Rheumatology Advances in Practice最新文献

{"title":"Recording of non-musculoskeletal manifestations, comorbidities and safety outcomes in European spondyloarthritis registries: a survey.","authors":"Zohra F Ahmadzay, Jette Heberg, Jacob B Jørgensen, Lykke M Ørnbjerg, Mikkel Østergaard, Signe Møller-Bisgaard, Brigitte Michelsen, Anne Gitte Loft, Gareth T Jones, Pasoon Hellamand, Almut Scherer, Michael J Nissen, Karel Pavelka, Jakub Závada, Karin Laas, Sigrid Vorobjov, Dan Nordström, Tuulikki Sokka-Isler, Anne C Regierer, Andreas Reich, Bjorn Gudbjornsson, Katrin Thorarinsdottir, Florenzo Iannone, Ennio Giulio Favalli, Marleen van de Sande, Sella Aarrestad Provan, Tore K Kvien, Ana Maria Rodrigues, Cátia F Gonçalves, Catalin Codreanu, Corina Mogosan, Ziga Rotar, Katja Perdan Prikmajer, Isabel Castrejon, Lucía Otero-Varela, Daniela Di Giuseppe, Johan K Wallman, Adrian Ciurea, Burkhard Möller, Gökçe Kenar-Artın, Tuba Demirci Yıldırım, Gary J Macfarlane, Ovidiu Rotariu, Bente Glintborg, Merete Lund Hetland","doi":"10.1093/rap/rkae135","DOIUrl":"10.1093/rap/rkae135","url":null,"abstract":"<p><strong>Objectives: </strong>Real-world evidence is needed to inform treatment strategies for patients with PsA and axial SpA (axSpA) who have non-musculoskeletal manifestations (NMMs), various risk factors and comorbidities. International collaboration is required to ensure statistical power and to enhance generalizability. The first step forward is identifying which data are currently being collected. Across 17 registries participating in the European Spondyloarthritis Research Collaboration (EuroSpA), we aimed to map recording practices for NMMs, comorbidities and safety outcomes in patients with PsA and axSpA.</p><p><strong>Methods: </strong>Through a survey with 4,420 questionnaire items, we explored the recording practices of 58 pre-defined conditions (i.e. NMMs, comorbidities and safety outcomes) covering 10 disease areas. In all registries we mapped for each condition whether it was recorded, the recording procedure and the potential to identify it through linkage to other national registries.</p><p><strong>Results: </strong>Conditions were generally recorded at entry into the registry and clinical follow-up visits using a pre-specified list or a coding system. Most registries recorded conditions within the following disease areas: NMMs (number of registries, <i>n</i> = 15-16), cardiovascular diseases (<i>n</i> = 10-14), gastrointestinal diseases (<i>n</i> = 12-13), infections (<i>n</i> = 10-13) and death (<i>n</i> = 14). Nordic countries had the potential for data linkage and generally had limited recording of conditions in their registry, while other countries had comprehensive recording practices.</p><p><strong>Conclusion: </strong>A wide range of conditions were consistently recorded across the registries. The recording practices of many conditions and disease areas were comparable across the registries. Our findings support the potential for future collaborative research.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae135"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramuscular methylprednisolone in hand osteoarthritis: a retrospective cohort study.","authors":"Merel Hartog, Jelle van Berkel, Bart J F Van den Bemt, Cornelia H M van den Ende, Calin D Popa","doi":"10.1093/rap/rkae136","DOIUrl":"10.1093/rap/rkae136","url":null,"abstract":"<p><strong>Objectives: </strong>To explore patient characteristics associated with response to intramuscular methylprednisolone (MP) therapy in hand OA.</p><p><strong>Methods: </strong>We performed an exploratory monocentric retrospective study. Patients with a clinical diagnosis of hand OA who visited our outpatient clinic between July 2016 and June 2021 and received at least once an intramuscular MP injection were included. Clinical data, including laboratory and radiologic results, were retrieved from electronic patient records (EPRs). Patients' reported response to MP and its duration in the first 6 months after injection was based on free text from the EPRs. Response was categorized into three groups: no response or worsening of symptoms, modest response and good response. Duration of response was categorized as short-term (<2 weeks) or long-term (≥2 weeks). Multivariable logistic regression models were performed to determine factors associated with good response to therapy with MP.