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`Frontier Therapeutics Exhibit 1022
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`VOL. 15, NO. 1
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`JANUARY-FEBRUARY 1972
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`arthritis
`and
`rheumatism
`
`Official Journal of The American Rheumatism Association
`Section of The Arthritis Foundation
`
`ARTHRITIS AND RHEUMATISM is the official journal of the American
`Rheumatism Association, Section of the Arthritis Foundation, 1212 Avenue of
`the Americas, New York, NY 10036.
`
`EDITORIAL COMMUNICATIONS should be sent to the Editor, Charles L.
`Christian, MD, Hospital for Special Surgery, 535 E 70 St, New York, NY 10021.
`Book Reviews. Books and monographs treating the same subject matter as this
`Journal will be reviewed as space permits. Send books for review to the Editor.
`
`BUSINESS COMMUNICATIONS, including all correspondence concerning
`subscriptions, changes of address, reprints, etc, should be sent to the publisher,
`Harper & Row, Publishers, Inc, 2350 Virginia Avenue, Hagerstown, Maryland
`21740.
`
`SUBSCRIPTION RATES are $10.00 per year for members within the USA;
`$11.00 for members elsewhere. $18.00 for nonmembers within the USA; $19.00
`for nonmembers elsewhere. Students, fellows, interns and residents are eligible
`for a special reduced rate of $10.00 per year. (A letter giving qualifying data
`must accompany such orders.) All subscriptions are on a calendar year basis.
`Single copies $3.00. RemiHances for subscriptions should be made by check,
`draft, post office or express money order to the publisher. The publisher
`should be advised of change of address at least 30 days before publication,
`with both the subscriber's old and new addresses being given.
`
`ADVERTISING OFFICES: Pharmaceutical Media Associates, 150 East 58th
`Street, New York, New York 10022. All advertising is subject to editorial review.
`
`~
`
`Published bimonthly by the Medical Department, Harper & Row, Publishers,
`Inc, 2350 Virginia Avenue, Hagerstown, Maryland 21740. Printed at 2901
`Byrdhill Road, Richmond, Va. 23228. Second-class postage paid at Hagers-
`town, Md. and additional offices.
`
`.
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`Copyright 1972 The Arthritis Foundation. New York, NY 10036. All rights reserved.
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`in phagocytosis of a single particle (ag~egate) ; c)
`When a vacuole remained connected to the exterior
`by a narrow channel; d) When extrusion of gran(cid:173)
`ules preceded the complete closing of pseudopods
`around the aggregates. In contrast, if soluble aggre(cid:173)
`gates of immunoglobulins (ie, not particulate) were
`incubated with neutrophils in suspension, release
`
`of enzymes did not occur. However, when such
`soluble aggregates were previously adsorbed to a
`large surface (eg, a mii:ropore filter) , they became
`highly active causing the release of enzymes from
`adherent neutrophils. This release occurred by a
`direct extrusion of granules from the cell.
`
`ABSTRACTS
`
`Methotrexate in Rheumatoid Arthritis
`REX T. HOFFMEISTER, Spokane, Washington
`
`This study was undertaken to determine whether
`methotrexate might be effective
`in rheumatoid
`arthritis in doses low enough to be free of unaccept(cid:173)
`able side effects. Twenty-nine patients with classic
`or definite adult rheumatoid arthritis have been
`treated with a single 10 to 15 mg dose once every
`7 days. All had active, severe disease in spite of con(cid:173)
`ventional therapy. Most were on 5 mg Prednisone
`daily, or less. All but 6 had received gold and ex(cid:173)
`hibited either toxicity or failure with chrysotherapy.
`Twenty-three were seropositive for RA factor. The
`average age was 56.5 years, with a range of 28 to 80.
`Average duration of RA was 11.5 years. Average
`duration of methotrexate therapy was 25.5 months.
`Twelve patients are still on therapy; 7 for 36 to
`48 months, 2 for 24 to 36 months, I for 12 to 24
`months, and 2 for less than 12 months. In the re(cid:173)
`maining 17 patients therapy was discoptinued be(cid:173)
`cause of remission in 3, no improv«:;ment in 2,
`hepatic toxicity in 4, intolerance in 5, change of
`residence in 3.
`Multiple parameters were evaluated weekly the
`
`first 4 weeks and monthly thereafter. Most factors
`were graded on basis of 0 to III. A change of three
`grades was considered major, two grades moderate
`and by one grade a minor change. Approximately
`half of the patients showed moderate or marked
`improvement in morning stiffness, fatigue, pain,
`swelling and decrease in sedimentation rate. Most
`showed definite improvement in joint count and
`grip strength. Improvement of functional capacity
`was moderate in 7, mild in 15 and absent in 7.
`Clinical improvement was estimated as major in 11,
`moderate in 14, and minor or none in 4. Decrease
`in dosage below 10 mg every 7 days, or discontinu(cid:173)
`ing therapy, produced definite deterioration in 22
`patients. Only I patient has shown significant eleva(cid:173)
`tion in SGOT. Eighteen liver biopsies in 14 patients
`have shown mild portal fibrosis in 3 patients, all of
`whom had been on therapy for 3 years or more and
`had normal SGOT.
`Further evaluation of methotrexate in RA ap(cid:173)
`pears warranted.
`
`Superficial Temporal Arteriography
`G. G. HUNDER, H. L BAKER, A. L. RHOTON, S. G. SHEPS and L. E. WARD, Rochester, MinnesOta
`
`The early recognition of temporal arteritis (T A)
`is frequently difficult because clinical findings are
`commonly nonspecific and vascular involvement may
`he segmental and missed on random biopsy. Because
`arteriograms permit examination of the entire tem(cid:173)
`poral arteries, it has been suggested that temporal
`arteriography may he helpful in the diagnosis of
`TA.
`In this study superficial temporal arteriography
`was performed under local anesthesia using magnifi(cid:173)
`cation technics on 31 patients suspected of having
`T A. The prearteriographic diagnosis in most was
`
`polymyalgia rheumatica. Biopsies from one or both
`temporal arteries were obtained from each patient
`at the time of arteriography. Mean biopsy specimen
`length was 5.5 em; serial sections were examined
`histologically. Nineteen females and 12 males, aged
`55 to 80 (mean 68) were studied.
`In 24 patients arteriograms showed smooth arte·
`rial channels. Collateral arteries and veins filled
`promptly. Histologic examination of biopsies showed
`no abnormalities or only minimal intimal fibrosis.
`In 5 other patients the arteriograms showed areas
`of irregular constriction and dilation of the arterial
`
`114
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`Arthritis and Rheumatism, Vol. 15, No. 1 (January-February 1972)
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`J
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