Rheumatology International最新文献

{"title":"Cerebrovascular risk in rheumatoid arthritis patients: insights from carotid artery atherosclerosis in the Paracelsus 10,000 study.","authors":"Mathias Ausserwinkler, Sophie Gensluckner, Vanessa Frey, Isabella Gostner, Bernhard Paulweber, Eugen Trinka, Patrick Langthaler, Christian Datz, Bernhard Iglseder, Jens Thiel, Hans-Joerg Neumann, Maria Flamm, Elmar Aigner, Bernhard Wernly","doi":"10.1007/s00296-024-05781-4","DOIUrl":"10.1007/s00296-024-05781-4","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by systemic inflammation. While RA primarily affects the joints, its systemic effects may lead to an increased cerebro- and cardiovascular risk. Atherosclerosis of the carotid arteries is a significant risk factor for cerebrovascular events and serves as a surrogate marker for cardiovascular risk. This study explores the link between RA and carotid artery atherosclerosis with data from the Paracelsus 10,000 Study. Baseline assessments were conducted on individuals randomly selected from Salzburg and its surrounding regions. Participants diagnosed with RA based on ACR-EULAR classification criteria and who underwent carotid artery ultrasound were included. Data were gathered from a total of 9729 participants, among whom 299 were diagnosed with RA. Carotid arteries were examined using ultrasound imaging. The primary endpoint was the difference in the prevalence of plaque presence between the RA and non-RA groups. One univariate (Model I) and three multivariate analyses were conducted, with adjustments in Model II incorporating SCORE 2, while Model III accounted for metabolic syndrome, age and sex. Additionally, Model IV included further adjustments for high-sensitivity C-reactive protein (hs-CRP). Plaque presence was defined as the ultrasound detection of plaque formation larger than 0 mm², regardless of whether it was unilateral or bilateral. Additional assessments included carotid stenosis, intima-media thickness (IMT) and total plaque area (TPA). RA patients had a higher prevalence of plaque (50%) compared to non-RA individuals (38%). The odds ratio (OR) for plaque presence in RA patients versus non-RA individuals was 1.64 (95% CI 1.30-2.06). This association persisted after adjusting for SCORE2, with an adjusted odds ratio (aOR) of 1.65 (95% CI 1.26-2.15). The association remained significant when adjusting for metabolic syndrome, age and sex (aOR = 1.32, 95% CI 1.02-1.72) and also in Model IV, which included further adjustment for hs-CRP (OR = 1.33, 95% CI 1.02-1.74). The findings underscore an increased risk of cerebrovascular disease associated with RA. This study highlights the importance of thorough cerebrovascular and cardiovascular risk assessments, along with proactive management, for RA patients to reduce this risk. Recognizing the substantial impact of RA on stroke and cerebrovascular disease is important for enhancing patient care strategies. Carotid ultrasound appears to be an effective method for atherosclerosis screening in RA patients.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 2","pages":"33"},"PeriodicalIF":3.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-management behaviors do not affect remission but mediate between mental health and disease outcomes in a longitudinal study of rheumatoid arthritis.","authors":"Melissa Sweeney, Lewis Carpenter, Savia de Souza, Emma Caton, James Galloway, Andrew Cope, Mark Yates, Elena Nikiphorou, Sam Norton","doi":"10.1007/s00296-024-05761-8","DOIUrl":"10.1007/s00296-024-05761-8","url":null,"abstract":"<p><p>Mental health has been shown to impact rheumatoid arthritis (RA) outcomes and is associated with self-management behaviors. The extent to which mental health impacts outcomes via different self-management behaviours has not been thoroughly investigated. Adult RA patients who were starting a new medication or dosage were recruited to a prospective cohort with follow-ups at 3 and 12-months covering clinical and patient-reported outcomes. The longitudinal relationships between mental health, self-management behaviors (diet, physical activity, sleep, smoking, alcohol, and medication nonadherence), disease outcome, and function were assessed. Self-management behaviors were considered mediators of mental health at baseline on outcomes at 3 and 12 months. Depression did not worsen the odds of EULAR response