</p><p><strong>Results: </strong>Data from 262 hand OA patients (76% female) were analysed. A good response was experienced by 150 patients (57.2%). Among those with modest-good response, the perceived response of 162 patients (80.6%) lasted ≥2 weeks. Univariate regression analysis indicated that the level of CRP was associated with good response [odds ratio 1.08 (95% CI 1.00, 1.17)]. However, multivariate regression analysis showed no statistically significant associations.</p><p><strong>Conclusion: </strong>In this retrospective study, more than half of hand OA patients displayed good response to intramuscular MP administration. The possible relation between the presence of low-grade inflammation and the response to this therapy warrants further investigation.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae136"},"PeriodicalIF":2.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similarities and differences in self-reported symptoms and comorbidities between hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders.","authors":"Ashley A Darakjian, Mira Bhutani, DeLisa Fairweather, S Christian Kocsis, Jessica J Fliess, Sami Khatib, Gabe J Weigel, Elizabeth J McCabe, Varsini Balamurugan, Evan E Perona, Jessica M Gehin, Emily R Whelan, Angita Jain, Hanna Sledge, David O Hodge, Todd D Rozen, Francis A Farraye, Ozan Soyer, Joseph Cheung, Stephanie L Grach, David Shirey, Shilpa Gajarawala, Bala Munipalli, Chrisandra L Shufelt, Dacre R T Knight, Katelyn A Bruno","doi":"10.1093/rap/rkae134","DOIUrl":"10.1093/rap/rkae134","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD) experience a wide array of symptoms and system disorders. This study aimed to identify whether differences occurred in 115 self-reported symptoms and comorbidities in patients diagnosed with hEDS or HSD.</p><p><strong>Methods: </strong>In this study we analysed self-reported data from an EDS Clinic intake questionnaire in patients diagnosed with hEDS, HSD or no hypermobile conditions.</p><p><strong>Results: </strong>From 1 November 2019 to 7 March 2024, the EDS Clinic saw 2088 patients. Using the 2017 diagnostic criteria, 66.5% were diagnosed with HSD (<i>n</i> = 1389), 20.3% with hEDS (<i>n</i> = 423), 10.6% with historic HSD (H-HSD) or localized HSD (L-HSD) (<i>n</i> = 256) (hypermobile controls) and 2.6% were not diagnosed with hEDS, HSD, H-HSD or L-HSD (<i>n</i> = 55) (controls). Symptoms/comorbidities that occurred with high prevalence in both hEDS and HSD included joint pain (hEDS 82.0%, HSD 88.9%), allergy (hEDS 77.0%, HSD 77.0%), subluxations (hEDS 71.2%, HSD 72.6%), brain fog (hEDS 70.0%, HSD 74.7%), headache (hEDS 68.1%, HSD 69.1%), anxiety (hEDS 60.3%, HSD 69.3%), depression (hEDS 52.2%, HSD 58.0%), migraine (hEDS 53.7%, HSD 52.5%), nausea (hEDS 54.6%, HSD 59.5%) and constipation (hEDS 53.0%, HSD 57.2%). In contrast, 9/115 (8%) symptoms/comorbidities were self-reported significantly more often in hEDS but 42/115 (37%) in HSD. hEDS patients reported more symptoms that suggest a defect in collagen, such as dislocation, hernias and rectal prolapse, while HSD patients reported more joint, muscle, allergy, neurological, gastrointestinal, sleep and psychological symptoms/comorbidities.</p><p><strong>Conclusion: </strong>Although we found an overlap in some symptoms and comorbidities self-reported by hEDS/HSD patients, such as allergy/atopy, headache/migraine and gastrointestinal symptoms, our findings suggest key differences exist between the two diagnoses, suggesting that hEDS and HSD may be distinct conditions.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae134"},"PeriodicalIF":2.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise and footwear in medial knee osteoarthritis: a randomized controlled trial comparing flat flexible footwear to stable supportive shoes.","authors":"Paolo Dainese, Jan Stautemas, Sophie De Mits, Ruth Wittoek, Ans Van Ginckel, Wouter Huysse, Heleen Demeyer, Hanne Mahieu, Patrick Calders","doi":"10.1093/rap/rkae133","DOIUrl":"10.1093/rap/rkae133","url":null,"abstract":"<p><strong>Objective: </strong>This randomized controlled trial (RCT) investigated whether adding daily use of flat flexible footwear (FFF) to a strengthening and aerobic exercise program improved short- and longer-term outcomes compared with adding stable supportive shoes (SSS) in people with medial tibiofemoral OA.