Open Access Rheumatology-Research and Reviews最新文献

{"title":"Venous Thromboembolism in Rheumatoid Arthritis: The Added Effect of Disease Activity to Traditional Risk Factors.","authors":"Mohammed A Omair,&nbsp;Sara A Alkhelb,&nbsp;Sadeen E Ezzat,&nbsp;Ayah M Boudal,&nbsp;Mohammed K Bedaiwi,&nbsp;Ibrahim Almaghlouth","doi":"10.2147/OARRR.S284757","DOIUrl":"https://doi.org/10.2147/OARRR.S284757","url":null,"abstract":"<p><p>Many epidemiological studies have shown an increased risk of venous thromboembolism (VTE) in patients with rheumatoid arthritis (RA). RA and VTE share some background factors, such as increasing age, smoking, and obesity. At the same time, other VTE factors, such as knee replacement and oral contraceptive pills, occur commonly in RA patients. In addition, the chronic inflammatory state of RA might hypothetically lead to endothelial injury and a hypercoagulable state. Two critical pathophysiological pathways lead to VTE. Recently, concerns increased about the increased risk of VTE in patients using Janus Kinase inhibitors. This review aims at reviewing the risk of VTE in RA and the role of traditional risk factors and disease-related inflammation and develops a conceptual framework that describes the interaction between these factors.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"231-242"},"PeriodicalIF":2.1,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/0d/oarrr-14-231.PMC9586712.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676037","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":"Lifting the Mask on Musculoskeletal Manifestations of COVID-19: Results of an Interview-Based Study.","authors":"Samar Tharwat,&nbsp;Noran Mohamed Shabana,&nbsp;Mohammed Kamal Nassar","doi":"10.2147/OARRR.S376289","DOIUrl":"https://doi.org/10.2147/OARRR.S376289","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease of 2019 (COVID-19) is considered a multi-system disease that might present with or develop complications during the acute phase of illness. The aim of this study was to describe the characteristics of musculoskeletal (MSK) manifestations in patients with COVID-19 infection and investigate their clinical correlations.</p><p><strong>Methods: </strong>This study was carried out on 110 patients with a history of RT-PCR confirmed COVID-19 infection. They completed a questionnaire that covered detailed information on their sociodemographic characteristics, clinical data of COVID-19 infection in addition to MSK discomfort form based on the Nordic MSK Questionnaire.</p><p><strong>Results: </strong>The mean age of the patients was 37.7 years (SD 12.9), 72.7% were females. The majority of patients (90.9%) reported MSK symptoms that occur during or shortly after the acute attack of COVID-19 infection. The median duration of onset of MSK symptoms was 2 days from the first day of COVID-19 infection (min-max: 0-45 days) with a median duration of MSK symptoms of 7 days. Myalgia was the main complaint (85.5%) followed by arthralgia 90 (81.8%). However, swollen joints were reported in only 9 patients (8.2%). According to the body areas, maximum number of patients felt pain at the lower back (60%), followed by neck (39.1%), and upper back (32.5%) followed by right and left shoulder (20.9%). Patients with MSK manifestations were associated higher severity of COVID-19 infection (p < 0.001), prolonged duration of COVID-19 symptoms (p < 0.001) and higher prevalence of fatigue (p < 0.001).</p><p><strong>Conclusion: </strong>MSK manifestations are common in COVID-19 patients and related to disease severity, duration and fatigue.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"211-220"},"PeriodicalIF":2.1,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/d7/oarrr-14-211.PMC9547602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33498084","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":"Misdiagnosis of Rheumatoid Arthritis in a Long-Term Cohort of Early Arthritis Based on the ACR-1987 Classification Criteria.","authors":"Monica Leu Agelii,&nbsp;Ingiäld Hafström,&nbsp;Björn Svensson,&nbsp;Sofia Ajeganova,&nbsp;Kristina Forslind,&nbsp;Maria Andersson,&nbsp;Inger Gjertsson","doi":"10.2147/OARRR.S372724","DOIUrl":"https://doi.org/10.2147/OARRR.S372724","url":null,"abstract":"<p><strong>Objective: </strong>Correct diagnosis of early rheumatoid arthritis (RA) is essential for optimal treatment choices. No pathognomonic test is available, and diagnosis is based on classification criteria, which can result in misdiagnosis. Here, we examined the differences between actual and misdiagnosed RA cases in a long-term cohort of patients included based on the ACR-1987 classification criteria.