Pub Date : 2022-11-19DOI: 10.1142/s2661341722500031
E. Lok, C. Mok
Objective: To evaluate the performance of the Hospital Anxiety and Depression Scale (HADS) for screening of depressive disorders and anxiety disorders in patients with rheumatoid arthritis (RA) in Hong Kong. Methods: Consecutive RA patients in the outpatient clinic of Pok Oi Hospital were invited to complete the validated Chinese-Cantonese version of the HADS questionnaire before clinical assessment by a psychiatrist for depressive disorders and anxiety disorders using the Chinese-bilingual Structured Clinical Interview for DSM-IV Axis I disorders, patient research version. Psychometric properties of the HADS were analyzed by the receiver operating characteristic (ROC) curve analysis. Results: For the HADS full scale, sensitivity and specificity at the optimal cut-off score of 16 for any psychiatric disorders were 83.0% and 81.0%, respectively (area under ROC curve [AUC] 0.91). For the depression subscale (HADS-D), sensitivity and specificity at the optimal cut-off score of 10 for any depressive disorders were 89.7% and 84.8%, respectively (AUC 0.93). For the anxiety subscale (HADS-A), sensitivity and specificity at the optimal cut-off score of 8 for any anxiety disorders were 88.5% and 74.1%, respectively (AUC 0.87). The HADS-D showed better screening properties for any depressive disorders than major depressive disorder. The HADS-A showed better screening properties for generalized anxiety disorder than any anxiety disorders. Conclusion: The HADS had good performance to screen for any psychiatric disorders and the HADS-D had good performance to screen for any depressive disorders. On the other hand, the HADS-A performed better for generalized anxiety disorder than for any anxiety disorders.
{"title":"The Performance of the Hospital Anxiety and Depression Scale for Screening of Anxiety and Depressive Disorders in Chinese Patients with Rheumatoid Arthritis in Hong Kong","authors":"E. Lok, C. Mok","doi":"10.1142/s2661341722500031","DOIUrl":"https://doi.org/10.1142/s2661341722500031","url":null,"abstract":"Objective: To evaluate the performance of the Hospital Anxiety and Depression Scale (HADS) for screening of depressive disorders and anxiety disorders in patients with rheumatoid arthritis (RA) in Hong Kong. Methods: Consecutive RA patients in the outpatient clinic of Pok Oi Hospital were invited to complete the validated Chinese-Cantonese version of the HADS questionnaire before clinical assessment by a psychiatrist for depressive disorders and anxiety disorders using the Chinese-bilingual Structured Clinical Interview for DSM-IV Axis I disorders, patient research version. Psychometric properties of the HADS were analyzed by the receiver operating characteristic (ROC) curve analysis. Results: For the HADS full scale, sensitivity and specificity at the optimal cut-off score of 16 for any psychiatric disorders were 83.0% and 81.0%, respectively (area under ROC curve [AUC] 0.91). For the depression subscale (HADS-D), sensitivity and specificity at the optimal cut-off score of 10 for any depressive disorders were 89.7% and 84.8%, respectively (AUC 0.93). For the anxiety subscale (HADS-A), sensitivity and specificity at the optimal cut-off score of 8 for any anxiety disorders were 88.5% and 74.1%, respectively (AUC 0.87). The HADS-D showed better screening properties for any depressive disorders than major depressive disorder. The HADS-A showed better screening properties for generalized anxiety disorder than any anxiety disorders. Conclusion: The HADS had good performance to screen for any psychiatric disorders and the HADS-D had good performance to screen for any depressive disorders. On the other hand, the HADS-A performed better for generalized anxiety disorder than for any anxiety disorders.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48051906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-20DOI: 10.1142/s2661341722300099
S. C. Chan, W. Yeung, C. Cheung, W. Kwok, Leo Tsz Long Chan, C. Ho
Rheumatoid arthritis (RA) is chronic inflammatory joint disease with a prevalence of up to 1%. Various extra-articular manifestations have been reported, including rheumatoid arthritis-associated interstitial lung disease (RA-ILD). RA-ILD contributes to significant morbidity and is a leading cause of death in patients with RA. Detection of lung involvement is therefore important. However, the prevalence of RA-ILD is not well known and varies among different studies depending on the methods of detection. Multiple clinical risk factors and novel biomarkers have been explored. To evaluate the usefulness of these predictors and to evaluate the burden of interstitial lung disease (ILD) among patients with RA, we designed a study (RAISE, Rheumatoid Arthritis-associated ILD: Screening and Evaluation in high-risk patients) to assess the prevalence of RA-ILD among RA patients with high risk, and to identify potential clinical and biochemical markers associated with the condition.
