Arthritis Care & Research最新文献

{"title":"When Usual Care Is Not So Usual: Protocol Violations and Generalizability in a Treat-to-Target Strategy Trial in Patients With Axial Spondyloarthritis","authors":"Clementina López-Medina,&nbsp;Filip van den Bosch,&nbsp;Désirée van der Heijde,&nbsp;Maxime Dougados,&nbsp;Anna Molto","doi":"10.1002/acr.25387","DOIUrl":"10.1002/acr.25387","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to evaluate the impact of protocol violations in the treat-to-target group in the Tight Control in Spondyloarthritis (TICOSPA) trial and to compare the proportion of patients optimally treated according to the Assessment of Spondyloarthritis International Society (ASAS)/EULAR 2016 recommendations for patients with axial spondyloarthritis (axSpA) between the treat-to-target versus usual care (UC) arms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a cluster-randomized, controlled 48-week trial including patients with axSpA who fulfilled the ASAS criteria, had an Axial Spondyloarthritis Disease Activity Score &gt;2.1, and were biologic disease-modifying antirheumatic drug naive. Eighteen axSpA expert centers were randomly allocated to one treatment arm: (a) treat-to-target prespecified management strategy (four-week visits), and (b) UC treatment decisions at the rheumatologist's discretion (12-week visits). Protocol violations in the treat-to-target arm and the fulfillment of the 2016 ASAS/EULAR recommendations in both arms were evaluated at every visit. ASAS Health Index (ASAS-HI) and disease activity outcomes at 48 weeks were compared between treat-to-target violators versus nonviolators. Patients treated according to the ASAS/EULAR recommendations were compared between both arms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 160 patients initiated the trial (80 patients with treat to target; 80 patients with UC). In the treat-to-target arm, 51.2% patients violated the protocol at least once (62.2% of violations resulting in maintenance/reduction of treatment against protocol). After 48 weeks, treat-to-target violators versus nonviolators showed similar ratios of ASAS-HI improvement. The proportion of patients managed according to the ASAS/EULAR recommendations after the first 12 weeks were 63.9% versus 61.8% for the treat-to-target and UC arms, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Protocol violations in the treat-to-target arm in the TICOSPA trial were frequent, although they did not have an impact on the rate of the primary outcome. The groups with UC was optimally treated, partly explaining the nonachievement of the primary objective in the TICOSPA trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 11","pages":"1540-1548"},"PeriodicalIF":3.7,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454941","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":"Adherence and Treat-to-Target Benchmarks in Older Adults With Gout Initiating Urate-Lowering Therapy in Ontario, Canada: A Population-Based Study","authors":"Timothy S. H. Kwok,&nbsp;Bindee Kuriya,&nbsp;Gillian Hawker,&nbsp;Lihi Eder,&nbsp;Ping Li,&nbsp;Gregory Choy,&nbsp;Jessica Widdifield","doi":"10.1002/acr.25380","DOIUrl":"10.1002/acr.25380","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We sought to evaluate urate-lowering therapy (ULT) adherence and treatment-to-target (T2T) serum uric acid (SUA) levels among older adults with gout starting ULT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a population-based retrospective cohort study in Ontario, Canada in patients with gout aged ≥66 years newly dispensed ULT between 2010 and 2019. We defined successful T2T as patients having SUA levels &lt;360 μmol/L (6 mg/dL) within 12 months after ULT dispensation. We also assessed adherence to ULT. Multilevel logistic regression clustered by ULT prescriber evaluated patient, physician, and prescription factors associated with reaching target SUA levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 44,438 patients (mean ± SD age 76.0 ± 7.3 years; 64.4% male), 30,057 (67.6%) patients had ≥1 SUA test completed. Overall, 52.3% patients reached SUA target within 12 months, improving from 45.2% in 2010 to 61.2% in 2019 (<i>P</i> &lt; 0.0001). ULT adherence was 55.3% overall and improved annually. Key factors associated with achieving T2T included febuxostat treatment (odds ratio [OR] 11.40, 95% confidence interval [95% CI] 5.10–25.43) (was only dispensed in 88 patients), ULT adherence (OR 5.17, 95% CI 4.89–5.47), allopurinol starting doses &gt;50 mg (OR 2.53, 95% CI 2.14–2.99), colchicine/oral glucocorticoids co-prescription (OR 1.24, 95% CI 1.14–1.34), and ULT prescription from a rheumatologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Only 52.3% of patients achieved an optimal SUA level within 1 year of ULT initiation. ULT adherence was suboptimal, although improving over time. ULT adherence and higher allopurinol starting doses had the strongest associations of achieving a target SUA level. This study highlights room for improvement in gout management and potential strategies to address care