</p><p><strong>Methods: </strong>Participants (<i>n</i> = 97) with medial tibiofemoral OA were randomly assigned (1:1) to the FFF (<i>n</i> = 50) or SSS (<i>n</i> = 47) group. Participants in both groups received a 9-month intervention (3 months supervised followed by 6 months unsupervised exercise). The primary outcome was the change in knee pain on walking at 3 months measured using an 11-point numeric rating scale (NRS). Secondary outcomes included the change from baseline to 3 and 9 months in the severity of knee pain overall (NRS), physical function (WOMAC subscale), habitual physical activity level (Physical Activity Scale for the Elderly), quality of life (QoL) (European Quality of Life 5-Dimensions 5-Levels questionnaire) and markers of inflammation (effusion and Hoffa synovitis) and structural disease progression (bone marrow lesions).</p><p><strong>Results: </strong>There were no significant differences between the groups in the change in pain on walking [between-group difference -0.67 (95% CI -1.62, 0.29)] at 3 months. Knee pain on walking and overall knee pain significantly decreased in both groups at 3 and 9 months. Physical function and QoL improved in both groups at 3 and 9 months. We found no between-group differences in any secondary outcome at any time.</p><p><strong>Conclusions: </strong>FFF added to exercise therapy did not provide additional better symptom nor structure-modification benefit compared with conventional SSS and exercise in people with medial tibiofemoral OA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (http://clinicaltrials.gov), NCT03796832.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae133"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scleroderma renal crisis, an increasingly rare but persistently challenging condition: a retrospective cohort study.","authors":"Rushab C Shah, Kathleen Morrisroe, Wendy Stevens, Nava Ferdowsi, Susanna Proudman, Mandana Nikpour, Laura J Ross","doi":"10.1093/rap/rkae131","DOIUrl":"10.1093/rap/rkae131","url":null,"abstract":"<p><strong>Objective: </strong>Scleroderma renal crisis (SRC) is associated with high morbidity and mortality and there remain unmet needs regarding early identification and treatment. We aimed to assess risk factors for and the outcomes of SRC at a large Australian tertiary hospital.</p><p><strong>Methods: </strong>Seventeen incident SRC cases were diagnosed between 2012 and 2022. Demographic, SSc manifestations and treatment data were extracted. Using data from the Australian Scleroderma Cohort Study (<i>n</i> = 483), logistic regression analysis was performed to identify risk factors for SRC.</p><p><strong>Results: </strong>The prevalence of SRC was 3.52%. The median SSc disease duration at SRC onset was 2 years [interquartile range (IQR) 1-4]. Peak creatinine occurred at a median of 11 days (IQR 5-14) post-SRC diagnosis, with a median peak creatinine of 144 µmol/l (IQR 86-306). Nine (52.94%) SRC patients had evidence of acute neurologic and/or cardiac complications. Acute haemofiltration was required in 3 (17.65%) patients. Over the follow-up period, 7 (41.18%) SRC patients died 2.75 years (IQR 0.74-7.25) after SRC onset. Patients with SRC were more likely to be male [odds ratio (OR) 9.73 (95% CI 3.57, 26.56)], have diffuse disease [OR 23.16 (95% CI 5.22, 102.80)] and have antibodies to Scl70 [OR 3.34 (95% CI 1.24, 9.04)] or RNA polymerase III (RNAPIII) [OR 5.15 (95% CI 1.91, 13.89)].</p><p><strong>Conclusion: </strong>SRC is an uncommon manifestation, but outcomes remain poor. A significant proportion of patients presenting with SRC in Australia are positive for Scl70 or RNAPIII antibody. Despite relatively low peak serum creatinine and rates of renal replacement therapy, SRC was still associated with significant mortality.