Advanced search options

Advanced Search Options 🞨

Browse by author name (“Author name starts with…”).

Find ETDs with:

in
/  
in
/  
in
/  
in

Written in Published in Earliest date Latest date

Sorted by

Results per page:

Sorted by: relevance · author · university · dateNew search

You searched for +publisher:"University of Manchester" +contributor:("KITAS, GEORGE G"). Showing records 1 – 2 of 2 total matches.

Search Limiters

Last 2 Years | English Only

No search limiters apply to these results.

▼ Search Limiters

1. Toms, Tracey. Dyslipidaemia in Rheumatoid Arthritis.

Degree: 2012, University of Manchester

Introduction: Rheumatoid arthritis (RA) is known to be associated with an increased risk of cardiovascular disease (CVD), resulting in excess mortality. Dyslipidaemia has been identified as a major CVD risk factor in the general population. Current evidence would suggest that lipid metabolism is altered in RA due to inflammation, and that use of anti-inflammatory therapy may reverse some of these changes. However, the impact of such lipid changes on CVD in RA remains unknown. Data regarding the effects of RA/drug therapy on lipid structure and function are sparse. Genetic factors are important in the pathogenesis of RA and play a central role in the regulation of lipid metabolism. To date, no studies have assessed the impact of genetic polymorphisms on lipids in RA.The aim of this thesis is to: 1) assess the prevalence of dyslipidaemia in RA and the CVD risk this confers 2) establish the effects of inflammation on lipid levels and lipid ratios 3) assess the impact of anti-inflammatory drug therapy (anti-TNF, rituximab and intravenous glucocorticoids) on lipid levels, structure and function 4) assess the prevalence and associations of particular genetic polymorphisms (RA susceptibility and lipid metabolism regulating genes) with lipids in RA.Methods: Data from 400 RA patients were used to address aims 1, 2 and 4 in cross-sectional studies. All patients had a clinical assessment and fasting blood taken. Blood was processed to provide data on the lipid profile, ESR, CRP and DNA was extracted for genotyping. Aim 2 and 4 also utilised a retrospective longitudinal cohort of 550 RA patients and the DNA from 400 healthy controls, respectively. Aim 3 was addressed using a longitudinal cohort including: patients due to commence anti-TNF (n=35), rituximab (n=10), intravenous glucocorticoids (n=12); 15 RA controls on stable therapy; and 40 healthy controls. Assessments and blood samples were taken at baseline, 2 weeks and 3 months.Results: Dyslipidaemia was highly prevalent (56.8%), but undertreated in many RA patients at risk of developing CVD. Systemic inflammation associated with many of the changes in lipid levels and structure. Lipid ratios were found to be less susceptible to fluctuations due to inflammation. The use of anti-inflammatory drug therapy produced changes in lipid structure and function through both generic suppression of inflammation and drug specific mechanisms (particularly in the case of glucocorticoids). The prevalence of cholesterol ester transfer protein (CETP) and Apolipoprotein C3 genetic polymorphisms differed between RA patients and local population controls. RA susceptibility genes (HLA-DRB1-SE and TRAF1C5) and several ’lipid metabolism genes’ (Apolipoprotein E, ATP-binding cassette transporter 1 (ABCA1) and CETP) were found to associate with lipid levels within the RA population. Conclusion: Dyslipidaemia is highly prevalent in RA and currently undertreated. Dyslipidaemia in RA is regulated by numerous factors including inflammation, drug therapy and genetic factors. Further longitudinal studies… Advisors/Committee Members: KITAS, GEORGE G, Symmons, Deborah, Kitas, George.

Subjects/Keywords: Dyslipidaemia; Rheumatoid Arthritis

…140 143 145 147 179 8 THE UNIVERSITY OF MANCHESTER ABSTRACT OF THESIS submitted by Dr… …University of Manchester certain rights to use such Copyright, including for administrative… 

Record DetailsSimilar RecordsGoogle PlusoneFacebookTwitterCiteULikeMendeleyreddit

APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Toms, T. (2012). Dyslipidaemia in Rheumatoid Arthritis. (Doctoral Dissertation). University of Manchester. Retrieved from http://www.manchester.ac.uk/escholar/uk-ac-man-scw:162973

Chicago Manual of Style (16th Edition):

Toms, Tracey. “Dyslipidaemia in Rheumatoid Arthritis.” 2012. Doctoral Dissertation, University of Manchester. Accessed October 20, 2020. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:162973.

MLA Handbook (7th Edition):

Toms, Tracey. “Dyslipidaemia in Rheumatoid Arthritis.” 2012. Web. 20 Oct 2020.

