Rheumatology Advances in Practice最新文献

{"title":"The influence of deprivation in the outcomes of psoriatic arthritis within the UK-utilizing Outcomes of Treatment in Psoriatic Arthritis Study Syndicate (OUTPASS) data.","authors":"Max Lyon, Sizheng Steven Zhao, Meghna Jani, Hector Chinoy, Anne Barton, James Bluett","doi":"10.1093/rap/rkae051","DOIUrl":"10.1093/rap/rkae051","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae051"},"PeriodicalIF":2.1,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11076919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898720","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":"Physician estimate of inflammation <i>vs</i> global assessment in explaining variations in swollen joint counts in rheumatoid arthritis patients.","authors":"Juan Schmukler, Tengfei Li, Theodore Pincus","doi":"10.1093/rap/rkae057","DOIUrl":"10.1093/rap/rkae057","url":null,"abstract":"<p><strong>Objective: </strong>To analyse patients with RA for inflammatory activity by physician estimate of global assessment (DOCGL) <i>vs</i> an estimate of inflammatory activity (DOCINF) to explain variation in the swollen joint count (SJC).</p><p><strong>Methods: </strong>Patients with RA were studied at routine care visits. Patients completed a multidimensional health assessment questionnaire (MDHAQ) and the physician completed a 28-joint count for swollen (SJC), tender (TJC) and deformed (DJC) joints and a RheuMetric checklist with a 0-10 DOCGL visual numeric scale (VNS) and 0-10 VNS estimates of inflammation (DOCINF), damage (DOCDAM) and patient distress (DOCSTR). The disease activity score in 28 joints with ESR (DAS28-ESR), Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) were calculated. Individual scores and RA indices were compared according to Spearman correlation coefficients and regression analyses.</p><p><strong>Results: </strong>A total of 104 unselected patients were included, with a median age and disease duration of 54.5 and 5 years, respectively. The median DAS28-ESR was 2.9 (Q1-Q3: 2.0-3.7), indicating low activity. DOCINF was correlated significantly with DOCGL (ρ = 0.775). Both DOCGL and DOCINF were correlated significantly with most other measures; correlations with DOCGL were generally higher than with DOCINF other than for SJC. In regression analyses, DOCINF was more explanatory of variation in SJC than DOCGL and other DAS28-ESR components.</p><p><strong>Conclusions: </strong>Variation in SJC is explained more by a 0-10 DOCINF VNS than the traditional DOCGL or any other measure in RA patients seen in routine care. DOCINF on a RheuMetric checklist can provide informative quantitative scores concerning inflammatory activity in RA patients monitored over long periods.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae057"},"PeriodicalIF":3.1,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155369","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":"BASDAI versus ASDAS in evaluating axial involvement in patients with psoriatic arthritis: a pooled analysis of two phase 3 studies.","authors":"Xenofon Baraliakos, Dafna D Gladman, Soumya D Chakravarty, Cinty Gong, May Shawi, Emmanouil Rampakakis, Mitsumasa Kishimoto, Enrique R Soriano, Philip J Mease","doi":"10.1093/rap/rkae058","DOIUrl":"10.1093/rap/rkae058","url":null,"abstract":"<p><strong>Objective: </strong>In the absence of axial psoriatic arthritis (axPsA)-specific tools, the BASDAI and Ankylosing Spondylitis Disease Activity Score (ASDAS) are used to assess axial symptoms in patients with PsA. Here, we assessed the performance of BASDAI and ASDAS in patients with PsA.</p><p><strong>Methods: </strong>Patients with active PsA in DISCOVER-1 and DISCOVER-2 (ClinicalTrials.gov: NCT03162796 and NCT03158285, respectively) with or without axPsA but with available baseline BASDAI information were analysed; those with investigator-identified axial symptoms and imaging-confirmed sacroiliitis comprised the axPsA cohort. Correlations between BASDAI/ASDAS and clinical variables were assessed with Pearson's coefficient (<i>r</i>). Longitudinal effects of enthesitis (Leeds Enthesitis Index [LEI]), swollen joint count and presence versus absence of axPsA on BASDAI/ASDAS (normalized 0-10 scale) were analysed with mixed models for repeated measures.</p><p><strong>Results: </strong>At baseline in the axPsA (<i>n</i> = 312) and non-axPsA (<i>n</i> = 124) cohorts, BASDAI scores showed no or weak correlation with swollen joint count (0.18-0.20), tender joint count (0.12-0.29), LEI (-0.04 to 0.24) and physician global assessment (0.35-0.43); moderate correlation with fatigue (both -0.56); and strong correlation with patient global assessment of disease activity (0.62-0.69) and patient-reported pain (0.66-0.70). Similar correlations were observed for ASDAS. Axial involvement versus non-involvement was associated with higher BASDAI scores and ASDAS (all β ≥ 0.5), without differences between instruments; longitudinal associations between swollen joint count (β ≤ 0.06)/LEI (β ≤ 0.19) and BASDAI/ASDAS were clinically unimportant.</p><p><strong>Conclusion: </strong>BASDAI and ASDAS performed similarly in patients with active PsA and axial involvement, independent of peripheral disease involvement, supporting their performance in assessing axial disease activity.