Pub Date : 2024-09-11DOI: 10.4081/reumatismo.2024.1779
B Ristic, C Bonetto, M Rossini, E Fracassi, A Carletto, S Tosato
Objective: The aim of the current study was to compare the clinical and treatment characteristics and dimensions of health-related quality of life between female and male patients with axial spondyloarthritis (SpA) and psoriatic arthritis (PsA).
Methods: The present study is cross-sectional and comprises 119 patients with axial SpA and 198 patients with PsA. Clinical data were collected by standardized and self-reported instruments. Disease activity was evaluated by the Ankylosing Spondylitis Disease Activity Score with C-reactive protein and the Disease Activity in PSoriatic Arthritis (for SpA and PsA, respectively). Health-related quality of life was assessed with the Medical Outcomes Study 36-item Short Form Survey. Patients were stratified by gender, and the socio-demographic, clinical, and quality-of-life data were compared.
Results: Women with axial SpA and PsA had significantly lower education (p<0.001, p=0.004, respectively) and higher disease activity (p<0.001, p=0.003, respectively). Female patients with axial SpA were more frequently under second-line therapy (p=0.026) and glucocorticoid treatment (p=0.005), while women with PsA had more radiographic progression (p=0.006). Female patients with axial SpA and PsA had worse scores in the dimensions of quality of life regarding physical role, bodily pain, vitality, and mental health. Women with axial SpA had lower scores in general health, while women with PsA had lower scores in physical and social functioning.
Conclusions: Women with axial SpA and PsA had worse scores than men in most clinical and treatment characteristics and health-related quality of life dimensions.
{"title":"Gender differences in clinical features and quality of life of patients with axial spondyloarthritis and psoriatic arthritis.","authors":"B Ristic, C Bonetto, M Rossini, E Fracassi, A Carletto, S Tosato","doi":"10.4081/reumatismo.2024.1779","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1779","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study was to compare the clinical and treatment characteristics and dimensions of health-related quality of life between female and male patients with axial spondyloarthritis (SpA) and psoriatic arthritis (PsA).</p><p><strong>Methods: </strong>The present study is cross-sectional and comprises 119 patients with axial SpA and 198 patients with PsA. Clinical data were collected by standardized and self-reported instruments. Disease activity was evaluated by the Ankylosing Spondylitis Disease Activity Score with C-reactive protein and the Disease Activity in PSoriatic Arthritis (for SpA and PsA, respectively). Health-related quality of life was assessed with the Medical Outcomes Study 36-item Short Form Survey. Patients were stratified by gender, and the socio-demographic, clinical, and quality-of-life data were compared.</p><p><strong>Results: </strong>Women with axial SpA and PsA had significantly lower education (p<0.001, p=0.004, respectively) and higher disease activity (p<0.001, p=0.003, respectively). Female patients with axial SpA were more frequently under second-line therapy (p=0.026) and glucocorticoid treatment (p=0.005), while women with PsA had more radiographic progression (p=0.006). Female patients with axial SpA and PsA had worse scores in the dimensions of quality of life regarding physical role, bodily pain, vitality, and mental health. Women with axial SpA had lower scores in general health, while women with PsA had lower scores in physical and social functioning.</p><p><strong>Conclusions: </strong>Women with axial SpA and PsA had worse scores than men in most clinical and treatment characteristics and health-related quality of life dimensions.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294222","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 : 2024-09-11DOI: 10.4081/reumatismo.2024.1760
R Ramonda, F Oliviero
Spondyloarthritis is an umbrella term for a heterogeneous group of chronic inflammatory diseases affecting the spine and/or peripheral joints, often associated with extra-articular manifestations, such as psoriasis, uveitis, and inflammatory bowel disease...
