Arthritis Care & Research最新文献

{"title":"American College of Rheumatology (ACR) Guidance Statements for Addressing Mental Health Concerns in Youth with Pediatric Rheumatologic Diseases.","authors":"Natoshia R Cunningham, Ashley N Danguecan, Samantha L Ely, Yaa Amponsah, Alaina Davis, Suzanne Edison, Julia Harris, Jordan T Jones, Alana Goldstein-Leever, Alison Manning, Anne McHugh, Crystal Mui, Ekemini Ogbu, Nikki Reitz, Martha Rodriguez, Natalie Rosenwasser, Alyse Tankanow, Erin Treemarcki, Katherine Winner, Tamar B Rubinstein, Andrea M Knight","doi":"10.1002/acr.25519","DOIUrl":"https://doi.org/10.1002/acr.25519","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric rheumatologic diseases (PRDs) are characterized by high rates of anxiety and depression known to impact health-related outcomes. We present guidance statements to assess and manage mental health concerns for youth with PRDs in pediatric rheumatology practice.</p><p><strong>Methods: </strong>Development of the guidance statements was initiated in 2019 and concluded in November 2023. It included: 1) Formation of a taskforce (including pediatric rheumatologists, pediatric behavioral health providers, patients, and parents), led by two licensed pediatric psychologists and two board-certified pediatric rheumatologists, 2) Iterative drafting of statements and rating of evidence based on the Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence, 3) An open comment period followed by revision of statements, 4) A Delphi Panel process to attain consensus on the statements, 5) Review by the ACR Committee on Quality of Care and refinement of statements to an identified list of those with strongest empiric evidence for endorsement by the ACR.</p><p><strong>Results: </strong>The taskforce drafted 34 statements for addressing mental health concerns in pediatric rheumatology, including identification, management, and clinic environment/education considerations. After two rounds of Delphi panel voting by a random sample of 76 members of the Childhood Arthritis and Rheumatology Research Alliance, 31 statements attained at least 80% consensus. Eleven of those statements had high empirical support and endorsement and were thus selected as the final guidance statements, including recommendations for depression and anxiety screening in youth ages 12 years and older, management of identified symptoms and education of patients about mental health.</p><p><strong>Conclusion: </strong>It is a goal that these recommendations be used to empower pediatric rheumatology teams to consider how they may better address mental health concerns in their setting, and help improve both mental health- and health-related outcomes for youth with rheumatologic diseases.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global trends in risk factors for low back pain. An analysis of the GBD study data from 1990 to 2021.","authors":"Katharine E Roberts, Manuela L Ferreira, Paula R Beckenkamp, Sneha Nicholson, Lyn March, Paulo H Ferreira","doi":"10.1002/acr.25520","DOIUrl":"https://doi.org/10.1002/acr.25520","url":null,"abstract":"<p><strong>Objectives: </strong>The increasing burden associated with low back pain (LBP) is a critical issue. This is a novel analysis of trends in risk factors for LBP aiming to identify risk factors that require further attention or consideration in global policies, to reduce the burden of LBP.</p><p><strong>Methods: </strong>The Global Burden of Disease (GBD) study meta-data were used to describe the trends in three modifiable categories of risk factors that contribute to the burden associated with LBP. The trends in occupational/ergonomic, behavioural (smoking), and metabolic (high body mass index (BMI)) risk factors for LBP between 1990 and 2021 have been described with attention to global, high sociodemographic index (SDI) areas, and low SDI areas.</p><p><strong>Results: </strong>The number of YLDs due to LBP increased globally, in high and low SDI areas between 1990 and 2021. The impact of smoking and occupational/ergonomic risk factors have decreased however, the impact of high BMI has increased markedly in the same time frame, with a particularly concerning impact in high SDI areas and on females.</p><p><strong>Conclusions: </strong>The burden of LBP is increasing globally, with a significant proportion of the YLDs due to LBP attributed to three modifiable lifestyle factors - occupational/ergonomic, smoking, and high BMI. Of significant concern is the rapidly increasing impact of high BMI on YLDs due to LBP with the greatest impact seen among females in low and high SDI areas. The role of additional risk factors, e.g. physical inactivity, still needs to be determined in the context of the global burden of LBP.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatology Medical Education Year in Review, 2023 - 2024.","authors":"Ann Cameron Barr, David Leverenz","doi":"10.1002/acr.25517","DOIUrl":"https://doi.org/10.1002/acr.25517","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Better Patient Care and Team Satisfaction Call for \"Both-And\" Approach.","authors":"Jennifer Brandt, S Sam Lim, Christie M Bartels","doi":"10.1002/acr.25516","DOIUrl":"https://doi.org/10.1002/acr.25516","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Telephone-Delivered Walk With Ease Program on Arthritis-Related Symptoms, Function, and Activity: A Randomized Trial.","authors":"Christine A Pellegrini, Sara Wilcox, Yesil Kim, Scott Jamieson, Katherine DeVivo, Daniel Heidtke","doi":"10.1002/acr.25515","DOIUrl":"https://doi.org/10.1002/acr.25515","url":null,"abstract":"<p><strong>Objective: </strong>Walk With Ease (WWE) is a 6-week arthritis-appropriate evidence-based physical activity program traditionally offered in a face-to-face format. As many populations encounter participation barriers to in-person programs, WWE was modified for telephone delivery (WWE-T). The short- and long-term effects of this program on physical activity and arthritis-related outcomes were examined.