Arthritis Care & Research最新文献

{"title":"Neighborhood Disadvantage and Knee Osteoarthritis Pain: Do Sleep and Catastrophizing Play a Role?","authors":"Felicitas A. Huber,&nbsp;Cesar Gonzalez,&nbsp;Daniel A. Kusko,&nbsp;Angela Mickle,&nbsp;Kimberly T. Sibille,&nbsp;David T. Redden,&nbsp;Casey B. Azuero,&nbsp;Roland Staud,&nbsp;Roger B. Fillingim,&nbsp;Burel R. Goodin","doi":"10.1002/acr.25458","DOIUrl":"10.1002/acr.25458","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective was to examine potential pathways linking neighborhood disadvantage to pain severity in individuals with knee pain consistent with or at risk for knee osteoarthritis (KOA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The current investigation is a cross-sectional analysis. Data were collected from 140 middle-aged to older non-Hispanic White and non-Hispanic Black adults from the Understanding Pain and Limitations in Osteoarthritic Disease Study 2 (UPLOAD-2). Relationships among neighborhood disadvantage, sleep efficiency, pain catastrophizing, and pain severity were assessed. Neighborhood disadvantage was quantified using the Area Deprivation Index, and actigraphy data were used to assess sleep efficiency. The Coping Strategies Questionnaire–Revised catastrophizing subscale and the Western Ontario and McMaster Universities Osteoarthritis Index pain severity scale were used to assess pain catastrophizing and pain severity, respectively. A serial mediation model assessed the neighborhood–sleep–catastrophizing–pain pathway, as well as the neighborhood–sleep–pain and the neighborhood–catastrophizing–pain pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Greater neighborhood disadvantage was associated with worse sleep efficiency, ultimately contributing to greater pain severity. Although neither neighborhood disadvantage nor sleep efficiency were associated with pain catastrophizing, pain catastrophizing itself was associated with greater KOA pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Neighborhood disadvantage impacts KOA pain outcomes through sleep efficiency but not pain catastrophizing, thereby highlighting environmental aspects that impact sleep as potential targets for intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 1","pages":"95-103"},"PeriodicalIF":3.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520870","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 Rituximab and Cyclophosphamide in Induction Therapy for Childhood-Onset Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: An ARChiVe Registry Cohort Study","authors":"Samuel J. Gagne,&nbsp;Vidya Sivaraman,&nbsp;Else S. Bosman,&nbsp;Brett Klamer,&nbsp;Kimberly A. Morishita,&nbsp;Adam Huber,&nbsp;Alvaro Orjuela,&nbsp;Barbara Eberhard,&nbsp;Charlotte Myrup,&nbsp;Dana Gerstbacher,&nbsp;Dirk Foell,&nbsp;Eslam Al-Abadi,&nbsp;Flora McErlane,&nbsp;Kathryn Cook,&nbsp;Linda Wagner-Weiner,&nbsp;Melissa Elder,&nbsp;L. Nandini Moorthy,&nbsp;Paul Dancey,&nbsp;Rae Yeung,&nbsp;Raju Khubchandani,&nbsp;Samundeeswari Deepak,&nbsp;Sirirat Charuvanij,&nbsp;Stacey Tarvin,&nbsp;Susan Shenoi,&nbsp;Tamara Tanner,&nbsp;Kelly Brown,&nbsp;David A. Cabral,&nbsp;for the ARChiVe Investigators Network within the PedVas Initiative","doi":"10.1002/acr.25455","DOIUrl":"10.1002/acr.25455","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) are chronic life-threatening vasculitides requiring substantial immunotherapy. Adult trials identified rituximab (RTX) as an alternative to cyclophosphamide (CYC) for remission induction of GPA and MPA. Disease rarity has limited feasibility of similar trials with pediatric patients. We aim to evaluate the relative efficacy and toxicity of CYC and RTX for patients with childhood GPA and MPA through registry-based comparative evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From A Registry of Childhood Vasculitis, we identified patients with GPA and MPA who received induction with RTX or CYC. Pediatric Vasculitis Activity Score (PVAS) and Pediatric Vasculitis Damage Index (pVDI) score evaluated disease activity and damage. Descriptive statistics summarized patient characteristics. RTX and CYC comparisons used logistic regression for primary outcomes of postinduction remission (PVAS = 0) or low disease activity (PVAS ≤ 2). Hospital admission for adverse events and pVDI scores were compared using logistic regression and ordinal regression, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 104 patients, 43% received RTX, 46% CYC, 11% both. Treatment groups did not significantly differ for diagnosis PVAS and onset age. There was no difference in remission among the groups (63% overall; odds ratio [OR] 1.07, 95% confidence interval [CI] 0.45–2.52). Hospitalizations occurred in 22% of patients receiving RTX versus 10% patients receiving CYC (OR 2.27, 95% CI 0.73–7.05). The median 12-month pVDI score was 1 in both groups (OR 0.98, 95% CI 0.43–2.22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study comparing CYC and RTX for induction in pediatric GPA and MPA. No significant differences were shown in rates of remission, severe adverse events, or organ damage. Limitations included lack of standardized treatment regimens, retrospectivity, and lack of longitudinal adverse drug-related event data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 4","pages":"504-512"},"PeriodicalIF":3.