Impact of thumb osteoarthritis on pain, function, and quality of life: a comparative study between erosive and non-erosive hand osteoarthritis
AbstractObjectiveThe study was aimed to compare the impact of thumb base osteoarthritis (TBOA) on pain, function, and quality of life in patients with erosive or non-erosive hand osteoarthritis (HOA).MethodsThis observational retrospective study included 232 patients: 64 with erosive HOA (EHOA) and concomitant TBOA, 36 with isolated EHOA, 97 with non-erosive HOA (non-EHOA) and TBOA, and 35 with isolated non-EHOA. Hand pain by a visual analogue scale (VAS), Functional Index for Hand Osteoarthritis (FIHOA) score, Health Assessment Questionnaire (HAQ), the Medical Outcomes Study 36-Item Short Form (SF-36), and the possible co...
Source: Clinical Rheumatology - February 22, 2020 Category: Rheumatology Source Type: research

Effects of rituximab therapy on B cell differentiation and depletion
AbstractRituximab is a human/murine chimeric anti-CD20 monoclonal antibody. It is largely used to treat B cell malignancies and has become standard in the management of B cell ‑mediated diseases such as rheumatoid arthritis and granulomatosis with polyangitis. The effects of rituximab need to be monitored by B cell phenotyping. Evaluate possible surface markers for monitoring B cell development in response to rituximab treatment. This review discusses the literature on the B cell surface markers analysed by flow cytometry in patients treated with rituximab. A panel of biomarkers of response to treatment to monitor by flo...
Source: Clinical Rheumatology - February 22, 2020 Category: Rheumatology Source Type: research

Treatment strategies are more important than drugs in the management of rheumatoid arthritis
AbstractThe treatment of inflammatory arthritides has been changed dramatically in the past two decades with the introduction of the biological (b) disease-modifying anti-rheumatic drugs (DMARDs) as well as the targeting synthetic (ts) DMARDs that can be used as monotherapy or in combination with conventional synthetic (cs) DMARDs. The concept of treat to target (T2T) and tight control monitoring of disease activity represents a therapeutic paradigm of modern rheumatology. In rheumatoid arthritis (RA), this treatment approach has proven to be effective in many clinical trials and is now a well-established approach. The mos...
Source: Clinical Rheumatology - February 22, 2020 Category: Rheumatology Source Type: research

Correction to: Prevalence of musculoskeletal complaints in urban communities in multi-ethnic Suriname: a cross-sectional study with the COPCORD methodology (stage 1, phase 1 and 2)
The footnote of Fig. 2 in the published original version of the above article went missing and the correct figure is presented in this article.] (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 22, 2020 Category: Rheumatology Source Type: research

Clinical phenotypes based on clinical prognostic factors in patients with secondary hip osteoarthritis: preliminary findings from a prospective cohort study
This study aimed to identify clinical phenotypes based on clinical prognostic factors in patients with secondary hip OA using data from prospective cohort studies and to define the clinical features of each phenotype.MethodsFifty patients participated. Two-step cluster analysis was performed to identify the phenotypes using the following potential prognostic factors for hip OA progression: spinal inclination in standing, thoracolumbar spine mobility, daily cumulative hip moment, and minimum joint space width (JSW) at baseline. Comprehensive basic and clinical features (age, body mass index, hip pain, Harris hip score, JSW,...
Source: Clinical Rheumatology - February 22, 2020 Category: Rheumatology Source Type: research

Prevalence of anti-DFS70 autoantibodies in a Latin American cohort of patients with systemic lupus erythematosus and without autoimmune diseases
ConclusionsAnti-DFS70 autoantibodies might be considered a biomarker to differentiate patients with SLE from ANA-positive individuals without autoimmune diseases.Key Points:• In a Latin American cohort, the anti-DFS70 was higher in individuals without autoimmune diseases compared with that in patients with SLE.• The anti-DFS70 might have utility as a biomarker of exclusion in patients with non-specific clinical signs of AARDs. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 22, 2020 Category: Rheumatology Source Type: research

