Arthritis and rheumatism最新文献

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Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoarthritis? 髌骨带能减轻髌骨骨关节炎引起的髌骨错位和疼痛吗?
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24872
Kay M Crossley, Giovanni P Marino, Michael D Macilquham, Anthony G Schache, Rana S Hinman
{"title":"Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoarthritis?","authors":"Kay M Crossley,&nbsp;Giovanni P Marino,&nbsp;Michael D Macilquham,&nbsp;Anthony G Schache,&nbsp;Rana S Hinman","doi":"10.1002/art.24872","DOIUrl":"https://doi.org/10.1002/art.24872","url":null,"abstract":"<p><strong>Objective: </strong>Patellar taping is a conservative treatment that may reduce patellar malalignment and pain in people with patellofemoral joint osteoarthritis (OA). This study aimed to compare patellar alignment in people with and without patellofemoral joint OA and to evaluate immediate effects of patellar taping on patellar alignment and pain in people with patellofemoral joint OA.</p><p><strong>Methods: </strong>Patellar malalignment was measured from magnetic resonance imaging (MRI; 15 degrees knee flexion) in 28 individuals (14 with patellofemoral joint OA and 14 asymptomatic, age-matched controls). In the patellofemoral joint OA group, MRI data were collected in 2 randomly allocated conditions (tape and no tape). Patellar alignment indices were measured from deidentified axial scans by 1 examiner. Pain during squatting was recorded in the 2 conditions (tape and no tape).</p><p><strong>Results: </strong>People with patellofemoral joint OA exhibited greater lateral displacement and bisect offset compared with controls (P < 0.001). Lateral patellar tilt angle did not differ between groups. In the patellofemoral joint OA group, patellar tape resulted in a significant lessening of lateral alignment, with reduced lateral displacement (P = 0.028) and increased lateral patellar tilt angle (P < 0.001). Mean pain during squatting decreased with patellar tape by 15 mm on a 100-mm scale (P = 0.045).</p><p><strong>Conclusion: </strong>Patellar tape may reduce malalignment and pain associated with patellofemoral joint OA.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1719-25"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539017","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}
引用次数: 69
"Should I tell my employer and coworkers I have arthritis?" A longitudinal examination of self-disclosure in the work place. “我应该告诉我的老板和同事我得了关节炎吗?”对工作场所自我表露的纵向调查。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24889
Monique A M Gignac, Xingshan Cao
{"title":"\"Should I tell my employer and coworkers I have arthritis?\" A longitudinal examination of self-disclosure in the work place.","authors":"Monique A M Gignac,&nbsp;Xingshan Cao","doi":"10.1002/art.24889","DOIUrl":"https://doi.org/10.1002/art.24889","url":null,"abstract":"<p><strong>Objective: </strong>To examine arthritis self-disclosure at work, factors associated with disclosure, and prospective relationships of self-disclosure and work place support with changes to work place interactions, work transitions, and work place stress.</p><p><strong>Methods: </strong>Using a structured questionnaire, participants with osteoarthritis or inflammatory arthritis were interviewed at 4 time points, 18 months apart. At time 1, all participants (n = 490; 381 women, 109 men) were employed. Of the entire sample, 71% were retained throughout the study. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. Self-disclosure and perceived support from managers and coworkers was assessed, as well as demographic, illness, work-context, and psychological variables. Generalized estimating equations modeled associations of disclosure and support on changes at work (e.g., job disruptions, work place stress).</p><p><strong>Results: </strong>At each time point, 70.6-76.6% of participants had self-disclosed arthritis to their manager and 85.2-88.1% had told a coworker. Intraindividual variability in disclosure was considerable. Factors associated with self-disclosure were often inconsistent over time, with the exception of variables assessing the need to self-disclose (e.g., activity limitations) and perceived coworker support. Self-disclosure was not associated with changes to work. However, coworker support was related to fewer job disruptions, help with work tasks, and being less likely to reduce hours. Perceived managerial support was associated with less work place stress.</p><p><strong>Conclusion: </strong>Greater awareness is needed about issues related to self-disclosing arthritis at work. This study emphasizes the importance of a supportive work place, especially supportive coworkers, in decisions to discuss arthritis at work and in changes to work that might enable people to remain employed.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1753-61"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539019","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}
引用次数: 74
