International Journal of Rheumatology最新文献

{"title":"Depression-, Pain-, and Health-Related Quality of Life in Patients with Systemic Lupus Erythematosus","authors":"N. Chalhoub, M. Luggen","doi":"10.1155/2022/6290736","DOIUrl":"https://doi.org/10.1155/2022/6290736","url":null,"abstract":"Objectives A significant number of patients with systemic lupus erythematosus (SLE) have depression, and many are untreated. We aim to assess the frequency of moderate to severe depression (MSD) in a multiethnic group of SLE patients with different sociodemographic backgrounds, identify modifiable factors associated with depression, and determine the impact of depression, disease activity, damage, cognitive function, and pain severity on health-related quality of life (HRQoL). Methods Ninety-nine patients with SLE were evaluated in a cross-sectional study. Sociodemographic data, Beck Depression Inventory (BDI II), SLE disease activity index (SLEDAI-2K), SLICC Damage Index (SLICC-DI), pain severity (10 cm visual analogue scale), cognitive function (Automated Neuropsychologic Assessment Metrics (ANAM)), and the physical (PCS) and mental (MCS) component scores of the Short Form Health Survey (SF-36) were recorded. Bivariate analysis identified potential associations of relevant variables with BDI II and SF-36. Regression analysis determined independent correlates with MSD, PCS, and MCS. Results Over 50% of subjects (50.5%) were African-American, 37.1% had a family income of ≤$20,000, and 31.3% had MSD. In the bivariate analysis, family income, SLEDAI-2K, cognitive function, and pain severity were associated with MSD. Using binary logistic regression, SLEDAI-2K and pain severity remained independently correlated with MSD (p = 0.004). In the multiple linear regression analysis, pain severity was the only independent correlate of PCS (p < 0.0001), while cognitive function and BDI II were the main factors associated with MCS (p = 0.020 and p < 0.0001, respectively). Conclusion Pain severity and disease activity are associated with MSD in our unique population, are potentially modifiable, and deserve further attention in the clinic. Depression and pain significantly affect HRQoL and should be aggressively managed.","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2022 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43037442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymorphism in STAT4 Increase the Risk of Systemic Lupus Erythematosus: An Updated Meta-Analysis","authors":"Shancui-zheng, Jinping-Zhang, Guoyuan-lu, Lei Liu, Zhiyong-deng","doi":"10.1155/2022/5565057","DOIUrl":"https://doi.org/10.1155/2022/5565057","url":null,"abstract":"Previous studies have reported that STAT4 rs7574865 conferred the susceptibility to systemic lupus erythematosus (SLE). In this study, a meta-analysis (including 32 comparative studies of 11384 patients and 17609 controls) was conducted to investigate the role of STAT4 polymorphism in SLE in a comprehensive way. We found that the Asian population had the highest prevalence of the T allele than any other study population at 32.2% and that STAT4 rs7574865 polymorphism was associated with SLE in the overall population (OR = 1.579, 95%CI = 1.497-1.665, P < 0.001). In the subgroup analysis by ethnicity, STAT4 rs7574865 T allele was shown to be risk factor in SLE in Asian, European, and American origins. Our results do support STAT4 rs7574865 polymorphism as a susceptibility factor for SLE in populations of different ethnic and that its prevalence is ethnicity dependent.","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49584932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Polymorphisms in the FCN1, FCN2, and FCN3 Genes on the Susceptibility to Develop Rheumatoid Arthritis: A Systematic Review.","authors":"Sebastián R Gil-Quiñones,&nbsp;Luz Gutierrez-Castañeda,&nbsp;Lorena Larios-Salazar,&nbsp;Susana Mejia-Mesa,&nbsp;Adriana Motta,&nbsp;David Tovar-Parra","doi":"10.1155/2022/1730996","DOIUrl":"https://doi.org/10.1155/2022/1730996","url":null,"abstract":"<p><p>Genetic association studies in rheumatoid arthritis conducted in various populations have yielded heterogeneous results. The present systematic review was conducted to synthesize