gaps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1379-1389"},"PeriodicalIF":3.7,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236877","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":"Hydroxychloroquine Improves Low Complement Levels","authors":"Rebecca Jacobson,&nbsp;Daniel Goldman,&nbsp;Andrea Fava,&nbsp;Laurence Magder,&nbsp;Michelle Petri","doi":"10.1002/acr.25381","DOIUrl":"10.1002/acr.25381","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Having a low complement level is associated with clinical systemic lupus erythematosus (SLE) disease activity and future organ damage. We studied the association of hydroxychloroquine (HCQ) whole blood levels with changes in complement level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed two analyses on data prospectively collected from an SLE cohort. In the first (a “new starts on HCQ” analysis), we compared changes in complement level between those starting HCQ and those not starting it. The second analysis evaluated the association between HCQ whole blood levels and low complement level in all cohort visits using conditional logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the “new starts on HCQ” analysis, a higher percentage of patients starting HCQ (as reflected in HCQ blood levels &gt;50) experienced a normalization of C4 level compared to those not starting HCQ (23 of 57 [40%] vs. 9 of 56 [13%]; <i>P</i> = 0.011), as well as a significantly greater increase in both C3 and C4 level (<i>P</i> = 0.048 and <i>P</i> = 0.017, respectively). In the “all cohort visits” analysis, there was a statistically significant higher probability of having normal C4 levels in visits with higher HCQ whole blood levels (odds ratio 1.8–2.6 depending on the levels). This relationship was most pronounced for whole blood HCQ levels of 200 ng/mL or more.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We observed significant improvement in complement levels when HCQ was started and among those with higher whole blood levels of HCQ, particularly with respect to C4. Modulating the pathogenic mechanisms that lead to complement consumption may be one mode by which HCQ prevents poor outcomes in SLE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1396-1399"},"PeriodicalIF":3.7,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236837","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":"Calculation of the effect of pain sensitization on opioid-induced hyperalgesia in knee osteoarthritis: comment on the article by Aoyagi et al","authors":"Michael R. Bubb","doi":"10.1002/acr.25379","DOIUrl":"10.1002/acr.25379","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1444"},"PeriodicalIF":3.7,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086462","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":"Relationship of Fatigue, Pain Interference, and Physical Disability in Children Newly Diagnosed With Juvenile Idiopathic Arthritis","authors":"Naomi Choong,&nbsp;Michelle Batthish,&nbsp;Roberta A. Berard,&nbsp;Gaëlle Chédeville,&nbsp;Brian M. Feldman,&nbsp;Kristin M. Houghton,&nbsp;Adam M. Huber,&nbsp;Sarah James,&nbsp;Jean-Philippe Proulx-Gauthier,&nbsp;Dax G. Rumsey,&nbsp;Heinrike Schmeling,&nbsp;Karine Toupin-April,&nbsp;Jaime Guzman,&nbsp;for the CAPRI Registry Investigators","doi":"10.1002/acr.25377","DOIUrl":"10.1002/acr.25377","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Our objectives were to quantify the relationships among fatigue, pain interference, and physical disability in children with juvenile idiopathic arthritis (JIA) and to test whether fatigue mediates the relationship between pain interference and physical disability in JIA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients enrolled within three months of JIA diagnosis in the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) Registry between February 2017 and May 2023 were included. Their parents completed the Patient-Reported Outcomes Measurement Information System fatigue and pain interference short proxy questionnaires and the Childhood Health Assessment Questionnaire disability index at registry enrollment. Associations were assessed using Pearson correlations and multiple linear regression. Structural equation modeling (SEM) was used to test if fatigue mediates the relationship between pain interference and physical disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 855 patients (61.4% female, 44.1% with oligoarthritis), most reported fatigue and pain interference scores similar to those in the reference population, but 15.6% reported severe fatigue and 7.3% reported severe pain interference, with wide variation across JIA categories. Fatigue was strongly correlated with pain interference (r = 0.72, <i>P</i> &lt; 0.001) and with physical disability (<i>r</i> = 0.60, <i>P</i> &lt; 0.001). Pain interference (β = 0.027, <i>P</i> &lt; 0.001) and fatigue (β = 0.013, <i>P</i> &lt; 0.001) were both associated with physical disability after controlling for each other and potential confounders. SEM supported our hypothesis that fatigue partially mediates the relationship between pain interference and physical disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest both fatigue and pain interference are independently associated with physical disability in children newly diagnosed with JIA, and the effect of pain interference may be partly mediated by fatigue.