{"title":"Rationale and the Protocol for the Rheumatoid Arthritis-Associated ILD: Screening and Evaluation in High-Risk Patients (RAISE) Study","authors":"S. C. Chan, W. Yeung, C. Cheung, W. Kwok, Leo Tsz Long Chan, C. Ho","doi":"10.1142/s2661341722300099","DOIUrl":"https://doi.org/10.1142/s2661341722300099","url":null,"abstract":"Rheumatoid arthritis (RA) is chronic inflammatory joint disease with a prevalence of up to 1%. Various extra-articular manifestations have been reported, including rheumatoid arthritis-associated interstitial lung disease (RA-ILD). RA-ILD contributes to significant morbidity and is a leading cause of death in patients with RA. Detection of lung involvement is therefore important. However, the prevalence of RA-ILD is not well known and varies among different studies depending on the methods of detection. Multiple clinical risk factors and novel biomarkers have been explored. To evaluate the usefulness of these predictors and to evaluate the burden of interstitial lung disease (ILD) among patients with RA, we designed a study (RAISE, Rheumatoid Arthritis-associated ILD: Screening and Evaluation in high-risk patients) to assess the prevalence of RA-ILD among RA patients with high risk, and to identify potential clinical and biochemical markers associated with the condition.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43320422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.1142/s266134172250002x
A. Mathkhor, Ali Altaqi, A. Abdullah, A. Khudhairy
Objective:Efficacy, tolerance, and safety of infliximab biosimilar are the same as infliximab reference product (RP) in the management of ankylosing spondylitis (AS) patients previously were on infliximab RP. We aimed to evaluate the biosimilar CT-P13 (Remsima) in terms of efficacy, tolerance, and safety to its RP. Materials and methods:Seventy-eight consecutive randomly selected patients were recruited for the study. All patients were naïve to any other biologics before receiving infliximab RP, and all were in clinical remission. The sample of patients was divided into two subgroups: 40 patients were continued on infliximab RP and 38 patients were switched to infliximab biosimilar. All patients underwent clinical evaluation and investigation. Both groups followed up for further 12 months. The disease activity was calculated utilizing Ankylosing Spondylitis Disease Activity Score (ASDAS), using the C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Remission considered when BASDAI < 4 and ASDAS < 1.3. Functional scores for all patients were assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI). Results:Sustained clinical remission was observed after 12 months of treatment in the infliximab RP continued and switched groups. At the end of the study, erythrocyte sedimentation rate (ESR), CRP, visual analog scale (VAS), ASDAS, BASDAI, and BASFI were 15.04 ± 2.37, 2.10 ± 0.88, 3.10 ± 0.78, 1.52 ± 0.40, 2.80 ± 0.37, and 3.05 ± 0.24 in the infliximab RP continued group, respectively, and were 15.15 ± 1.45, 2.29 ± 0.89, 3.21 ± 0.69, 1.59 ± 0.57, 2.76 ± 0.45, and 2.89 ± 0.92 for the switching group, respectively; the difference was statistically not significant ([Formula: see text] values > 0.05). No significant adverse events were noted in the switching group compared to the continuous group groups. Conclusion:We found infliximab biosimilar CT-P13 (Remsima) was not inferior to infliximab RP and can maintain patients with ankylosing spondylitis in clinical remission.