Vancouver:

Toms T. Dyslipidaemia in Rheumatoid Arthritis. [Internet] [Doctoral dissertation]. University of Manchester; 2012. [cited 2020 Oct 20]. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:162973.

Council of Science Editors:

Toms T. Dyslipidaemia in Rheumatoid Arthritis. [Doctoral Dissertation]. University of Manchester; 2012. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:162973


University of Manchester

2. Binkley, George Michael. An investigation of adherence to statin therapy in patients with rheumatoid arthritis.

Degree: 2016, University of Manchester

BackgroundRheumatoid arthritis (RA) patients are more likely to experience a cardiovascularevent (CVE) than the general population. This is a result of atherosclerotic diseaseaugmented by systemic inflammation. HMG-CoA (3-hydroxy-3-methylglutarylcoenzyme A) reductase inhibitors (statins) lower the risk of CVEs;further, pleiotropic effects are of clinical relevance for RA disease activity. Manypatients do not achieve ideal clinical outcomes because of poor medicationadherence. This study sought to determine the rates and predictors of adherence inthe TRACE-RA population.MethodsData collected from the Trial of Atorvastatin for the primary prevention ofCardiovascular Events in patients with Rheumatoid Arthritis (TRACE-RA) wereused to meet these aims. Two thousand nine hundred and eighty six patients from102 centres were randomised to receive either atorvastatin or placebo. Adherencewas determined up to 3, 6 and 12 months using data on pill counts and self-reports.Rates and responses were dichotomised as adherent (>80% consumption or ‘Mosttablets consumed’) and non-adherent (<80% consumption or ‘Some/None tabletsconsumed’). Univariate logistic regression analysis and multivariate logisticregression analysis were performed to determine predictors of adherence for patientswith complete data in both arms of TRACE-RA and for those solely in theatorvastatin arm. The multivariate models were adjusted for age and gender.ResultsAdherence to trial medication was 49.4%, 49.1% and 50.1% up to 3, 6 and 12months respectively. No significant differences for the rates of adherence wereobserved between arms. Patients who consumed alcohol on a monthly or less basis(OR=0.65, 95%CI 0.42-0.97) were less likely to adhere to the allocated TRACE-RAintervention than patients who never consumed alcohol. Patients who reported‘extreme pain/ discomfort’ were 67% more likely to adhere to the TRACE-RAintervention than those who reported no pain/ discomfort (OR=1.67, 95%CI 0.96-2.90). In the atorvastatin arm, patients with a high disease activity were moreadherent towards statin therapy than patients in remission (OR=1.64, 95%CI 0.83-3.24).ConclusionAdherence to trial medication was sub-optimal in TRACE-RA. This research hasimportance for adherence in RA populations, predictors of adherence to statintherapy, and interventions such as counselling or adherence programmes.Underlying attitudes, motivations and beliefs of non-adherent patients requirefurther examination. Advisors/Committee Members: KITAS, GEORGE G, VERSTAPPEN, SUZANNE S, SERGEANT, JAMIE JC, Symmons, Deborah, Kitas, George, Verstappen, Suzanne, Sergeant, Jamie.

Subjects/Keywords: adherence; statin; rheumatoid arthritis; cardiovascular event; primary prevention; TRACE-RA

Record DetailsSimilar RecordsGoogle PlusoneFacebookTwitterCiteULikeMendeleyreddit

APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Binkley, G. M. (2016). An investigation of adherence to statin therapy in patients with rheumatoid arthritis. (Doctoral Dissertation). University of Manchester. Retrieved from http://www.manchester.ac.uk/escholar/uk-ac-man-scw:306313

Chicago Manual of Style (16th Edition):

Binkley, George Michael. “An investigation of adherence to statin therapy in patients with rheumatoid arthritis.” 2016. Doctoral Dissertation, University of Manchester. Accessed October 20, 2020. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:306313.

MLA Handbook (7th Edition):

Binkley, George Michael. “An investigation of adherence to statin therapy in patients with rheumatoid arthritis.” 2016. Web. 20 Oct 2020.

Vancouver:

Binkley GM. An investigation of adherence to statin therapy in patients with rheumatoid arthritis. [Internet] [Doctoral dissertation]. University of Manchester; 2016. [cited 2020 Oct 20]. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:306313.

Council of Science Editors:

Binkley GM. An investigation of adherence to statin therapy in patients with rheumatoid arthritis. [Doctoral Dissertation]. University of Manchester; 2016. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:306313

.