Relative efficacy and safety of iguratimod monotherapy for the treatment of patients with rheumatoid arthritis: a systematic review and meta-analysis
ConclusionOur evidence suggests that iguratimod may be considered a potential alternative to methotrexate to treat rheumatoid arthritis.Key Points•The Asia Pacific League of Association for Rheumatology (APLAR) has recommended that iguratimod may be used a first-line drug for rheumatoid arthritis in specific cases.•Patients on iguratimod may have similar treatment response, functional ability, disease state, and adverse event profile at 24  weeks compared with those on methotrexate.•Iguratimod may be considered a better alternative to methotrexate in RA patients having high CRP and ESR values.•Futu...
Source: Clinical Rheumatology - February 20, 2020 Category: Rheumatology Source Type: research

Characterizing hand and wrist ultrasound pattern in primary Sj ögren’s syndrome: a case-control study
AbstractIntroduction/objectivesTo evaluate the clinical relevance of high-resolution hand and wrist ultrasound (US) findings and their possible associations with anti-citrullinated peptide antibodies in primary Sj ögren’s syndrome (pSS).MethodsNinety-seven consecutive pSS patients (American-European Consensus Group, 2002) without meeting the American College of Rheumatology (ACR) criteria (1987) for rheumatoid arthritis (RA); 20 RA patients (ACR/European League Against Rheumatism (EULAR) criteria, 2010); and 80 healthy individuals with comparable age, gender, and ethnicity were enrolled in a case-control study. ...
Source: Clinical Rheumatology - February 19, 2020 Category: Rheumatology Source Type: research

Central nervous system involvement in patients with antineutrophil cytoplasmic antibody –associated vasculitis: a study of 29 cases in a single Chinese center
AbstractBackgroundIn antineutrophil cytoplasmic antibody (ANCA) –associated vasculitis (AAV), central nervous system (CNS) involvement is relatively uncommon. The current study retrospectively investigated the clinical features and outcomes of AAV patients with CNS involvement.MethodsA total of 497 AAV patients were retrospectively recruited in our center, twenty-nine of which had CNS involvement. Clinical and radiological manifestations and the outcomes of these patients were analyzed.ResultsThe predominant symptom was sensorimotor impairment. According to the MRI findings, twenty-four patients had cerebral ischemic...
Source: Clinical Rheumatology - February 16, 2020 Category: Rheumatology Source Type: research

Risk factors of ultrasound-detected tophi in patients with gout
ConclusionsThe main factors that may influence the formation of tophi are disease duration and eGFR.Key Points•Lower eGFR and longer course duration are independent risk factors of tophi formation in gout patients.•The incidence of ultrasound manifestations including double contour sign (DCS) and erosion in patients with tophi were higher than those without tophi. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 15, 2020 Category: Rheumatology Source Type: research

At the crossroads of gout and psoriatic arthritis: “psout”
AbstractPsoriatic arthritis and gout are frequently encountered conditions sharing a number of common risk factors, which render their independent study difficult. Epidemiological studies have demonstrated a strong link between these diseases, suggesting the presence of underlying, intertwined pathophysiological mechanisms that currently remain unknown. Indeed, sodium urate crystals could play a pathogenic role in psoriasis and psoriatic arthritis. In daily practice, the distinction between psoriatic arthritis associated with hyperuricemia and a gouty arthropathy with psoriasis is complex. Several common pathogenic feature...
Source: Clinical Rheumatology - February 15, 2020 Category: Rheumatology Source Type: research

Big data and data processing in rheumatology: bioethical perspectives
AbstractBig data analytics and processing through artificial intelligence (AI) are increasingly being used in the health sector. This includes both clinical and research settings, and newly in specialties like rheumatology. It is, however, important to consider how these new methodologies are used, and particularly the sensitivities associated with personal information. Based on current applications in rheumatology, this article provides a narrative review of the bioethical perspectives of big data. It presents examples of databases, data analytic methods, and AI in this specialty to address four main ethical issues: priva...
Source: Clinical Rheumatology - February 15, 2020 Category: Rheumatology Source Type: research

