Correlation between Anti-CCP Titer and Body Mass Index Score in Rheumatoid Arthritis Patients in Cipto Mangunkusumo Hospital

Background: Rheumatoid Arthritis (RA) is a chronic systemic inflammation that attacks and damages joints of upper and lower extremities. RA causes morbidity and disability, hence, affects the quality of life. Chronic inflammation, as the disease progressing causes lowering of body mass index in RA patients. Titer of anti-CCP is specific for RA which indicates the progressivity and severity of the disease. Study about anti-CCP titer and body mass index has not been done in Indonesia. Therefore, this study done to understand the correlation between anti-CCP titer and body mass index score in rheumatoid arthritis patients in Cipto Mangunkusumo hospital. Method: The design of this study is cross-sectional study with 42 samples. The data included anti-CCP titer, body weight, height, and body mass index are collected from patients’ medical records. Results: RA patients in Cipto Mangunkusumo hospital in 2012-2016 with negative and positive anti-CCP titer consecutively are 28.6% and 71.4%. The result of this correlation study is p>0.05; r-0.03. Conclusion: In conclusion, there is no correlation between anti-CCP titer and body mass index score in RA patients in Cipto Mangunkusumo hospital Keywords: Anti-CCP; Body Mass Index; Rheumatoid Arthriti

The Correlation Value of DAS28 with Anti-CCP Titer on Rheumatoid Arthritis Patients in Cipto Mangunkusumo Hospital in 2012-2016

Background: Rheumatoid Arthritis (RA) is one of the diseases associated with the immune system which causes joint damage and effect to the quality of patient’s life. DAS28 CRP value describes RA disease activity. The anti-CCP titer is a very specific examination which provide an overview prognosis of RA patient’s 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 cross-sectional with the sample amounted to 34. anti-CCP and DAS28 CRP were obtained through patient’s medical records.Result The result of this correlationstudy is (p = 0,582) and r = 0,086. Conclusion: In conclusion, there is no correlation between anti-CCP and DAS28 in Cipto Mangunkusumo hospital. Keywords: Anti-CCP; DAS28 CRP; Rheumatoid Arthriti

Reliability and Validity of European Quality of Life 5 Dimension (EQ-5D) for Measuring Health-related Quality of Life in Knee Osteoarthritis Patients at Cipto Mangunkusumo General Hospital

Background: Quality of life is very important to knee osteoarthritis (OA) patients. The term quality of life denotes one that is health-related. One of the questionnaires most frequently used to measure the quality of life is the European Quality of Life 5-Dimension (EQ-5D) questionnaire. At Cipto Mangunkusumo General Hospital, until today there has not been any instrument for measuring the health-related quality of life in knee OA patients that has been tested for its reliability and validity.Objective: To prove the reliability and validity of EQ-5D as a measurement tool in determining the healthrelated quality of life in knee OA patients at Cipto Mangunkusumo General Hospital.Methods: This is a validity study in which all patients were asked to complete both the EQ-5D form and 36- item short form (SF-36) on their fi rst visit. They were subsequently asked again to complete only the EQ-5Dform one week after their fi rst visit.Results: Data were obtained from 86 respondents.The value of the intraclass correlation coeffi cient of each EQ-5D dimension, EQ-5D index, and visual analogue scale (VAS) was excellent (>0.75). Cronbach's α value for internal consistency reliability in this study was0.6772 (<0.7). The external validity of EQ-5D compared to SF-36 was analyzed with the Pearson's correlation test and revealed a signifi cant correlation (p<0.01) of all EQ-5D dimensions, EQ-5D index, and EQ-5D VAS with total score of SF-36 except for the dimensions of self-care, pain, and anxiety/depression. The construct validity of EQ-5D showed that all of the dimensions were signifi cantly correlated with the EQ-5D index (p<0.01) except for self-care dimension.Conclusion: EQ-5D is a valid and reliable measurement tool. It is thus recommended for measuring the healthrelated quality of life in knee OA patients at CiptoMangunkusumo General Hospital

Predictor Factors of Atherosclerosis and Atherosclerosis Plaque in Rheumatoid Arthritis Patients

Background: Atherosclerosis and cardiovascular diseases have been known as the cause of increasing mortality among rheumatoid arthritis (RA) patients. Carotid intima media thickness (CIMT) measurement by ultrasound has been used as surrogate marker of atherosclerosis and cardiovascular disease.Methods: A cross sectional study of 86 RA patients fulfills EULAR/ACR 2010 critera for RA was conducted to study proportion and predictor factors of atherosclerosis and atherosclerosis plaque in rheumatoid arthritis patients.Results: Atherosclerosis and plaque was found in 47,7% and 29 % of patients. Age ≥ 40 yo, hypertension and duration of illness ≥ 24 mo were associated with atherosclerosis in multivariate logistic regression analysis with OR 10.70 (95% CI: 2.93-39.10), 4.99 (95% CI: 1.15-21.61) and 3.66 (95% CI: 1.11-11.99) respectively. Whereas hypertension, presence of antiCCP antibody and age ≥ 40 yo, were associated with plaque formation with OR 3.96 (95% CI: 1.15-13.57), 3.20 (95% CI: 1.11-9.24) and 3.61 (95% CI: 1.03-12.63) respectively.Conclusions: Age ≥ 40 yo, hypertension and duration of illness ≥ 24 mo was the predictors ofatherosclerosis, while hypertension, presence of antiCCP antibody and age ≥ 40 yo was the predictors of atherosclerosis plaque

