Denosumab in patients with giant cell tumor and its recurrence: A systematic review

Recent studies suggest that Denosumab reduces tumor size, therefore, makes the surgery easier with lower morbidity. However, some studies have reported several complications for this drug. So, this systematic review was performed to determine the effectiveness and safety of Denosumab in reducing bone destructions activity of giant cell tumor and skeletal-related events (SRE) in affected patients with giant cell tumor of bone (GCTB) and its recurrence. We explored studies in PubMed, and Cochrane Library. For this purpose, articles of various levels were retrieved until October 22, 2016. Two reviewers assessed the articles independently based on predefined criteria to extract the relevant data. Primary outcomes associated with skeletal-related event, overall survival, and secondary outcomes such as pain, quality of life and adverse events were evaluated and analyzed. The total population of this meta-analysis consisted of 686 patients. Of this population, 55 had primary GCTB and 45 had giant cell tumor recurrence, with 2 experiencing secondary recurrence. The results showed the effectiveness of Denosumab in reducing the tumor size due to inhibiting the Osteoclastogenesis. Denosumab didnot show any effect on reducing tumor recurrence, but, in cases where complete tumor surgery is not possible and tumor residuals may remain, Denosumab can be helpful. Also, the clinicians should consider the risk benefit of Denosumab. © 2018 By The Archives of Bone and Joint Surgery

A multicenter study of clinical and laboratory findings of palindromic rheumatism in Iran

Objective: Considering demographic, clinical and laboratory characteristics of palindromic rheumatism and finding out the difference between rheumatoid factor and anti-cyclic citrullinated peptide positive and negative cases of palindromic rheumatism in Iran. Methods: In this cross-sectional and multicenter study, patients with intermittent arthritis were evaluated by a rheumatologist for palindromic rheumatism. Diagnosis of palindromic rheumatism was made after ruling out other causes of recurrent arthritis, and the fulfillment of the Pasero and Barbieri criteria. Then the demographic and clinical characteristics were recorded and compared in rheumatoid factor and anti-cyclic citrullinated peptide positive and negative patients. Results: Of the 69 patients with palindromic rheumatism, 35 were men and 34 were women. The mean ages of the patients at the time of diagnosis were 38.5 ± 14.6 years. The mean attack intervals and duration of the attacks were 66.3 ± 38.4 days and 3.9 ± 3.3 days, respectively. The most commonly involved joints were knees, metacarpophalangeals and proximal interphalangeals. Rheumatoid factor in 46.4 and anti-cyclic citrullinated peptide in 42 of the cases were positive. Palindromic patients with positive anti-cyclic citrullinated peptide had higher age, shorter duration of disease, shorter duration of attacks, more frequent attacks and more metacarpophalangeal joints involvement. Conclusions: Rheumatoid factor and anti-cyclic citrullinated peptides were found in a high proportion of patients with palindromic rheumatism. The clinical features of the disease in our study were different in rheumatoid factor and anti-cyclic citrullinated peptide positive and negative patients. © 2012 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd