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the rheumatologist

Valentin Ritschl, Angelika Lackner, Carina Boström, Erika Mosor, Michaela Lehner, Maisa Omara, Romualdo Ramos, Paul Studenic, Josef Sebastian Smolen, Tanja Alexandra Stamm
BACKGROUND: It is estimated that 50-70% of patients with rheumatoid arthritis (RA) are non-adherent to their recommended treatment. Non-adherent patients have a higher risk of not reaching an optimal clinical outcome. We explored factors associated with nonadherence from the patient's perspective. METHODS: Four hundred and fifty-nine RA patients (346 (75.4%) females; mean age 63.0 ± 14.8 years) who failed to attend follow-up visits in two rheumatology centres were eligible to participate in a qualitative interview study...
October 19, 2018: Arthritis Research & Therapy
Ennio Giulio Favalli, Andrea Becciolini, Roberto Caporali, Monica Todoerti, Florenzo Iannone, Liliana Dinoia, Marco Sebastiani, Amelia Spinella, Elisa Gremese, Francesco Cianci, Fabiola Atzeni, Francesca Bandinelli, Gianfranco Ferraccioli, Giovanni Lapadula
OBJECTIVE: The project aimed to collect expert consensus statements for the profiling of patients with axial spondyloarthritis (axSpA) candidate to biologic agents (bDMARDs) treatment, in order to better define the drivers for the best treatment choice. METHODS: The 6 more interesting topics about axSpA patient profiling were identified by the project steering committee and a panel of axSpA Italian experts. A systematic literature review (SLR) was performed for each of the selected topics according to the PICO format...
October 16, 2018: Autoimmunity Reviews
Dana DiRenzo, Monica Crespo-Bosque, Neda Gould, Patrick Finan, Julie Nanavati, Clifton O Bingham
PURPOSE OF REVIEW: To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA). RECENT FINDINGS: We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants...
October 18, 2018: Current Rheumatology Reports
Antonio Furlan, Roberto Stramare
PURPOSE: To investigate the frequency of thickening of pulleys for flexor tendons in patients with early arthritis in their hands, and to evaluate it as a predictive sign of PsA. METHODS: A prospective observational study involving 228 consecutive patients presenting with recent onset of arthritis in their hands was conducted at rheumatology outpatient clinics in the Veneto region of Italy between October 2014 and September 2017. Diabetic patients were excluded because of the high frequency of trigger finger...
October 15, 2018: Journal of Ultrasound
Žiga Rotar, Matija Tomšič, Sonja Praprotnik
To assess the persistence of golimumab and other tumour necrosis factor-α inhibitors (TNFis) in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in Slovenia. We analysed prospectively the collected data of all patients treated with golimumab and other TNFis from 1 January 2010 to 31 July 2018 from the mandatory national registry. We assessed the treatment persistence stratified by treatment type, indication and prior exposure to bDMARDs using the Kaplan-Meier method and Cox proportional regression hazards' models adjusted for the well-appreciated confounders...
October 15, 2018: Clinical Rheumatology
Sara Alicia González Porto, María Teresa Silva Díaz, Ana Reguera Arias, Jorge Pombo Otero, Alba González Rodríguez, Javier Valero Gasalla, Francisco Javier de Toro Santos
BACKGROUND: Giant cell arteritis (GCA) is a vasculitis that affects medium- and large-sized arteries. Temporal artery biopsy is the gold standard for diagnosis. In view of the high demand for temporal biopsies, the purpose of this study is to evaluate the usefulness of Doppler ultrasonography in patients with suspected giant cell arteritis, to determine its sensitivity and specificity as a diagnostic test and to determine whether it would be possible to substitute biopsy for ultrasonography...
October 11, 2018: Reumatología Clinica
Claire Daien, Charlotte Hua, Cécile Gaujoux-Viala, Alain Cantagrel, Madeleine Dubremetz, Maxime Dougados, Bruno Fautrel, Xavier Mariette, Nathalie Nayral, Christophe Richez, Alain Saraux, Gérard Thibaud, Daniel Wendling, Laure Gossec, Bernard Combe
The 2014 French Society for Rheumatology (Société Française de Rheumatologie, SFR) recommendations about the management of rheumatoid arthritis (RA) have been updated by a task force composed of 12 expert rheumatologists, 2 patient self-help group representatives, and an occupational therapist. The material used by the task force included recent EULAR recommendations, a systematic literature review, and expert opinion. Four general principles and 15 recommendations were developed. The general principles emphasize the need for shared decision-making between the rheumatologist and the patient and for a global management program including both pharmacological and nonpharmacological treatments...
October 10, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Carolina Zorzanelli Costa, Claudia Goldenstein-Schainberg, Sueli Carneiro, José Joaquim Rodrigues, Ricardo Romiti, Thiago Bitar Martins Barros, Gladys Martins, Jamile Carneiro, Rachel Grynszpan, Ana Luisa Sampaio, Tânia Maria Silva Mendonça, Carlos Henrique Martins Silva, Abrar A Qureshi, Rogerio de Melo Costa Pinto, Roberto Ranza
PASE (Psoriatic Arthritis Screening and Evaluation) was developed in the English language to screen for inflammatory arthritis among patients with psoriasis. It is 15 item self administered questionnaire with a score from 15 to 75. A higher score indicates a greater risk for inflammatory joint disease. The purpose of this study was to translate, adapt and validate this questionnaire into Brazilian Portuguese (PASE-P). METHODS: 465 patients diagnosed with psoriasis (158 with psoriatic arthritis confirmed by a rheumatologist according to the CASPAR criteria and 307 without) were evaluated in dermatology clinics...
2018: PloS One
Annika Steffen, Jakob Holstiege, Kerstin Klimke, Manas K Akmatov, Jörg Bätzing
This study aimed at providing a current and nearly complete picture of the patterns of the initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with newly diagnosed RA. Based on ambulatory drug prescription data and physician billing claims data covering 87% of the German population, we assembled a cohort of incident RA patients aged 15-79 years (n = 54,896) and assessed the prescription frequency of total DMARDs, conventional synthetic (csDMARDs) and biologic DMARDs (bDMARDs) within the first year of disease...
October 10, 2018: Rheumatology International
Eirik Ikdahl, Silvia Rollefstad, Grunde Wibetoe, Anne Salberg, Frode Krøll, Kjetil Bergsmark, Tore K Kvien, Inge C Olsen, Dag Magnar Soldal, Gunnstein Bakland, Åse Lexberg, Clara G Gjesdal, Christian Gulseth, Glenn Haugeberg, Anne Grete Semb
Objective: The European League Against Rheumatism recommends implementing cardiovascular disease (CVD) risk assessments for patients with inflammatory joint diseases (IJDs) into clinical practice. Our goal was to design a structured programme for CVD risk assessments to be implemented into routine rheumatology outpatient clinic visits. Methods: The NOrwegian Collaboration on Atherosclerosis in patients with Rheumatic joint diseases (NOCAR) started in April 2014 as a quality assurance project including 11 Norwegian rheumatology clinics...
2018: RMD Open
E H Vogelzang, R C F Hebing, M T Nurmohamed, A W R van Kuijk, J W F Kruijff, M J l'Ami, C L M Krieckaert, G Wolbink
OBJECTIVES: To determine the percentage non-adherence to etanercept in patients with rheumatoid arthritis during three years of follow-up. METHODS: During study visits in this prospective cohort study, blood samples were taken to determine serum etanercept concentrations using ELISA and patients were asked if they had missed an etanercept dose, at which date and for what reason. Non-adherence was defined as serum etanercept concentration <0.1 μg/mL and no valid reason to miss the prescribed etanercept dose...
2018: PloS One
John J Carey, Bjoern Buehring
Osteoporosis is a global pandemic affecting children, men and women of all ages and ethnicities. Millions of people suffer fragility fractures each year around the world as a result of this bone disease, which can have devastating consequences for them, including permanent disability and death. Many fractures are preventable by identifying people at high risk for fracture and falls, and diagnosing those who already have osteoporosis, before they fracture. Rheumatologists commonly encounter people with fragile bones, either as an isolated entity, or a co-morbidity to their underlying rheumatic illness or treatment...
September 2018: Clinical and Experimental Rheumatology
Sobia Hassan
Within the realm of rheumatology, the field of musculoskeletal ultrasound (MSUS) has grown exponentially over the last few decades. This review, aimed at the clinical rheumatologist, provides a basic overview of the principles of image generation and the commonly used clinical applications of MSUS, while also highlighting its advantages and limitations. In particular, the role of MSUS in the assessment of early and established rheumatoid arthritis, crystalline disease, the spondyloarthropathies and Sjögren's disease is discussed in more detail and by reviewing the pertinent literature...