{"title":"Women and spondyloarthritis.","authors":"R Ramonda, F Oliviero","doi":"10.4081/reumatismo.2024.1760","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1760","url":null,"abstract":"<p><p>Spondyloarthritis is an umbrella term for a heterogeneous group of chronic inflammatory diseases affecting the spine and/or peripheral joints, often associated with extra-articular manifestations, such as psoriasis, uveitis, and inflammatory bowel disease...</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294237","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1704
F M Galassi, L Ingaliso, V Papa, R Lorenzi, E Percivaldi, E Varotto
Recognized since antiquity, gout is still a relevant pathology with rising prevalence and incidence. This study aims to assess the reference accuracy in journal articles mentioning the early use of the word 'gout'. Specifically, it investigates whether the term was indeed coined in the 13th century by the Dominican monk Randolphus of Bocking, as widely believed. Several historical sources in their original Latin were consulted to test the hypothesis of literary mentions predating Randolphus of Bocking's description. At the same time, biomedical articles spanning the last two decades were perused using specific keywords in different combinations to determine the accuracy level of references related to the earliest use of the word 'gout'. The results showed that several biomedical publications wrongly ascribed the origin of the word 'gout' to Randolphus of Bocking. Indeed, various texts predate his mention by many years. In particular, gutta, the Latin word used to indicate a host of rheumatological conditions including gout, is recorded as early as the 10th century in a biography dedicated to the martyred nun Saint Wiborada of St. Gall. Written by Swiss monks between AD 960 and 963, this text should be regarded as containing the earliest known adoption of the word. For this reason, scholars should now avoid quoting Randolph of Bocking's description as the first use of the word 'gout' in Western literature.
{"title":"On the early uses of the word 'gout': novel evidence and a critical assessment of the published literature.","authors":"F M Galassi, L Ingaliso, V Papa, R Lorenzi, E Percivaldi, E Varotto","doi":"10.4081/reumatismo.2024.1704","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1704","url":null,"abstract":"<p><p>Recognized since antiquity, gout is still a relevant pathology with rising prevalence and incidence. This study aims to assess the reference accuracy in journal articles mentioning the early use of the word 'gout'. Specifically, it investigates whether the term was indeed coined in the 13th century by the Dominican monk Randolphus of Bocking, as widely believed. Several historical sources in their original Latin were consulted to test the hypothesis of literary mentions predating Randolphus of Bocking's description. At the same time, biomedical articles spanning the last two decades were perused using specific keywords in different combinations to determine the accuracy level of references related to the earliest use of the word 'gout'. The results showed that several biomedical publications wrongly ascribed the origin of the word 'gout' to Randolphus of Bocking. Indeed, various texts predate his mention by many years. In particular, gutta, the Latin word used to indicate a host of rheumatological conditions including gout, is recorded as early as the 10th century in a biography dedicated to the martyred nun Saint Wiborada of St. Gall. Written by Swiss monks between AD 960 and 963, this text should be regarded as containing the earliest known adoption of the word. For this reason, scholars should now avoid quoting Randolph of Bocking's description as the first use of the word 'gout' in Western literature.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446947","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1696
M Rossini, F P Cantatore, A Del Puente, B Frediani, D Gatti, S Giannini, M Varenna, O Viapiana, G D Sebastiani
Objective: Fragility fractures (FF) resulting from osteoporosis pose a significant public health challenge in Italy, with considerable socio-health and economic implications. Despite the availability of safe and effective drugs, osteoporosis remains underdiagnosed and undertreated, leaving over 2 million high-risk Italian women without treatment. This paper aims to identify and propose key improvements in the management of osteoporosis, focusing particularly on the critical issues related to the use of anabolic drugs in secondary prevention, according to the current Italian Medicines Agency (AIFA) Note 79.
Methods: The Expert Panel, composed of nine recognized Italian experts in rheumatology, analyzed current practices, prescribing criteria, and the most recent literature. Three main reasons for revising the indications on pharmacological treatment of osteoporosis were identified: inadequate treatment of osteoporosis, new evidence regarding frontline placement of anabolics in high-risk conditions, and emerging sequential or combined strategies.
Results: The proposed improvements include the adoption of the Derived Fracture Risk Assessment algorithm for accurate fracture risk assessment, revision of AIFA Note 79 to reflect current evidence, improved prescribing appropriateness, broader access to anabolic agents, and the provision of sequential therapies with antiresorptives for teriparatide. These changes aim to enhance patient outcomes, streamline healthcare processes, and address the high percentage of undertreated individuals.
Conclusions: This expert opinion emphasizes the importance of the appropriate use of anabolic drugs to reduce FF and associated costs while ensuring the sustainability of the National Health Service. The proposed recommendations are in line with the latest scientific evidence, providing a comprehensive strategy to optimize the management of osteoporosis in Italy. On behalf of the Study Group on Osteoporosis and Skeletal Metabolic Diseases of the Italian Society of Rheumatology.