{"title":"Patients with Ankylosing Spondylitis Can Maintain Clinical and Functional Improvement after Switching from Infliximab Reference Product to Infliximab Biosimilar (REMSIMA): 12 Months Comparative Open-Label Study","authors":"A. Mathkhor, Ali Altaqi, A. Abdullah, A. Khudhairy","doi":"10.1142/s266134172250002x","DOIUrl":"https://doi.org/10.1142/s266134172250002x","url":null,"abstract":"Objective:Efficacy, tolerance, and safety of infliximab biosimilar are the same as infliximab reference product (RP) in the management of ankylosing spondylitis (AS) patients previously were on infliximab RP. We aimed to evaluate the biosimilar CT-P13 (Remsima) in terms of efficacy, tolerance, and safety to its RP. Materials and methods:Seventy-eight consecutive randomly selected patients were recruited for the study. All patients were naïve to any other biologics before receiving infliximab RP, and all were in clinical remission. The sample of patients was divided into two subgroups: 40 patients were continued on infliximab RP and 38 patients were switched to infliximab biosimilar. All patients underwent clinical evaluation and investigation. Both groups followed up for further 12 months. The disease activity was calculated utilizing Ankylosing Spondylitis Disease Activity Score (ASDAS), using the C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Remission considered when BASDAI < 4 and ASDAS < 1.3. Functional scores for all patients were assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI). Results:Sustained clinical remission was observed after 12 months of treatment in the infliximab RP continued and switched groups. At the end of the study, erythrocyte sedimentation rate (ESR), CRP, visual analog scale (VAS), ASDAS, BASDAI, and BASFI were 15.04 ± 2.37, 2.10 ± 0.88, 3.10 ± 0.78, 1.52 ± 0.40, 2.80 ± 0.37, and 3.05 ± 0.24 in the infliximab RP continued group, respectively, and were 15.15 ± 1.45, 2.29 ± 0.89, 3.21 ± 0.69, 1.59 ± 0.57, 2.76 ± 0.45, and 2.89 ± 0.92 for the switching group, respectively; the difference was statistically not significant ([Formula: see text] values > 0.05). No significant adverse events were noted in the switching group compared to the continuous group groups. Conclusion:We found infliximab biosimilar CT-P13 (Remsima) was not inferior to infliximab RP and can maintain patients with ankylosing spondylitis in clinical remission.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46325176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-17DOI: 10.1142/s2661341722300087
Jing Li, X. Tian, Xiaofeng Zeng
The clinical studies of Takayasu’s arteritis and antineutrophil cytoplasm antibodies (ANCA)-associated vasculitis are very active in the Asia Pacific region. The results of these studies give us a more comprehensive understanding of these vasculitis, which may not only change the management and long-term prognosis of the disease, but also reduce complications and prolonged survival time. Therefore, we summarize the results of these studies that were led or actively participated by investigators in the Asia Pacific region from 2020 to 2021, mainly focusing on the clinical characteristics and management.
{"title":"Review of Novel Therapies and Update for Takayasu Arteritis and ANCA-Associated Vasculitis with Relevance to the Asia Pacific Region","authors":"Jing Li, X. Tian, Xiaofeng Zeng","doi":"10.1142/s2661341722300087","DOIUrl":"https://doi.org/10.1142/s2661341722300087","url":null,"abstract":"The clinical studies of Takayasu’s arteritis and antineutrophil cytoplasm antibodies (ANCA)-associated vasculitis are very active in the Asia Pacific region. The results of these studies give us a more comprehensive understanding of these vasculitis, which may not only change the management and long-term prognosis of the disease, but also reduce complications and prolonged survival time. Therefore, we summarize the results of these studies that were led or actively participated by investigators in the Asia Pacific region from 2020 to 2021, mainly focusing on the clinical characteristics and management.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44862685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-03DOI: 10.1142/s2661341722300026
C. Mok
The risk of osteoporosis and fragility fracture is increased in patients with autoimmune rheumatic diseases. Although the use of glucocorticoids is the major contributing factor, inflammation mediated by cytokines and growth factors and other medications, including the biologic and targeted disease-modifying antirheumatic drugs, also play important roles in bone remodeling. Pro-inflammatory cytokines such as IL-1, IL-6, IL-17, and TNF[Formula: see text] increase RANK expression and promote osteoclast activity while inhibiting osteoblast-mediated bone formation through the Dickkopf-1 pathway. Certain autoantibodies stimulate differentiation of the osteoclasts, resulting in localized bone resorption. This article covers the prevalence and risk factors for osteoporosis in patients with common rheumatic diseases and the role of inflammatory cytokines and other clinical factors. Controlling disease-related inflammation and optimizing the diagnostic and therapeutic instrumentation is needed to reduce fragility fractures in patients with rheumatic diseases.