Precision medicine and the antiphospholipid syndrome: what is the future?
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 15, 2020 Category: Rheumatology Source Type: research

Serum adipokine levels in patients with sarcoidosis
ConclusionsIn this study, high serum adiponectin level was detected in patients with sarcoidosis while serum leptin level was similar in the sarcoidosis and control group. Adiponectin, an anti-inflammatory protein, may play a role in the pathogenesis of sarcoidosis. Studies are needed to shed light on this topic.Key Points• Sarcoidosis is a chronic granulomatous disease characterized by granuloma formation• High serum adiponectin level was found in sarcoidosis patients• Serum adiponectin level was associated with some clinical features such as arthralgia and arthritis• High adiponectin levels in sarcoid...
Source: Clinical Rheumatology - February 14, 2020 Category: Rheumatology Source Type: research

Acknowledgement to referees 2019
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 14, 2020 Category: Rheumatology Source Type: research

Competency-based medical education for the clinician-educator: the coming of Milestones version 2
AbstractCompetency-based medical education is emphasized by institutions overseeing medical school and postgraduate training worldwide. The high rate of preventable errors in medicine underscores this need. Expanding physician competency beyond the domains of patient care and medical knowledge towards goals that emphasize a more holistic view of the healthcare system is one aspect of this emphasis. The Accreditation Council on Graduate Medical Education (ACGME), which oversees postgraduate training programs in the USA, has recently expanded to oversee training programs internationally. The original ACGME Milestones effort ...
Source: Clinical Rheumatology - February 13, 2020 Category: Rheumatology Source Type: research

Comparison of cytokine profiles between anti-ARS antibody-positive interstitial lung diseases and those with anti-MDA-5 antibodies
ConclusionsAnti-MDA-5-positive ADM-ILD had poorer survival than anti-ARS-ILD. IP-10 seems to be most deeply involved in the pathophysiology of anti-MDA-5-associated ADM-ILD.Key Points•To clarify differences in the inflammatory and immunological features of anti-MDA-5-positive ADM-ILD and anti-ARS-ILD, we performed an observational study to measure serum cytokine concentrations before treatment using a multiplex immunoassay system.•Multivariate logistic regression models revealed that IP-10 was associated with the most significant relative risk for ADM-ILD with anti-MDA-5 antibodies.•Levels of IP-10 were elev...
Source: Clinical Rheumatology - February 13, 2020 Category: Rheumatology Source Type: research

Validation of the 2019 ACR/EULAR classification criteria of systemic lupus erythematosus in 100 Japanese patients: a real-world setting analysis
The objective of the study is to evaluate the sensitivity of the new criteria for the classification of systemic lupus erythematosus (SLE), when applied to real SLE cases. We retrospectively reviewed the electronic medical records of 100 consecutive patients who visited St. Luke ’s International Hospital. Patients were included if they were clinically diagnosed as having SLE and excluded if they had other autoimmune disease or if they were less than 18 years old. Each patient was evaluated if they satisfied the American College of Rheumatology (ACR) 1997 classification c riteria (1997 criteria), 2012 Systemic Lu...
Source: Clinical Rheumatology - February 12, 2020 Category: Rheumatology Source Type: research

Re-establishment of efficacy of tofacitinib, an oral JAK inhibitor, after temporary discontinuation in patients with rheumatoid arthritis
ConclusionsTofacitinib efficacy can be re-established after temporary withdrawal and reinitiation. The safety profile of patients who temporarily discontinued tofacitinib in the sub-study was consistent with previous tofacitinib LTE studies over 9  years.Clinical trial registration numberNCT00413699Key Points•In this sub-study of the long-term extension (LTE) study, ORAL Sequel, the efficacy of tofacitinib was re-established after temporary withdrawal (2  weeks) and reinitation of treatment in patients with RA.•Patients with RA who temporarily discontinued tofacitinib had similar safety events to those ...
Source: Clinical Rheumatology - February 12, 2020 Category: Rheumatology Source Type: research