{"title":"Expert opinion on the management of patients with osteoporosis with anabolic drugs in Italy.","authors":"M Rossini, F P Cantatore, A Del Puente, B Frediani, D Gatti, S Giannini, M Varenna, O Viapiana, G D Sebastiani","doi":"10.4081/reumatismo.2024.1696","DOIUrl":"10.4081/reumatismo.2024.1696","url":null,"abstract":"<p><strong>Objective: </strong>Fragility fractures (FF) resulting from osteoporosis pose a significant public health challenge in Italy, with considerable socio-health and economic implications. Despite the availability of safe and effective drugs, osteoporosis remains underdiagnosed and undertreated, leaving over 2 million high-risk Italian women without treatment. This paper aims to identify and propose key improvements in the management of osteoporosis, focusing particularly on the critical issues related to the use of anabolic drugs in secondary prevention, according to the current Italian Medicines Agency (AIFA) Note 79.</p><p><strong>Methods: </strong>The Expert Panel, composed of nine recognized Italian experts in rheumatology, analyzed current practices, prescribing criteria, and the most recent literature. Three main reasons for revising the indications on pharmacological treatment of osteoporosis were identified: inadequate treatment of osteoporosis, new evidence regarding frontline placement of anabolics in high-risk conditions, and emerging sequential or combined strategies.</p><p><strong>Results: </strong>The proposed improvements include the adoption of the Derived Fracture Risk Assessment algorithm for accurate fracture risk assessment, revision of AIFA Note 79 to reflect current evidence, improved prescribing appropriateness, broader access to anabolic agents, and the provision of sequential therapies with antiresorptives for teriparatide. These changes aim to enhance patient outcomes, streamline healthcare processes, and address the high percentage of undertreated individuals.</p><p><strong>Conclusions: </strong>This expert opinion emphasizes the importance of the appropriate use of anabolic drugs to reduce FF and associated costs while ensuring the sustainability of the National Health Service. The proposed recommendations are in line with the latest scientific evidence, providing a comprehensive strategy to optimize the management of osteoporosis in Italy. On behalf of the Study Group on Osteoporosis and Skeletal Metabolic Diseases of the Italian Society of Rheumatology.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446945","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1620
F M Mariani, A Alunno, F Carubbi, C Ferri
The safety profile of baricitinib (BARI), a Janus kinase inhibitor broadly used for the treatment of rheumatoid arthritis (RA), includes asymptomatic laboratory abnormalities, such as an increase in creatine kinase (CK). Data from randomized controlled trials suggest that concomitant myalgia is rare in RA and does not lead to drug discontinuation. We describe the case of a 68-year-old Caucasian female with longstanding, multi-failure RA who started BARI and achieved disease remission. However, she developed a symptomatic CK increase, as well as a parallel increase in total cholesterol, low-density lipoprotein, and triglycerides. Dechallenge-rechallenge demonstrated a plausible relationship between the clinical/laboratory abnormalities and BARI. In fact, when the drug was withdrawn, CK returned to normal and myalgia disappeared, whereas symptoms returned and CK levels increased when BARI was restarted. BARI may be rarely associated with symptomatic CK elevation, and this may pose clinical challenges, particularly for patients with multi-failure RA who achieved good disease control with BARI but required drug discontinuation due to intolerance.