</p><p><strong>Methods: </strong>Patients in the BARFOT (Better Anti-Rheumatic PharmacOTherapy) cohort (n=2543) with at least four follow-up visits during the initial 5 years from enrolment were assessed, and a change in diagnosis was reported by the treating rheumatologist. The groups were analysed with respect to the individual classification criteria, antibodies to citrullinated proteins (ACPA), disease activity (DAS28) and radiographic changes from inclusion up to 2 years.</p><p><strong>Results: </strong>Forty-five patients (1.8%) were misdiagnosed (<i>RA-change</i> group). When compared to those in the <i>RA-change</i> group, the patients who kept their diagnosis (<i>RA-keep</i>) were more often RF positive (64% vs 21%, p<0.001) or ACPA positive (59% vs 8%, p<0.001). They were also more likely to fulfil more than four ACR-1987 criteria (64% vs 33%, p<0.001) and to have radiographic changes at inclusion (<i>RA-keep</i> 27% vs <i>RA-change</i> 12%, p=0.04). The groups had a similar evolution of DAS28 and its components as well as of radiological joint destruction.</p><p><strong>Conclusion: </strong>Diagnosis of RA according to the ACR-1987 criteria had a high precision in this long-term cohort. A diagnosis of RA should be re-evaluated in patients who do not fulfil more than four ACR-1987 criteria especially in patients negative for RF.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"187-194"},"PeriodicalIF":2.1,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40381553","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":"Silent Lupus Nephritis: Renal Histopathological Profile and Early Detection with Urinary Monocyte Chemotactic Protein 1.","authors":"Wesam Gouda,&nbsp;Aldosoky Abd Elaziz Alsaid,&nbsp;Awad Saad Abbas,&nbsp;Tarek M Abdel-Aziz,&nbsp;Mohamed Z Shoaeir,&nbsp;Abd Allah S Abd Elazem,&nbsp;Mohammad Hamdy Sayed","doi":"10.2147/OARRR.S373589","DOIUrl":"https://doi.org/10.2147/OARRR.S373589","url":null,"abstract":"<p><strong>Objective: </strong>Lupus nephritis (LN) affects almost half of all individuals with systemic lupus erythematosus (SLE). Overt LN (OLN) symptoms might vary from asymptomatic microscopic hematuria to renal failure. However, when there are no clinical or laboratory indicators of renal involvement, some people with silent LN (SLN) may have pathological evidence of renal involvement identified by renal biopsy. Monocyte Chemotactic Protein 1 (MCP-1) is a chemotactic factor that promotes leukocyte migration to the kidney. MCP-1 urine levels (uMCP-1) have been demonstrated to be high in individuals with active LN. The purpose of this study was to discover the occurrence of SLN, as well as the possible variations between overt LN (OLN) and SLN across SLE patients based on the histopathological assessment, as well as the role of uMCP-1 in the early detection of SLN.</p><p><strong>Methods: </strong>An overall of 144 patients with SLE were included in the current research. Patients were subsequently divided into two groups: individuals who did not have clinical evidence of LN (84 patients) and those with OLN (60 patients). All the patients were subjected to the following investigations: uMCP-1, erythrocyte sedimentation rate (ESR), complement C3 (C3), complement C4 (C4), creatinine, albumin/creatinine ratio (uACR), creatinine clearance, quantitative assessment of proteinuria by 24-hour urine proteinuria (24hr UP) and percutaneous renal biopsy.</p><p><strong>Results: </strong>Sixty patients from group I (71.4%) showed glomerular lesions on renal biopsy (SLN), and class II was the predominant class. uMCP-1 had a sensitivity of 95.2% and a specificity of 98% in the detection of SLN, and uMCP-1 values were markedly higher in patients with OLN in comparison to SLN.</p><p><strong>Conclusion: </strong>The actual frequency of SLN may be higher than expected. High levels of uMCP-1 may have warranted the early activity of LN. uMCP-1 can be used as a non-invasive, useful tool for the prediction of LN.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"161-170"},"PeriodicalIF":2.1,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/b0/oarrr-14-161.PMC9482965.