Understanding the lack of understanding: invalidation from the perspective of the patient with fibromyalgia. 认识缺乏认识:从纤维肌痛患者的角度看无效。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24922
Marianne B Kool, Henriët van Middendorp, Hennie R Boeije, Rinie Geenen
{"title":"Understanding the lack of understanding: invalidation from the perspective of the patient with fibromyalgia.","authors":"Marianne B Kool,&nbsp;Henriët van Middendorp,&nbsp;Hennie R Boeije,&nbsp;Rinie Geenen","doi":"10.1002/art.24922","DOIUrl":"https://doi.org/10.1002/art.24922","url":null,"abstract":"<p><strong>Objective: </strong>Patients with fibromyalgia have difficulty with the invisibility and medically unexplained character of the syndrome. Disbelief, lack of acceptance, and stigmatization by their spouse, family, colleagues, the health care system, and society are key issues in their lives. Nevertheless, the components of this phenomenon that we term \"invalidation\" are not clear. The aim of our study was to identify the definition and structure of invalidation as perceived by patients with fibromyalgia.</p><p><strong>Methods: </strong>A hierarchical cluster analysis was applied to examine everyday invalidation experiences of patients with fibromyalgia. Ninety-four statements about invalidation that were derived from interviews and a card-sorting (Q-sort) technique provided the input for this cluster analysis.</p><p><strong>Results: </strong>The hierarchical structure of invalidation showed a higher-order distinction between statements reflecting \"discounting\" and \"understanding.\" Discounting was subdivided into the components \"denying\" and \"patronizing\" (consisting of \"lecturing\" and \"overprotecting\"). Understanding was subdivided into \"supporting\" and \"acknowledging.\" These higher-order constructs were further subdivided into 15 lower-order clusters that reflected cognitive, affective, and behavioral aspects of invalidation.</p><p><strong>Conclusion: </strong>Invalidation as perceived by patients with fibromyalgia includes active negative social responses (denying, lecturing, and overprotecting) as well as a lack of positive social responses (supporting and acknowledging) with respect to the patient and the condition of the patient. This definition of invalidation provides a basis to quantify invalidation and to study its impact on symptom severity, quality of life, therapy adherence, therapy outcome, and other important aspects of fibromyalgia.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1650-6"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539023","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}
引用次数: 159
Modeling the need for hip and knee replacement surgery. Part 2. Incorporating census data to provide small-area predictions for need with uncertainty bounds. 模拟髋关节和膝关节置换手术的需求。第2部分。结合人口普查数据,在不确定范围内提供小范围的预测。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24732
Andy Judge, Nicky J Welton, Jat Sandhu, Yoav Ben-Shlomo
{"title":"Modeling the need for hip and knee replacement surgery. Part 2. Incorporating census data to provide small-area predictions for need with uncertainty bounds.","authors":"Andy Judge,&nbsp;Nicky J Welton,&nbsp;Jat Sandhu,&nbsp;Yoav Ben-Shlomo","doi":"10.1002/art.24732","DOIUrl":"https://doi.org/10.1002/art.24732","url":null,"abstract":"<p><strong>Objective: </strong>To develop methods to produce small-area estimates of need for hip and knee replacement surgery to inform local health service planning.</p><p><strong>Methods: </strong>Multilevel Poisson regression modeling was used to estimate rates of need for hip/knee replacement by age, sex, deprivation, rurality, and ethnic mix using a nationally representative population-based survey (the English Longitudinal Study of Ageing, n = 11,392 people age > or =50 years). Estimates of need from the regression model were then combined with stratified census population counts to produce small-area predictions of need. Uncertainty in the predictions was obtained by taking a Bayesian simulation-based approach using WinBUGS software. This allows correlations in parameter estimates to be appropriately incorporated in the credible intervals for the small-area predictions.</p><p><strong>Results: </strong>Small-area estimates of need for hip/knee replacement have been produced for wards and districts in England. Rates of need are adjusted for the sociodemographic characteristics of an area and include 95% credible intervals. Need for hip/knee replacement varies geographically, dependant on the sociodemographic characteristics of an area.</p><p><strong>Conclusion: </strong>For the first time, small-area estimates of need for hip/knee replacement surgery have been produced together with estimates of uncertainty to inform local health planning. The methodologic approach described here could be reproduced in other countries and for other disease indicators. Further research is required to combine small-area estimates of need with provision to determine whether there is equitable access to care.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1667-73"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539970","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}