</p><p><strong>Methods: </strong>Participants (n=267) with arthritis were randomized to WWE-T or waitlist control. WWE-T participants received 2 telephone calls/week (1 group and 1 individual call) for 6 weeks. Group calls focused on arthritis education and social support. Individual calls focused on problem solving and goal setting. Physical function tests, patient-reported outcomes, and physical activity were assessed at baseline, 6 weeks, 6 months, and 12 months.</p><p><strong>Results: </strong>Participants were 92% female, 60% Black, 64.1±9.4 years with a BMI of 34.2±7.7 kg/m². Retention ranged from 93.6% at 6 weeks to 83.8% at 12 months. Participants attended 9.8±2.6 calls. At 6 weeks, WWE-T participants had greater improvements in physical function (p=0.03), fatigue (p=0.03), self-efficacy (p≤0.0001), and activity impairment due to health (p=0.01) as compared to the control. By 12 months, WWE-T participants had better physical function (p=0.02), higher arthritis self-efficacy (p≤0.0001), lower depression symptoms (p=0.02), and lower impairment of daily activities (p=0.02) than at baseline.</p><p><strong>Conclusion: </strong>A telephone-delivered WWE program led to improvements in physical function, self-efficacy, and impairment related to daily activities in adults with arthritis. Although changes were not seen in all outcomes, this remotely-delivered program may be an effective alternative for adults with arthritis who face barriers to in-person programs.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we rheumatologists or just internists who also care for patients with rheumatologically-related challenges?","authors":"Bruce Rothschild","doi":"10.1002/acr.25518","DOIUrl":"https://doi.org/10.1002/acr.25518","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Metabolic Syndrome and Radiographic Changes in Psoriatic Arthritis: A Cohort Study.","authors":"Fadi Kharouf, Shangyi Gao, S Ercan Tunc, Justine Y Ye, Daniel Pereira, Dafna D Gladman, Vinod Chandran","doi":"10.1002/acr.25513","DOIUrl":"https://doi.org/10.1002/acr.25513","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic syndrome (MetS) is a known comorbidity of psoriatic arthritis (PsA) and is associated with PsA disease activity. We aimed to explore the association between MetS and radiographic features (peripheral and axial) in PsA.</p><p><strong>Methods: </strong>We included patients with PsA followed at our prospective observational cohort for the period between 1978 and 2024. We identified patients with MetS on longitudinal follow-up and used generalized estimating equations (GEE) analysis to define the radiographic features independently associated with MetS, adjusting for age, sex, PsA disease duration, calendar decade, and use of targeted disease modifying anti-rheumatic drugs.</p><p><strong>Results: </strong>The study population consisted of 1422 patients, out of which 400 (28.1%) had MetS at baseline (clinic entry) and 836 (58.79%) ever had a record of MetS (per the harmonized definition by Alberti et al.) over a median [interquartile range] follow-up duration of 10.59 [4.52, 18.28] years. The mean (standard deviation [SD]) age of our cohort at baseline was 44.43 (12.98) years, with 789 (55.5%) patients identifying as male. Mean (SD) body mass index was 28.79 (6.36) kg/m². In the GEE analysis, MetS was not significantly associated with axial disease or radiographic damage to peripheral joints, assessed as the presence of syndesmophytes or sacroiliitis and the radiographic damaged joint count, respectively. On the other hand, MetS was significantly associated with calcaneal spurs, diffuse idiopathic skeletal hyperostosis, and degenerative disc disease.</p><p><strong>Conclusion: </strong>MetS is associated with degenerative and metabolic changes in the spine and entheses, but not with radiographic damage in PsA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequence Analysis to Phenotype Healthcare Patterns in Adults with Musculoskeletal Conditions Using Primary Care Electronic Health Records.","authors":"Smitha Mathew, George Peat, Emma Parry, Ross Wilkie, Kelvin P Jordan, Jonathan C Hill, Dahai Yu","doi":"10.1002/acr.25514","DOIUrl":"https://doi.org/10.1002/acr.25514","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to apply sequence analysis (SA) to phenotype healthcare patterns of adult patients with musculoskeletal (MSK) conditions using primary care electronic health records and to investigate the association between these healthcare patterns and post-consultation patient's self-reported outcome.</p><p><strong>Methods: </strong>Data from the Multi-level Integrated Data for musculoskeletal health intelligence and ActionS (MIDAS) programme conducted in North Staffordshire and Stoke-on-Trent, UK was utilised. The study included patients aged ≥18 years who consulted primary care for MSK conditions between September 2021 and July 2022. SA was employed to categorise patients with similar healthcare patterns in primary care in the five years prior to their index consultation in respect to consultations, analgesic prescriptions, imaging, physiotherapy, and secondary care referrals. Association of socio-demographic characteristics and self-reported outcome with clusters were determined.