the results of the studies in order to establish the impact of polymorphisms in the ficolin-coding genes FCN1, FCN2, and FCN3 on the susceptibility to develop rheumatoid arthritis. A systematic literature review was performed using the following keywords \"gene (FCN1/FCN2/FCN3)\", \"Polymorphism/Genetic Variant\", and \"rheumatoid arthritis\" in different databases until January 2022. Authors assessed articles by title/abstract and then assessed by full text for data extraction. The risk of bias was assessed using the Newcastle-Ottawa scale. Data synthesis was performed qualitatively and quantitatively. A total of 1519 articles were eligible for inclusion in this review, 3 were identified as relevant for the quantitative synthesis with 670 patients and 1019 controls. For the FCN1 gene, an association was found in the dominant and recessive genetic models of the variants rs2989727 (genotype TT = OR: 0.577, 95% CI: 0.430-0.769) and rs1071583 (genotype GG = OR: 1.537, 95% CI: 1.153-2.049, <i>p</i> = 0.0032) with the development of rheumatoid arthritis as a protective or susceptibility factor. FCN2 and FCN3 genes did not show association with disease development. The FCN1 gene variants rs2989727 and rs1071583 are associated with the risk of developing rheumatoid arthritis in populations from Brazil and Belgium, but not in FCN2 and FCN3 gene variants.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2022 ","pages":"1730996"},"PeriodicalIF":2.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10804012","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":"Autoimmune Regulator Gene Polymorphisms in Egyptian Systemic Lupus Erythematosus Patients: Preliminary Results.","authors":"Doaa Hs Attia,&nbsp;Dalia Ah Dorgham,&nbsp;Ahmed A El Maghraby,&nbsp;Marwa Alkaffas,&nbsp;Mahitab A Abdel Kawy,&nbsp;Mai M Sherif,&nbsp;Radwa M Abdel Halim","doi":"10.1155/2021/5546639","DOIUrl":"https://doi.org/10.1155/2021/5546639","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a systemic autoimmune disease. The autoimmune regulator (<i>AIRE</i>) is a master regulator of self-tolerance development. <i>AIRE</i> mutations lead to the development of autoimmune polyglandular syndrome type 1 while <i>AIRE</i> polymorphisms have been linked to organ-specific autoimmunity. The study is aimed at addressing the association between <i>AIRE</i> polymorphisms, rs2075876 (G > A) and rs760426 (A > G), and SLE susceptibility and expression in Egyptian patients.</p><p><strong>Methods: </strong>Ninety-nine patients were included. One hundred and ten, and 123 control subjects were genotyped for rs2075876 and rs760426, respectively. Lupus severity was assessed using the Lupus Severity of Disease Index and Lupus Severity Index (LSI). Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) damage index was considered. Genotyping was done using StepOne Real-Time PCR. <i>Results. AIRE</i> rs760426 GG was more frequent in the patients under the genotype level (14.1% vs. 4.9%, <i>p</i> = 0.032) and recessive model (14.1% vs. 4.9%, <i>p</i> = 0.017, OR = 3.2 (1.2-8.7)). Musculoskeletal involvement and nephritis were associated with <i>AIRE</i> rs2075876 under the dominant (97.9% vs. 80.8%, <i>p</i> = 0.009, OR = 11 (1.3-89.2)) and recessive models (100% vs. 69.3%, <i>p</i> = 0.032), respectively; and both were linked to <i>AIRE</i> rs2075876 at the allelic level: 98.3% vs. 85%, <i>p</i> = 0.005, OR = 10.1 (1.3-76.6) and 82.8% vs. 68.6, <i>p</i> = 0.041, OR = 2.2 (1-4.7), respectively. Patients with <i>AIRE</i> rs2075876 A alleles had a higher damage index ( 1 ± 1.3 vs. 0.6 ± 1.1, <i>p</i> = 0.045) while the LSI was greater in patients with <i>AIRE</i> rs2075876 (8.5 ± 0.5 vs. 7.8 ± 1.3, <i>p</i> = 0.002) and rs760426 (8.6 ± 11 vs. 7.8 ± 1.2, <i>p</i> = 0.031) under the recessive models. <i>Conclusion. AIRE</i> rs760426 could share in SLE susceptibility while <i>AIRE</i> rs2075876 could influence the disease expression and burden in Egyptian patients.