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Inhibition of synovial proliferation has just lately been reported to become a promising therapeutic strategy for RA.

Methods: Microarray analysiswas performed to identifythe (-)-MK 801 Maleate genes that had upregulated expression inmice with collagen induced arthritis. The effect of candidate genes on the proliferation of synovial fibroblasts was screened using antisense oligodeoxynucleotides and small interfering RNAs. Results: We identified a novel gene named SPACIA1/SAAL1 that was associated with aberrant proliferation of synovial fibroblasts. Immunohistochemical analysis indicated that SPACIA1/SAAL1 was strongly expressed in the foot joints of mice with CIA and in the thickened synovial lining of the human RA synovium. Transfection of siRNA targeting SPACIA1/SAAL1into RA synovial fibroblastscould inhibit tumor necrosis factor a induced proliferation more effectively thanit could inhibit serum induced proliferation.

Recently, biologics such as anti tumor necrosis factor antibodies have also been tried in certain PARP refractory cases. Results: We have had two cases of AOSD which were treated successfully with anti interleukin 6 receptor antibody, tocilizumab. A 36 year old woman who was diagnosed 8 years previously, and had been treated with various DMARDs plus etanercept or adalimumab, presented with a high spiky fever and elevated liver enzymes. After excluding infection, she was treated with TOC. A 26 year old man with new onset AOSD, which was shown to be resistant to multiple immunosuppressants including infliximab and ETA, was treated with TOC starting 7 months after the diagnosis. In both cases, serum IL 18 was extremely high, and TOC promptly improved clinical symptoms and liver function.

New York, NY, USA, 3SDG, LLC, Cambridge, MA, USA, 4Stanford University, Palo Alto, CA, USA, 5Hennepin County Medical Center, Minneapolis, MN, USA Arthritis Research & Therapy 2012, 14 :P63 Background: The GI Randomized (-)-MK 801 Maleate Event and Safety Open Label NSAID Study was a novel prospective, randomized, open label, blinded end point study that measured adjudicated clinical outcomes throughout the GI tract. It was designed to assess if celecoxib use in patients with osteoarthritis at moderate GI risk is associated with a lower incidence of clinically significant upper and lower GI events compared to nsNSAIDs, with/without proton pump inhibitors, in standard US clinical practice.

Treatment doses could be adjusted per US prescribing information. Patients randomized to the nsNSAID arm could switch between nsNSAIDs, however, crossover between treatment arms was not allowed. PPIs and histamine 2 receptor antagonists were prescribed at the providers discretion. Results: 4035 celecoxib and 4032 nsNSAID patients were randomized and included in the ITT analyses. Baseline demographics were similar.

2596 celecoxib and 2611 nsNSAID users completed the study. 189 patients were lost to follow up. Attributing the primary end point to all LTFU patients, celecoxib remained superior. A 205804 AEs, SAEs and discontinuations were similar in both treatment groups. 23% of celecoxib and 24% of nsNSAID patients used a PPI. Moderate to severe abdominal symptoms were experienced by 94 celecoxib and 138 nsNSAID patients.