September 2018: Clinical and Experimental Rheumatology
Jeffrey R Curtis, Fenglong Xie, Shuo Yang, Sasha Bernatsky, Lang Chen, Huifeng Yun, Kevin Winthrop
BACKGROUND: Increased herpes zoster (HZ) has been observed with janus kinase inhibitors such as tofacitinib. However, it is unclear whether concomitant methotrexate (MTX) and/or glucocorticoids (GC) confer additional (additive or multiplicative) risk. We evaluated HZ risk in tofacitinib users with and without MTX and GC. METHODS: Within MarketScan and Medicare data (2011-2016) we identified all rheumatologist-diagnosed RA patients initiating tofacitinib (index date); demographics and baseline covariates were evaluated in the year prior to index date...
October 8, 2018: Arthritis Care & Research
Isabel Castrejon, Najia Shakoor, Jacquelin R Chua, Joel A Block
The study compares patient-physician discordance in global assessment in patients with osteoarthritis (OA) versus patients with rheumatoid arthritis (RA) seen in routine care. This is a cross-sectional study conducted at an academic rheumatology center at which all patients are asked to complete a Multi-Dimensional Health Assessment Questionnaire (MDHAQ), which includes a patient global assessment (PATGL). Rheumatologists are encouraged to complete a physician questionnaire, which includes a physician global assessment (DOCGL)...
October 6, 2018: Rheumatology International
Monica Todoerti, Ennio Giulio Favalli, Florenzo Iannone, Ignazio Olivieri, Maurizio Benucci, Alberto Cauli, Alessandro Mathieu, Leonardo Santo, Giovanni Minisola, Giovanni Lapadula, Romano Bucci, Elisa Gremese, Roberto Caporali
Objective: To establish evidence-based and experts' opinion filtered statements on the optimal treatment choice between cycling (switch) and changing mode of action strategies (swap) in RA patients failing TNF inhibitors (TNFis). Methods: The relevant question (switch vs swap) was rephrased into a research question according to the population, intervention, comparison and outcome (PICO) strategy, considering all the available scientific evidence published from the 2013 EULAR set of recommendations up to mid-January 2016...
October 1, 2018: Rheumatology
Alessandra Bortoluzzi, Guido Valesini, Salvatore D'Angelo, Bruno Frediani, Laura Bazzichi, Antonella Afeltra, Giuseppe Paolazzi, Andrea Doria, Pier Luigi Meroni, Marcello Govoni
Objective: To establish clinical consensus for the optimal placement of TNF inhibitor (TNFi) in DMARDs-naïve RA patients. Methods: The steering group was composed of 15 Italian rheumatologists expert in the field of RA, who proposed and selected by consensus the clinically relevant questions on the role of TNFi treatment in DMARDs-naïve RA patients. The question was rephrased according to the population, intervention, comparison and outcome statement. The available scientific evidence on this topic were collected by updating the systematic literature reviews used for the EULAR 2013 recommendations up to January 2016...
October 1, 2018: Rheumatology
Kei Ohnuma, Ryo Hatano, Nam H Dang, Chikao Morimoto
Immune checkpoint inhibitors (ICIs) have drastically altered cancer treatment paradigms, with increasing numbers of novel ICIs being currently evaluated in numerous clinical trials for various cancers. ICIs release "brakes" against tumor immunity to control cancer growth via T cell-dependent anti-tumor activity. Meanwhile, side effects associated with ICIs are directly related to their mechanism of action, as nonspecific immune activation targeting non-tumor organs results in undesirable off-target inflammation and autoimmunity...
October 4, 2018: Modern Rheumatology
M S Chimenti, A Di Stefani, P Conigliaro, A Saggini, S Urbani, A Giunta, M Esposito, L Bianchi, K Peris, R Perricone
Rheumatological systemic autoimmune diseases, such as connective tissue diseases, rheumatoid arthritis or spondyloarthritis, are characterized by the presence of joint involvement associated with extra-articular manifestations. Among them, cutaneous diseases are often the most relevant and representative clinical manifestation, as in psoriatic arthritis, scleroderma or systemic lupus erythematosus. In this context, it is useful for rheumatologists to understand better skin diseases and their histopathological features...
October 3, 2018: Reumatismo
Kalum Deshapriya
In Sri Lanka, record keeping in rheumatology clinics is purely paper-based. Clinic record books are given to patients, and the hospital does not retain clinical data. Different clinics and different rheumatology specialists practice different formats of record keeping in Sri Lanka. This project was aimed to develop a uniform record keeping system which can be used in all government rheumatology clinics in Sri Lanka. Project was carried out in two phases. First phase was carried out in seven rheumatology clinics to identify deficiencies in existing practice of record keeping in rheumatoid arthritis (RA), spondyloarthritis (SPA), and systemic lupus erythematosus (SLE)...
October 2, 2018: Clinical Rheumatology
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