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Arthritis Care & Research

Daniel H Solomon, Zhi Yu, Jeffrey N Katz, Asaf Bitton, Cassandra Corrigan, Liana Fraenkel, Leslie R Harrold, Josef S Smolen, Elena Losina, Bing Lu
INTRODUCTION: Treat to target (TTT) is an accepted paradigm for care of patients with rheumatoid arthritis (RA). Since TTT can be associated with more medication switches, concerns arise whether implementing TTT may increase adverse events and/or resource use. METHODS: We used data from six practices enrolled in an 18-month cluster-randomized controlled trial to compare adverse events and resource use before (months 1-9) and during (months 10-18) a TTT intervention...
September 17, 2018: Arthritis Care & Research
Lucas Grisanti, Alysia Kwiatkowski, Peter Dyrda, Ellen Field, Joseph Grisanti, James Hatem, Raphael J Dehoratius, Norman Gaylis
OBJECTIVE: Two surveys were conducted with patients with rheumatologic diseases to evaluate perceptions of different routes of administration (intravenous [IV] or subcutaneous [SC]) for biologic therapy. METHODS: In Survey I, patient preferences towards biologic treatment were evaluated at a rheumatology practice in Buffalo, New York. In Survey II, Canadian patients enrolled in the BioAdvance® patient support program and scheduled to receive IV biologic therapy were asked about their opinions of IV treatment...
September 17, 2018: Arthritis Care & Research
Thomas Davergne, Adrien Pallot, Agnès Dechartres, Bruno Fautrel, Laure Gossec
OBJECTIVE: Wearable activity trackers (WATs) could be a promising strategy to improve physical activity (PA) in patients with rheumatic and musculoskeletal diseases (RMDs). The aim was to assess the adherence and effectiveness of WATs to increase PA levels in RMDs. METHODS: A systematic review was performed to identify all cohorts and controlled trials evaluating WATs in RMDs, published between 2000 and 2018, by searching MEDLINE, EMBASE, PsycINFO and Cochrane. Data collected pertained to (a) adherence, (b) effectiveness on PA or (c) effectiveness on symptoms (pain, function, quality of life or fatigue)...
September 17, 2018: Arthritis Care & Research
Anthony Concannon, Genevieve Ostring, Peter Reed
OBJECTIVE: To describe the incidence, demographics, diagnostic clinical manifestations and severity of Juvenile Idiopathic Arthritis (JIA) in Maori and Pacific Island children compared to European children. METHOD: A chart review was conducted of all children with JIA seen by Auckland Pediatric and Rheumatology services between 2000 and 2015. Demographic data and diagnostic clinical manifestations including poor prognostic features were collated. The incidence, diagnostic clinical manifestations and severity of JIA were determined and compared between ethnic groups, in particular Maori and Pacific and European children...
September 17, 2018: Arthritis Care & Research
Daniel P Erhardt, Grant W Cannon, Chia-Chen Teng, Ted R Mikuls, Jeffrey R Curtis, Brian C Sauer
OBJECTIVE: Combination treatments for rheumatoid arthritis (RA) patients with inadequate response to methotrexate (MTX) alone include the addition of tumor necrosis factor inhibitors (TNFi) or the addition of sulfasalazine (SSZ) and hydroxychloroquine (HCQ) to MTX (triple therapy, TT). We compared persistence and adherence rates between these two combination therapies in US Veterans and report the reasons for discontinuation of combination treatment in these groups. METHODS: Using Veteran's Affairs (VA) clinical and administrative data from 2006 to 2012, veterans with RA escalating treatment from MTX to MTX-TNFi or triple therapy were examined for a 12-month period after combination initiation...
September 17, 2018: Arthritis Care & Research
Kathryn L Bacon, Neil A Segal, Britt Elin Øiestad, Cora E Lewis, Michael C Nevitt, Carrie Brown, David T Felson
OBJECTIVE: Quadriceps weakness, associated with functional limitations, is a target of treatment of knee osteoarthritis (OA). Limited data exist on modest strength increases and improvements in function. We evaluated concurrent change in strength and physical function over 5 years. METHODS: Using subjects from the Multicenter Osteoarthritis (MOST) study, we excluded those with knee replacement after baseline. A 3-category variable defined whether, at 5 years, knee extensor strength increased, decreased or remained within 15% of baseline, a clinically important cutoff...
September 17, 2018: Arthritis Care & Research
J Birnbaum, A Lalji, A Saed, A N Baer
INTRODUCTION: Painful small-fiber neuropathies (SFN) in primary Sjögren's syndrome (SS) may present as pure or mixed with concurrent large-fiber involvement. SFN can be diagnosed by punch skin biopsies, which identifies decreased intra-epidermal nerve-fiber density (IENFD) of unmyelinated nerves. METHODS: We compared 23 consecutively evaluated SS patients with pure and mixed SFN versus 98 without. We distinguished between markers of dorsal root ganglia (DRG) degeneration (decreased IENFD proximal thigh versus distal leg) versus axonal degeneration (decreased IENFD distal leg versus proximal thigh)...
