Arthritis Care & Research最新文献

{"title":"Improving documentation rates of contraception and reproductive planning in rheumatic disease patients.","authors":"Benjamin Moon, Puneet Bajaj, Megan Clowse, James Roberts, Kathryn Dao, Bonnie L Bermas, Brooke S Mills","doi":"10.1002/acr.25562","DOIUrl":"https://doi.org/10.1002/acr.25562","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to improve contraception and reproductive planning documentation within rheumatology providers' notes at a single academic center.</p><p><strong>Methods: </strong>Female patients aged 18-45 years old with autoimmune inflammatory rheumatic diseases were identified and chart review was performed for documentation of contraception and pregnancy planning. Baseline data were collected from 148 charts between May 2022 and March 2023. In June 2023, a reproductive health assessment questionnaire was integrated into the electronic health record and sent to patients for completion prior to their visits. Post intervention data was collected from 176 charts between July 2023 and December 2023. Demographics of patients (race, ethnicity, gender) and provider gender were collected. Telehealth and face to face visits were assessed separately.</p><p><strong>Results: </strong>A statistically significant increase (p<0.0001) was seen in provider documentation of both contraception (44.6% to 70.5%) and pregnancy planning (15.5% to 60.2%) after implementation of the pre-visit questionnaire. When patients prescribed teratogenic medications were analyzed separately, there was statistically significant (p<0.0001) better documentation of pregnancy planning after the intervention. Secondary analyses found that patient age, race/ethnicity, encounter type, or provider gender had no significant impact on documentation rates.</p><p><strong>Conclusions: </strong>By integrating an electronic, pre-visit questionnaire into the patient portal, documentation was significantly improved for contraception and pregnancy planning. The results were sustained for 6 months. Further studies are needed to see if improved documentation translates into more effective reproductive health care discussions, referrals to gynecology, and subsequent improvement in reproductive health outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975427","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":"Acetaminophen Safety in Older Adults With OA: Key Considerations.","authors":"Fernando Gallardo-Landauro, Germán Delgado de la Flor-Aquino, Luis A Fernández-Cornejo","doi":"10.1002/acr.25559","DOIUrl":"https://doi.org/10.1002/acr.25559","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963827","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":"Survival in immune checkpoint inhibitor-treated patients with rheumatoid arthritis and non-small cell lung cancer: an observational cohort study.","authors":"Deanna P Jannat-Khah, Fenglong Xie, Ashish Saxena, Jeffrey R Curtis, Anne R Bass","doi":"10.1002/acr.25561","DOIUrl":"https://doi.org/10.1002/acr.25561","url":null,"abstract":"<p><strong>Objective: </strong>To compare overall survival (OS) in immune checkpoint inhibitor (ICI)-treated patients with metastatic non-small cell lung cancer (mNSCLC) with pre-existing RA versus those without RA.</p><p><strong>Methods: </strong>A retrospective cohort study using Medicare Claims data was performed. Participants included patients ≥ 66 years of age with a diagnosis of a malignant neoplasm of lung and bronchus (who initiated nivolumab, pembrolizumab, or atezolizumab between 3/4/2015-4/11/2019, which is after FDA approval of ICIs for mNSCLC but prior to first FDA approval for stage III disease. Survival analysis using Kaplan Meier and adjusted Cox Proportional Hazard models was performed.</p><p><strong>Results: </strong>A total of 2,732 people with mNSCLC (N=790 RA and N=1942 non-RA) were in the analytic cohort. RA patients were more likely to be female and had more comorbidities, than non-RA patients. RA patients were more likely to be taking steroids than non-RA patients (63% vs 45%), but equally likely to be taking dexamethasone, usually prescribed for cancer palliation, specifically (27% vs 28%) prior to ICI initiation. There was no difference in overall survival (OS) between the RA and non-RA NSCLC Kaplan Meier survival curves (log-rank p-value=0.08) and in adjusted models, (Hazard Ratio 0.92 [0.78, 1.09]). Male sex, having more comorbidities, and steroid dose prior to ICI initiation were associated with worse OS. In a sensitivity analysis omitting patients on baseline dexamethasone, steroid dose prior to ICI initiation was no longer associated with worse OS.