Diagnosing relapsing polychondritis remains a common challenge: experience from a Chinese retrospective cohort
ConclusionsIncorrect and delayed diagnosis of RP is common in our cohort, and insufficient awareness of the disease in non-rheumatologic specialists at least partially contributes to this. It is imperative to revise the current criteria for early diagnosis.Key Points•Diagnosing relapsing polychondritis (RP) in early stage remains challenging after all these years, especially among non-rheumatologic specialists, indicating the importance of teaching non-rheumatologic specialists to improve their understanding of this rare disease.•Many RP patients did not fully meet with the current criteria, suggesting that revis...
Source: Clinical Rheumatology - February 8, 2020 Category: Rheumatology Source Type: research

Mental health conditions and the risk of chronic opioid therapy among patients with rheumatoid arthritis: a retrospective veterans affairs cohort study
ConclusionsHistory of mental health conditions and duration of the initial opioid prescription were associated with an increased risk of chronic opioid therapy among patients with RA.Key Points•Approximately a third of patients with RA are exposed to opioid analgesics.•Patients with RA and history of mental health disease, especially substance use disorders, who initiate opioid use have an increased risk of chronic opioid therapy.•This study provides insight in an underrepresented population of mainly male patients with RA. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 8, 2020 Category: Rheumatology Source Type: research

Cerebrospinal fluid biomarkers implicated in the pathogenesis of anti-neutrophil cytoplasmic antibody-related hypertrophic pachymeningitis
ConclusionThe levels of BAFF, APRIL, and TGF- β1 may serve as useful CSF biomarkers for assessing the disease activity of immune-mediated HP. Moreover, BAFF and APRIL in the CSF may be implicated in the pathogenesis of ANCA-HP via promoting autoreactive B cells, while detecting MPO- or PR3-ANCA in the CSF may be found in some patients with ANC A-HP.Key Points•CSF BAFF, APRIL, and TGF- β1 levels increase significantly in immune-mediated HP.•CSF BAFF and APRIL levels are significantly correlated with IgG index in ANCA-HP.•Detection of MPO- or PR3-ANCA in the CSF is found in some patients with ANCA-HP...
Source: Clinical Rheumatology - February 8, 2020 Category: Rheumatology Source Type: research

Benefits of exercise in patients with rheumatoid arthritis: a randomized controlled trial of a patient-specific exercise programme
AbstractBackgroundPatients with rheumatoid arthritis (RA) tend to be more overweight, take less physical exercise, exhibit decreased cardiorespiratory fitness and demonstrate reduced muscle strength compared with age- and sex-matched controls. Impaired cognitive function in RA is an important associated factor, although it has been less well-recognized. The aim of this study was to investigate the effects of a specifically designed exercise programme on body composition, aerobic capacity, muscle strength and cognition in RA.MethodsSixty-six patients with RA were randomized to a specifically designed, personalized exercise ...
Source: Clinical Rheumatology - February 8, 2020 Category: Rheumatology Source Type: research

New onset of axial spondyloarthropathy in patients treated with isotretinoin for acne vulgaris: incidence, follow-up, and MRI findings
ConclusionIsotretinoin-induced axial SpA is a prevalent side effect in acne vulgaris patients. Early detection and follow-up of isotretinoin-induced sacroiliitis can be facilitated by MRI. Cessation of isotretinoin resulted in complete resolution in all affected patients.Key Points•Detection of underdiagnosed isotretinoin side effects which are common but not always correctly diagnosed and managed.•Incidence, diagnosis, and management of these side effects in a real-world setting.• This is the first large prospective longitudinal cohort study to report on axial manifestations in patients treated with isotret...
Source: Clinical Rheumatology - February 7, 2020 Category: Rheumatology Source Type: research