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33468907","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":"Salivary Gland Ultrasound in Primary Sjögren's Syndrome: Current and Future Perspectives.","authors":"Michele Lorenzon,&nbsp;Erica Spina,&nbsp;Francesco Tulipano Di Franco,&nbsp;Ivan Giovannini,&nbsp;Salvatore De Vita,&nbsp;Alen Zabotti","doi":"10.2147/OARRR.S284763","DOIUrl":"https://doi.org/10.2147/OARRR.S284763","url":null,"abstract":"<p><p>Salivary gland ultrasound (SGUS) is the imaging modality of choice for the assessment of parotid and submandibular gland parenchyma. Being highly effective, non-invasive and easy to perform, SGUS has become increasingly popular among specialists in assessing salivary gland (SG) abnormalities, including those commonly found in primary Sjögren's syndrome (pSS). SGUS may be useful in the assessment of pSS and its complications, the most serious being the development of non-Hodgkin's lymphoma (NHL). SGUS may also be useful in the characterization and differential diagnosis of diffuse and focal abnormalities commonly associated with pSS, and may act as a guide for core-needle biopsy (CNB), an established, safe, and feasible technique, which provides enough viable tissue for the diagnosis and assessment of lymphoproliferative diseases of the SG. The combination of SGUS with other tools, such as sonoelastography and artificial intelligence (AI), could further improve the usefulness of SGUS in the management of pSS. In this perspective, we summarize current and future applications of SGUS in pSS.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"147-160"},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/ac/oarrr-14-147.PMC9444027.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448505","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":"Rheumatoid Vasculitis, an Uncommon Complication of Non-Deforming Rheumatoid Arthritis: A Case Report.","authors":"Ziryab Imad Taha,&nbsp;Yassin Abdelrahim Abdalla,&nbsp;Salih Boushra Hamza,&nbsp;Mohammed Faisal Eltagalawi,&nbsp;Mohammed Elmuntaga Abubakr,&nbsp;Jimmy William,&nbsp;Sami Ahmed Abdalgadir","doi":"10.2147/OARRR.S367253","DOIUrl":"https://doi.org/10.2147/OARRR.S367253","url":null,"abstract":"<p><p>We present an 18-year-old female from South Sudan presented with right fingertips ulceration and black discolouration associated with bilateral wrist/metacarpophalangeal joints pain for five months. The ulceration began at the tip of the right middle finger and gradually progressed to involve the rest of the hand and was associated with agonizing pain. A Doppler study of the right upper limb revealed thrombosis of the antecubital portion of the basilar, ulnar, and part of the distal radial arteries. Blood investigations showed high anti-CCP, doubtful rheumatoid factor titre and ANA titre of 1:320 with coarse and nucleated cells; however, all ANA parameters were negative. A definitive diagnosis of rheumatoid arthritis complicated by rheumatoid vasculitis was made. Unfortunately, the middle finger could not be preserved and ended up amputated, and the patient was commenced on steroids, DMARDs and warfarin. The patient responded very well to the management plan with pain alleviation, ulcers healing and clot resolution.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"141-146"},"PeriodicalIF":2.1,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/d1/oarrr-14-141.PMC9307864.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40554491","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":"Psychological Fragility in an Italian Cohort of Systemic Sclerosis Patients During COVID-19 Pandemic Category: Short Communication.","authors":"Davide Mohammad Reza Beigi,&nbsp;Greta Pellegrino,&nbsp;Marius Cadar,&nbsp;Ilaria Bisconti,&nbsp;Francesca Romana Di Ciommo,&nbsp;Katia Stefanantoni,&nbsp;Fabrizio Conti,&nbsp;Valeria Riccieri","doi":"10.2147/OARRR.S367424","DOIUrl":"https://doi.org/10.2147/OARRR.S367424","url":null,"abstract":"<p><strong>Objective: </strong>This work aims to evaluate the prevalence of anxiety and COVID-19-related fear in systemic sclerosis (SSc) patients during the second and third waves of the SARS-CoV-2 pandemic in Italy and their possible associated factors.</p><p><strong>Methods: </strong>A cohort study was carried out on 114 SSc patients referred to our Scleroderma Clinic, matched for sex and age. Twenty-eight of them had missed scheduled examinations during the October 2020-March 2021 period and 86 has attended regular outpatient visits during the same period. Both groups were administered (by telephone for cases and in-person for controls) the <i>Generalized Anxiety Disorder Scale-7</i> (GAD-7) questionnaire and the validated on SSc patients <i>COVID-19 Fears Questionnaire for Chronic Medical Conditions</i> (COVID-19 Fears). Concurrent factors related to higher scores were investigated in patients who did not have an outpatient follow-up.</p><p><strong>Results: </strong>The missing group had significantly more patients scoring ≥8 on the GAD-7 questionnaire [22 (78.6%) vs 16 (18.6%), p < 0.0001] and significantly higher scores on the COVID-19 Fears questionnaire (median [quartiles] 31.5 [26.25;37.25] vs 20 [13.75;28], p < 0.0001) than the attending group. Multivariate analysis performed on the missing patients group showed a significant association of the lack of work and ongoing therapy for anxiety/depression with GAD-7 (p = 0.0275 and p = 0.0188) and COVID-19 Fears score (p = 0.0016 and p = 0.0099).