September 17, 2018: Arthritis Care & Research
Ans Van Ginckel, Ruth Wittoek, Sophie De Mits, Patrick Calders
OBJECTIVE: To investigate associations between engagement in knee bending (stair climbing, kneeling, squatting, heavy lifting, getting in/out of a squatting position) and synovitis prevalence on non-contrast magnetic resonance imaging (MRI) in people at risk and with knee osteoarthritis (OA). METHODS: We included baseline data from 594 participants (age: 61.5 ± 8.9 years; 61% Kellgren-Lawrence grade ≥2; 59% female; body mass index: 30.7 ± 4.8 kg/m2 ) of the Osteoarthritis Biomarker Consortium Foundation for the National Institutes of Health project...
September 17, 2018: Arthritis Care & Research
Jonathan S Hausmann, Richard M Schwartzstein
Meeting the increased demand for rheumatology care in the future will require changing the way rheumatology is taught. Enhancing rheumatology education may encourage more trainees to pursue rheumatology careers and improve knowledge about musculoskeletal conditions for primary care providers. However, the inherent uncertainty that surrounds the etiology, diagnosis, and treatment of many rheumatic diseases presents a unique challenge to rheumatology education and demands a distinct approach. By mastering the art of questioning, faculty can improve a learner's ability to understand and remember the material, apply knowledge in new settings, overcome cognitive biases, support an environment of inquiry, and develop metacognition, even under uncertainty...
September 17, 2018: Arthritis Care & Research
Rick Bucala, Marian Hannan
The founding of Arthritis & Rheumatism by the American Rheumatism Association in 1958 occurred at the advent of knowledge of immunologic abnormalities in patients with rheumatoid arthritis, SLE, and related disorders. Over its ensuing 60 year history, "A&R" (renamed to Arthritis & Rheumatology in 2014) developed into a preeminent publication for disseminating research findings and advancing the field scientifically. Landmark papers included the role of autoantibodies and lymphocytes in rheumatic diseases and, in recent years, the clinical translation of cell and cytokine-based paradigms of disease...
September 10, 2018: Arthritis Care & Research
Sarah Doaty, Nicole Bitencourt, William Harvey, Sharon Kolasinski, E Blair Solow
OBJECTIVE: Rheumatology fellowship programs lack formal curricular content to educate trainees about legislative and regulatory healthcare policies that have a profound impact on academic and community practices. Advocacy 101 was created as a program to address this gap and engage fellows-in-training (FIT) in health advocacy efforts. METHODS: A web-based survey was sent via the American College of Rheumatology (ACR) FIT listserve in July 2015 and April 2016. The survey queried respondents about their knowledge of and participation in health policy and advocacy...
September 7, 2018: Arthritis Care & Research
Augustin Latourte, Anna Moltó
We would like to thank F.J. Olmedo-Garzón and A. Ruiz-Ollero for their interest in our article examining the presence of imaging features suggestive of axial spondyloarthritis (axSpA) in patients with diffuse idiopathic skeletal hyperostosis (DISH) (1). We have read with great interest their comments on our results indicating a high prevalence of inflammatory lesions (especially bone marrow edema [BME]) at the spine but not at the sacro-iliac joints (SIJ) (2). Similar findings have been observed recently in the ILOS-DESIR study, comparing age-matched patients with recent onset chronic back pain (n=97) vs...
September 7, 2018: Arthritis Care & Research
F Javier Olmedo-Garzón, Antonio Ruiz Ollero
We read with great interest the article by Latourte et al about axial spondyloarthritis (SpA) like imaging in Diffuse Idiopathic Skeletal Hyperostosis (DISH) (1). On the spine magnetic resonance imaging, 76.9% of their cohort of patients with symptomatic DISH had at least 1 inflammatory lesion, as assessed by bone medullar edema (BME). As soft tissue edema, BME may be caused by mechanical stress or by inflammation (2). Mechanical stress is implicated in the pathogenesis of DISH. This article is protected by copyright...
September 7, 2018: Arthritis Care & Research
Kristin Ursin, Stian Lydersen, Johan F Skomsvoll, Marianne Wallenius
OBJECTIVE: To study disease activity in women with peripheral psoriatic arthritis (PsA) during and after pregnancy. Previous knowledge on this topic is sparse. METHODS: The study included 108 pregnancies in 103 women with PsA from a Norwegian nationwide register. Disease activity was assessed prospectively at seven time points before, throughout and after pregnancy with the disease activity scores DAS28-CRP-3 and BASDAI. Scores assessed at each time point were analyzed in a linear mixed model...