Levels of satisfaction with rheumatoid arthritis treatment and associated alignment between physicians and patients across Latin America
ConclusionsHigh treatment satisfaction and alignment were observed among RA patients and their physicians in Latin America. Misaligned patients were more likely to report more severe disease and were less likely to be in remission. Addressing misalignment may lead to improved RA disease control.Key Points• High treatment satisfaction was observed among RA patients and their treating physicians in Latin America.• One-fifth of physician-patient pairs were misaligned in treatment satisfaction.• Patients misaligned with their physicians reported higher disease activity, lower quality of life, and greater disabil...
Source: Clinical Rheumatology - February 7, 2020 Category: Rheumatology Source Type: research

Patient-specific reference values for objective physical function tests: data from the Osteoarthritis Initiative
ConclusionsEstablishing an individual ’s relative level of objective physical function by comparing their performance to individuals with similar sex, age, KL grade, or BMI may help improve interpretation of physical function performance. The interactive reference value table will provide clinicians and researchers a clinically access ible avenue to use these reference values.Key Points• Since greater age, radiographic knee osteoarthritis severity, and body mass index are all associated with worse objective physical function, reference values should consider the complex inter-play among these patient characteris...
Source: Clinical Rheumatology - February 6, 2020 Category: Rheumatology Source Type: research

Integrity of clinical research conduct, reporting, publishing, and post-publication promotion in rheumatology
AbstractThe number of rheumatology journals, and papers related to this specialty, is expanding every day. Careful consideration for ethical aspects of such published work is mandatory for authors, readers, reviewers, editors, and all stakeholders. Recent instances of lack of appropriate research ethics committee overview, or participant consent for inclusion in the research study, or a case report, resulting in retractions, emphasize the need for greater awareness regarding these ethical aspects. Authors should strive to avoid redundancy, especially for review articles, both systematic and narrative. Clinical trial regist...
Source: Clinical Rheumatology - February 5, 2020 Category: Rheumatology Source Type: research

TNF inhibitor treating osseous sarcoidosis and dactylitis: case and literature review
AbstractA 49-year-old African American male with multiorgan sarcoidosis presented with recurrent episodes of dactylitis and arthritis. Imaging had shown sarcoid osseous involvement of both hands. This would improve temporarily with high-dose corticosteroids but once tapered, he would experience recurrent flares. Despite several different oral immunosuppressant regimens, significant improvement was only observed after the initiation of adalimumab. Not only was adalimumab successful in symptomatic relief, in addition, patient continues to be in remission with no recurrent episodes of dactylitis. Prednisone was successfully t...
Source: Clinical Rheumatology - February 4, 2020 Category: Rheumatology Source Type: research

Correction to: Association of rheumatoid arthritis-related autoantibodies with pulmonary function test abnormalities in a rheumatoid arthritis registry
The publisher regrets that the two sections under the Results omitted inadvertently on the original published version of the above article. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 4, 2020 Category: Rheumatology Source Type: research

Correction to: The association between anxiety and disease activity and quality of life in rheumatoid arthritis: a systematic review and meta-analysis
The authors of the published original version of the above article wanted to correct the below text in the Abstract section. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 4, 2020 Category: Rheumatology Source Type: research

Obesity and its role in the management of rheumatoid and psoriatic arthritis
AbstractIn the last decade, interest has been growing in the relationship between obesity and several other clinical conditions, besides the well-established links between body mass index (BMI) and cardiovascular diseases or cancer. A particular focus has been put on the impact of a higher BMI on immune-mediated diseases such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Obesity has been found to be associated with greater arthritis activity and a reduced probability of response to anti-tumor necrosis factor (TNF) agents. On the other hand, weight loss increases the chances of treatment success. Although the ...
Source: Clinical Rheumatology - February 3, 2020 Category: Rheumatology Source Type: research