</p><p><strong>Conclusion: </strong>After controlling for demographics and comorbid conditions, ICI-treated RA patients with mNSCLC had no difference in OS compared to non-RA patients. After excluding patients on dexamethasone, steroid dose was not associated with worse OS.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955136","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":"Recommendations for the use of DMARDs in pregnancy and reproductive health for patients with rheumatic disease: A scoping review.","authors":"Athena Chin, Alice Terrett, Mihye Kwon, Samuel Whittle, Catherine Hill","doi":"10.1002/acr.25558","DOIUrl":"https://doi.org/10.1002/acr.25558","url":null,"abstract":"<p><strong>Objective: </strong>Autoimmune rheumatic diseases commonly affect individuals of childbearing age, with historically increased adverse pregnancy outcomes in this group. The advent of disease-modifying anti-rheumatic drugs (DMARDs) has fostered more suitable conditions for pregnancy; however, this is accompanied by challenges in ensuring safe use in reproductive health. The aim of this review is to compare existing guideline recommendations for the use of DMARDs in pregnancy and reproductive health for patients with rheumatic disease.</p><p><strong>Methods: </strong>A scoping review was performed with Medline and EMBASE, in addition to a hand search, to identify guidelines published since 2014 by academic societies in rheumatology that addressed management of DMARDs in pregnancy in any of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus. Conventional synthetic DMARDs (csDMARDS; methotrexate, sulfasalazine, leflunomide, hydroxychloroquine), biologic DMARDs (bDMARDs; adalimumab, etanercept, infliximab, golimumab, certolizumab, abatacept, tocilizumab, rituximab, anakinra) and targeted synthetic DMARDs (tsDMARDs; tofacitinib, baricitinib, upadacitinib) were targeted. Two authors performed data extraction in duplicate.</p><p><strong>Results: </strong>18 guidelines were included. Recommendations for DMARD use in pre-conception were present in 10 (56%), lactation in 12 (67%) and male fertility in 6 (33%). 13 (72%) guidelines included recommendations for csDMARDs, 13 (72%) bDMARDs and 5 (28%) tsDMARDs. There was moderate evidence supporting relatively uniform csDMARD recommendations, compared to minimal evidence for b/tsDMARD use with variable recommendations.</p><p><strong>Conclusion: </strong>There is heterogeneity in formulation of guidelines on the use of DMARDs in pregnancy. Recommendations for csDMARDs were similar between guidelines. There was significant variability in recommendations for b/tsDMARD use, reflecting current minimal literature in this area.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961245","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":"A Consensus Based Shoulder Examination for Rheumatology Training.","authors":"H Berk Degirmenci, Robert Kalish, Ratnesh Chopra, Katarzyna Gilek-Seibert, Fotios Koumpouras, Vasileios Kyttaris, Santhanam Lakshminarayanan, Bonita Libman, Stephanie Mathew, Kenneth O'Rourke, Anthony Reginato, Eugene Kissin","doi":"10.1002/acr.25556","DOIUrl":"https://doi.org/10.1002/acr.25556","url":null,"abstract":"<p><strong>Background: </strong>Physical examination of a patient with nonspecific shoulder pain is a non-standardized teaching objective among rheumatology fellowship programs. We investigated consensus among rheumatology fellowship program directors (PD) in shoulder examination maneuvers to be performed by rheumatology fellows.</p><p><strong>Methods: </strong>Past or present rheumatology PDs currently working in New England taught a 5-minute shoulder examination to one of their trainees and recorded the resulting video of the shoulder examination. We cataloged all the performed maneuvers from these videos. Anonymized electronic surveys instructed PDs to rank each maneuver into one of the three categories: (Tier 1) Teach all fellows and should be performed routinely; (Tier 2) Teach all fellows but should be performed only in specific scenarios; (Tier 3) Teach only to selected fellows and should be performed only in specific scenarios. For maneuvers performed differently, we surveyed for consensus. Items not meeting ≥70% consensus threshold were included in the second survey and this process was repeated for a third survey. A separate survey collected PD demographics.