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1409-1418"},"PeriodicalIF":3.7,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070408","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":"Predicting Gout Flares in People Starting Allopurinol Using the Start-Low Go-Slow Dose Escalation Strategy","authors":"Lisa K. Stamp,&nbsp;Anne Horne,&nbsp;Borislav Mihov,&nbsp;Jill Drake,&nbsp;Janine Haslett,&nbsp;Peter Chapman,&nbsp;Christopher Frampton,&nbsp;Nicola Dalbeth","doi":"10.1002/acr.25376","DOIUrl":"10.1002/acr.25376","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study objective was to determine predictors of gout flare when commencing allopurinol using the “start-low go-slow” dose escalation strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A post hoc analysis of a 12-month double-blind placebo-controlled noninferiority trial with participants randomized 1:1 to colchicine 0.5 mg daily or placebo for the first six months was undertaken. Multivariate logistic regression models were used to identify independent predictors of gout flares in the first and last six months of the trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariable analysis revealed a significant association between risk of a gout flare in the first six months and flare in the month before starting allopurinol (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.36–5.17) and allopurinol 100 mg starting dose (OR 3.21, 95% CI 1.41–7.27). The predictors of any gout flares in the last six months of the trial, after stopping colchicine or placebo, were having received colchicine (OR 2.95, 95% CI 1.48–5.86), at least one flare in the month before stopping study drug (OR 5.39, 95% CI 2.21–13.15), and serum urate ≥0.36 mmol/L at month 6 (OR 2.85, 95% CI 1.14–7.12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anti-inflammatory prophylaxis when starting allopurinol using the “start-low go-slow” dose escalation strategy may be best targeted at those who have had a gout flare in the month before starting allopurinol and are commencing allopurinol 100 mg daily. For those with ongoing gout flares during the first six months of starting allopurinol who have not yet achieved serum urate target, a longer period of prophylaxis may be required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1371-1378"},"PeriodicalIF":3.7,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25376","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065299","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":"Opioid Treatment for Adults With and Without Systemic Autoimmune/Inflammatory Rheumatic Diseases: Analysis of 2006–2019 United States National Data","authors":"Yinan Huang,&nbsp;Sebastian Bruera,&nbsp;Sandeep Krishna Agarwal,&nbsp;Maria E. Suarez-Almazor,&nbsp;Shadi Bazzazzadehgan,&nbsp;Sujith Ramachandran,&nbsp;Kaustuv Bhattacharya,&nbsp;John P. Bentley,&nbsp;Yi Yang","doi":"10.1002/acr.25378","DOIUrl":"10.1002/acr.25378","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study compared opioid prescribing among ambulatory visits with systemic autoimmune/inflammatory rheumatic diseases (SARDs) or without and assessed factors associated with opioid prescribing in SARDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used the National Ambulatory Medical Care Survey between 2006 and 2019. Adult (≥18 years) visits with a primary diagnosis of SARDs, including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or systemic lupus erythematosus were included in the study. Opioid prescribing was compared between those with vs without SARDs using multivariable logistic regression accounting for the complex survey design and adjusting for predisposing, enabling, and need factors within Andersen's Behavioral Model of Health Services Use. Another multivariable logistic regression examined the predictors associated with opioid prescribing in SARDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Annually, an average of 5.20 million (95% confidence interval [CI] 3.58–6.82) visits were made for SARDs, whereas 780.14 million (95% CI 747.56–812.72) visits were made for non-SARDs. The SARDs group was more likely to be prescribed opioids (22.53%) than the non-SARDs group (9.83%) (adjusted odds ratio [aOR] 2.65; 95% CI 1.68–4.18). Among the SARDs visits, patient age from 50 to 64 (aOR 1.95; 95% CI 1.05–3.65 relative to ages 18–49) and prescribing of glucocorticoids (aOR 1.75; 95% CI 1.20–2.54) were associated with an increased odd of opioid prescribing, whereas private insurance relative to Medicare (aOR 0.50; 95% CI 0.31–0.82) was associated with a decreased odds of opioid prescribing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Opioid prescribing in SARDs was higher compared to non-SARDs. Concerted efforts are needed to determine the appropriateness of opioid prescribing in SARDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1427-1435"},"PeriodicalIF":3.7,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065295","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":"Interpreting