巴利昔尼(BARI)是一种广泛用于治疗类风湿性关节炎(RA)的 Janus 激酶抑制剂,其安全性包括无症状的实验室异常,如肌酸激酶(CK)升高。随机对照试验的数据表明,伴随肌痛的情况在类风湿性关节炎中很少见,也不会导致停药。我们描述了一例 68 岁的白种女性患者,她患有长期、多发的 RA,开始使用 BARI 后疾病得到缓解。然而,她出现了无症状的 CK 升高,总胆固醇、低密度脂蛋白和甘油三酯也同时升高。去挑战-再挑战证明了临床/实验室异常与 BARI 之间的合理关系。事实上,停药后,肌酸激酶恢复正常,肌痛消失,而重新开始服用 BARI 时,症状恢复,肌酸激酶水平升高。BARI可能很少与无症状的CK升高相关联,这可能会给临床带来挑战,尤其是对于使用BARI后疾病控制良好但因不耐受而需要停药的多发RA患者。
{"title":"A rare case of symptomatic creatine kinase elevation in a patient with rheumatoid arthritis treated with baricitinib.","authors":"F M Mariani, A Alunno, F Carubbi, C Ferri","doi":"10.4081/reumatismo.2024.1620","DOIUrl":"10.4081/reumatismo.2024.1620","url":null,"abstract":"<p><p>The safety profile of baricitinib (BARI), a Janus kinase inhibitor broadly used for the treatment of rheumatoid arthritis (RA), includes asymptomatic laboratory abnormalities, such as an increase in creatine kinase (CK). Data from randomized controlled trials suggest that concomitant myalgia is rare in RA and does not lead to drug discontinuation. We describe the case of a 68-year-old Caucasian female with longstanding, multi-failure RA who started BARI and achieved disease remission. However, she developed a symptomatic CK increase, as well as a parallel increase in total cholesterol, low-density lipoprotein, and triglycerides. Dechallenge-rechallenge demonstrated a plausible relationship between the clinical/laboratory abnormalities and BARI. In fact, when the drug was withdrawn, CK returned to normal and myalgia disappeared, whereas symptoms returned and CK levels increased when BARI was restarted. BARI may be rarely associated with symptomatic CK elevation, and this may pose clinical challenges, particularly for patients with multi-failure RA who achieved good disease control with BARI but required drug discontinuation due to intolerance.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446940","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1684
F Sari, S Sari
Objective: Chronic diseases, which caused 36 million deaths in 2008, are the most common cause of death worldwide. Exercise is one of the non-pharmacological treatment methods. Although exercise benefits are well known, more than half of the population does not exercise due to the burden of exercise. The objectives of the current study were to evaluate the Turkish version of the Exercise Therapy Burden Questionnaire (ETBQ-T) and to investigate its reliability and validity.
Methods: A total of 100 participants (female: 69, male: 31) who were diagnosed with at least one chronic disease participated in the translation validity and reliability analysis of the study. Cross-cultural adaptation of the ETBQ-T was performed according to Beaton's guidelines. The ETBQ-T, the European Quality of Life 5 Dimensions (EQ-5D), pain, satisfaction, and self-efficacy were applied for convergent validity. The ETBQ-T was retested to examine its reliability after 7 days.
Results: The internal consistency and reliability were excellent (intraclass correlation coefficient=0.959; Cronbach's α=0.919). The standard error of measurement was reported as 5.35. The minimum detectable difference was also demonstrated at 1.35. The ETBQ-T had a good correlation with pain (r=0.545, p<0.001), satisfaction (r=-501, p<0.001), and self-efficacy (r=-0.579, p<0.001). However, the correlation of the ETBQ-T with EQ-5D (r=0.340, p=0.001) was weak. A factor was extracted, accounting for 58.289% of the total variation. There were no floor or ceiling effects.
Conclusions: The ETBQ-T is a reliable and valid tool to evaluate the exercise burden in the Turkish population with chronic disease.
{"title":"Cross-cultural adaptation, reliability, and validity of the Turkish version of the Exercise Therapy Burden Questionnaire for individuals with chronic diseases.","authors":"F Sari, S Sari","doi":"10.4081/reumatismo.2024.1684","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1684","url":null,"abstract":"<p><strong>Objective: </strong>Chronic diseases, which caused 36 million deaths in 2008, are the most common cause of death worldwide. Exercise is one of the non-pharmacological treatment methods. Although exercise benefits are well known, more than half of the population does not exercise due to the burden of exercise. The objectives of the current study were to evaluate the Turkish version of the Exercise Therapy Burden Questionnaire (ETBQ-T) and to investigate its reliability and validity.</p><p><strong>Methods: </strong>A total of 100 participants (female: 69, male: 31) who were diagnosed with at least one chronic disease participated in the translation validity and reliability analysis of the study. Cross-cultural adaptation of the ETBQ-T was performed according to Beaton's guidelines. The ETBQ-T, the European Quality of Life 5 Dimensions (EQ-5D), pain, satisfaction, and self-efficacy were applied for convergent validity. The ETBQ-T was retested to examine its reliability after 7 days.</p><p><strong>Results: </strong>The internal consistency and reliability were excellent (intraclass correlation coefficient=0.959; Cronbach's α=0.919). The standard error of measurement was reported as 5.35. The minimum detectable difference was also demonstrated at 1.35. The ETBQ-T had a good correlation with pain (r=0.545, p<0.001), satisfaction (r=-501, p<0.001), and self-efficacy (r=-0.579, p<0.001). However, the correlation of the ETBQ-T with EQ-5D (r=0.340, p=0.001) was weak. A factor was extracted, accounting for 58.289% of the total variation. There were no floor or ceiling effects.</p><p><strong>Conclusions: </strong>The ETBQ-T is a reliable and valid tool to evaluate the exercise burden in the Turkish population with chronic disease.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446943","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1638
F La Torre, C Coppola, M G Anelli, F Cacciapaglia, G Lopalco, F Cardinale, F Iannone
Objective: The indices to measure disease activity of chronic arthritis in adulthood and childhood are different. Therefore, assessing the status of the disease in young patients with juvenile idiopathic arthritis (JIA) can be tricky, especially when the transition to adult care is ongoing. The aim of our study was to assess the level of correlation between adult and juvenile scores in the measurement of disease activity in JIA patients during transitional care.