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Escalation to Biologics After Methotrexate Among US Veterans With Rheumatoid Arthritis Grouped by Rural Versus Urban Areas","authors":"Anisha Naik,&nbsp;Aaron Baraff,&nbsp;Katherine D. Wysham,&nbsp;Jean W. Liew,&nbsp;Bryant R. England,&nbsp;Punyasha Roul,&nbsp;Michael George,&nbsp;Joshua F. Baker,&nbsp;Jennifer L. Barton,&nbsp;Una E. Makris,&nbsp;Gail Kerr,&nbsp;Grant W. Cannon,&nbsp;Ted R. Mikuls,&nbsp;Namrata Singh","doi":"10.1002/acr.25457","DOIUrl":"10.1002/acr.25457","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Racial and ethnic disparities in rheumatoid arthritis (RA) outcomes are well recognized. However, whether disparities in RA treatment selection and outcomes differ by urban versus rural residence, independent of race, have not been studied. Our objective was to evaluate whether biologic disease-modifying antirheumatic drug (bDMARD) initiation after methotrexate administration differs by rural versus urban residence among veterans with RA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective cohort study using national US Veterans Affairs (VA) databases, we identified adult patients with RA based on the presence of diagnostic codes and DMARD administration. We included patients receiving an initial prescription of methotrexate (index date) between 2005 and 2014, with data through 2016 used for follow-up. Urban–rural status was categorized using the Veteran Health Administration's Urban/Rural classification. Our primary outcome of interest was time to biologic initiation within two years of starting methotrexate. Multivariable Cox proportional hazards models were conducted adjusting for demographics, comorbidities, and rheumatoid factor or anti-cyclic citrullinated peptide positivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 17,395 veterans with RA (88% male, 42% with rural residence) fulfilling eligibility criteria, 3,259 (19%) initiated a biologic within the first two years of follow-up. In multivariable models, residence in an urban area was associated with a statistically significant higher biologic administration compared to rural areas (adjusted hazard ratio 1.10 [95% confidence interval 1.02–1.18]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study found only modest differences in the initiation of biologic therapies among rural- versus urban-residing veterans with RA in the VA health care system. These findings suggest that disparities are not easily explained by rurality within the VA health care system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 1","pages":"23-29"},"PeriodicalIF":3.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520869","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":"Building the OAChangeMap to Improve the Service Delivery of the New South Wales Osteoarthritis Chronic Care Program: A Worked Example of Using a Codesign Framework","authors":"Jillian P. Eyles,&nbsp;Sarah Kobayashi,&nbsp;Vicky Duong,&nbsp;David J. Hunter,&nbsp;Christos Avdalis,&nbsp;Tom Buttel,&nbsp;Greer Dawson,&nbsp;Murillo Dório,&nbsp;Nicole D'Souza,&nbsp;Kirsty Foster,&nbsp;Katherine Maka,&nbsp;Marie K. March,&nbsp;Fred Menz,&nbsp;Carin Pratt,&nbsp;Nicole M. Rankin,&nbsp;Daniel Richardson,&nbsp;Julia Thompson,&nbsp;Charlotte Strong,&nbsp;Jocelyn L. Bowden","doi":"10.1002/acr.25454","DOIUrl":"10.1002/acr.25454","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The Osteoarthritis Chronic Care Program (OACCP) has been implemented in Australian public hospitals to deliver best evidence osteoarthritis (OA) care. It is important to ensure that the OACCP continues to deliver evidence-based OA care as intended. We aimed to identify barriers and enablers to delivering the OACCP, prioritize the barriers, and generate strategies to address them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study provides a worked example of a seven-step theory-informed codesign framework. We invited OACCP coordinators to participate in semistructured interviews (analyzed thematically) and complete a questionnaire to identify barriers and enablers to delivery of the OACCP. We then invited a broader group of stakeholders (OACCP coordinators, health managers, policy makers, consumers, and researchers) to prioritize the barriers via a short survey (survey 2). We held five codesign workshops in which we mapped