</p><p><strong>Conclusion: </strong>Anxiety disorder and COVID-19-related fear were greater in SSc patients who missed regular follow-ups and are associated with a lack of work activity. These findings aim to identify a subgroup deserving attention regarding risk factors for missed periodic controls.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"133-139"},"PeriodicalIF":2.1,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/5c/oarrr-14-133.PMC9285850.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40623864","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":"From Symptoms to Diagnosis: An Observational Study of the Journey of SLE Patients in Saudi Arabia.","authors":"Mishal F Karremah,&nbsp;Rola Y Hassan,&nbsp;Ammar Z Faloudah,&nbsp;Lujain K Alharbi,&nbsp;Albraa F Shodari,&nbsp;Ahmad A Rahbeeni,&nbsp;Nouf K Alharazi,&nbsp;Ahmad Z Binjabi,&nbsp;Mohamed M Cheikh,&nbsp;Hanadi Manasfi,&nbsp;Sultana Abdulaziz,&nbsp;Albadr Hamza Hussein,&nbsp;Ahmed Alhazmi,&nbsp;Hani Almoallim","doi":"10.2147/OARRR.S362833","DOIUrl":"https://doi.org/10.2147/OARRR.S362833","url":null,"abstract":"<p><strong>Background and objectives: </strong>Early diagnosis and treatment is associated with improved outcomes in patients with systemic lupus erythematosus (SLE). Studying the journey of SLE patients in Saudi Arabia is essential to direct future health-care plans.</p><p><strong>Patients and methods: </strong>This is a cross-sectional, multicenter study. Eligibility criteria included a diagnosis of SLE that was confirmed by a rheumatologist. Patients younger than 18 at the time of interview were excluded. Primary objectives were to determine time from first symptoms to initial physician visit (Lag 1), time from initial physician visit to encounter with rheumatologist (Lag 2), time from first visit to a rheumatologist to diagnosis of SLE (Lag 3), and time from diagnosis to start of treatment (Lag 4). Secondary objectives were to determine the number and specialty of physicians seen by patients, the speciality type that confirmed the diagnosis, first symptoms experienced, and age at first diagnosis of SLE.</p><p><strong>Results: </strong>Three hundred patients (92.3% women) with SLE were evaluated. Mean age at diagnosis was 29.92 years. Mean disease duration was 8.1 years. The majority were college educated (43.0%). The most common initial symptom was joint pain (68%), followed by skin rash (23%), and fever (3.7%). Lag 1 was less than one month in 68.2% of patients. Lag 2 was less than one month in 33.4% of patients and exceeded one year in 25.8%. Lag 3 was less than 1 month in 68.7% of patients. Lag 4 was less than one month in 94.4% of patients. The diagnosis of SLE was made most frequently by rheumatologists (80%). Evaluation by primary care, orthopedic and dermatology physicians were associated with delays in diagnosis.</p><p><strong>Conclusion: </strong>Delay was marked in Lag 2. Causes of delay included evaluation by non-specialists and visiting higher numbers of physicians before diagnosis confirmation.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"103-111"},"PeriodicalIF":2.1,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/69/oarrr-14-103.PMC9250784.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40586923","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":"Biologic Initiation Rate in Systemic-Naïve Psoriatic Arthritis Patients Starting Treatment with Apremilast vs Methotrexate: 1-Year Retrospective Analysis of a US Claims Database.","authors":"M Elaine Husni,&nbsp;Eunice Chang,&nbsp;Michael S Broder,&nbsp;Caleb Paydar,&nbsp;Katalin Bognar,&nbsp;Pooja Desai,&nbsp;Yuri Klyachkin,&nbsp;Ibrahim Khilfeh","doi":"10.2147/OARRR.S342123","DOIUrl":"https://doi.org/10.2147/OARRR.S342123","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the rate of biologic initiation after commencing treatment with apremilast (APR) vs methotrexate (MTX), in systemic-naïve patients with psoriatic arthritis (PsA).</p><p><strong>Patients and methods: </strong>Systemic-naïve patients with PsA who started treatment with either APR or MTX between 01/01/2015 and 12/31/2018 were analyzed using claims data from the IBM^® MarketScan^® Commercial and Medicare Supplemental databases (2014-2019). PsA patients were identified via diagnosis codes; the first prescription date for APR or MTX was the index date. Patient demographics, clinical characteristics, healthcare utilization during the year pre-index (baseline) and the year post-index (follow-up), and median time to biologic initiation were reported descriptively. The rates and risk of biologic initiation during follow-up were compared between APR and MTX users by logistic and Cox regressions, respectively. Models were adjusted for demographics, clinical and utilization measures during the baseline period.