</p><p><strong>Results: </strong>11 of 13 recruited PDs agreed to participate and 100% of participants completed all rounds of the study. The study addressed 65 items: 52 questions for tier designation of the examination maneuvers and 13 questions for different examination techniques. Participants achieved consensus for 40/52 tier designation items and for 8/13 technique items.</p><p><strong>Conclusion: </strong>This is the first study focused on shoulder examination specific to rheumatology practice and these results can provide high yield guidance for the rheumatology community. Febuxostat use is associated with a significantly greater risk of mild to moderate perturbation of liver function compared to benzbromarone in patients with gout.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968162","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":"Ageism in Rheumatology: the Healthcare Professional's Perspective.","authors":"Aaron P Smith, Pooja M Achanta, Jiha Lee, Namrata Singh, Una E Makris","doi":"10.1002/acr.25557","DOIUrl":"https://doi.org/10.1002/acr.25557","url":null,"abstract":"<p><strong>Objective: </strong>Ageism (age-based stereotypes, prejudice, or discrimination) is prevalent and linked to prolonged disability and reduced lifespan in older adults. Little is known about ageism within rheumatology. This study explores the healthcare professional's (HCP) perception of the care of older adults and how ageist attitudes or perspectives may impact rheumatologic care.</p><p><strong>Methods: </strong>A REDcap survey related to the clinical care of older adults that included the validated Expectations Regarding Aging (ERA-12) instrument (higher scores associated with less age-related bias) was administered to a convenience sample of HCP caring for patients with rheumatic disease. We calculated correlations between ERA-12 scores and the responses to other survey questions.</p><p><strong>Results: </strong>255 surveys were collected from 01/2023 to 12/2023. Respondents were predominantly female (63%), White (70%), physicians (75%) with academic (66%), urban (64%) practices and most practices having >25% adults over the age of 65 (88%). The median ERA-12 score was 36/48 indicating that respondents on average disagreed with the stereotypes regarding aging. Higher ERA-12 scores were associated with greater enjoyment of the care of older adults (p<0.001) and awareness of the Geriatric 5Ms (p<0.001), a framework for improving age-friendly care. Lower ERA-12 scores were associated with believing that older adults are more demanding of attention (p<0.001) and shifting from disease modifying therapy to symptom relief in older adults (p<0.001).</p><p><strong>Conclusion: </strong>Stereotypical beliefs regarding aging are associated with self-reported changes to patient counseling and medical decision making, suggesting age related biases may affect the care of older adults with rheumatic diseases.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957266","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":"Real-World Cost-Effectiveness of a Standardized Education and Exercise Therapy Program Hip and Knee Osteoarthritis Compared to Usual Care.","authors":"Darren R Mazzei, Jackie L Whittaker, Peter Faris, Tracy Wasylak, Deborah A Marshall","doi":"10.1002/acr.25555","DOIUrl":"https://doi.org/10.1002/acr.25555","url":null,"abstract":"<p><strong>Objective: </strong>We estimated the real-world cost-effectiveness of a standardized education and exercise therapy program (GLA:D®) compared to usual care (UC) for people managing hip and/or knee osteoarthritis (HKOA).