for the total PHQ at 3 months (OR = 0.96, p = 0.36) or 12 months (OR = 0.99, p = 0.99) nor for the categorical PHQ at 3 months (OR = 0.64, p = 0.34) or 12 months (OR = 0.67, p = 0.44). Anxiety also did not worsen the odds of EULAR response for the total GAD at 3 months (OR = 0.98, p = 0.76) or 12 months (OR1.04, 0.53) nor for the categorical GAD at 3 months (OR = 0.99, p = 0.99) or 12 months (OR = 0.94, p = 0.75). However, depression was associated with the DAS-28 at 3 months (b = 0.22, p = 0.04). Among the self-management behaviors, insomnia was found to be a significant mediator between depression and the WSAS (b = 0.08, p = 0.03) as well as anxiety and the WSAS (b = 0.07, p = 0.03). Alcohol was also a significant mediator between depression and the DAS-28 (b = 0.21, p = 0.04). Mental health was associated with worse quality of life and disease outcomes, but not EULAR response. Self-management behaviors were associated with disease outcomes and mental health.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 2","pages":"31"},"PeriodicalIF":3.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Physical component of SF-36 is associated with measures of disease activity in patients with psoriatic arthritis: a real-life study from a tertiary referral centre.","authors":"Ines Doko Vajdić, Selma Cvijetić Avdagić, Frane Grubišić, Katarina Doko Šarić, Tonko Vlak, Hana Skala Kavanagh, Daniela Šošo, Simeon Grazio","doi":"10.1007/s00296-025-05790-x","DOIUrl":"https://doi.org/10.1007/s00296-025-05790-x","url":null,"abstract":"","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 2","pages":"32"},"PeriodicalIF":3.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an e-self-management intervention (Happy Hands app) for hand osteoarthritis: Study protocol for a multicentre randomised controlled trial.","authors":"Anne Therese Tveter, Kristine Aasness Fjeldstad, Cecilie Varsi, Marit Kristin Maarnes, Stein Jarle Pedersen, Barbara S Christensen, Thalita Blanck, Sissel B Nyheim, Yeliz Prior, Mathilda Björk, Tim Pelle, Ingvild Kjeken","doi":"10.1007/s00296-025-05787-6","DOIUrl":"10.1007/s00296-025-05787-6","url":null,"abstract":"<p><strong>Objective: </strong>This protocol paper describes the rationale and design of a randomised controlled trial (RCT) that aims to evaluate the (cost-)effectiveness of a 12 week e-self-management intervention (Happy Hands app) in people with hand osteoarthritis (HOA).</p><p><strong>Methods: </strong>In this multicentre RCT, 376 people with HOA will be recruited from all four health regions in Norway. Consenting participants will be randomly allocated to either a control group receiving usual care or an intervention group receiving the Happy Hands app in addition to usual care. Primary outcome will be measured at 3-months follow-up as the proportion of participants classified as OMERACT-OARSI responders (a composite score comprising change in pain, function, and disease activity), analysed using logistic regression. Secondary outcomes, including pain, hand function, stiffness, quality-of-care, health-related quality-of-life, grip strength, adherence and healthcare costs will be measured at 3- and 6-months follow-up.</p><p><strong>Results: </strong>Recruitment was initiated in November 2022 with a total of 386 participants recruited by August 2023, 194 in the intervention group and 192 in the control group. Data collection was completed in February 2024.</p><p><strong>Discussion: </strong>To our knowledge, this is one of the first large-scale, multicentre RCTs assessing the (cost-)effectiveness of a self-management program delivered through a smartphone app for people with HOA. The results from this trial can enhance our understanding of the role technology can play in managing HOA.</p><p><strong>Trial registration: </strong>NCT05568875 ( https://clinicaltrials.gov/study/NCT05568875 , pre-registered October 3, 2022).</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 1","pages":"30"},"PeriodicalIF":3.