the priority barriers to the Theoretical Domains Framework and developed strategies to address them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen coordinators were interviewed, and the main barriers identified were as follows: (1) patients often have beliefs that are inconsistent with best evidence care, (2) there are aspects of clinical care that are not delivered optimally, and (3) system-level factors are a barrier to optimal patient care and sustainability of the OACCP. We codesigned a plan for action with patient educational materials, shared decision-making tools, and health professional education and training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our worked example of codesign used a theory-based, data-driven approach with key stakeholders, identified and prioritized barriers to the delivery of the OACCP, acknowledged enablers, and generated a plan for feasible strategies to improve the program.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 4","pages":"491-503"},"PeriodicalIF":3.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520867","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":"Evaluating Criteria for Symptoms Suggestive of Early Osteoarthritis Over Two Years Post–Anterior Cruciate Ligament Reconstruction: Data From the New Zealand Anterior Cruciate Ligament Registry","authors":"Matthew S. Harkey,&nbsp;Jeffrey B. Driban,&nbsp;David Todem,&nbsp;Christopher Kuenze,&nbsp;Armaghan Mahmoudian,&nbsp;Rebecca Meiring,&nbsp;Daniel O'Brien,&nbsp;Sarah Ward","doi":"10.1002/acr.25453","DOIUrl":"10.1002/acr.25453","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objectives were to determine the prevalence of meeting criteria for symptoms suggestive of early osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) and to characterize the longitudinal changes in these symptoms during the first two years post-ACLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 10,231 patients aged 14 to 40 years in the New Zealand ACL Registry who completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6, 12, and 24 months post-ACLR. Symptoms suggestive of early OA were defined as scoring ≤85% on at least two of four KOOS subscales. Longitudinal patterns of change were categorized as persistent, resolution, new, inconsistent, or no symptoms across the three visits. Prevalence and odds ratios (ORs) of symptoms were compared across visits, sex, and age groups using generalized estimating equations, and longitudinal patterns of symptom change were analyzed using multinomial logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prevalence of meeting criteria of symptoms suggestive of early OA was 68% at 6 months, 54% at 12 months, and 46% at 24 months post-ACLR. Longitudinally, 33% had persistent symptoms, 23% had no symptoms, 29% showed symptom resolution, 6% developed new symptoms, and 9% had inconsistent symptoms. Women consistently showed higher odds of symptoms (OR range 1.17–1.52). Older age groups demonstrated higher odds of symptoms, particularly at 6 months (OR range 1.64–2.45).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Symptoms suggestive of early OA are highly prevalent within two years post-ACLR, with one third of patients experiencing persistent symptoms. These findings indicate that symptoms are more likely to persist rather than newly develop, emphasizing the importance of early identification and targeted interventions.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 4","pages":"475-483"},"PeriodicalIF":3.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Season, Environmental Temperature, and Humidity on Raynaud Phenomenon in an Australian Systemic Sclerosis Cohort","authors":"Laura Taylor,&nbsp;Dylan Hansen,&nbsp;Kathleen Morrisroe,&nbsp;Jessica Fairley,&nbsp;Alicia Calderone,&nbsp;Shereen Oon,&nbsp;Laura Ross,&nbsp;Wendy Stevens,&nbsp;Nava Ferdowsi,&nbsp;Alannah Quinlivan,&nbsp;Joanne Sahhar,&nbsp;Gene-Siew Ngian,&nbsp;Diane Apostolopoulos,&nbsp;Lauren V. Host,&nbsp;Jennifer Walker,&nbsp;Maryam Tabesh,&nbsp;Susanna Proudman,&nbsp;Mandana Nikpour","doi":"10.1002/acr.25452","DOIUrl":"10.1002/acr.25452","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to determine the impact of season, temperature and humidity on the severity of Raynaud phenomenon (RP) in systemic sclerosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Australian Scleroderma Cohort Study were used to assess associations of patient-reported worsened RP in the month preceding each study visit. Mean monthly weather data were obtained from the closest weather station to the patient's address. We evaluated the relationship between worsened RP and health-related quality of life (HRQoL) measured using the Short Form 36 instrument.