and Addressing Racialized Inequities in Rheumatic Disease Care and Outcomes","authors":"Sherry Yang,&nbsp;Candace H. Feldman","doi":"10.1002/acr.25375","DOIUrl":"10.1002/acr.25375","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 7","pages":"908-913"},"PeriodicalIF":3.7,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943123","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":"Old Before Their Time? The Impact of Osteoarthritis on Younger Adults","authors":"Jessica M. Wilfong,&nbsp;Elizabeth M. Badley,&nbsp;Anthony V. Perruccio","doi":"10.1002/acr.25374","DOIUrl":"10.1002/acr.25374","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Osteoarthritis (OA) is frequently perceived as a disease of the elderly and an inevitable result of aging. Because OA studies often are restricted to older adults, there is limited information on OA in younger adults. This study describes the burden of OA across a wide age range and compares younger and older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Descriptive analysis of the Survey on Living with Chronic Diseases in Canada – Arthritis Component, a nationally representative survey of Canadians ≥20 years who reported an arthritis diagnosis in the Canadian Community Health Survey, a general health population survey. Analyses were restricted to those reporting OA and no other kind of arthritis (n = 1,749).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the representative group with OA, 55.4% were younger than 65 years. The mean age at diagnosis was 50 years, with 30.4% reporting being diagnosed before age 45 years. Younger adults reported similar symptom severity as their older counterparts with OA regarding the mean number of affected joint sites, severity of pain and fatigue, and activity limitations. In the youngest age group, those with OA were significantly more likely to report fair or poor overall and mental health and life dissatisfaction compared with their general counterparts; the same was not the case in the oldest age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>OA is not uncommon among younger and middle-aged adults, and they experience OA impacts comparable with those for older adults. These findings suggest that younger adults with OA will live many years with symptoms and disability and highlight a need for effective OA management across ages.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1400-1408"},"PeriodicalIF":3.7,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943219","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":"Informing Digital Programs for Lupus Self-Management Education: A Systematic Scoping Review","authors":"Katherine Carpenter,&nbsp;Sarah Gilman,&nbsp;Melissa French,&nbsp;Yasmine Shakur,&nbsp;Charmayne Dunlop-Thomas,&nbsp;Laura Cullerton,&nbsp;Cristina Drenkard,&nbsp;Kamil E. Barbour,&nbsp;S. S. Lim","doi":"10.1002/acr.25357","DOIUrl":"10.1002/acr.25357","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We describe the characteristics, content, and effectiveness of digital self-management (SM) education programs for lupus and other chronic conditions to identify gaps and inform the improvement of future programs in lupus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three bibliographic databases were searched for articles published between May 2012 and April 2022. The search was cast to capture the breadth of digital SM education programs in the following conditions: lupus, epilepsy, fibromyalgia, multiple sclerosis, sickle cell anemia, Sjögren syndrome, psoriatic arthritis, and rheumatoid arthritis. Title and abstract screening, as well as full-text review, was conducted by two independent reviewers. Data extraction was first completed by one author charting all studies and then, a second time, by four members of the research team charting collaboratively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1,969 articles identified through the search, 14 met inclusion criteria. Two additional articles were included following bibliography review. The 16 articles represented 12 unique digital SM education programs. Programs covered five conditions: epilepsy (n = 3), fibromyalgia (n = 2), multiple sclerosis (n = 4), lupus (n = 1), and rheumatoid arthritis (n = 2). Most programs were asynchronous and internet-based (n = 9) with a prescribed sequence of content (n = 8). Peer, technical, or specialist support was offered in seven programs. Most programs demonstrated statistically significant improvement of symptoms in the intervention group (n = 8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This scoping review summarizes the current landscape for digital SM education programs in lupus and similar conditions. In lupus, further investigation will fill in the gaps around digital SM education needs, user experience, and evaluation of outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 9","pages":"1211-1223"},"PeriodicalIF":3.7,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911546","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}