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae131"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and future advances in practice: SAPHO syndrome and chronic non-bacterial osteitis (CNO).","authors":"Victoria Furer, Mitsumasa Kishimoto, Tetsuya Tomita, Ori Elkayam, Philip S Helliwell","doi":"10.1093/rap/rkae114","DOIUrl":"https://doi.org/10.1093/rap/rkae114","url":null,"abstract":"<p><p>Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a rare, underdiagnosed disease with a wide clinical spectrum. Sterile bone inflammation, predominantly of the anterior chest, and skin manifestations (palmoplantar pustulosis, psoriasis vulgaris and acne) are the key features of SAPHO, which shares certain similarities with SpA. SAPHO is closely related to paediatric chronic non-bacterial osteitis (CNO), a spectrum of autoinflammatory bone diseases. The aetiology of SAPHO is considered multifactorial based on a complex interplay of genetic, immune and infectious factors. Despite the increasing awareness of SAPHO/CNO, diagnostic delay is common, as validated classification and diagnostic criteria are lacking. Treatment of SAPHO represents a challenge and includes anti-inflammatory drugs, antibiotics, bisphosphonates, synthetic conventional DMARDs and off-label use of anti-cytokine biologics and Janus kinase inhibitors. This review summarizes the current diagnostic and practical treatment approach to SAPHO/CNO and highlights the ongoing research endeavours concerning the definition and validation of diagnostic criteria, core domains and treatment.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae114"},"PeriodicalIF":2.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11474108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analysis and systematic review of the use of transition tools for patients transitioning from paediatric to adult rheumatology services.","authors":"Kiron Griffin, Fiona Pearce, Jonathan Packham","doi":"10.1093/rap/rkae130","DOIUrl":"10.1093/rap/rkae130","url":null,"abstract":"<p><strong>Objectives: </strong>Transitioning from paediatric to adult care can be challenging, but transition tools are designed to increase successful rates of transfer. We aimed to conduct a meta-analysis and systematic review of the use of transition tools in the transfer of care from paediatric to adult services for rheumatology patients.</p><p><strong>Methods: </strong>An extensive literature search was conducted using MEDLINE, PubMed and Embase. A total of 12 papers were included in the systematic review and 8 in the meta-analysis looking at the use of transition tools in successful follow-up in adult clinics.</p><p><strong>Results: </strong>The meta-analysis showed 86.6% (95% CI 53.3, 80.6) of patients who used a transition tool attended an adult outpatient clinic within 1 year of their last paediatric appointment, compared with 67.7% (95% CI 56.7, 99.7) of patients who successfully transferred without a transition tool.</p><p><strong>Conclusions: </strong>The systematic review demonstrated several unique transition tools with local success, but no dominant method. This article demonstrated a general positive influence of transition tools on successful transfer, but more research is needed to strengthen the association.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae130"},"PeriodicalIF":2.1,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11593498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of over-the-counter supplements, sleep aids and analgesic medicines in rheumatology: results of a cross-sectional survey.","authors":"Mehreen Soomro, Stephanie Lyons, Ramiro Bravo, John McBeth, Mark Lunt, William G Dixon, Meghna Jani","doi":"10.1093/rap/rkae129","DOIUrl":"https://doi.org/10.1093/rap/rkae129","url":null,"abstract":"<p><strong>Objectives: </strong>Pain, fatigue and sleep disturbances are common symptoms in patients with rheumatic and musculoskeletal diseases (RMDs) that may prompt the use of over-the-counter (OTC) supplements, sleep aids and analgesics as self-management strategies. This study evaluated the prevalence of OTC supplements, sleep aids and pain relievers and the financial burden associated with their use in rheumatology.