{"title":"Osteoporosis in Rheumatic Diseases","authors":"C. Mok","doi":"10.1142/s2661341722300026","DOIUrl":"https://doi.org/10.1142/s2661341722300026","url":null,"abstract":"The risk of osteoporosis and fragility fracture is increased in patients with autoimmune rheumatic diseases. Although the use of glucocorticoids is the major contributing factor, inflammation mediated by cytokines and growth factors and other medications, including the biologic and targeted disease-modifying antirheumatic drugs, also play important roles in bone remodeling. Pro-inflammatory cytokines such as IL-1, IL-6, IL-17, and TNF[Formula: see text] increase RANK expression and promote osteoclast activity while inhibiting osteoblast-mediated bone formation through the Dickkopf-1 pathway. Certain autoantibodies stimulate differentiation of the osteoclasts, resulting in localized bone resorption. This article covers the prevalence and risk factors for osteoporosis in patients with common rheumatic diseases and the role of inflammatory cytokines and other clinical factors. Controlling disease-related inflammation and optimizing the diagnostic and therapeutic instrumentation is needed to reduce fragility fractures in patients with rheumatic diseases.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47504884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-03DOI: 10.1142/s2661341722300038
A. L. Lim, S. Yeap
Osteoporosis and osteoporotic fracture are one of the most common side effects of glucocorticoid therapy. All patients who are taking any dose of glucocorticoids for over 3 months should have a bone health assessment. After consideration of their clinical risk factors, glucocorticoid dose, bone mineral density measurement, and the Fracture Risk Assessment Tool score, patients can be stratified into low-, moderate-, and high-risk groups. General measures include optimization of calcium and vitamin D intake, reducing glucocorticoid dosage and lifestyle modifications. In patients with moderate to high risk of fracture, pharmacological agents should be prescribed, of which bisphosphonates, denosumab, and teriparatide are the most widely used.
{"title":"Update on the Treatment of Glucocorticoid-Induced Osteoporosis","authors":"A. L. Lim, S. Yeap","doi":"10.1142/s2661341722300038","DOIUrl":"https://doi.org/10.1142/s2661341722300038","url":null,"abstract":"Osteoporosis and osteoporotic fracture are one of the most common side effects of glucocorticoid therapy. All patients who are taking any dose of glucocorticoids for over 3 months should have a bone health assessment. After consideration of their clinical risk factors, glucocorticoid dose, bone mineral density measurement, and the Fracture Risk Assessment Tool score, patients can be stratified into low-, moderate-, and high-risk groups. General measures include optimization of calcium and vitamin D intake, reducing glucocorticoid dosage and lifestyle modifications. In patients with moderate to high risk of fracture, pharmacological agents should be prescribed, of which bisphosphonates, denosumab, and teriparatide are the most widely used.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46570999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-03DOI: 10.1142/s266134172272004x
J. Á. Troncoso, Laura Lacruz Ballester, A. Mozo, Manuel Lorenzo Diéguez, Á. Marhuenda, Rafael Genaro Martínez Marín, J. Blanco
A 21-year-old woman with unremarkable past health presented with an intense headache and visual disturbance, followed by a secondary generalized tonic-clonic focal seizure. She had a history of arthritis, livedo reticularis, myalgia, elevated erythrocyte sedimentation rate, and nonspecific constitutional manifestations (fever and weight loss). Examination revealed new-onset severe hypertension. Complete immunological studies were negative. Electroencephalogram showed abnormalities compatible with secondarily generalized tonic–clonic focal occipital seizures. Brain magnetic resonance imaging (MRI) revealed high signal intensity on T2 in occipital lobes, cerebellum, and brainstem and renal imaging multiple hypoenhancing parenchymal images (renal infarction). Follow-up brain MRI at 3 months showed marked improvement. A diagnosis of polyarteritis nodosa with posterior reversible encephalopathy syndrome was made.