Is the prevention of rheumatoid arthritis possible?
AbstractPreclinical phases of rheumatoid arthritis (RA) have been described, genetic and environmental risk factors for RA development have been identified, and several biomarkers of RA have been detected long before the clinical onset of the disease; all of which have opened the possibility for preventive interventions. Several studies are currently exploring pharmacological and non-pharmacological interventions to prevent the development of RA. We will review the evidence for prevention of RA and discuss key challenges for preventive interventions, including identification of the adequate target population, the risks of ...
Source: Clinical Rheumatology - February 3, 2020 Category: Rheumatology Source Type: research

Possible benefit of tadalafil cream for the treatment of Raynaud ’s phenomenon and digital ulcers in systemic sclerosis
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 3, 2020 Category: Rheumatology Source Type: research

Study on the relationship between FFA and gout flare
AbstractObjectivesTo detect the serum free fatty acid (FFA) concentration in patients with primary gouty arthritis (GA) and to explore the correlation between FFA and gout flare.MethodSixty patients with acute GA, 60 patients with GA remission, 60 patients with asymptomatic hyperuricemia (HUA), and 60 normal controls were enrolled in this study. Serum FFA concentration was detected by enzymatic determination in four groups, and the relationship between serum FFA, serum urate (SU), and other clinical and laboratory parameters was analyzed.Results(1) Serum FFA concentration was significantly higher in the acute GA than in th...
Source: Clinical Rheumatology - February 3, 2020 Category: Rheumatology Source Type: research

Experience of musculoskeletal ultrasound scanning improves physicians ’ physical examination skills in assessment of synovitis
ConclusionOur data suggest that the experience in musculoskeletal US improves physical examination skills particularly to avoid overestimation.Key Points•Physicians with longer US experience are less likely to overestimate synovitis by physical examination.•Musculoskeletal US is a useful tool for rheumatologists to improve their physical examination skill.•Presence of osteophytes, joint tenderness and obesity influence the accuracy of physical examination of joints. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 1, 2020 Category: Rheumatology Source Type: research

A critical review of the reproductive safety of Leflunomide
AbstractLeflunomide, an inhibitor of pyrimidine synthesis, is used for the treatment of rheumatic diseases, which are prevalent in women of childbearing age. Due to the very long half-life of the active metabolite, its mechanism of action and the teratogenicity observed in animal studies at doses similar to or lower than human therapeutic doses on a weight basis, it is recommended that women stop the treatment before conception and a drug elimination procedure be performed. However, unintended gestational exposures may occur, posing challenges in risk assessment. In order to address the safety of leflunomide in unintended ...
Source: Clinical Rheumatology - February 1, 2020 Category: Rheumatology Source Type: research

Preeclampsia in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis
This study was performed to systematically assess the association between preeclampsia and SLE.MethodAccording to the PRISMA statement, designed literature research was performed in PubMed, Web of Science, and Cochrane Library from inception to June 30, 2018. The pooled risk ratio (RR) of preeclampsia in pregnant SLE patients compared with health controls was synthesized by fixed effect model or random effects model depending on heterogeneity.ResultsTen studies involving 6,389 SLE patients were included. Pregnant women with SLE have significantly increased risk of preeclampsia (RR = 2.99, 95% CI = 2.31 to 3.88;Z = 8.31,P
Source: Clinical Rheumatology - February 1, 2020 Category: Rheumatology Source Type: research

Late-onset systemic lupus erythematosus: characteristics and outcome in comparison to juvenile- and adult-onset patients —a multicenter retrospective cohort
This study included 575 SLE patients managed at Cairo, Alexandria, and Helwan universities from August 2014 to 2018: of whom 49 (8.5%), 420 (73%), and 106 (18.4%) were elderly- (>  50 years), adult- (17–50 years), and juvenile- (≤ 16 years) onset patients, respectively. Cumulative characteristics were recorded. Disease activity at the last visit was investigated through the Systemic Lupus Erythematosus Disease Activity Index-2K (SLEDAI-2K), whereby lupus low diseas e activity (LLDA) was defined as a SLEDAI-2K score ≤ 4. The disease outcome was assessed through inves...
Source: Clinical Rheumatology - February 1, 2020 Category: Rheumatology Source Type: research