引用次数: 13
The importance of allocation concealment and patient blinding in osteoarthritis trials: a meta-epidemiologic study. 骨关节炎试验中分配、隐瞒和患者盲法的重要性:一项荟萃流行病学研究。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24894
Eveline Nüesch, Stephan Reichenbach, Sven Trelle, Anne W S Rutjes, Katharina Liewald, Rebekka Sterchi, Douglas G Altman, Peter Jüni
{"title":"The importance of allocation concealment and patient blinding in osteoarthritis trials: a meta-epidemiologic study.","authors":"Eveline Nüesch,&nbsp;Stephan Reichenbach,&nbsp;Sven Trelle,&nbsp;Anne W S Rutjes,&nbsp;Katharina Liewald,&nbsp;Rebekka Sterchi,&nbsp;Douglas G Altman,&nbsp;Peter Jüni","doi":"10.1002/art.24894","DOIUrl":"https://doi.org/10.1002/art.24894","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association of adequate allocation concealment and patient blinding with estimates of treatment benefits in osteoarthritis trials.</p><p><strong>Methods: </strong>We performed a meta-epidemiologic study of 16 meta-analyses with 175 trials that compared therapeutic interventions with placebo or nonintervention control in patients with hip or knee osteoarthritis. We calculated effect sizes from the differences in means of pain intensity between groups at the end of followup divided by the pooled SD and compared effect sizes between trials with and trials without adequate methodology.</p><p><strong>Results: </strong>Effect sizes tended to be less beneficial in 46 trials with adequate allocation concealment compared with 112 trials with inadequate or unclear concealment of allocation (difference -0.15; 95% confidence interval [95% CI] -0.31, 0.02). Selection bias associated with inadequate or unclear concealment of allocation was most pronounced in meta-analyses with large estimated treatment benefits (P for interaction < 0.001), meta-analyses with high between-trial heterogeneity (P = 0.009), and meta-analyses of complementary medicine (P = 0.019). Effect sizes tended to be less beneficial in 64 trials with adequate blinding of patients compared with 58 trials without (difference -0.15; 95% CI -0.39, 0.09), but differences were less consistent and disappeared after accounting for allocation concealment. Detection bias associated with a lack of adequate patient blinding was most pronounced for nonpharmacologic interventions (P for interaction < 0.001).</p><p><strong>Conclusion: </strong>Results of osteoarthritis trials may be affected by selection and detection bias. Adequate concealment of allocation and attempts to blind patients will minimize these biases.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1633-41"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28538928","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}
引用次数: 122
Patient responsibility for medical decision making and risky treatment options. 患者对医疗决策和风险治疗方案的责任。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24947
Liana Fraenkel, Ellen Peters
{"title":"Patient responsibility for medical decision making and risky treatment options.","authors":"Liana Fraenkel,&nbsp;Ellen Peters","doi":"10.1002/art.24947","DOIUrl":"https://doi.org/10.1002/art.24947","url":null,"abstract":"<p><strong>Objective: </strong>Studies have shown that increasing patient participation in decision making decreases utilization of risky procedures. It has been demonstrated that risk perception is increased under conditions that emphasize volition, or the act of choosing. The objective of this study was to examine whether emphasizing volition increases patients' risk perception and decreases their willingness to accept risk.</p><p><strong>Methods: </strong>Consecutive patients attending outpatient clinic appointments viewed a video in which a physician described the availability of a new medication associated with a rare risk of a serious side effect. Patients' willingness to accept treatment and worry about the risk of the serious side effect were measured under 2 different conditions: one that minimized patient involvement and the one that maximized patient involvement in the decision-making process.</p><p><strong>Results: </strong>The willingness of the subject to take the proposed medication was lower (mean +/- SD 4.2 +/- 3.7 versus 5.3 +/- 3.7; P < 0.001) and their worry about the risk of the adverse event was greater in the high compared with the low involvement condition (mean +/- SD 6.1 +/- 3.7 versus 5.5 +/- 3.8; P < 0.001).</p><p><strong>Conclusion: </strong>Increasing patient responsibility in medical decision making may decrease the patient's willingness to accept risky treatment options.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1674-6"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24947","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539967","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}
引用次数: 20
Do mothers and fathers hold similar views about their child's arthritis? 母亲和父亲对孩子的关节炎有相似的看法吗?