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, http://clinicaltrials.gov, NCT03162796 and NCT03158285.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae058"},"PeriodicalIF":3.1,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065864","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":"Life after tocilizumab given for giant cell arteritis: a patient survey and argument for re-treatment.","authors":"Vanessa Quick, Fran Benson, Sarah L Mackie","doi":"10.1093/rap/rkae054","DOIUrl":"10.1093/rap/rkae054","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae054"},"PeriodicalIF":3.1,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898672","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":"Does a history of smoking increase the risk of developing systemic sclerosis? Insights from the Leiden Combined Care in Systemic Sclerosis cohort.","authors":"Jacopo Ciaffi, Sophie I E Liem, Suzanne C Cannegieter, Saad Ahmed, Eva Hoekstra, Tom Huizinga, Jeska De Vries-Bouwstra","doi":"10.1093/rap/rkae055","DOIUrl":"10.1093/rap/rkae055","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae055"},"PeriodicalIF":3.1,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910870","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":"Effectiveness of methotrexate and leflunomide as corticoid-sparing drugs in patients with polymyalgia rheumatica.","authors":"Juan Pablo Vinicki, Alejandra Cusa, Daniela Domingo, José Luis Velasco Zamora, Sebastián Magri, Alejandro Brigante, Maria Marcela Schmid, Paola Ávila, Natalia Zamora, Laura Sorrentino, Anabella M Rodriguez, Miguel Linarez, Cecilia Pisoni, Carolina Costi, Gustavo Rodriguez Gil, María Andrea Spinetto, Vanesa Ursula Paris, Natalia Perrotta, María Del Rosario Maliandi, Oscar Rillo, Claudia Pena, Julio Got, Javier Cavallasca, Maximiliano Machado Escobar, Carolina Iturralde, María Victoria Martire, Romina Tessel, N Saravia Chocobar, Graciela Alarcon","doi":"10.1093/rap/rkae033","DOIUrl":"10.1093/rap/rkae033","url":null,"abstract":"<p><strong>Objectives: </strong>The need for glucocorticoid-sparing drugs (GCSD) remains an important issue and is an unmet need in the treatment of polymyalgia rheumatica (PMR). We therefore aimed to assess the effectiveness and safety of methotrexate (MTX) and of leflunomide (LEF) in daily clinical practice in PMR patients from Argentina.</p><p><strong>Methods: </strong>A multicentre and observational study (medical records review) of PMR patients seen between 2007 and 2023, who had at least three months of follow-up after starting a GCSD, either MTX or LEF, was performed. Results are expressed as medians and interquartile ranges [25th-75th (IQR)] for continuous variables and percentages for categorical ones. The two treatment groups were compared using χ² test for categorical variables, Mann-Whitney U test for continuous variables and the log-rank test for time-to-event data. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression. In all cases, a <i>p</i>-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>One-hundred and eighty-six patients (79% female) with a median age of 72 years (IQR, 65-77 years) were included. One-hundred and forty-three patients (77%) were prescribed MTX (15, IQR 10-15) and 43 (23%) LEF (20 mg, fixed dose). Flare-ups (relapses and recurrences) occurred in 13 patients (7%) and were comparable between both groups. Persistent GCSD intake was observed in 145 patients (78%). Glucocorticoid (GC) withdrawal was achieved in 67 of these 145 patients (46%) and this occurred more frequently in the LEF group (<i>P = 0.001</i>). Furthermore, time until prednisone discontinuation was shorter in the LEF-treated patients (4.7 months, IQR 3-20 on LEF versus 31.8 months, IQR 10-82 on MTX, <i>P = 0.000</i>). Remission was found more frequently in the LEF group (<i>P = 0.003</i>). In the multivariate analysis, the probability of remission was higher with LEF therapy (<i>P </i>=<i> </i>0.010) and this finding persisted in the subgroup analysis who were followed up < 40 months (OR 3.12, 95% CI = 1.30-7.47, <i>P </i>= 0.011).</p><p><strong>Conclusions: </strong>This study demonstrated the clinical effectiveness of LEF and even its superiority in achieving remission when compared with MTX as GCSD in PMR patients. Further research is needed to support these findings.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae033"},"PeriodicalIF":3.1,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10978571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336787","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":"Work participation and the COVID-19 pandemic: an observational study in people with inflammatory rheumatic diseases and population controls.","authors":"Maarten Butink, Laura Boekel, Annelies Boonen, Angelique deRijk, Gertjan Wolbink, Casper Webers","doi":"10.1093/rap/rkae026","DOIUrl":"https://doi.org/10.1093/rap/rkae026","url":null,"abstract":"<p><strong>Objective: </strong>During the coronavirus disease 2019 (COVID-19) crisis, people with inflammatory rheumatic diseases (iRDs) might have been more vulnerable for adverse work outcomes (AWOs) and restrictions in work ability and work performance. Our objectives were to compare AWOs during the pandemic and current work ability between iRD patients and controls, understand which patients are most vulnerable for these outcomes and (3) explore the role of work characteristics on work performance while working remotely.