Methods: We estimated the disease activity by using the Juvenile Arthritis Disease Activity Score 71 (JADAS71), clinical JADAS, adult Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) in JIA patients in transitional care. We enrolled patients older than 16 years at the time of the first transition visit, and disease activity was assessed at baseline and 12 months. Regression analyses were carried out to estimate the level of agreement among the different indices.
Results: We recruited 26 patients with JIA; 11 patients were polyarticular (42.3%) and 15 patients were oligoarticular (53.1%). The mean age at diagnosis was 7.7±3.9 years and the age at the first evaluation was 20.9±3.7 years. The correlation between JADAS71 and DAS28 was r2=0.69, r2=0.86 between JADAS71 and SDAI, and r2=0.81 between JADAS71 and CDAI.
Conclusions: SDAI and JADAS71 showed the best correlation, but a few patients were not captured at the same level of disease activity. New prospective studies with a larger number of patients will be needed in this field.
{"title":"Disease activity assessment for juvenile idiopathic arthritis in transitional care.","authors":"F La Torre, C Coppola, M G Anelli, F Cacciapaglia, G Lopalco, F Cardinale, F Iannone","doi":"10.4081/reumatismo.2024.1638","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1638","url":null,"abstract":"<p><strong>Objective: </strong>The indices to measure disease activity of chronic arthritis in adulthood and childhood are different. Therefore, assessing the status of the disease in young patients with juvenile idiopathic arthritis (JIA) can be tricky, especially when the transition to adult care is ongoing. The aim of our study was to assess the level of correlation between adult and juvenile scores in the measurement of disease activity in JIA patients during transitional care.</p><p><strong>Methods: </strong>We estimated the disease activity by using the Juvenile Arthritis Disease Activity Score 71 (JADAS71), clinical JADAS, adult Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) in JIA patients in transitional care. We enrolled patients older than 16 years at the time of the first transition visit, and disease activity was assessed at baseline and 12 months. Regression analyses were carried out to estimate the level of agreement among the different indices.</p><p><strong>Results: </strong>We recruited 26 patients with JIA; 11 patients were polyarticular (42.3%) and 15 patients were oligoarticular (53.1%). The mean age at diagnosis was 7.7±3.9 years and the age at the first evaluation was 20.9±3.7 years. The correlation between JADAS71 and DAS28 was r2=0.69, r2=0.86 between JADAS71 and SDAI, and r2=0.81 between JADAS71 and CDAI.</p><p><strong>Conclusions: </strong>SDAI and JADAS71 showed the best correlation, but a few patients were not captured at the same level of disease activity. New prospective studies with a larger number of patients will be needed in this field.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446944","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1608
E Molteni, C Pirone, F Ceccarelli, C Castellani, C Alessandri, M Di Franco, V Riccieri, F R Spinelli, R Priori, R Scrivo, F Conti
Objective: Data from trials demonstrated that abatacept (ABA) has a good safety and efficacy profile in treating rheumatoid arthritis. We have studied the retention rate of ABA in a real-life cohort of patients with rheumatoid arthritis.
Methods: This is a monocentric, retrospective study including patients with rheumatoid arthritis classified by the American College of Rheumatology/European League Against Rheumatism 2010 criteria who started treatment with ABA. The Kaplan-Meier method was applied to evaluate the ABA retention rate.