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1,972 patients with systemic sclerosis, RP was a near-universal finding, and worsened RP in the preceding month was reported in 26.7% of 9,175 visits. “Worsened RP” showed significant environmental variability. On multivariable analysis, worsened RP was associated with low mean maximum temperatures (odds ratio [OR] 0.91, 95% confidence interval [95% CI] 0.90–0.92, <i>P</i> &lt; 0.001), high relative humidity (OR 1.05, 95% CI 1.04–1.05, <i>P</i> &lt; 0.001) and lower mean daily evaporation (OR 0.77, 95% CI 0.73–0.81, <i>P</i> &lt; 0.001). Worsened RP was strongly associated with telangiectasia, calcinosis, and digital ulceration, as well as demonstrating an association with anticentromere antibody and gastroesophageal reflux disease and a negative correlation with diffuse disease. Worsened RP was also strongly associated with worse HRQoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lower environmental temperature and higher relative humidity had significant associations with worsened RP in this systemic sclerosis cohort, suggesting an important role for dry warmth in managing this condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 1","pages":"61-68"},"PeriodicalIF":3.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456867","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":"Determinants of Self-Management Behavior in Gout: A Scoping Review","authors":"Jeffrey van der Ven,&nbsp;Bart J. F. van den Bemt,&nbsp;Marcel Flendrie,&nbsp;Johanna E. Vriezekolk,&nbsp;Lise M. Verhoef","doi":"10.1002/acr.25449","DOIUrl":"10.1002/acr.25449","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to identify modifiable determinants of self-management behavior in patients with gout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four databases (Medline, Embase, PsycINFO, and CINAHL) were searched using terms related to gout, self-management, and determinants of behavior as described in the Theoretical Domains Framework (TDF). Two reviewers independently selected relevant studies via screening of title/abstract and full text. Thematic synthesis was performed for qualitative data; quantitative data were summarized using cross-tabulation displaying the investigated associations of determinants with self-management behavior. The TDF facilitated identification and grouping of determinants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2,087 unique articles found, 56 studies were included in this review, of which there were 27 qualitative and 29 quantitative studies. Eight themes were identified: knowledge and skills for self-management, acceptance of disease, beliefs about necessity of self-management to improve gout-related health, resistance and reluctance for medication adherence and dietary alteration/changes, negative emotions influencing self-management, social support and interactions, environmental context, and self-regulation of behavior. Quantitative determinants associated with self-management behavior, predominantly medication adherence, were mapped to 12 of the 14 domains of the TDF. No determinants regarding skills and goals have been identified in quantitative research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Intervention targets for self-management behavior in patients with gout mainly included determinants related to knowledge, implicit and explicit beliefs and attitudes, the environmental context and resources, and (social) support and reinforcement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 4","pages":"534-544"},"PeriodicalIF":3.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Identification of At-Risk Behaviors in Adolescents With Rheumatic Disease","authors":"Kristina Ciaglia,&nbsp;May Lau,&nbsp;Chan-hee Jo,&nbsp;Lorien Nassi","doi":"10.1002/acr.25450","DOIUrl":"10.1002/acr.25450","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Many adolescent patients view their rheumatologist as their primary physician, and therefore it is important to screen youth for sexual activity and substance use as recommended by the American Academy of Pediatrics. We implemented an electronic social history questionnaire (SHQ) and alert system to identify at-risk behaviors in adolescents with rheumatic disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SHQ was administered to adolescents 14 years and older with a goal to survey patients’ sexual activity and alcohol, tobacco, and drug use. The SHQ was given via tablet at each rheumatology outpatient visit. A positive response triggered a best practice advisory (BPA) alert when the chart was opened to remind the clinician to discuss these results privately.