Scandinavian Journal of Rheumatology最新文献

Objective: Pain hypersensitivity and hypersensitivity to other sensory modalities (visual, auditory, olfactory, and tactile) are considered defining features in nociplastic pain states. A self-report measure of sensory sensitivity may help to characterize sensory profiles across pain populations. This study aimed to evaluate the psychometric properties of a newly developed Danish nine-item Sensory Sensitivity Profile (SSP) questionnaire in patients with fibromyalgia.

Method: Baseline assessments from a randomized controlled trial population of 200 individuals with a confirmed diagnosis of fibromyalgia who had completed the SSP were used in this study. Rasch analysis was applied to the dataset, allowing for a detailed analysis of the rating scale properties and further aspects of validity, including fit of individual scale items to a unidimensional model indicating assessment of a single construct, and assessment of the instrument's ability to provide precise and reliable measures of sensory sensitivity.

Results: The Rasch analyses revealed that the 0-3 ordinal rating scale of the SSP had sound psychometric properties, and supported the idea that the nine SSP items contributed towards measurement of a single construct. The study population exhibited expected and valid response patterns, with sensitivity to sound and pain being the most endorsed items. The SSP demonstrated adequate precision and reliability of item difficulty estimates and person sensory sensitivity measures when applied in our study population.

Conclusion: From the perspective of the Rasch measurement model, this first version of the SSP demonstrated adequate psychometric properties for characterizing and quantifying sensitivity to specific sensory modalities in patients with fibromyalgia.

Objective: To investigate the reliability of lacrimal gland ultrasound (LGUS) in patients with clinically suspected Sjögren's disease (SjD).

Method: Of 41 consecutive patients with clinically suspected SjD, 28 were diagnosed with SjD and 13 were classified as non-SjD. Forty patients were scored for bilateral lacrimal gland (LG) B-mode evaluation; LGs were 'not visible' in one case. Of these 40, 31 patients also underwent colour Doppler ultrasound (CDUS) evaluation. Images and videos were scored for both LGs using the Hocevar, Outcome Measures in Rheumatology (OMERACT) B-mode, and OMERACT CDUS scoring systems, and scored independently by four blinded observers in two sessions.

Results: For the Hocevar scoring system, intraobserver reliability was fair to moderate, with intraclass correlation coefficients (ICCs) ranging from 0.34 to 0.50. Interobserver reliability was fair, with ICCs of 0.31 and 0.25 between sessions 1 and 2. Individual Hocevar items showed poor to fair interobserver reliability. For the OMERACT B-mode scoring system, intraobserver reliability was fair to moderate, with ICCs ranging from 0.27 to 0.54. Interobserver reliability was poor to fair, with ICCs of 0.23 and 0.16 in sessions 1 and 2. Finally, for OMERACT CDUS, intraobserver reliability was good, with ICCs ranging from 0.61 to 0.80, and interobserver reliability also good, with ICCs of 0.63 and 0.69 in sessions 1 and 2.

Conclusion: This study, performing LGUS in patients with clinically suspected SjD, shows that the reliability of B-mode ultrasound may be a concern. The reliability of OMERACT CDUS is superior to Hocevar and OMERACT B-mode scoring of the LGs.

Objectives: This study aims to translate and cross-culturally adapt the European Alliance of Associations for Rheumatology (EULAR) Systemic Sclerosis Impact of Disease (ScleroID) questionnaire to Danish; and to assess its reliability in patients with systemic sclerosis (SSc).

Method: The translation and cross-cultural adaptation of the ScleroID questionnaire were conducted according to COnsensus-based Standard for the selection of health Measurement INstruments (COSMIN) guidelines. The test-retest reliability was assessed in 50 Danish patients with SSc.

Results: All steps for the translation process were followed and approved by the developers of ScleroID. The translation process resulted in changes to the wording of 'aspects' to 'symptoms', 'phenomenon' to 'syndrome', and 'social life' to 'social relations and leisure activities' to create a more meaningful translation in a Danish context. For the Danish version of the ScleroID, the intraclass correlation coefficient (ICC) was 0.90 [95% confidence interval (CI) 0.83; 0.94]. The ICC for each of the 10 individual health domains in ScleroID ranged from 0.52 (95% CI 0.29; 0.70) (digital ulcers) to 0.87 (0.78; 0.92) (lower gastrointestinal symptoms and fatigue).