Results: This analysis was conducted on 161 patients [male/female 21/140, median age 65 years, interquartile range (IQR) 18.7, median disease duration 169 months, IQR 144.0]. 111 patients (68.9%) received ABA subcutaneously. ABA was associated with methotrexate in 61.9% of patients and was the first biological disease-modifying antirheumatic drug in 41%. We observed a median ABA survival of 66 months [95% confidence interval (CI) 57.3-74.7], with a retention rate of 88% at 6 months and 50.9% at 5 years. Drug survival was significantly higher in patients treated with ABA subcutaneously and in male patients (p=0.039 and p=0.018, respectively). Adjusted for main confounders, female gender was the main predictor of withdrawal (hazard ratio 5.1, 95% CI 1.2-21.3).
Conclusions: Our study shows that better survival is associated with subcutaneous administration and male gender, confirming ABA effectiveness.
目的:试验数据表明,阿巴他赛(ABA)在治疗类风湿关节炎方面具有良好的安全性和有效性。我们研究了类风湿关节炎患者队列中阿巴他赛普的保留率:这是一项单中心回顾性研究,研究对象包括根据美国风湿病学会/欧洲抗风湿联盟 2010 年标准分类的类风湿关节炎患者,他们都开始接受 ABA 治疗。采用卡普兰-梅耶法评估 ABA 的保留率:分析对象为 161 名患者[男性/女性 21/140,中位年龄 65 岁,四分位数间距 (IQR) 18.7,中位病程 169 个月,IQR 144.0]。111名患者(68.9%)皮下注射了ABA。在61.9%的患者中,ABA与甲氨蝶呤同时使用,在41%的患者中,ABA是第一种生物改变病情抗风湿药物。我们观察到,ABA 的中位生存期为 66 个月[95% 置信区间 (CI) 为 57.3-74.7],6 个月和 5 年的保留率分别为 88% 和 50.9%。皮下注射 ABA 的患者和男性患者的药物存活率明显更高(分别为 p=0.039 和 p=0.018)。对主要混杂因素进行调整后,女性性别是预测停药的主要因素(危险比 5.1,95% CI 1.2-21.3):我们的研究表明,皮下注射和男性性别与更好的存活率有关,证实了 ABA 的有效性。
{"title":"Retention rate of abatacept in rheumatoid arthritis patients in a real-life setting: results from a monocentric cohort.","authors":"E Molteni, C Pirone, F Ceccarelli, C Castellani, C Alessandri, M Di Franco, V Riccieri, F R Spinelli, R Priori, R Scrivo, F Conti","doi":"10.4081/reumatismo.2024.1608","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1608","url":null,"abstract":"<p><strong>Objective: </strong>Data from trials demonstrated that abatacept (ABA) has a good safety and efficacy profile in treating rheumatoid arthritis. We have studied the retention rate of ABA in a real-life cohort of patients with rheumatoid arthritis.</p><p><strong>Methods: </strong>This is a monocentric, retrospective study including patients with rheumatoid arthritis classified by the American College of Rheumatology/European League Against Rheumatism 2010 criteria who started treatment with ABA. The Kaplan-Meier method was applied to evaluate the ABA retention rate.</p><p><strong>Results: </strong>This analysis was conducted on 161 patients [male/female 21/140, median age 65 years, interquartile range (IQR) 18.7, median disease duration 169 months, IQR 144.0]. 111 patients (68.9%) received ABA subcutaneously. ABA was associated with methotrexate in 61.9% of patients and was the first biological disease-modifying antirheumatic drug in 41%. We observed a median ABA survival of 66 months [95% confidence interval (CI) 57.3-74.7], with a retention rate of 88% at 6 months and 50.9% at 5 years. Drug survival was significantly higher in patients treated with ABA subcutaneously and in male patients (p=0.039 and p=0.018, respectively). Adjusted for main confounders, female gender was the main predictor of withdrawal (hazard ratio 5.1, 95% CI 1.2-21.3).</p><p><strong>Conclusions: </strong>Our study shows that better survival is associated with subcutaneous administration and male gender, confirming ABA effectiveness.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446948","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1572
G El Hasbani, J E Nassar, A M Elsayed Ali, I Uthman, A Jawad
Objective: Nicotine has major side effects on human health through numerous mechanisms, one of which is the alteration of the immune system and its genetic components. Such alteration can be a predisposing factor for autoimmune diseases such as spondyloarthritis (SpA) and rheumatoid arthritis (RA). This review aims to shed light on the effects of nicotine smoking on the pathophysiology, clinical presentation, and management of SpA and RA.