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 877 unique patients were surveyed. Ninety patients (12%) reported being sexually active, and sexually active patients were significantly older than those who were not (17.2 vs 15 years; <i>P</i> &lt; 0.001). Seventy-two percent of patients were female, and the mean age was 15.8 years. Sexually active patients were more likely to be smokers, to drink alcohol, and to use other drugs (<i>P</i> &lt; 0.001). Strong associations were observed between alcohol use and male sex (<i>P</i> = 0.0227), White race (<i>P</i> = 0.0052), and public insurance (<i>P</i> = 0.0021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, 12% of patients reported being sexually active, underscoring the need to screen adolescents for sexual activity given many rheumatology patients take teratogenic medication. A smaller proportion used substances. Implementing an electronic medical record–based SHQ can help identify patients most at risk, and the BPA serves as a useful tool to remind clinicians to discuss the SHQ privately.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 4","pages":"522-527"},"PeriodicalIF":3.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities Between Rural and Urban Communities: Response to 18 Months of Diet and Exercise Versus Control for Knee Osteoarthritis and Overweight or Obesity","authors":"Stephen P. Messier,&nbsp;Megan G. Monroe,&nbsp;Leigh F. Callahan,&nbsp;Shannon L. Mihalko,&nbsp;Daniel P. Beavers,&nbsp;Kate Queen,&nbsp;Gary D. Miller,&nbsp;Elena Losina,&nbsp;Jeffrey N. Katz,&nbsp;Richard F. Loeser,&nbsp;Paul DeVita,&nbsp;David J. Hunter,&nbsp;Sara A. Quandt","doi":"10.1002/acr.25448","DOIUrl":"10.1002/acr.25448","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study objective was to determine whether the clinical response of older adults with knee osteoarthritis and overweight or obesity to 18 months of diet and exercise (D + E) or attention control (C) interventions differed between participants from rural versus urban communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 823 older adults (mean age, 64.6 years; 77% women) with knee osteoarthritis and overweight or obesity who resided in rural (n = 410) and urban (n = 413) counties in North Carolina. All were enrolled in the Weight Loss and Exercise for Communities with Arthritis in North Carolina clinical trial that randomly assigned participants to either 18 months of D + E or C interventions. General linear models were used to examine differences in clinical outcomes between rural and urban groups after adjusting for covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rural group had significant differences (<i>P</i> &lt; 0.05) at baseline in clinical outcomes, education, comorbidities, medication use, and income compared with the urban dwellers. After adjusting for baseline differences, the group (rural or urban) by treatment (D + E or C) interactions for Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) pain (rural: D + E – C = −0.63, 95% confidence interval [CI] −1.31 to 0.06; urban: D + E − C= −0.29, 95% CI −0.99 to 0.41; <i>P</i> = 0.50) and WOMAC function (rural: D + E − C = −4.60, 95% CI −6.89 to −2.31; urban: D + E − C = −1.38, 95% CI −3.73 to 0.94; <i>P</i> = 0.054) indicated that the groups responded similarly to the interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among participants with knee osteoarthritis and overweight or obesity, D + E compared to C led to similar pain outcomes in rural and urban dwellers that favored D + E. The possibility that there may be greater differential efficacy in functional outcomes among rural participants needs further study.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 1","pages":"69-76"},"PeriodicalIF":3.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis","authors":"Belinda J. Lawford,&nbsp;Rana S. Hinman,&nbsp;Libby Spiers,&nbsp;Alexander J. Kimp,&nbsp;Andrea Dell'Isola,&nbsp;Alison R. Harmer,&nbsp;Martin Van der Esch,&nbsp;Michelle Hall,&nbsp;Kim L. Bennell","doi":"10.1002/acr.25451","DOIUrl":"10.1002/acr.25451","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting &lt;60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: −0.38 [95% confidence interval (CI) −0.59 to −0.17] vs −0.31 [95% CI −0.45 to −0.16], respectively; SMD function: −0.43 [95% CI −0.64 to −0.21] vs −0.36 [95% CI −0.58 to −0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: −0.60 [95% CI −0.81 to −0.39] vs −0.93 [95% CI −1.27 to −0.59]; SMD function: −0.64 [95% CI −0.83 to −0.44] vs −0.85 [95% CI −1.20 to −0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: −0.79 [95% CI −1.20 to −0.38] vs −1.00 [95% CI −2.52 to 0.53]; SMD function: −0.83 [95% CI −1.27 to −0.38] vs −0.76 [95% CI −2.02 to 0.50]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. Given there was substantial heterogeneity and many publications were at risk of bias, our results should be interpreted with caution.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 4","pages":"460-474"},"PeriodicalIF":3.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456863","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}