{"title":"Posterior Reversible Encephalopathy (PRES) as a Presentation Form of Classical Polyarteritis Nodosa (PAN)","authors":"J. Á. Troncoso, Laura Lacruz Ballester, A. Mozo, Manuel Lorenzo Diéguez, Á. Marhuenda, Rafael Genaro Martínez Marín, J. Blanco","doi":"10.1142/s266134172272004x","DOIUrl":"https://doi.org/10.1142/s266134172272004x","url":null,"abstract":"A 21-year-old woman with unremarkable past health presented with an intense headache and visual disturbance, followed by a secondary generalized tonic-clonic focal seizure. She had a history of arthritis, livedo reticularis, myalgia, elevated erythrocyte sedimentation rate, and nonspecific constitutional manifestations (fever and weight loss). Examination revealed new-onset severe hypertension. Complete immunological studies were negative. Electroencephalogram showed abnormalities compatible with secondarily generalized tonic–clonic focal occipital seizures. Brain magnetic resonance imaging (MRI) revealed high signal intensity on T2 in occipital lobes, cerebellum, and brainstem and renal imaging multiple hypoenhancing parenchymal images (renal infarction). Follow-up brain MRI at 3 months showed marked improvement. A diagnosis of polyarteritis nodosa with posterior reversible encephalopathy syndrome was made.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41342847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1142/s2661341722300075
C. Cheung, S. Ho, S. Krishnamoorthy, Xiaowen Zhang
Osteoporosis is a prevalent disease globally, with fragility fracture being the clinical outcome. Hip fracture is mostly associated with morbidity, immobility, and mortality among all fragility fractures. Although earlier studies in the 1990s projected that half of the hip fractures in the world will occur in Asia by 2050, epidemiology studies in Asia are inadequate. On the other hand, although the stabilizing or reducing trend of hip fracture incidence was reported in some countries or regions, the total number of hip fractures may still increase due to the rapid increase of the oldest old population. The oldest old usually have the highest fracture incidence, while the available treatment and management of osteoporosis for them are suboptimal. The undertreatment could be due to the “unfavorable” risk–benefit profile, lack of fracture prediction tool for the oldest old, and the presence of multiple comorbidities. A strategic management plan for osteoporosis in the oldest old can help cope with the coming “fracture tsunami” and achieve the “healthy aging” goal among the oldest old. Here, we reviewed the recent Asian epidemiology studies on hip fracture, focusing on the current treatment, fracture prediction, and comorbidities of the oldest old.