</p><p><strong>Methods: </strong>We used a prospective matched cohort design to recruit people (age>45 years) diagnosed with HKOA who used GLA:D® or UC (not on a surgical waitlist) throughout Alberta, Canada. Demographics, pain, function, quality of life, and an HKOA-related cost questionnaire were administered over 12 months. The primary Ministry of Health (MOH) perspective used administrative data to estimate all public healthcare costs. The secondary healthcare perspective included MOH, private insurance, and out-of-pocket costs. We calculated our cost-effectiveness measure, incremental net monetary benefit (INMB), over 12 months with a $30,000/QALY willingness to pay threshold and adjusted for the differences between cohorts. A Markov model was used to extend INMB over a lifetime time horizon (3% discounting). Model uncertainty was explored by probabilistic sensitivity analyses.</p><p><strong>Results: </strong>254 participants (GLA:D® n=127, UC n=127; 72% female), with a mean age of 64.3 years (95%CI:63.1-65.5), diagnosed with knee OA (63%), hip OA (24%) or both (13%) for a mean of 5.5 years (95%CI:4.8-6.3). The adjusted INMB of GLA:D® compared to UC was $6,065 (95%CI:$3,648-$8,482) and $499 (95%CI:-$2,913-$3,912) from a MOH and healthcare perspective over 12 months and $6,574 and $1,775 over a lifetime with 54% and 51% probability of being cost-effective using a threshold of willingness to pay of $30,000 per QALY.</p><p><strong>Conclusions: </strong>GLA:D® had a positive INMB compared to UC from the MOH perspective over 12 months. The INMB remained positive but was less certain over a lifetime or when out-of-pocket and private insurance costs were considered.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061997","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":"Development, Usability, and Validity Evidence of a Rheumatology Telehealth Feedback Form.","authors":"Lisa Zickuhr, Alberto Sobrero, Daniel Albert, Amanda S Alexander, Tami Bonnett-Ami, Sarah Dill, Sharon Dowell, Elizabeth D Ferucci, Connie Herndon, Bharat Kumar, David Leverenz, Jennifer Mandal, Amaad Rana, Irene J Tan, Swamy Venuturupalli, Tiffany Westrich-Robertson, Marcy B Bolster, Jason Kolfenbach","doi":"10.1002/acr.25552","DOIUrl":"https://doi.org/10.1002/acr.25552","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatology telehealth is widespread, making it essential that rheumatology fellows-in-training (FITs) achieve competence delivering telehealth care before entering the workforce. Feedback enhances telehealth skill development. This study develops a Rheumatology Telehealth Feedback Form (RTFF) that incorporates existing data and expertise as well as gathers validity evidence supporting its use.</p><p><strong>Methods: </strong>The American College of Rheumatology Workforce Solutions Committee formed a Working Group with expertise in rheumatic diseases, telehealth, and medical education. The Working Group conducted a modified Delphi and focus groups to define content grounded in Rheumatology Telehealth Competencies and evidence-based practice as well as develop the RTFF. Rheumatology educators and FITs piloted the RTFF during patient care and simulated telehealth encounters, rating the helpfulness of the RTFF and providing data to calculate intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>The modified Delphi identified 16 skills essential to conducting rheumatology telehealth encounters, which were converted into 17 items on the RTFF. Comment boxes prompted supplementary narrative. Five educators and ten FITs piloted the materials. All (5/5) \"agreed\" or \"strongly agreed\" that the RTFF helped teach rheumatology telehealth skills. ICCs calculated from two simulated telehealth encounters demonstrated moderately-to-strongly supportive interrater reliability (ICC=0.857 and 0.632).</p><p><strong>Conclusion: </strong>The RTFF incorporates evidence-based, expert consensus of the skills most essential for rheumatology telehealth encounters. Educators can use the RTFF as a guide for observing FITs delivering telehealth care, providing formative feedback, and helping FITs develop their skills before entering the workforce. The RTFF is the first direct observation formative assessment tool designed for teaching rheumatology telehealth skills.