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset Systemic Lupus Erythematosus.","authors":"Prakashini Mruthyunjaya, Sakir Ahmed, Aliya Botabekova, Chokan Baimukhamedov, Olena Zimba","doi":"10.1007/s00296-024-05784-1","DOIUrl":"10.1007/s00296-024-05784-1","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a multisystem autoimmune rheumatic disease (ARD) that results from the dysregulation of multiple innate and adaptive immune pathways. Late-onset SLE (Lo-SLE) is the term used when the disease is first diagnosed after 50-65 years, though the standard age cut-off remains undefined. Defining \"late-onset\" as lupus with onset after 50 years is more biologically plausible as this roughly corresponds to the age of menopause. Lo-SLE comprises nearly 20% of all cases of lupus. With advancing age, the female predominance of lupus declines to nearly 4:1 to even 1.1:1. The natural history of the disease varies, with lesser major organ involvement like nephritis but higher damage accrual. The latter is possibly owed to the atypical presentation and hesitation among physicians to diagnose SLE at this age, a diagnostic delay with late treatment initiation may accelerate the damage accrual. Multimorbidity is a central issue in these patients, which includes osteoporosis, sarcopenia, accelerated atherosclerosis in the background of existing dyslipidemia, diabetes mellitus, major depression, hypertension, coronary artery disease and other thrombotic events.With the rising ages of populations worldwide, awareness about late-onset lupus is paramount, especially due to the associated diagnostic delays and higher overlap with Sjogren's disease. Also, pharmacotherapeutics must be optimized considering factors associated with ageing like declining glomerular filtration rate (GFR), sarcopenia, osteoporosis, and the associated comorbidities. Measures to minimize the exposure to long-term exposure to high-dose steroids are crucial. Beyond this, it is of essence to adopt non-pharmacological interventions as an adjunct to traditional immunosuppression to improve pain, fatigue, depression, and anxiety, improve cardiovascular health and overall better quality of life with favourable long-term outcomes.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 1","pages":"29"},"PeriodicalIF":3.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated inflammatory involvement of the occipital artery in giant cell arteritis and polymyalgia rheumatica: findings from a retrospective analysis and the critical role of MRI in diagnosis.","authors":"Konstanze V Guggenberger, Lukas Riedling, Daria Kern, Rudolf A Werner, Marius L Vogt, Matthias Fröhlich, Marc Schmalzing, Mirko Pham, Thorsten A Bley","doi":"10.1007/s00296-024-05765-4","DOIUrl":"10.1007/s00296-024-05765-4","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of Giant Cell Arteritis (GCA) and Polymyalgia rheumatica (PMR) may be challenging as many patients present with non-specific symptoms. Superficial cranial arteries are predilection sites of inflammatory affection. Ultrasound is typically the diagnostic tool of first choice supplementary to clinical and laboratory examination. Inflammation of temporal arteries can be detected sonographically with high reliability. However, due to the vessel's course and location, occipital arteries evade sonographic detectability.</p><p><strong>Objective: </strong>The aim of our study was to evaluate the infestation pattern of superficial cranial arteries in GCA and PMR patients with special focus on the occipital arteries.</p><p><strong>Methods: </strong>90 treatment-naïve patients with clinically and/or histologically proven GCA and/or PMR (51 GCA, 20 PMR, 10 GCA-PMR) were included in the study. All patients underwent contrast-enhanced, fat-suppressed, high-resolution black blood 2D T1-weighted spin echo imaging at 3T MRI. Images were read by three different readers independently. Temporal and occipital arteries were assessed regarding vasculitic affection. Circumferential mural hyperenhancement and thickening of the vessel wall ≥ 600 μm was considered positive for vasculitis.</p><p><strong>Results: </strong>9/90 (10%) of all patients revealed inflammatory changes of the occipital artery only. Prevalence of isolated inflammatory affection of occipital artery was even higher in the GCA subgroup with 7/51 (14%) patients.</p><p><strong>Conclusion: </strong>14% of GCA patients and 10% of GCA-PMR patients present with signs of inflammation of the occipital artery only. Since the occipital artery is not accessible to routine ultrasound examination, MRI renders incremental value in the diagnosis of GCA and PMR patients.