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2021 ","pages":"5546639"},"PeriodicalIF":2.3,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39495467","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":"Tocilizumab Effect on Lipid Profile in Correlation to Cardiovascular Events: A Retrospective Cohort Study.","authors":"Toka Alsulaim,&nbsp;Noor Alhassan,&nbsp;Hala Khalil,&nbsp;Abdullah Almutlaq","doi":"10.1155/2021/5535486","DOIUrl":"https://doi.org/10.1155/2021/5535486","url":null,"abstract":"<p><strong>Objective: </strong>To study the effect of tocilizumab initiation on the lipid profile, in correlation to a composite of any cardiovascular events.</p><p><strong>Methods: </strong>A retrospective cohort study, using data from the King Faisal Specialist Hospital & Research Centre database, from January 2014 to December 2019. Patients with rheumatoid arthritis or juvenile idiopathic arthritis who were ≥18 years old, initiated either on tocilizumab or other biologic treatment (anti-TNFs or Rituximab), were included, with a follow-up interval duration at a minimum of 6-12 months up to 3-5 years. Any patient with established cardiovascular disease or aged <18 were excluded.</p><p><strong>Results: </strong>Only one cardiovascular mortality was reported in the tocilizumab group. Fifty percent of patients reached high cholesterol levels ≥ 5.2 mmol/L and LDL ≥ 3.37 mmol/L in the tocilizumab group at 36 months in a shorter time period compared to controls (60 months), <i>P</i> 0.001. There were no significant differences between groups for statin use (27% vs. 28%) However, there was a significantly higher mean dose of atorvastatin in the tocilizumab group compared to controls (20.6 mg vs. 16.6 mg, <i>P</i> 0.03).</p><p><strong>Conclusion: </strong>There was a lack of evidence of increased cardiovascular risk in correlation to hyperlipidemia secondary to tocilizumab treatment.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2021 ","pages":"5535486"},"PeriodicalIF":2.3,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39334266","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":"Cutaneous Manifestations of \"Lupus\": Systemic Lupus Erythematosus and Beyond.","authors":"Elizabeth E Cooper, Catherine E Pisano, Samantha C Shapiro","doi":"10.1155/2021/6610509","DOIUrl":"10.1155/2021/6610509","url":null,"abstract":"<p><p>Lupus, Latin for \"wolf,\" is a term used to describe many dermatologic conditions, some of which are related to underlying systemic lupus erythematosus, while others are distinct disease processes. Cutaneous lupus erythematosus includes a wide array of visible skin manifestations and can progress to systemic lupus erythematosus in some cases. Cutaneous lupus can be subdivided into three main categories: acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus. Physical exam, laboratory studies, and histopathology enable differentiation of cutaneous lupus subtypes. This differentiation is paramount as the subtype of cutaneous lupus informs upon treatment, disease monitoring, and prognostication. This review outlines the different cutaneous manifestations of lupus erythematosus and provides an update on both topical and systemic treatment options for these patients. Other conditions that utilize the term \"lupus\" but are not cutaneous lupus erythematosus are also discussed.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2021 ","pages":"6610509"},"PeriodicalIF":2.3,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39100470","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":"Update in the Management of ANCA-Associated Vasculitis: Recent Developments and Future Perspectives.","authors":"Karla N Samman, Carolyn Ross, Christian Pagnoux, Jean-Paul Makhzoum","doi":"10.1155/2021/5534851","DOIUrl":"10.1155/2021/5534851","url":null,"abstract":"<p><p>Significant progress has been made in the treatment of ANCA-associated vasculitides (AAV), notably in granulomatosis with polyangiitis and microscopic polyangiitis. Over the past few years, many innovative studies have changed the way we now induce and maintain remission in AAV; achieving remission while limiting treatment toxicity is the key. This article provides an in-depth, up-to-date summary of recent trials and suggests treatment algorithms for induction and maintenance of remission based on the latest guidelines. Future possible therapies in AAV will also be discussed.