Therapeutic efficacy and safety of chaperonin 10 in patients with rheumatoid arthritis: A double-blind randomised trial

Background Chaperonin 10 (heat shock protein 10, XToll(TM)) has anti-inflammatory properties related to the inhibition of Toll-like receptor signalling pathways. Our aim was to establish whether chaperonin 10 is safe and effective in the treatment of rheumatoid arthritis. Methods in this randomised, double-blind, multicentre study, 23 patients with moderate to severe active rheumatoid arthritis receiving disease-modifying antirheumatic drugs were randomly allocated to three treatment groups receiving intravenous chaperonin 10 twice weekly for 12 weeks at doses of 5 mg (n=8), 7.5 mg (8), or 10 mg (7). The primary outcomes were change in disease activity score (DAS28) and improvement of core disease measures (American College of Rheumatology response score) from baseline to week 12. All analyses were done by intention to treat. This study is registered with the Australian Clinical Trials Registry, number ACTRNO12606000041550. Findings Primary endpoint measures improved from day 14 in all groups and continued to improve to day 84. By end of study, a 20% improvement of core disease measures was seen in six (86%, 95% Cl 43-100), a 50% improvement in four (57%, 14-86), and a 70% improvement in two (29%, 0-57) patients given the highest dose of chaperonin 10. Clinical remission (as defined by a DAS28

Therapies for axial disease in psoriatic arthritis. A systematic review

Prevalence rates for axial involvement in psoriatic arthritis (PsA) vary from 40% to 74% depending upon criteria for diagnosis. In the absence of trial evidence to assess axial involvement in PsA. the GRAPPA croup, by consensus, has suggested that outcome measures and therapies for axial disease ill ankylosing spondylitis (AS) be used. This systematic review addresses the management of axial disease in PsA, and provides treatment recommendations based oil the AS literature.

Prediction of steady-state flux through variably saturated zones within a septic absorption trench

This paper describes effluent flow dynamics within a septic absorption system and the prediction of flow through the biomat and sub-biomat zone. Using soil hydraulic properties in a one dimensional model we demonstrate how soil hydraulic properties interact with biomat resistances to determine long-term acceptance rate (LTAR). The LTAR is a key parameter used in the Australian and New Zealand Standard AS1547:2000 to calculate the area of trench required to ensure trenches are not overloaded. Results show that several orders of magnitude variation in saturated hydraulic conductivity (Ks) collapse to a one order of magnitude variation in LTAR. These results are calculated from a model using basic flow theory, allowing LTAR to be estimated for any combination of biomat resistance and soil hydraulic properties. To increase the reliability of prediction of septic trench hydrology, HYDRUS 2D was used to model two dimensional flow. For more permeable soils, the exfiltration zone above sidewall biomat growth is shown to be a key pathway for excess effluent flow.