</p><p><strong>Methods: </strong>Patients and population controls in a Dutch COVID-19 cohort study provided information in March 2022 on work participation in March 2020 (pre-pandemic, retrospective) and March 2022 (current). AWOs comprised withdrawal from paid work, working hours reduction or long-term sick leave. Multivariable logistic/linear regression analyses compared outcomes (AWOs/work ability) between groups (patients/controls) and within patients.</p><p><strong>Results: </strong>Of the pre-pandemic working participants, 227/977 (23%) patients and 79/430 (18%) controls experienced AWOs following pandemic onset. A minority of AWOs (15%) were attributed to COVID-19. Patients were more likely to experience any-cause AWOs (odds ratio range 1.63-3.34) but not COVID-related AWOs, with female patients and patients with comorbidities or physically demanding jobs being most vulnerable. Current work ability was lower in female patients compared with controls [β = -0.66 (95% CI -0.92 to -0.40)]. In both groups, when working remotely, care for children and absence of colleagues had varying effects on work performance (positive 19% and 24%, negative 34% and 57%, respectively), while employer support and reduced commuting had mainly positive effects (83% and 86%, respectively).</p><p><strong>Conclusion: </strong>During the pandemic, people with iRDs remained at increased risk of AWOs. COVID-related AWOs, however, were infrequent.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae026"},"PeriodicalIF":3.1,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10987210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870197","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":"Delayed diagnosis of vertebral fracture in long-standing ankylosing spondylitis.","authors":"Sara Paiva Dinis, Ana Sofia Pinto, Filipe Cunha Santos, Duarte Augusto, Joana Fonseca Ferreira, Cláudia Vaz, Nathalie Madeira","doi":"10.1093/rap/rkae025","DOIUrl":"https://doi.org/10.1093/rap/rkae025","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae025"},"PeriodicalIF":3.1,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176263","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":"Impact of a resilience-building energy management intervention for people with systemic sclerosis: a mixed methods study.","authors":"Yen T Chen, Alexandra E Harper, Tiffany Phanhdone, Mary Alore, Sheri Hicks, Adam Pape, Gina M Jay, Shannen Bolde, Jennie Feldpausch, Timothy C Guetterman, Dinesh Khanna, Susan L Murphy","doi":"10.1093/rap/rkae040","DOIUrl":"https://doi.org/10.1093/rap/rkae040","url":null,"abstract":"<p><strong>Objectives: </strong>People with SSc often experience fatigue, which significantly affects daily life functioning and quality of life. We aimed to explore participants' experiences of a peer health-coached resilience-building energy management to enhance well-being (RENEW) intervention on symptoms and well-being and to use mixed methods to compare how SSc duration influenced the experiences of participants who had clinically significant fatigue improvement <i>vs</i> those who did not.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 21 participants from the parent clinical trial randomized to the RENEW intervention. Data were analysed using the rigorous and accelerated data reduction technique combined with thematic content analysis. A mixed methods approach used a joint display to identify themes related to the impact of SSc duration on fatigue improvement status. Participants were categorized into short/improvement, short/limited improvement, long/improvement, and long/limited improvement.</p><p><strong>Results: </strong>Our team generated four themes: participant and peer health-coach relationship, physical and psychological well-being improvement, need for a tailored approach and easy program access through technology. Mixed methods analysis revealed that, regardless of SSc duration, participants with improved fatigue reported increasing self-awareness of SSc-related symptoms and learning coping strategies to manage fatigue. Participants in the short/improvement group reported preferences for slower pacing of the program and pairing with a coach with similar symptom severity. Participants in the long/limited improvement group sought SSc-specific symptom management information.</p><p><strong>Conclusion: </strong>Incorporating peer health coaches and technology is beneficial for self-management interventions for people with SSc. Future tailoring of RENEW based on SSc duration and symptom severity is needed.</p><p><strong>Clinical trial registration number: </strong>clinicatrials.gov, NCT04908943.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae040"},"PeriodicalIF":3.1,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11015950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871675","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":"Area postrema syndrome secondary to primary Sjogren's syndrome.","authors":"Weilu Chen, Wanling Chen, Ruyu Yan","doi":"10.1093/rap/rkae031","DOIUrl":"https://doi.org/10.1093/rap/rkae031","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae031"},"PeriodicalIF":3.1,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176262","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}