Transfusion-related acute lung injury (TRALI) after intravenous immunoglobulins: French multicentre study and literature review
AbstractTransfusion-related acute lung injury (TRALI), defined as the onset of acute respiratory distress after blood transfusion, is a rare complication which is a leading cause of transfusion related-mortality. In this retrospective study, we report the French nationwide experience of intravenous immunoglobulin (IVIG)-related TRALI, with a literature review and analysis of management and outcome of this rare condition. With the pharmacovigilance services, we conducted a retrospective multicenter study in the French network of intensive care units with TRALI concomitant to IVIG use and pooled with data from a literature r...
Source: Clinical Rheumatology - February 1, 2020 Category: Rheumatology Source Type: research

Symptomatic elevation creatine kinase following treatment of rheumatoid arthritis with baricitinib
We report the first two documented cases in Australia of baricitinib-induced symptomatic elevation of CK. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - February 1, 2020 Category: Rheumatology Source Type: research

Interactions and perceptions of patients with rheumatoid arthritis participating in an online support group
ConclusionParticipants were generally enthusiastic and shared disease-related information and personal experiences. Social media groups may provide alternative means of providing education and peer support often lacking in traditional models of care.Key Points•The study examines how patients with rheumatoid arthritis engage in an online support group and the nature of their interactions.• This study reveals that social media platforms could provide viable options or complements to the traditional face-to-face small group patient support system.• It may be necessary to pay special attention to how to ensure a...
Source: Clinical Rheumatology - January 31, 2020 Category: Rheumatology Source Type: research

Plasma gelsolin levels in patients with psoriatic arthritis: a possible novel marker
AbstractBackgroundPsoriatic arthritis (PsA) is an inflammatory disorder affecting the joints of psoriatic patients. Gelsolin regulated the actin assembly and disassembly. Reduction in plasma gelsolin levels was detected in tissue damages, including trauma, sepsis, and chronic inflammatory disorders.ObjectivesThe study aims to investigate the potential role of gelsolin in PsA and to determine the association between gelsolin and the disease activity.MethodsPlasma gelsolin levels were measured in 76 PsA patients in comparison with 40 patients having psoriasis only and 40 age- and sex -matched healthy controls.ResultsPlasma g...
Source: Clinical Rheumatology - January 30, 2020 Category: Rheumatology Source Type: research

No evidence of abnormal metabolic or inflammatory activity in the brains of patients with rheumatoid arthritis: results from a preliminary study using whole-brain magnetic resonance spectroscopic imaging (MRSI)
This study used whole-brain magnetic resonance spectroscopic imaging (MRSI) to investigate whether abnormal inflammatory activity in the central nervous system may be associated with such symptoms. We hypothesized that RA patients would show higher brain choline (CHO), myo-inositol (MI), and lactate (LAC), and higher brain temperature than healthy controls. We further hypothesized that the metabolite levels would be positively correlated with self-reported fatigue.MethodThirteen women with RA provided fatigue severity ratings and underwent whole-brain MRSI and a joint examination. Thirteen healthy controls (HC) provided co...
Source: Clinical Rheumatology - January 30, 2020 Category: Rheumatology Source Type: research

Disease activity –based management of rheumatoid arthritis in Dutch daily clinical practice has improved over the past decade
AbstractTo re-evaluate the adherence to clinical practice guidelines recommended disease activity –based management of rheumatoid arthritis (RA) in daily clinical practice, among Dutch rheumatologists in the past decade. In 2007, disease activity was measured in only 16% of outpatient visits. All rheumatologists that participated in the 2007 study were invited to re-enter our study in 2016/201 7. If necessary, data were supplemented with data from other rheumatologists. For all 26 rheumatologists who agreed to participate in our study, data were collected from 30 consecutive patients that visited the outpatient clini...
Source: Clinical Rheumatology - January 29, 2020 Category: Rheumatology Source Type: research