Methods: This review looked into the studies, excluding case reports and series, which were cited by PubMed/MEDLINE.
Results: Patients with established autoimmune conditions may have a different underlying pathophysiology and disease course when exposed to nicotine through cigarette smoking. Through the involvement of several cytokines, endothelial dysfunction, and epigenetic mechanisms, the severity of SpA is more prominent in smokers. The global health status, pain, and fatigue are worse in SpA patients. The evidence on the effect of nicotine smoking on the treatment of SpA is still limited. Nicotine can contribute to RA via the disruption of cellular regulatory activity, inflammatory responses, morphological, physiological, biochemical, and enzymatic responses. As such, smokers with RA have higher disease activity and are more likely to be seropositive through the citrullination of peptides. In addition, these patients are at risk of achieving a suboptimal response to tumor necrosis factor inhibitors.
Conclusions: Cigarette smoking can substantially affect the pathophysiology and clinical presentation of patients with SpA and RA. The impact of nicotine on the management of these diseases still needs to be further studied.
目的尼古丁通过多种机制对人体健康产生重大副作用,其中之一就是改变免疫系统及其基因成分。这种改变可能是脊柱关节炎(SpA)和类风湿性关节炎(RA)等自身免疫性疾病的诱发因素。本综述旨在阐明吸烟尼古丁对脊柱关节炎和类风湿性关节炎的病理生理学、临床表现和治疗的影响:本综述调查了PubMed/MEDLINE引用的研究,不包括病例报告和系列研究:结果:已确诊的自身免疫性疾病患者通过吸烟接触尼古丁后,其潜在的病理生理学和病程可能会有所不同。通过多种细胞因子、内皮功能障碍和表观遗传机制的参与,吸烟者 SpA 的严重程度更为突出。SpA患者的总体健康状况、疼痛和疲劳都会恶化。有关吸烟尼古丁对治疗 SpA 的影响的证据仍然有限。尼古丁可通过扰乱细胞调节活动、炎症反应、形态学、生理学、生物化学和酶学反应而导致 RA。因此,患有 RA 的吸烟者具有更高的疾病活动性,并且更有可能通过肽的瓜氨酸化而出现血清阳性。此外,这些患者还有可能对肿瘤坏死因子抑制剂产生不理想的反应:吸烟会严重影响SpA和RA患者的病理生理学和临床表现。尼古丁对这些疾病治疗的影响仍有待进一步研究。
{"title":"The impact of nicotine smoking on spondyloarthritis and rheumatoid arthritis.","authors":"G El Hasbani, J E Nassar, A M Elsayed Ali, I Uthman, A Jawad","doi":"10.4081/reumatismo.2024.1572","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1572","url":null,"abstract":"<p><strong>Objective: </strong>Nicotine has major side effects on human health through numerous mechanisms, one of which is the alteration of the immune system and its genetic components. Such alteration can be a predisposing factor for autoimmune diseases such as spondyloarthritis (SpA) and rheumatoid arthritis (RA). This review aims to shed light on the effects of nicotine smoking on the pathophysiology, clinical presentation, and management of SpA and RA.</p><p><strong>Methods: </strong>This review looked into the studies, excluding case reports and series, which were cited by PubMed/MEDLINE.</p><p><strong>Results: </strong>Patients with established autoimmune conditions may have a different underlying pathophysiology and disease course when exposed to nicotine through cigarette smoking. Through the involvement of several cytokines, endothelial dysfunction, and epigenetic mechanisms, the severity of SpA is more prominent in smokers. The global health status, pain, and fatigue are worse in SpA patients. The evidence on the effect of nicotine smoking on the treatment of SpA is still limited. Nicotine can contribute to RA via the disruption of cellular regulatory activity, inflammatory responses, morphological, physiological, biochemical, and enzymatic responses. As such, smokers with RA have higher disease activity and are more likely to be seropositive through the citrullination of peptides. In addition, these patients are at risk of achieving a suboptimal response to tumor necrosis factor inhibitors.</p><p><strong>Conclusions: </strong>Cigarette smoking can substantially affect the pathophysiology and clinical presentation of patients with SpA and RA. The impact of nicotine on the management of these diseases still needs to be further studied.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446950","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 : 2024-06-24DOI: 10.4081/reumatismo.2024.1660
T Sahbaz, B Cigdem-Karacay
Objective: There is no study comparing knee and spine osteoarthritis. The purpose of the study is to examine the effects of pain and disability on quality of life (QoL) and the factors affecting QoL in patients with knee osteoarthritis and spondylosis.