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.25008
Kathleen Mulligan, Angela Etheridge, Laura Kassoumeri, Lucy R Wedderburn, Stanton Newman
{"title":"Do mothers and fathers hold similar views about their child's arthritis?","authors":"Kathleen Mulligan,&nbsp;Angela Etheridge,&nbsp;Laura Kassoumeri,&nbsp;Lucy R Wedderburn,&nbsp;Stanton Newman","doi":"10.1002/art.25008","DOIUrl":"https://doi.org/10.1002/art.25008","url":null,"abstract":"<p><strong>Objective: </strong>Evaluations of the well-being of children with juvenile idiopathic arthritis (JIA) typically rely on parents as proxy respondents. An assumption of several studies appears to be that mothers' and fathers' ratings are interchangeable, as reports do not always specify which parent completed the assessments nor, in repeated measures, whether they were completed by the same parent. The aim of this study was to examine the level of agreement between mothers' and fathers' ratings of their child's quality of life (QOL) and to identify possible predictors of disagreement.</p><p><strong>Methods: </strong>Mothers and fathers (n = 82) of children with JIA completed ratings of their child's symptoms, QOL, and measures of their mood and beliefs about their child's illness and treatment. The number of active and limited joints and the physician's global assessment were also recorded.</p><p><strong>Results: </strong>Intraclass correlation coefficients between mothers' and fathers' ratings of physical and psychosocial QOL were high (0.824 and 0.755, respectively). However, calculation of difference scores revealed that 70.6% and 65.9%, respectively, were classified as discordant. Where parents differed, the direction of difference was not systematic. Discordance in parents' mood states and in their illness and treatment beliefs explained a small amount of the variance in discordance in QOL.</p><p><strong>Conclusion: </strong>It should not be assumed that proxy ratings of a child's well-being can be generalized from one parent to the other. Studies that take repeated assessments should ensure that the same parent completes assessments at all time points. Other factors that may explain discordance between parents' ratings need to be explored.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1712-8"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.25008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539968","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}
引用次数: 20
Getting them even earlier: Identifying individuals before clinical presentation with rheumatoid arthritis. 更早地发现它们:在类风湿关节炎临床表现之前识别个体。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24991
Katherine P Liao, Karen H Costenbader
{"title":"Getting them even earlier: Identifying individuals before clinical presentation with rheumatoid arthritis.","authors":"Katherine P Liao,&nbsp;Karen H Costenbader","doi":"10.1002/art.24991","DOIUrl":"https://doi.org/10.1002/art.24991","url":null,"abstract":"","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1620-2"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28538926","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}
引用次数: 6
Clinical appropriateness and not race predicted referral for joint arthroplasty. 临床适宜性而非种族预测关节置换术的转诊。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24944
Dennis C Ang, Golda James, Timothy E Stump
{"title":"Clinical appropriateness and not race predicted referral for joint arthroplasty.","authors":"Dennis C Ang,&nbsp;Golda James,&nbsp;Timothy E Stump","doi":"10.1002/art.24944","DOIUrl":"https://doi.org/10.1002/art.24944","url":null,"abstract":"<p><strong>Objective: </strong>To understand the reasons behind racial disparities in the use of total joint arthroplasty (TJA), we sought to examine the predictors of time to referral to orthopedic surgery for consideration of joint replacement.</p><p><strong>Methods: </strong>In this prospective, longitudinal study of 676 primary care clinic patients with at least a moderately severe degree of hip or knee osteoarthritis (OA), we examined the effects of race, health beliefs (i.e., perceived benefits and risks) of TJA, and clinical appropriateness of TJA on referral to orthopedic surgery.