HDL cholesterol efflux capacity is related to disease activity in psoriatic arthritis patients
ConclusionCEC is inversely associated with disease activity in PSA patients, reinforcing the role of disease activity as a key factor in the development of accelerated atherosclerosis in these patients.Key Points• Cholesterol efflux capacity is linked to cardiovascular events in the general population.• In patients with psoriatic arthritis, cholesterol efflux capacity is inversely associated with disease activity (beta coefficient − 0.75[95% CI− 1.39 –− 0.11] %, p  = 0.023).• This finding reinforces the role of disease activity as a key factor in inc...
Source: Clinical Rheumatology - January 28, 2020 Category: Rheumatology Source Type: research

Physician-patient alignment in satisfaction with psoriatic arthritis treatment in Latin America
ConclusionsHigh levels of treatment satisfaction and alignment were observed among PsA patients and their physicians in Latin America. Patients in this study nevertheless experienced a considerable clinical and quality-of-life burden, especially the misaligned patients. Addressing misalignment may lead to improved PsA disease control.Key points• High treatment satisfaction was observed among PsA patients and their treating physicians in Latin America.• Patients experienced a considerable clinical and quality-of-life burden, especially the misaligned patients.• One-fifth of physician-patient pairs were misali...
Source: Clinical Rheumatology - January 28, 2020 Category: Rheumatology Source Type: research

Real-world experience of secukinumab treatment for ankylosing spondylitis at the Royal National Hospital for Rheumatic Diseases, Bath
AbstractWe reviewed our experience of treating ankylosing spondylitis patients with the IL-17 inhibitor secukinumab at the Royal National Hospital for Rheumatic Diseases, Bath. A total of 76 patients were included, of whom secukinumab was the first-line biologic drug used in 24, second line in 23, and third line in 29 patients, respectively. Only 5 patients discontinued the drug due to side effects before their first outpatient review, including 1 new case of inflammatory bowel disease. Significant improvements were seen in all disease outcome measures in patients receiving secukinumab as their first-line biologic agent, w...
Source: Clinical Rheumatology - January 27, 2020 Category: Rheumatology Source Type: research

Lung function is associated with minimal EQ-5D changes over time in patients with systemic sclerosis
AbstractIn systemic sclerosis (SSc) therapeutic efforts are often directed to prevent progressive respiratory impairment, but it is unclear to what extent changes in pulmonary function tests (PFTs) are associated with health-related quality of life (HRQoL). The aim of our study is to evaluate how modifications in PFTs contribute to longitudinal variations in HRQoL, assessed through the multidimensional questionnaire EQ-5D, in patients with SSc. We included SSc patients with forced vital capacity (FVC%), diffusing capacity of the lungs for carbon monoxide (DLCO%) and EQ-5D assessed in at least two visits. The EQ-5D consists...
Source: Clinical Rheumatology - January 24, 2020 Category: Rheumatology Source Type: research

The use of tocilizumab in the treatment of refractory eosinophilic fasciitis: a case-based review
We report the thir d case to our knowledge of the efficacy of tocilizumab in a refractory EF to corticosteroids and other immunosuppressive drugs. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - January 23, 2020 Category: Rheumatology Source Type: research

Validation of a renal risk score in a cohort of ANCA-associated vasculitis patients with severe kidney damage
ConclusionsWe validated the renal risk score as a prognostic tool in a cohort with predominantly mixed and sclerotic histologic categories. Since patients in the high-risk group still benefited from immunosuppressive therapy, this score should be used in conjunction with other predictive parameters to aid therapeutic decisions.Key Points• The ANCA renal risk score is validated in a cohort with advanced kidney damage.• Patients in the high-risk group still benefited from immunosuppressive therapy.• Parameters not included in the risk score are associated with renal survival and may be useful. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - January 22, 2020 Category: Rheumatology Source Type: research