Methods: This cross-sectional study included 114 patients with spondylosis and 126 patients with knee osteoarthritis. Demographic data were recorded. The visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Roland Morris Questionnaire (RMQ), and the Short Form Health Questionnaire (SF-36) were filled out.
Results: Statistically, patients with spondylosis and knee osteoarthritis did not differ significantly in terms of gender, age, body mass index, number of concomitant conditions, marital status, years of schooling, pain scores, or SF-36 characteristics. SF-36 physical function, vitality, and mental health assessments were lower in women than men, while VAS scores were higher. There was no correlation between marital status, educational level, and QoL subscales. WOMAC and RMQ scores were negatively correlated with the SF-36 subscales. RMS scores were not related to mental health.
Conclusions: Spondylosis and knee osteoarthritis affect all subscales of QoL in the same way. The management of patients with spondylosis and knee osteoarthritis should focus on pain and functionality to improve QoL.
研究目的目前尚无膝关节骨关节炎与脊柱骨关节炎的比较研究。本研究旨在探讨膝骨关节炎和脊柱炎患者的疼痛和残疾对生活质量(QoL)的影响,以及影响 QoL 的因素:这项横断面研究包括 114 名脊柱炎患者和 126 名膝关节骨性关节炎患者。记录了人口统计学数据。填写视觉模拟量表(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、罗兰-莫里斯问卷(RMQ)和简表健康问卷(SF-36):据统计,脊柱炎和膝关节骨性关节炎患者在性别、年龄、体重指数、并发症数量、婚姻状况、受教育年限、疼痛评分或 SF-36 特征方面没有显著差异。女性的 SF-36 身体功能、活力和心理健康评估低于男性,而 VAS 评分则高于男性。婚姻状况、教育水平和 QoL 子量表之间没有相关性。WOMAC 和 RMQ 分数与 SF-36 分量表呈负相关。RMS评分与心理健康无关:结论:脊椎病和膝关节骨性关节炎对 QoL 的所有分量表都有相同的影响。脊柱炎和膝关节骨性关节炎患者的治疗应重点关注疼痛和功能,以改善 QoL。
{"title":"Assessment of factors affecting quality of life in patients with chronic pain due to knee osteoarthritis and spondylosis: spine <i>versus</i> knee?","authors":"T Sahbaz, B Cigdem-Karacay","doi":"10.4081/reumatismo.2024.1660","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1660","url":null,"abstract":"<p><strong>Objective: </strong>There is no study comparing knee and spine osteoarthritis. The purpose of the study is to examine the effects of pain and disability on quality of life (QoL) and the factors affecting QoL in patients with knee osteoarthritis and spondylosis.</p><p><strong>Methods: </strong>This cross-sectional study included 114 patients with spondylosis and 126 patients with knee osteoarthritis. Demographic data were recorded. The visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Roland Morris Questionnaire (RMQ), and the Short Form Health Questionnaire (SF-36) were filled out.</p><p><strong>Results: </strong>Statistically, patients with spondylosis and knee osteoarthritis did not differ significantly in terms of gender, age, body mass index, number of concomitant conditions, marital status, years of schooling, pain scores, or SF-36 characteristics. SF-36 physical function, vitality, and mental health assessments were lower in women than men, while VAS scores were higher. There was no correlation between marital status, educational level, and QoL subscales. WOMAC and RMQ scores were negatively correlated with the SF-36 subscales. RMS scores were not related to mental health.</p><p><strong>Conclusions: </strong>Spondylosis and knee osteoarthritis affect all subscales of QoL in the same way. The management of patients with spondylosis and knee osteoarthritis should focus on pain and functionality to improve QoL.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"76 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446941","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}