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 1","pages":"27"},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypermobile type Ehlers-Danlos syndrome and generalized hypermobile spectrum disorder treatment preferences - a cross-sectional survey of patients.","authors":"Patricia Teran-Wodzinski, Ambuj Kumar","doi":"10.1007/s00296-024-05782-3","DOIUrl":"https://doi.org/10.1007/s00296-024-05782-3","url":null,"abstract":"<p><p>We aimed to assess the typical experiences, desired outcomes, satisfaction with clinical and anticipated outcomes, and the importance of improvements for individuals with Hypermobile Ehlers-Danlos Syndrome (hEDS) and Generalized Hypermobility Spectrum Disorder (G-HSD). A cross-sectional survey was conducted among adults aged 18 and above with hEDS and G-HSD. The survey included the Patient-Centered Outcome Questionnaire and an adapted version addressing common concerns in these individuals. Descriptive statistics were used for analysis. The survey received 483 responses with an 82% completion rate. Most respondents were females (90%), aged 21-30 (30%), living in North America (76%), and diagnosed with hEDS (80%). Participants diagnosed with hEDS reported higher typical levels of pain compared to those diagnosed with G-HSD and higher expected levels of pain and interference with daily activities post-treatment (p < 0.05). The areas of most significant concern were pain, fatigue, interference with daily activities, and walking issues. Our findings revealed no differences in how individuals from both groups rated their treatment expectations, except for the usual pain level and the expected pain level and interference with daily activities post-treatment. Patients' perspectives are essential for developing appropriate treatment plans and improving outcomes for this patient population. Our results will hopefully inform the development of new interventions to impact outcomes that matter to individuals with hEDS and G-HSD.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 1","pages":"25"},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporomandibular joint septic arthritis: a report of thirteen cases and a systematic review of the literature.","authors":"Florent Barry, Matthias Schlund, Jean-François Guignardat, Pierre-Antoine Dubreuil, Constance Delmotte, Joël Ferri, Romain Nicot","doi":"10.1007/s00296-024-05754-7","DOIUrl":"10.1007/s00296-024-05754-7","url":null,"abstract":"<p><strong>Introduction: </strong>Temporomandibular joint (TMJ) septic arthritis is a rare frequently misdiagnosed condition with non-specific symptoms. We present our experience of thirteen cases of TMJ septic arthritis and perform a systematic review of the literature to collate the multiple characteristics of this condition.</p><p><strong>Material and method: </strong>A total of 133 cases of TMJ septic arthritis in humans across 62 studies were analyzed by searching PubMed, Cochrane Library, DOAJ and ClinicalTrials.gov using the following search terms: \"TMJ septic arthritis,\" \"Temporomandibular septic arthritis,\" \"TMJ infectious arthritis,\" and \"Temporomandibular infectious arthritis.\"</p><p><strong>Results: </strong>We identified three routes of TMJ septic arthritis dissemination: the hematogenous route, direct inoculation, and local contiguity. Joint and rheumatic pathologies and immunomodulatory diseases are risk factors. The most frequently causative bacterial genus is Staphylococcus, followed by Streptococcus. Causative bacteria can be identified by bacteriological analysis. Magnetic resonance imaging, computed tomography (CT), and scintigraphy can be used for diagnosis, but CT is the gold standard in an emergency setting. Blood tests often reveal a high C-reactive protein concentration and high leukocyte counts. Signs and symptoms include preauricular swelling and trismus, and, less commonly, fever, ipsilateral hemifacial pain, joint disorder, and malocclusion with mandibular deviation. Timely treatment is key to avoid short and long-term complications, because proteolytic enzymes from granulocytes can cause irreversible damage within 7 days. Antibiotic therapy, arthroplasty, and physiotherapy are commonly used treatment modalities.</p><p><strong>Conclusion: </strong>TMJ septic arthritis can be misdiagnosed due to its non-specific clinical manifestations. Complications can occur; thus, timely and effective treatment is key.