Conclusion: The overall ICC for the Danish version of the ScleroID was excellent, which indicates that it can be implemented as a reliable patient-reported outcome measure in patients with SSc in Denmark.

Objective: Several studies have reported an association between rheumatoid arthritis (RA) disease activity and the risk of Alzheimer's disease and related dementias (AD/ADRD). We examined the role of RA flares on the risk of AD/ADRD.

Method: This population-based study was conducted on an inception cohort of RA patients aged ≥ 50 years, who were residents of Minnesota, USA (1988-2014). RA-related flare/remission status was ascertained via medical record review. In definition 1, flares were considered to start on the day of documentation and resolve halfway to the next visit. In definition 2, 'acute flares' were defined as lasting for 6 weeks. Incident dementia was defined by the presence of two ICD-9/10 codes for AD/ADRD ≥ 30 days apart. Cox models were used to assess the association of RA flares with AD/ADRD.

Results: We included 774 patients with RA. During a median follow-up of 7.8 years, 79 patients (10%) developed AD/ADRD. During a total of 12 437 medical visits, patients were flaring at 3407 visits (27.4%) and in remission at 2900 visits (23.3%). Using definition 1, we found no significant evidence of a higher risk of incident AD/ADRD when in RA flare versus remission [hazard ratio (HR) 1.11, 95% confidence interval (CI) 0.63-1.96]. Using definition 2, patients with RA flare had an estimated 1.8-fold increased risk of AD/ADRD (HR 1.82, 95% CI 0.82-4.06) versus remission, which was not statistically significant.

Conclusion: We found that RA flares are common. A detrimental effect of active flares on cognitive status cannot be excluded.

Objective: Previous publications have reported that increased absolute monocyte counts are associated with treatment non-response in patients with rheumatoid arthritis (RA). This study investigated whether full blood count (FBC) components from routine clinical testing before treatment with a biological disease-modifying anti-rheumatic drug (bDMARD) were associated with treatment non-response after 6 months of treatment.

Method: From a UK-based prospective multicentre study of patients with RA starting a bDMARD, data from 246 patients attending five of the participating centres were retrieved. FBC components were analysed for their association with European Alliance of Associations for Rheumatology non-response after 6 months of treatment using backward stepwise logistic regression, adjusting for potential confounders. Final models underwent resampling with 200 repeats of out-of-bag bootstrapping to assess model performance using area under the receiver operating characteristics (AUROC) curves. Model fit was compared using the Akaike information criterion (AIC).

Results: After 6 months of treatment, the only FBC component predictive of non-response was pretreatment absolute monocyte count [adjusted odds ratio (OR_adj) 9.56, 95% confidence intervals (CI) 1.61-59.86, p = 0.01, AUROC = 60.42%). The model including monocytes as a predictor demonstrated superior performance to the covariates-only model (AIC 184.36 vs 188.51, respectively).

Conclusion: In the largest study to date, increasing absolute monocyte counts were associated with bDMARD non-response after 6 months of treatment, replicating previous reports. Validation and mechanistic studies are required to inform future treatment selection.

Objective: Interstitial lung disease (ILD) is a serious complication of rheumatoid arthritis (RA). The aim of this study was to compare pulmonary function trajectories in RA-ILD, focusing on the impact of oral corticosteroid therapy and radiographic pattern.

Method: We used a multiple regression model with line artime trend and individual random coefficients for intercept and slope to assess forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO), allowing the description of individual linear patterns and systematic differences at a group level.

Results: We included 101 patients with RA-ILD retrospectively. Mean FVC and DLCO were lower in patients who received corticosteroid therapy for ILD than in untreated patients (79% vs 95% predicted, and 48% vs 58% predicted). The change in FVC per 30 days was -0.10 [95% confidence interval (95% CI) -0.18; -0.04] in the treated and -0.13 (95% 20 CI -0.19; -0.07) in the untreated group. The between-group difference was not significant (-0.03, 95% CI -0.12; 0.06, p = 0.571). For DLCO, the change per 30 days was -0.10 (95% CI -0.15; -0.04) in the treated and -0.10 (95% CI -0.14; -0.05) in the untreated group, with no significant between-group difference (0.0007, 95% CI -0.07; 0.07, p = 0.985). Inclusion of radiographic pattern did not change the results.

Conclusion: The rate of pulmonary function decline was similar for corticosteroid-treated and untreated patients, although treated patients had significantly lower pulmonary function. This may indicate a limited disease-modifying effect in RA-ILD, but further studies are needed.