</p><p><strong>Results: </strong>In total, 1,875 patients consulting primary care for MSK conditions were available for analysis. SA identified five clusters of prior healthcare patterns among patients with MSK conditions, including \"increasing consultation and analgesia\" (5.60%), \"low consultation and healthcare use\" (57.39%), \"high consultation and healthcare use\" (8.32%), \"low consultation but high analgesia\" (13.01%), and \"low consultation but moderate healthcare use\" (15.68%). Patients in the \"high consultation and healthcare use\" group were predominantly female, older, obese, had more comorbidities and lived in the most deprived areas compared to those in the \"low consultation and healthcare use\" group. Additionally, self-reported outcome varied significantly between clusters, with patients in the \"high consultation and healthcare use\" group reporting worse self- reported outcome.</p><p><strong>Conclusion: </strong>This analysis identified five distinct clusters of healthcare patterns for patients with MSK conditions in primary care and observed substantial variations in patient's self-reported outcome and socio-demographic profiles across these different groups of patients.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in efficacy and safety outcomes in axial spondyloarthritis randomized clinical trials: A systematic literature review and meta-analysis.","authors":"Angel Gao, Jordi Pardo Pardo, Steven Dang, Lianne S Gensler, Philip Mease, Lihi Eder","doi":"10.1002/acr.25512","DOIUrl":"https://doi.org/10.1002/acr.25512","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess differences in baseline characteristics, efficacy, and safety of advanced therapies between male and female axial spondyloarthritis (axSpA) patients in randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>We conducted a systematic literature search for RCTs assessing the efficacy of advanced therapies in axSpA patients until March 19, 2023. We extracted the following outcomes by sex: baseline participant characteristics, Assessment in Spondylarthritis International Society criteria (ASAS40/20), and the Axial Spondyloarthritis Disease Activity Score low disease activity or inactive disease (ASDAS-LDA/ID). Random-effects models were used to calculate pooled effects for responses in males vs. females for different medication classes.</p><p><strong>Results: </strong>We included 79 RCTs (n=23,748, 69.7% males). Only 9 trials (11.4%), 22 trials (28%) and 9 trials (11.4%) reported baseline characteristics, efficacy endpoints and safety endpoints by sex, respectively. At baseline, females were significantly older and had higher pain scores, while males had higher c-reactive protein levels. Overall, male patients were more likely to achieve an ASAS40 response compared to female patients for all advanced therapies (Odds Ratio (OR) 1.88, 95% confidence intervals (CI) 1.44, 2.46), and for IL-17A inhibitors (i) (OR 1.82), TNFi (OR 2.42), and numerically higher for IL-17A/Fi. Male patients were also more likely to achieve an ASDAS-LDA/ID (OR 2.19, 95% CI 1.47, 3.26) across all advanced therapies and for IL-17Ai (OR 2.08) and TNFi (OR 2.42) individually.</p><p><strong>Conclusions: </strong>Female patients with axSpA are less likely to achieve efficacy outcomes on advanced therapies compared to their male counterparts, with similar differences across medication classes. Future studies should study the biological (sex-related) and socio-cultural (gender-related) mechanisms underlying these differences.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Community-Level Social Determinants of Health with Patient Race in Total Hip Arthroplasty Outcomes.","authors":"Bella Mehta, Yi Yiyuan, Diyu Pearce-Fisher, Kaylee Ho, Susan M Goodman, Michael L Parks, Fei Wang, Mark A Fontana, Said Ibrahim, Peter Cram, Rich Caruana","doi":"10.1002/acr.25511","DOIUrl":"https://doi.org/10.1002/acr.25511","url":null,"abstract":"<p><strong>Objective: </strong>Social determinants of health (SDOH) including race have a key role in total hip arthroplasty (THA) disparities. We compared the collective influence of community-level SDOH to individual factors such as race on THA outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study of the Pennsylvania Health Care Cost Containment Council Database - 2012 to 2018 included 105,336 patients undergoing unilateral primary elective THA. We extracted \"community\" factors from the US census by geocoding patient zip codes including walkability index, household income, foreign-born, English proficiency, computer/internet access, unpaid family workers, those lacking health insurances, and education. We trained an explainable boosting machine, a modern form of generalized additive models to predict 90-day readmission, 90-day mortality, 1-year revision, and length of stay (LOS). Mean absolute scores were aggregated to measure variable importance (i.e. variables that contributed most to the prediction).</p><p><strong>Results: </strong>The rates of readmission, revision, and mortality were 8%, 1.5%, and 0.3% respectively, with a median LOS of 2 days. Predictive performance measured by area under receiver operating characteristic was 0.76 for mortality, 0.66 for readmission, and 0.57 for 1-year revision. For LOS, root mean squared error was 0.41 (R²=0.2). The top three predictors of mortality were \"community\", discharge location, and age; for readmission they were discharge location, age, and comorbidities; for revision they were community, discharge location, and comorbidities and for LOS they were discharge location, community, and comorbidities.</p><p><strong>Conclusion: </strong>Community-level SDOH were significantly more important than individual race in contributing to the prediction of THA outcomes, especially for 90-day mortality.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}