September 7, 2018: Arthritis Care & Research
Aurélien Mary, Amélie Boursier, Isabelle Desailly Henry, Franck Grados, Alice Séjourné, Sarah Salomon, Patrice Fardellone, Michel Brazier, Vincent Goëb
OBJECTIVES: To assess the impact of weekly text messages on adherence in patients taking methotrexate (MTX) for rheumatoid arthritis (RA). METHODS: This prospective, randomized pilot, single-site study included RA patients stabilized on MTX combined or not with biologics. Participants were randomized to three interventions: a standard consultation (controls), a 15-min pharmacist-led counselling session or the receipt of text message reminders. The change over time in the Compliance Questionnaire Rheumatology (CQR-19) score between baseline and 6 months was defined as the primary outcome for adherence...
September 7, 2018: Arthritis Care & Research
Tracy V Ting, Patricia Vega-Fernandez, Edward J Oberle, Deirdre De Ranieri, Hulya Bukulmez, Clara Lin, David Moser, Nicholas J Barrowman, Yongdong Zhao, Heather M Benham, Laura Tasan, Akaluck Thatayatikom, Johannes Roth
OBJECTIVE: The use of musculoskeletal ultrasound is increasing among pediatric rheumatologists. Reliable scoring systems are needed for the objective assessment of synovitis. The aims of this study were: 1) to create a standardized and reproducible image acquisition protocol for B-Mode and Doppler ultrasound of the pediatric knee; and 2) to develop a standardized scoring system and determine its reliability for pediatric knee synovitis. METHODS: Six pediatric rheumatologists developed a set of standard views for knee assessment in children with juvenile arthritis...
September 7, 2018: Arthritis Care & Research
Lindsey C McKernan, Matthew C Lenert, Leslie J Crofford, Colin G Walsh
OBJECTIVE: Fibromyalgia (FM) patients are 10x more likely to die by suicide than the general population. The purpose of this study was to externally validate published models predicting suicidal ideation and attempts in FM and identify interpretable risk and protective factors for suicidality unique to FM. METHODS: This is a case-control study of large-scale EHR data collected from 1998-2017, identifying FM cases with validated PheKB criteria. Model performance was measured through discrimination including area under the receiver operating characteristic (AUC), sensitivity, specificity, and through calibration including calibration plots...
September 7, 2018: Arthritis Care & Research
Fenglong Xie, Huifeng Yun, Emily B Levitan, Paul Muntner, Jeffrey R Curtis
BACKGROUND: Multiple studies have observed seemingly unfavorable changes in lipid profiles associated with IL6 receptor antagonists (IL-6R) and some other rheumatoid arthritis (RA) therapies. The real-world cardiovascular disease (CVD) risk associated with the first approved anti IL-6R medication for RA, tocilizumab, remains uncertain. METHODS: A cohort study using 2006-2015 Medicare and MarketScan claims data was conducted, studying RA patients who initiated biologic disease-modifying antirheumatic drugs after January 1, 2010...
September 3, 2018: Arthritis Care & Research
Julia Nascimben, Caroline Cubbison, Emma C Lape, Jeffrey N Katz
OBJECTIVE: Persons in low- and middle-income countries often have insufficient resources to pay for treatments prescribed for their medical conditions. We aimed to determine, using qualitative methods, how people with arthritis in the Dominican Republic manage the costs of chronic illnesses. METHODS: We conducted individual interviews with 17 Dominican adults with advanced arthritis undergoing total knee replacement (TKR) or total hip replacement (THR) at a hospital in Santo Domingo, Dominican Republic...
September 1, 2018: Arthritis Care & Research
Lihi Eder, Jessica Widdifield, Cheryl F Rosen, Richard Cook, Ker-Ai Lee, Raed Alhusayen, J Michael Paterson, Stephanie Y Cheng, Shirin Jabbari, Willemina Campbell, Sasha Bernatsky, Dafna D Gladman, Karen Tu
OBJECTIVE: To estimate the prevalence and incidence of psoriasis and psoriatic arthritis (PsA) over time in Ontario, Canada. METHODS: We performed a population-based study of Ontario health administrative data using validated case definitions for psoriasis and PsA. We computed the crude and age/sex-standardized cumulative prevalence and incidence of psoriasis from 2000 to 2015. RESULTS: Among the 10,774,802 individuals aged 20 years and older residing in Ontario in 2015, we identified 273,238 and 18,655 patients with psoriasis and PsA, respectively, equating to cumulative prevalence estimates of 2...
September 1, 2018: Arthritis Care & Research
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