</p><p><strong>Results: </strong>A total of 2116 patients with PsA newly treated with APR (n = 534) or MTX (n = 1582) were identified. Mean age was similar (50.5 vs 50.4; <i>P</i> = 0.938), and proportion of females was higher for APR vs MTX users (59.4% vs 54.0%; <i>P</i> = 0.031). Mean time to biologic initiation among patients who initiated during follow-up was 194.1 vs 138.7 days between APR vs MTX users (<i>P</i> < 0.001). After adjusting for confounders, the likelihood of biologic initiation was 58% lower (OR, 0.42 [95% CI, 0.32-0.54]; <i>P</i> < 0.001) with APR, with a significantly lower predicted rate of biologic initiation among APR users when compared to MTX users during follow-up (20.0% [95% CI, 16.6-23.9%] vs 37.5% [95% CI, 35.0-40.1%]). Additionally, APR users had a lower risk of biologic initiation than MTX users (HR, 0.46 [95% CI, 0.37-0.57]; <i>P</i> < 0.001) during the 1-year follow-up.</p><p><strong>Conclusion: </strong>Systemic-naïve patients with PsA have a lower rate of, and longer time to, biologic initiation over one-year following APR initiation, compared to those initiating MTX.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"123-132"},"PeriodicalIF":2.1,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/bc/oarrr-14-123.PMC9207121.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40225415","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 Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience.","authors":"Asal Ridha,&nbsp;Saba Hussein,&nbsp;Ali AlJabban,&nbsp;Levent Mert Gunay,&nbsp;Faiq I Gorial,&nbsp;Nizar Abdulateef Al Ani","doi":"10.2147/OARRR.S368190","DOIUrl":"https://doi.org/10.2147/OARRR.S368190","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the clinical impact of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA)'s seropositivity on treatment response in patients with rheumatoid arthritis (RA) treated with etanercept.</p><p><strong>Patients and methods: </strong>A retrospective analysis of patients with RA registered in Baghdad Teaching Hospital Registry from May 2012 to August 2019 was conducted. Patients aged ≥18 years, meeting the ACR/EULAR 2010 criteria for RA, being treated with etanercept, and followed up at ≥1 year after etanercept initiation were included; patients who received any other biologics for RA were excluded. Patients were classified as seropositive (RF- and ACPA-positive), seronegative (RF- and ACPA-negative), RF-positive, RF-negative, ACPA-positive, and ACPA-negative. The primary outcomes included Clinical Disease Activity Index (CDAI) and Disease Activity Score 28 (DAS28) which were measured at one year after treatment initiation.</p><p><strong>Results: </strong>At baseline, a total of 1318 (88.3%) patients were seropositive; 1122 (75.2%) and 1054 (70.6%) patients were RF- and ACPA-positive, respectively. Baseline mean CDAI scores were significantly (<i>P</i> = 0.001) higher among seropositive patients compared with seronegative patients. The baseline mean DAS28 score was also significantly higher in ACPA-positive group compared with the ACPA-negative group (<i>P</i> = 0.021). At baseline, the number of patients who had high CDAI scores was significantly higher among the seropositive, RF-positive, and ACPA-positive groups (<i>P</i> = 0.001, <i>P</i> = 0.001, and <i>P</i> = 0.002, respectively). After one year of treatment with etanercept, among seropositive versus seronegative and ACPA-positive versus ACPA-negative groups, there was a significant improvement in terms of the mean CDAI score (<i>P</i> = 0.004 and <i>P</i> = 0.017, respectively) and CDAI response (<i>P</i> = 0.011 and <i>P</i> = 0.048, respectively). At one year, the proportion of patients among the seropositive versus seronegative group who reached remission were 566 (42.9%) versus 78 (44.6%) and 642 (47.3%) versus 83 (47.4%), for CDAI and DAS28 response, respectively.</p><p><strong>Conclusion: </strong>The results imply that seropositivity and ACPA-positivity may influence the treatment response in patients with RA, who were treated with etanercept.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":" ","pages":"113-121"},"PeriodicalIF":2.1,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/33/oarrr-14-113.PMC9215842.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40402466","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}