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2021 ","pages":"5534851"},"PeriodicalIF":2.3,"publicationDate":"2021-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38941651","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":"Clinical Outcomes of Myocarditis after Moderate-Dose Steroid Therapy in Systemic Sclerosis: A Pilot Study.","authors":"Burabha Pussadhamma,&nbsp;Thapanee Tipparot,&nbsp;Naruemol Chaosuwannakit,&nbsp;Ajanee Mahakkanukrauh,&nbsp;Siraphop Suwannaroj,&nbsp;Ratanavadee Nanagara,&nbsp;Chingching Foocharoen","doi":"10.1155/2020/8884442","DOIUrl":"https://doi.org/10.1155/2020/8884442","url":null,"abstract":"<p><strong>Background: </strong>Myocarditis is reported in systemic sclerosis (SSc); however, treatment options and outcomes are limited. Our objective was to define cardiac outcomes after moderate-dose steroid therapy in SSc patients with myocarditis.</p><p><strong>Method: </strong>An open-label study was conducted among SSc patients with myocarditis-as defined by cardiovascular magnetic resonance (CMR), disease onset <5 years, and a NYHA functional class ≥II. All enrolled patients received prednisolone (30 mg/d) which would be tapered off by week 24, and CMR was followed up at the end of treatment.</p><p><strong>Results: </strong>A total of 20 SSc patients were enrolled which 12 patients completed the study. At week 24, 8 of the 12 cases experienced improvement of myocarditis. Compared to those with no improvement, these 8 patients had significantly longer disease duration (<i>p</i> = 0.03), higher heart rate at baseline (<i>p</i> = 0.049) and week 24 (<i>p</i> = 0.04), lower left ventricular (LV) and right ventricular (RV) stroke volume at baseline (<i>p</i> = 0.002 and <i>p</i> = 0.01) and week 24 (<i>p</i> = 0.01 and <i>p</i> = 0.02), and lower LV and RV cardiac output at week 24 (<i>p</i> = 0.01 and <i>p</i> = 0.01). Four cases died during follow-up (3 due to cardiac complications, 1 due to renal crisis). The two who died from heart failure had very high NT-prohormone-brain natriuretic peptide (NT-proBNP) and impaired LV ejection fraction (LVEF), and the one who died from arrhythmia had very high sensitivity of cardiac Troponin-T (hs-cTnT).</p><p><strong>Conclusions: </strong>Moderate-dose steroid therapy may improve myocarditis in SSc. A proportion of patients died due to cardiac complications during treatment, particularly those with high hs-cTnT, high NT-proBNP, and impaired LVEF. This trial is registered with NCT03607071.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2020 ","pages":"8884442"},"PeriodicalIF":2.3,"publicationDate":"2020-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39130520","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":"Intracytoplasmic Expression of IL-6 and IL-17A in Circulating CD4+ T Cells Are Strongly Associated with and Predict Disease Activity in Rheumatoid Arthritis: A Case-Control Study in Ghana.","authors":"Samuel Asamoah Sakyi,&nbsp;Tonnies Abeku Buckman,&nbsp;Daniel Antwi-Berko,&nbsp;Kwame Yeboah-Mensah,&nbsp;Dzifa Dey,&nbsp;Eddie-Williams Owiredu,&nbsp;Benjamin Amoani,&nbsp;Richard Mantey","doi":"10.1155/2020/2808413","DOIUrl":"https://doi.org/10.1155/2020/2808413","url":null,"abstract":"<p><strong>Background: </strong>T cell cytokines play important roles in the development and progression of rheumatoid arthritis (RA). Loss of Th1/Th2 and Th17/Treg balance has been reported in several inflammatory autoimmune diseases. However, their role in RA within hitherto rare Ghanaian context has not been explored. Here, we evaluated the intracytoplasmic CD4+ T cell cytokine patterns in rheumatoid arthritis patients in Ghana and determined their relationship with disease activity.</p><p><strong>Methods: </strong>This case-control study included 48 newly diagnosed RA patients and 30 apparent healthy controls from two major hospitals in Ghana. Validated structured questionnaires were administered to obtain demographic data; blood samples were collected and processed for flow cytometric analysis.