</p><p><strong>Methods: </strong>A web-based survey developed with patients was administered in rheumatology clinics in an English hospital. Participants shared demographic information and detailed their use of OTC supplements, sleep aids and pain relief in the past week. The data were analysed using descriptive statistics and logistic regression models to identify influencing factors.</p><p><strong>Results: </strong>A total of 876 people consented to participate in the survey. More than half of patients (54.5%) reported daily supplement intake, typically spending £10/month (interquartile range 5-20), ranging up to £200/month. The most commonly administered supplements were vitamin D, multivitamins, vitamin C, vitamin B/B complex and omega-3/-6 supplements, with multiple overlaps. Prescription, OTC or non-prescription pain relief use was reported by 82% of respondents, with sleep aids being used by 13%. Of the 327 patients who took NSAIDs, 165 (50.4%) also reported taking OTC supplements, while among the 131 patients using opioids (20.5%), 66 (50.3%) reported supplement use, some of which have documented interactions.</p><p><strong>Conclusion: </strong>The use of OTC supplements, pain relief and sleep aids is common in patients with RMDs. Healthcare professionals should be encouraged to proactively ask about these during consultations, especially from a drug safety perspective, but also to provide timely, reliable advice about such strategies that may be sought by patients.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae129"},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GP consultations and prescribed treatments for Raynaud's: a survey among primary Raynaud's patients in the community.","authors":"Anthony Chen, Stephanie J Lax, Matthew J Grainge, Peter C Lanyon, Fiona A Pearce, Nick Jeffries-Owens, Sue Farrington","doi":"10.1093/rap/rkae126","DOIUrl":"https://doi.org/10.1093/rap/rkae126","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae126"},"PeriodicalIF":2.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between Zoster serology, vaccination uptake and infection rates: a single-centre cross-sectional study.","authors":"Saad Ahmed, Martin Lauran, Adaeze Ugwoke, Tom Walton, Chris Holroyd, James Galloway","doi":"10.1093/rap/rkae127","DOIUrl":"10.1093/rap/rkae127","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the prevalence of Varicella-Zoster Virus (VZV) immunity, vaccination uptake and incidence of VZV-related events in inflammatory arthritis (IA) patients initiating biologic or targeted synthetic disease-modifying antirheumatic drugs.</p><p><strong>Methods: </strong>An observational study was conducted in a single hospital between March 2019 and December 2020. Ninety-three IA patients were included. Data were collected from electronic health records and analysed using the chi-squared test.</p><p><strong>Results: </strong>The majority of patients (91.4%) were seropositive for VZV, reaffirming the necessity for vaccination. In total, 8.6% of the cohort received the Zostavax vaccine, despite a small yet significant number of patients (4.3%) experiencing Herpes Zoster after initiating treatment. Multiple factors contributed to low vaccine uptake, including limited vaccine availability, discrepancies between the British Society for Rheumatology and Joint Committee on Vaccination and Immunisation guidelines, vaccine hesitancy and concerns regarding vaccine efficacy and risks.</p><p><strong>Discussion: </strong>Significant VZV immunity exists among patients prior to targeted therapy commencement. Risk factors for VZV-related events include Janus kinase inhibition, increasing age and long-term steroid use. VZV-related events occurred exclusively in patients with prior viral immunity. Despite most patients having serological evidence of prior VZV exposure, our study exposes critical gaps between current clinical guidelines and practice, particularly in VZV vaccine uptake. Barriers to vaccination include inconsistent guidelines, limited vaccine availability and patient-level hesitancy. This is concerning as our cohort demonstrated small but significant rates of zoster, mostly among patients on long-term steroids.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae127"},"PeriodicalIF":2.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}