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 1","pages":"28"},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery calcification progression and renal involvement in patients with systemic lupus erythematosus: a longitudinal cohort study.","authors":"Lise Zinglersen, Amanda Hempel Zinglersen, Katrine Aagaard Myhr, Marie-Louise Hermansen, Klaus Fuglsang Kofoed, Andreas Fuchs, Louise P Diederichsen, Søren Jacobsen","doi":"10.1007/s00296-025-05785-8","DOIUrl":"10.1007/s00296-025-05785-8","url":null,"abstract":"<p><p>To investigate if progression of coronary artery calcification (CAC) in patients with systemic lupus erythematosus (SLE) is associated with renal and traditional cardiovascular risk factors as well as incidence of myocardial infarctions. CAC progression was evaluated by cardiac computed tomography (CT) at baseline and after 5 years. Multivariable Poisson regression was applied to investigate associations between CAC progression and baseline values for traditional cardiovascular risk factors, CAC, SLE disease duration, lupus nephritis, and renal function. Regarding renal function, three groups were defined based on eGFR. Further, we analysed association between CAC progression and myocardial infarction during follow-up. Of the 147 SLE patients, 99 had cardiac CT at baseline and 5-year follow-up, with a total of 502 patient-years. At baseline, their median age was 47 years, median SLE disease duration was 14 years, 88% were women, 58% had lupus nephritis, and the median eGFR was 99 mL/min/1.73m². 38/99 (39%) had CAC progression. CAC progression was associated with smoking (ever) (relative risk [RR] 1.69, CI95% 1.19-2.40), SLE disease duration (RR per year 1.03, CI95% 1.01-1.04), and CAC presence (RR 2.52, CI95% 1.68-3.78) at baseline. During follow-up, myocardial infarction occurred in three (7.9%) CAC progressors and in two (3.3%) patients who did not have CAC at any time (RR 2.1, CI95% 0.0-5.5). In this study, progression of CAC was associated with smoking, SLE disease duration and the prior presence of CAC, but it was inconclusive as to associations with renal involvement and incidence of MI.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 1","pages":"26"},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue patterns surrounding biologic disease-modifying antirheumatic drug injection in patients with an inflammatory rheumatic disease: an ecological momentary assessment study.","authors":"Jette A van Lint, Johanna E Vriezekolk, Naomi T Jessurun, Alfons A den Broeder, Bart J F van den Bemt, Victor J B Huiskes","doi":"10.1007/s00296-024-05779-y","DOIUrl":"10.1007/s00296-024-05779-y","url":null,"abstract":"<p><p>This study investigated severity, course and patterns of fatigue surrounding subcutaneous biological disease-modifying antirheumatic drug (bDMARD) injection in inflammatory rheumatic disease (IRD) patients using ecological momentary assessments and investigated self-reported adverse drug reactions (ADRs). In this prospective cohort study, IRD patients completed fatigue severity numeric rating scales (0-10) in web-based ecological momentary assessments in three waves of five days surrounding bDMARD injection. The course of fatigue was measured by the change in fatigue from pre-dosing to post-dosing scores and was classified as: worsening, improving or no clinically relevant change. A pattern was defined as a course of worsening, improving or no clinically relevant change in fatigue in at least two out of three waves for patients completing assessments across all three waves. ADRs could be reported on day five of each wave. In total 609 participants completed ecological momentary assessments surrounding 1541 bDMARD injections. Overall average fatigue severity across all three waves was 4.5 (± SD 2.4) and 78% experienced severe fatigue in at least one assessment. Of 398 patients completing all three waves, 61% had no clinically relevant change in fatigue in at least two out of three waves, 13% had a pattern of worsening fatigue and 18% had a pattern of improving fatigue. Of 398 patients, 36% had a consistent pattern in all three waves. IRD patients using a bDMARD may consistently experience specific fatigue patterns surrounding bDMARD administration. These patterns provide insights for clinical practice and could be used to inform patients properly.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 1","pages":"24"},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}