</p><p><strong>Results: </strong>The sample included 255 African Americans (38%) and 421 whites (62%); 523 patients had knee OA (78%) and 153 had hip OA (22%). Subjects were 60% male, with a mean +/- SD age of 64 +/- 9 years, a mean +/- SD body mass index of 33.6 +/- 8 kg/m(2), and a mean +/- SD summary Western Ontario and McMaster Universities Osteoarthritis Index score of 56 +/- 14, suggesting moderately severe OA. At baseline, African Americans perceived fewer benefits and greater risk from TJA than whites. There were no significant racial group differences in the proportions of cases deemed clinically appropriate for TJA. After controlling for potential confounders, clinical appropriateness (hazard ratio [HR] 1.95, 95% confidence interval [95% CI] 1.15-3.32; P = 0.01) predicted referral to orthopedic surgery. Neither race (HR 1.30, 95% CI 0.94-2.05; P = 0.1) nor health beliefs (HR 1.0, P = 0.5) were associated with referral status.</p><p><strong>Conclusion: </strong>In this sample of primary care clinic patients, African Americans and whites were equally likely to be referred by their physicians to orthopedic surgery. Clinical appropriateness predicted future referral to orthopedic surgery, and not race or TJA-specific health beliefs.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1677-85"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24944","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539966","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}
引用次数: 28
A prospective approach to investigating the natural history of preclinical rheumatoid arthritis (RA) using first-degree relatives of probands with RA. 一种前瞻性的方法来调查临床前类风湿关节炎(RA)的自然历史,使用RA先证者的一级亲属。
Arthritis and rheumatism Pub Date : 2009-12-15 DOI: 10.1002/art.24833
Jason R Kolfenbach, Kevin D Deane, Lezlie A Derber, Colin O'Donnell, Michael H Weisman, Jane H Buckner, Vivian H Gersuk, Shan Wei, Ted R Mikuls, James O'Dell, Peter K Gregersen, Richard M Keating, Jill M Norris, V Michael Holers
{"title":"A prospective approach to investigating the natural history of preclinical rheumatoid arthritis (RA) using first-degree relatives of probands with RA.","authors":"Jason R Kolfenbach,&nbsp;Kevin D Deane,&nbsp;Lezlie A Derber,&nbsp;Colin O'Donnell,&nbsp;Michael H Weisman,&nbsp;Jane H Buckner,&nbsp;Vivian H Gersuk,&nbsp;Shan Wei,&nbsp;Ted R Mikuls,&nbsp;James O'Dell,&nbsp;Peter K Gregersen,&nbsp;Richard M Keating,&nbsp;Jill M Norris,&nbsp;V Michael Holers","doi":"10.1002/art.24833","DOIUrl":"https://doi.org/10.1002/art.24833","url":null,"abstract":"<p><strong>Objective: </strong>To describe a large, multicenter prospective cohort study of first-degree relatives (FDRs) of probands with rheumatoid arthritis (RA), and outline the use of such a study in investigating the natural history of RA development.</p><p><strong>Methods: </strong>A total of 1,058 FDRs, none of whom met the American College of Rheumatology criteria for RA, were enrolled in a prospective study investigating genetic and environmental influences on the development of RA-related autoimmunity. Demographic, epidemiologic, genetic, autoantibody, and physical examination data from the initial study enrollment visit were described for these FDRs, and the relationship was examined between genetic factors, autoantibodies, inflammation, and joint disease.</p><p><strong>Results: </strong>Fifty-five percent of the FDRs had > or =1 copy of the shared epitope, 20% had > or =1 copy of the PTPN22 polymorphism, and approximately 16% were positive for rheumatoid factor (RF; including isotypes) and/or anti-cyclic citrullinated peptide antibody. IgM-RF positivity is associated with > or =1 tender joint on examination (odds ratio [OR] 2.50, 95% confidence interval [95% CI] 1.27-4.89; P < 0.01) and elevated C-reactive protein (CRP) levels (OR 5.31, 95% CI 1.45-19.52; P = 0.01).</p><p><strong>Conclusion: </strong>FDRs without RA demonstrate high prevalences of genetic risk factors and RA-related autoantibodies. Additionally, an RF association with tender joints and elevated CRP levels suggests that autoantibodies are a valid intermediate marker of RA-related autoimmunity in this cohort. This prospective FDR cohort will be a valuable resource for evaluating the relationship between genetic and epidemiologic factors and the development of RA-related autoimmunity.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 12","pages":"1735-42"},"PeriodicalIF":0.0,"publicationDate":"2009-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28539972","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}
引用次数: 148
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