</p><p><strong>Results: </strong>IFN-<i>γ</i>, TNF-<i>α</i>, IL-4, IL-6, IL-10, IL-17A, IL-6/IL-4, and IL-17/IL-10 expressions were significantly higher in RA cases compared to the healthy controls. The expression of IL-6 (0.00 (0.00-0.98) vs. 0.82 (0.34-1.10) vs. 1.56 (1.39-1.68), <i>p</i> < 0.0001), IL-17A (0.00 (0.00-0.02) vs. 0.19 (0.09-0.30) vs. 0.99 (0.64-1.25), <i>p</i> < 0.0001), and IL-17A/IL-10 (0.00 (0.00-0.39) vs. 0.15 (0.09-0.26) vs. 0.88 (0.41-1.47), <i>p</i> < 0.0001) increased significantly from the healthy controls through RA patients with low DAS scores to RA patients with moderate DAS scores. IL-6 (<i>β</i> = 0.681, <i>r</i> ² = 0.527, <i>p</i> < 0.0001), IL-17A (<i>β</i> = 0.770, <i>r</i> ² = 0.593, <i>p</i> < 0.0001), and IL-17A/IL-10 (<i>β</i> = 0.677, <i>r</i> ² = 0.452, <i>p</i> < 0.0001) expressions were significantly directly associated with DAS28 scores. IL-6 (cutoff = 1.32, sensitivity = 100.0%, specificity = 100.0%, accuracy = 100.0%, and AUC = 1.000) and IL-17A (cutoff = 0.58, sensitivity = 100.0%, specificity = 100.0%, accuracy = 100.0%, and AUC = 1.000) presented with the best discriminatory power in predicting moderate DAS scores from low DAS scores.</p><p><strong>Conclusion: </strong>Th1- and Th17-related cytokines predominate in the pathophysiology of RA, with IL-6 and IL-17 being principally and differentially expressed based on the severity of the disease. IL-6 and IL-17A could serve as useful prognostic and disease-monitoring markers in RA in the African context.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2020 ","pages":"2808413"},"PeriodicalIF":2.3,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2808413","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38532798","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":"Direct Healthcare Costs Associated with Oligoarticular Juvenile Idiopathic Arthritis at a Single Center.","authors":"Amit Thakral,&nbsp;Daniel Pinto,&nbsp;Michael Miller,&nbsp;Megan L Curran,&nbsp;Marisa Klein-Gitelman,&nbsp;Dustin D French","doi":"10.1155/2020/5640425","DOIUrl":"https://doi.org/10.1155/2020/5640425","url":null,"abstract":"<p><p>Oligoarticular juvenile idiopathic arthritis (JIA) is a common disease in pediatric rheumatology. The management of oligoarticular JIA can result in a considerable economic burden. This study is a four-year, retrospective cost identification analysis performed to determine the annual direct cost of care for patients with oligoarticular JIA and possible predictive clinical factors. Direct healthcare costs were defined as those associated with office visits, laboratory studies, hospital admissions, joint injections, medications, infusions, radiology tests, and emergency room visits. Disease characteristics and patient information included ANA status, gender, age at diagnosis, duration from diagnosis to initial visit during the study period, and whether uveitis had been diagnosed. We identified 97 patients with oligoarticular JIA eligible for the study. The median age of diagnosis was 4.3 years. Positive ANA were noted in 75% of patients. 34% of patients received at least one intra-articular steroid injection. 32% of patients were prescribed a biologic during the study period, predominantly with other medications, while 23% of patients received only NSAIDs. 20% of patients were prescribed oral steroids. The average total direct medical cost in this study per year for an oligoarticular JIA patient was $3929 ± 6985. Medications accounted for 85% of annual direct medical costs. Clinic visits and laboratory testing accounted for 8% and 5%, respectively. Patient characteristics and demographics were tested for association with direct medical costs by the Wilcoxon rank sum test and Kruskal-Wallis test. Patients who were ANA positive had increased annual costs compared to patients who are ANA negative. ANA-positive patients were found to have statistically significant costs, particularly, in laboratory tests, procedural costs, radiology costs, and medication costs. The results reported here provide information when allocating healthcare resources and a better understanding of the economic impact oligoarticular JIA has on the United States healthcare system.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":"2020 ","pages":"5640425"},"PeriodicalIF":2.3,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5640425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38496638","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}