{"title":"Hip Fracture in Asia with a Special Focus in the Oldest Old: A Brief Review","authors":"C. Cheung, S. Ho, S. Krishnamoorthy, Xiaowen Zhang","doi":"10.1142/s2661341722300075","DOIUrl":"https://doi.org/10.1142/s2661341722300075","url":null,"abstract":"Osteoporosis is a prevalent disease globally, with fragility fracture being the clinical outcome. Hip fracture is mostly associated with morbidity, immobility, and mortality among all fragility fractures. Although earlier studies in the 1990s projected that half of the hip fractures in the world will occur in Asia by 2050, epidemiology studies in Asia are inadequate. On the other hand, although the stabilizing or reducing trend of hip fracture incidence was reported in some countries or regions, the total number of hip fractures may still increase due to the rapid increase of the oldest old population. The oldest old usually have the highest fracture incidence, while the available treatment and management of osteoporosis for them are suboptimal. The undertreatment could be due to the “unfavorable” risk–benefit profile, lack of fracture prediction tool for the oldest old, and the presence of multiple comorbidities. A strategic management plan for osteoporosis in the oldest old can help cope with the coming “fracture tsunami” and achieve the “healthy aging” goal among the oldest old. Here, we reviewed the recent Asian epidemiology studies on hip fracture, focusing on the current treatment, fracture prediction, and comorbidities of the oldest old.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46785127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1142/s2661341722300063
J. Li-Yu
Osteoporosis is a systemic skeletal disorder that affects bone microarchitecture resulting to fragility fractures. Randomized controlled trials have shown efficacy of antiresorptives and osteoanabolic agents in addressing concerns of osteoporosis especially in the older population. However, published guidance from several organizations started to focus as well on the perceived harms most especially of bisphosphonates considering their persistent effect on the bones. Similar to other chronic diseases, decision on whether or not to continue therapy depends on factors that might persistently provide signal on the individual’s further risk of unwanted but preventable outcomes.
{"title":"Concerns on Medications Used in Osteoporosis","authors":"J. Li-Yu","doi":"10.1142/s2661341722300063","DOIUrl":"https://doi.org/10.1142/s2661341722300063","url":null,"abstract":"Osteoporosis is a systemic skeletal disorder that affects bone microarchitecture resulting to fragility fractures. Randomized controlled trials have shown efficacy of antiresorptives and osteoanabolic agents in addressing concerns of osteoporosis especially in the older population. However, published guidance from several organizations started to focus as well on the perceived harms most especially of bisphosphonates considering their persistent effect on the bones. Similar to other chronic diseases, decision on whether or not to continue therapy depends on factors that might persistently provide signal on the individual’s further risk of unwanted but preventable outcomes.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47688571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1142/s2661341722300051
S. Chaiamnuay
Recently, several updates in the assessment and treatment of postmenopausal osteoporosis guidelines were published. This review discusses international guidelines, including the algorithm for management of patients at risk of osteoporotic fracture from the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) 2020, The Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Clinical Practice Guideline (2019)/Guideline Update (2020), and the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 update. Due to the recent COVID-19 pandemics, the joint guidance on osteoporosis management in the era of COVID-19 pandemic will also be included. The criterion for diagnosis of osteoporosis has been published by AACE/ACE. All postmenopausal women of age ≥50 years old should be evaluated for osteoporosis risk. Those at very high risk for fracture are recommended to start treatment with anabolic agents and those at high risk for fracture are recommended to start treatment with antiresorptive agent such as bisphosphonates or denosumab. Intervention thresholds and treatment options vary from country to country. Physicians should individualize the treatment according to risks, benefits, patient preferences, as well as treatment accessibility.
{"title":"Assessment and Treatment of Postmenopausal Osteoporosis: An Appraisal of International Guidelines","authors":"S. Chaiamnuay","doi":"10.1142/s2661341722300051","DOIUrl":"https://doi.org/10.1142/s2661341722300051","url":null,"abstract":"Recently, several updates in the assessment and treatment of postmenopausal osteoporosis guidelines were published. This review discusses international guidelines, including the algorithm for management of patients at risk of osteoporotic fracture from the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) 2020, The Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Clinical Practice Guideline (2019)/Guideline Update (2020), and the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 update. Due to the recent COVID-19 pandemics, the joint guidance on osteoporosis management in the era of COVID-19 pandemic will also be included. The criterion for diagnosis of osteoporosis has been published by AACE/ACE. All postmenopausal women of age ≥50 years old should be evaluated for osteoporosis risk. Those at very high risk for fracture are recommended to start treatment with anabolic agents and those at high risk for fracture are recommended to start treatment with antiresorptive agent such as bisphosphonates or denosumab. Intervention thresholds and treatment options vary from country to country. Physicians should individualize the treatment according to risks, benefits, patient preferences, as well as treatment accessibility.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45043691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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