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All Journal The International Journal of Medical Science and Health Research
Veronica Winda Soesanto
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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What is The Progression of Joint Deformity and Disability in Rheumatoid Arthritis Patients with Different Treatment Approaches? : A Systematic Review Billy Jonathan; Veronica Winda Soesanto; Chaira Sultana Mazaya
The International Journal of Medical Science and Health Research Vol. 13 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/vtj3wd73

Abstract

Introduction: Rheumatoid Arthritis (RA) is a chronic autoimmune disease leading to progressive joint destruction and disability. Modern management has shifted towards early, aggressive "treat-to-target" strategies to halt disease progression. This systematic review evaluates the progression of joint deformity and disability in RA patients under various treatment approaches. Methods: Following PRISMA guidelines, we systematically reviewed randomized controlled trials from PubMed, Springer, Semantic Scholar, and Google Scholar. We included studies on adult RA patients with at least a 12-month follow-up that assessed joint deformity or functional disability. Nine studies met the inclusion criteria for the final analysis. Results: Early, aggressive treat-to-target strategies resulted in minimal radiographic progression, with some studies showing a complete halt in joint damage over long-term follow-up of up to 10 years. Functional disability, measured by the Health Assessment Questionnaire (HAQ), improved across all pharmacological interventions. Non-pharmacological interventions, like complex rehabilitation, significantly improved functional status, reducing HAQ scores by up to 73.8%, but their effect on radiographic outcomes was not reported. Baseline anti-CCP positivity and high disease activity were predictors of poorer outcomes. Discussion: The evidence confirms that early and sustained pharmacological treatment is crucial for controlling structural damage and preserving function. Combining these treatments with non-pharmacological therapies like targeted exercise provides additional functional benefits. However, a gap remains in understanding the impact of non-pharmacological interventions on long-term joint structure. Conclusion: An integrated approach combining early, aggressive pharmacotherapy with adjunctive non-pharmacological interventions offers the most effective strategy for managing RA. This approach successfully limits joint deformity and improves patient disability and quality of life.
Massive Pleural Effusion in Tuberculosis Due to Systemic Lupus Erythematosus: A Case Report Anthony Tjajaindra; Veronica Winda Soesanto; Anak Agung Made Sucipta
The International Journal of Medical Science and Health Research Vol. 13 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/wy3xjh07

Abstract

Introduction : Tuberculosis (TB) posed a significant risk for mortality and morbidity in autoimmune disorders like systemic lupus erythematosus (SLE). TB in SLE patients often manifests as extrapulmonary disease, affecting areas like the pleura, leading to pleuritis and effusion. This case report aims to assess a case of massive pleural effusion in tuberculosis patient due to co-existing SLE. Case Description : We present the case of a 17 y.o. girl who experienced progressive shortness of breath, worsening one day prior to her admission to the Emergency Department of Wangaya Regional General Hospital. Examination indicated a massive pleural effusion. Pleural drainage was performed the following day, yielding a total of 2,800 mL of pleural fluid. Further examination revealed symptoms of SLE, strengthen by family history. A positive antinuclear antibody (ANA) test confirmed the diagnosis of SLE. Patient then given pulse intravenous methylprednisolone at dose of 600 mg once a day for three days and antituberculosis Fixed-Dose Combination therapy. After the effusion resolved, patient had outpatient treatment and control periodically.  Conclusion : The increased risk of tuberculosis in SLE individual linked to immunological abnormalities in SLE, which hampers the body’s ability to control TB infection. Suspecting of SLE in patients with massive pleural effusion can lead to prompt treatment.
Co-Authors Anak Agung Made Sucipta Anthony Tjajaindra Billy Jonathan Chaira Sultana Mazaya