Open Artery Trial
WOEST
: What is the Optimal antiplatElet and anticoagulant therapy in patients with oral anticoagulation and coronary StenTing

Guidelines summarize and evaluate all evidence available, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well …

/pdf/2013-esc-guidelines-on-the-management-of-stable-coronary-2178xukyyy.pdf

2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology.

Authors/Task Force Members: Franz-Josef Neumann* (ESC Chairperson) (Germany), Miguel Sousa-Uva* (EACTS Chairperson) (Portugal), Anders Ahlsson (Sweden), Fernando Alfonso (Spain), Adrian P. Banning (UK), Umberto Benedetto (UK), Robert A. Byrne (Germany), Jean-Philippe Collet (France), Volkmar Falk (Germany), Stuart J. Head (The Netherlands), Peter Jüni (Canada), Adnan Kastrati (Germany), Akos Koller (Hungary), Steen D. Kristensen (Denmark), Josef Niebauer (Austria), Dimitrios J. Richter (Greece), Petar M. Seferovi c (Serbia), Dirk Sibbing (Germany), Giulio G. Stefanini (Italy), Stephan Windecker (Switzerland), Rashmi Yadav (UK), Michael O. Zembala (Poland) Document Reviewers: William Wijns (ESC Review Co-ordinator) (Ireland), David Glineur (EACTS Review Co-ordinator) (Canada), Victor Aboyans (France), Stephan Achenbach (Germany), Stefan Agewall (Norway), Felicita Andreotti (Italy), Emanuele Barbato (Italy), Andreas Baumbach (UK), James Brophy (Canada), Héctor Bueno (Spain), Patrick A. Calvert (UK), Davide Capodanno (Italy), Piroze M. Davierwala

/pdf/2014-esc-eacts-guidelines-on-myocardial-revascularization-3fr5n9jz36.pdf

2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI).

Microarray Pathway Analysis Comparing Baricitinib and Adalimumab in Moderate to Severe Rheumatoid Arthritis Patients, from a Phase 3 Study

Summary Patients with SLE suffer from accelerated atherosclerosis due to systemic inflammation. We examined subclinical coronary artery involvement in patients with systemic lupus erythematous (SLE) by contrast enhanced inversion recovery (CE-IR) coronary magnetic resonance imaging. Background Vessel wall inflammation plays a key role in the initiation and progression of atherosclerosis, from endothelial injury to remodeling and plaque formation. Cardiovascular (CV) magnetic resonance (CMR) provides noninvasive visualization and characterization of arterial remodeling both in the great vessels, and also the coronary arteries. Contrast-enhanced inversion-recovery (CEIR) prepared coronary imaging allows detection of vessel wall enhancement by visualization of contrast agent uptake. We examined subclinical coronary artery involvement in patients with systemic lupus erythematous (SLE) by contrast enhanced inversion recovery (CE-IR) coronary magnetic resonance imaging. Methods

/pdf/contrast-enhancement-imaging-in-coronary-arteries-in-50kkqycawp.pdf

Contrast enhancement imaging in coronary arteries in patients with systemic lupus erythematosus

Mode of administration in rheumatoid arthritis treatments: an exploration of patient preference for an 'ideal treatment'

Background In patients with active rheumatoid arthritis (RA), haemoglobin (Hb) levels have been inversely associated with radiographic progression of structural joint damage.1-3. In two randomized 52-week (wk) studies, baricitinib (BARI), a selective JAK1/JAK2 inhibitor, reduced radiographic progression in patients with moderate to severe active RA who had received no/minimal prior methotrexate (MTX; RA- BEGIN)4 or had inadequate response to MTX (RA-BEAM).5 Objectives To assess the association between baseline Hb levels and structural damage progression and to study the effect of BARI 4-mg once daily on structural damage progression at 52 wks based on baseline Hb levels. Methods Data from the modified intention-to-treat (mITT) populations of RA-BEGIN (MTX=210; BARI 4-mg=159; BARI 4-mg + MTX=215 patients) and RA-BEAM (placebo [PBO]=488, adalimumab [ADA]=328, BARI 4-mg=487 patients) were included for analysis. Structural damage progression was defined as change from baseline (CFB) greater than the smallest detectable change (SDC) in the modified total Sharp score (mTSS) at wk 52. In RA-BEGIN SDC was 1.4 and in RA-BEAM SDC was 1.5. Missing mTSS data at wk 52 were imputed using linear extrapolation based on baseline data and the most recent radiographic data prior to the missed radiograph. Observed proportions of patients with CFB in mTSS >SDC at wk 52 were calculated for low (males: 3mg/L), baseline CDAI, baseline HAQ-DI, BMI, smoking status (Yes/No), geographical area and joint erosion status at baseline (Yes/No in RA-BEGIN; ≥3/1 or 2 + seropositivity in RA-BEAM). Thirty-nine patients from RA-BEGIN (MTX=18; BARI 4-mg=5; BARI 4-mg + MTX=16) and 68 patients from RA-BEAM (PBO=36; ADA=18; BARI 4-mg=14) with missing baseline/post-baseline radiographic data were excluded from MLR analyses; in addition, 7 and 19 patients from RA-BEGIN and RA-BEAM with missing data for the covariates of the MLR were excluded. All analyses were post-hoc. Results Overall, RA-BEGIN and RA-BEAM patients with higher baseline Hb were less likely to show CFB in mTSS >SDC (RA-BEGIN: adjusted odds ratio [OR]=0.72, p=0.001; RA-BEAM: adjusted OR=0.76, p SDC was less frequent in patients with low baseline Hb who received BARI alone or BARI + MTX versus those on MTX alone; in patients with normal baseline Hb, the difference between treatments was less pronounced. In RA-BEAM (Figure B), CFB in mTSS >SDC was less frequent in patients with both low or normal baseline Hb for patients receiving BARI or ADA versus PBO. Conclusion In patients with RA, lower baseline Hb levels were associated with increased structural damage progression. Treatment with BARI 4-mg reduced structural progression, irrespective of patient baseline Hb status; structural progression at 52 wks was more pronounced in patients with low baseline Hb receiving MTX alone (RA-BEGIN) or PBO and background MTX (RA-BEAM). Reference [1] Moller B et al. Arthritis Care Res (Hoboken). 2018;70(6):861-8; 2Moller B et al. Ann Rheum Dis. 2014;73(4):691-6; 3Westhovens R et al. Ann Rheum Dis 2016;75:237-8; 4Fleischmann R et al. Arthritis Rheumatol. 2017;69(3):506-17; 5Taylor PC et al. N Engl J Med 2017;376:652-62 Disclosure of Interests Burkhard Moeller Consultant for: Swissmedic Human Medicines Expert Committee Member (regulatory agency), Patrick Durez Speakers bureau: Bristol-Myers Squibb, Eli Lilly, Sanofi, Celltrion, Axel Finckh Grant/research support from: Bristol-Myers Squibb, Pfizer Inc, Consultant for: AbbVie, A2Bio, Bristol-Myers Squibb, MSD, Roche, Pfizer Inc, and UCB, Pedro Lopez-Romero Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Clementine Perrier Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Francesco de Leonardis Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Inmaculada De La Torre Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Peter C. Taylor Grant/research support from: Celgene, Galapagos, Eli Lilly, UCB, Consultant for: AbbVie, Galapagos, Gilead, Eli Lilly, Pfizer Inc

https://ard.bmj.com/content/annrheumdis/78/Suppl_2/1117.2.full.pdf

Sat0102 association between baseline haemoglobin levels and radiographic joint damage progression in patients with rheumatoid arthritis treated with baricitinib or standard of care

Since its inception, myocardial revascularization has steadily evolved. The patient population is older with more extensive cardiac disease. Surgical mortality is currently 1% with a less than 1% perioperative myocardial infarction rate. The number of grafts done per patient has increased to more than three with 80% of the patients being completely revascularized. Ninety percent of the patients receive at least one internal mammary artery graft. With more complete revascularization and greater use of the internal mammary artery, the prospects for long-term survival and palliation have improved.

Peter C. Taylor

Papers

Microarray Pathway Analysis Comparing Baricitinib and Adalimumab in Moderate to Severe Rheumatoid Arthritis Patients, from a Phase 3 Study

Contrast enhancement imaging in coronary arteries in patients with systemic lupus erythematosus

Mode of administration in rheumatoid arthritis treatments: an exploration of patient preference for an 'ideal treatment'

Sat0102 association between baseline haemoglobin levels and radiographic joint damage progression in patients with rheumatoid arthritis treated with baricitinib or standard of care

Myocardial revascularization: evolution of a surgical procedure.