Proportion and Factors that Associate with Incidence of Hepatotoxicity in Rheumatoid Arthritis Patients Treated with Methotrexate in RSCM Year 2013-2015

Background Rheumatoid arhtirtis (RA) is a chronic autoimmune disease that mainly attacks joints. It may causes joint deformities which leads to lower quality of life of RA patients. RA is treated with metothrexate (MTX) which inhibiting disease progression. MTX is known for its hepatotoxicity side effect, which is described by an elevation of aspartate aminotransferaseÂ&nbsp;(AST) and/or alanine aminotransferase (ALT) beyond the upper normal limit. Factors that may enhance hepatotoxicity are gender, age, cummulative dose of MTX, and duration therapy of MTX. Prevalence of hepatotoxicity caused by MTX therapy in RA patients in Indonesia is still unknown. The objective of this research is to know the proportion of hepatotoxicity and its associations with the factors that may enhance hepatotoxicity caused by MTX therapy in RA patients in RSCM. Method Data about gender, age, cummulative dose and duration therapy of MTX are obtained from 115 RA patients' medical records. Result Proportion of hepatotoxicity in RA patients treated with MTX in RSCM is 42.60%. Gender, age, cummulative dose and duration therapy of MTX do not significantly enhance hepatotoxicity (p&gt;0.05). Conclusion In conclusion gender, age, cummulative dose and duration therapy of MTX do not have association with hepatotoxicity in RA patients treated with MTX. Â&nbsp; Keywords: Rheumatoid Arthritis, Methotrexate, Hepatotoxicit

The Relationship Between Gastric Mucosa Mucous Thickness and Gastroscopic Findings in Patients Receiving Non-Steroidal Anti-Inflammatory Drugs

Non-steroid anti-inflammatory drugs (NSAID) can cause gastropathy and gastric mucosa, especially the mucous may play an important prevention role. This cross-sectional, single group study was conducted to know the difference in mucous thickness in antrum or corpus mucosa and the correlation of gastric mucous thickness to gastropathy. Patients who received NSAID from the rheumatology clinic were studied. Healthy subjects of 14 – 65 years old who never received NSAID were included as normal controls. Piroxicam 20 mg daily was given to the patients for 7 days, then gastroscopy and gastric mucosa biopsy with frozen section were performed. Specimens were stained with haematoxyline eosin and thickness of the mucous layer was measured using ocular micrometer. Thirty-two out of 70 patients participated in the study. All cases had hyperemia on gastroscopy with erosions and ulcer in 32 and 9 cases, respectively. The mean thickness of mucosa in distal antrum, proximal antrum and corpus was 28.5 ± 9, 37.4 ± 13.1 and 43.3 ± 13.1 microns, respectively. There was significant relationship between gastric mucosa mucous thickness with gastroscopic findings. In conclusion, this study confirmed that thickness of gastric mucosa mucous has an important role in preventing NSAID gastropathy and dyspeptic complaints in this kind of patients does not suggest abnormalities of gastric mucosa

Reliability and validity of European Quality of Life 5 Dimension (EQ-5D) for measuring health-related quality of life in knee osteoarthritis patients at Cipto Mangunkusumo General Hospital

Background: Quality of life is very important to knee osteoarthritis (OA) patients. The term quality of life denotes one that is health-related. One of the questionnaires most frequently used to measure the quality of life is the European Quality of Life 5-Dimension (EQ-5D) questionnaire. At Cipto Mangunkusumo General Hospital, until today there has not been any instrument for measuring the health-related quality of life in knee OA patients that has been tested for its reliability and validity.Objective: To prove the reliability and validity of EQ-5D as a measurement tool in  determining the healthrelated quality of life in knee OA patients at Cipto Mangunkusumo General Hospital.Methods: This is a validity study in which all patients were asked to complete both the EQ-5D form and 36- item short form (SF-36) on their fi rst visit. They were subsequently asked again to complete only the EQ-5Dform one week after their fi rst visit.Results: Data were obtained from 86 respondents.The value of the intraclass correlation coeffi cient of each EQ-5D dimension, EQ-5D index, and visual analogue scale (VAS) was excellent (&gt;0.75). Cronbach’s α value for internal consistency reliability in this study was0.6772 (&lt;0.7). The external validity of EQ-5D compared to SF-36 was analyzed with the Pearson’s correlation test and revealed a signifi cant correlation (p&lt;0.01) of all EQ-5D dimensions, EQ-5D index, and EQ-5D VAS with total score of SF-36 except for the dimensions of self-care, pain, and anxiety/depression. The construct validity of EQ-5D showed that all of the dimensions were signifi cantly correlated with the EQ-5D index (p&lt;0.01) except for self-care dimension.Conclusion: EQ-5D is a valid and reliable measurement tool. It is thus recommended for measuring the healthrelated quality of life in knee OA patients at CiptoMangunkusumo General Hospital