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974947","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":"Gastrointestinal perforation as a safety concern among patients with rheumatoid arthritis on Janus kinase inhibitor therapy: A systematic review and network meta-analysis.","authors":"Thipsukhon Sathapanasiri, Manuel Meraz, Hamraz Mokri, Sajesh Veettil, Karn Wijarnpreecha, Naomi Schlesinger, Arthur Kavanaugh, Nathorn Chaiyakunapruk","doi":"10.1002/acr.25554","DOIUrl":"https://doi.org/10.1002/acr.25554","url":null,"abstract":"<p><strong>Objective: </strong>Gastrointestinal perforation (GIP) is a rare and life-threatening safety concern associated with Janus kinase inhibitors (JAKi). We aimed to review the evidence regarding the risk of GIP associated with the use of JAKi in patients with rheumatoid arthritis (RA) using a systematic review and network meta-analysis (NMA) approach.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov through August 2024. Included were randomized controlled trials (RCTs) comparing JAKi with other comparators in adult RA patients (age ≥ 18 years) and reports of GIP. Risk ratios (RR) with 95% confidence interval (CI) were estimated using a random-effects model. Surface under the cumulative ranking curves (SUCRA) were used to rank interventions.</p><p><strong>Results: </strong>A total of 23 RCTs, involving 20,023 patients were included, with median follow-up time of 24 weeks. The overall incidence of GIP among JAKi-treated patients was 0.19% (95% CI: 0.10-0.35%), with 24 events occurring out of 12,430 patients. Pairwise meta-analysis showed that the risk of GIP among JAKi was not significantly increased compared to csDMARDs (RR = 1.02; 95% CI: 0.41-2.56; I² = 0.0%). The results of the network meta-analysis are consistent with the pairwise meta-analysis finding. Compared to csDMARDs, there was no statistically significant increase in GIP risk with JAKi (RR 0.83; 95% CI: 0.37-1.84; p=0.64) with inconsistency (P=0.55). The SUCRA of JAKi (50.8%) and bDMARDs (77.0%) indicated a low risk of GIP.</p><p><strong>Conclusion: </strong>JAK inhibitors were not associated with an increased risk of gastrointestinal perforation compared to csDMARDs in RA patients.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975426","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":"Two-Year Follow-Up of a Multidisciplinary Lifestyle Intervention for Rheumatoid Arthritis and Osteoarthritis.","authors":"Carlijn A Wagenaar, Wendy Walrabenstein, Marike van der Leeden, Franktien Turkstra, Martijn Gerritsen, Jos W R Twisk, Maarten Boers, Martin van der Esch, Henriët van Middendorp, Peter J M Weijs, Dirkjan van Schaardenburg","doi":"10.1002/acr.25553","DOIUrl":"https://doi.org/10.1002/acr.25553","url":null,"abstract":"<p><strong>Objective: </strong>The Plants for Joints intervention (PFJ), including a whole-food plant-based diet, exercise, and stress reduction, reduced signs and symptoms of rheumatoid arthritis (RA) or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared to usual care. This study examined outcomes two years later.</p><p><strong>Methods: </strong>After two 16-week randomized controlled trials in people with 1) RA or 2) MSOA, control groups received the active PFJ intervention. All participants were then followed in a two-year observational extension study. Primary outcomes were DAS28 (RA) and WOMAC (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes, and adherence to intervention recommendations. Within-group differences were assessed using linear mixed models, comparing the start and end of the intervention to two years post-intervention.</p><p><strong>Results: </strong>48 (62%) of 77 RA participants and 44 (69%) of 64 MSOA participants completed the extension study. Two years post-intervention the DAS28 in RA participants (-0.9 points 95% CI -1.2, -0.6) and WOMAC score in MSOA participants (-8.8 points 95% CI -12.6, -5.1) were significantly lower than start intervention. Also, CRP in the RA group, and weight, BMI, waist circumference, and diastolic blood pressure in the MSOA group, were significantly lower compared to start intervention. Primary endpoints remained similar from the end of the intervention to the end of the extension study. During the extension study, medication use decreased slightly, and participants continued to follow the intervention recommendations.</p><p><strong>Conclusion: </strong>Two years after the PFJ intervention, improvements in RA disease activity, MSOA symptoms and functioning, and intervention adherence were sustained.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967376","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}