E. Kelty, M. Ognjenovic, W. Raymond, C. Inderjeeth, H. Keen, D. Preen, J. Nossent
Objective. To examine mortality rates in hospitalized patients with ankylosing spondylitis (AS) and the association of extraarticular manifestations (EAMs) and comorbidities with mortality rates. Methods. This study was a retrospective, population-based cohort study using linked administrative data from patients with AS who were hospitalized (n = 1791) and patients in a matched comparison group (n = 8955). Mortality data for patients were obtained from the Western Australia Death Register. The presence of EAMs and comorbidities was identified from hospital records. Mortality rates were compared between the 2 groups using Cox proportional hazard models overall and stratified by a history of EAMs, comorbidities, and smoking status. Results. Crude mortality rates were significantly higher among patients with AS than among patients in the comparison group (hazard ratio [HR] 1.85, 95% CI 1.62–2.12), with excess mortality in the AS group associated with cardiovascular disease (CVD; HR 5.32, 95% CI 3.84–7.35), cancer (HR 1.68, 95% CI 1.27–2.23), external causes (HR 3.92, 95% CI 2.28–6.77), and infectious diseases (HR 25.92, 95% CI 7.50–89.56). When patients were stratified by history of EAMs, CVD, and smoking, the risk of mortality was elevated in patients both with and without each risk factor. Among patients with AS, histories of CVD (HR 6.33, 95% CI 4.79–8.38), diabetes (HR 2.81, 95% CI 1.99–3.95), smoking (HR 1.49, 95% CI 1.18–1.89), and EAMs (HR 1.62, 95% CI 1.24–2.11) were associated with an increased risk of mortality. Conclusion. The presence of comorbidities, EAMs, and smoking contributes to an increased risk of all-cause mortality among patients with AS who are hospitalized compared to patients in the comparison group. These results support the need to prevent or reduce the occurrence of comorbidities and smoking in patients with AS.
目标。研究强直性脊柱炎(AS)住院患者的死亡率、关节外表现(EAMs)和合并症与死亡率的关系。方法。本研究是一项回顾性、基于人群的队列研究，使用来自住院AS患者(n = 1791)和匹配对照组患者(n = 8955)的相关管理数据。患者死亡率数据来自西澳大利亚死亡登记册。从医院记录中确定了eam和合并症的存在。采用Cox比例风险模型对两组患者的总体死亡率进行比较，并根据EAMs病史、合并症和吸烟状况进行分层。结果。AS患者的粗死亡率显著高于对照组(风险比[HR] 1.85, 95% CI 1.62-2.12)，且AS组的高死亡率与心血管疾病(CVD;HR 5.32, 95% CI 3.84-7.35)，癌症(HR 1.68, 95% CI 1.27-2.23)，外因(HR 3.92, 95% CI 2.28-6.77)和传染病(HR 25.92, 95% CI 7.50-89.56)。当按EAMs、CVD和吸烟史对患者进行分层时，有或没有这些危险因素的患者的死亡风险都升高。在AS患者中，心血管疾病(HR 6.33, 95% CI 4.79-8.38)、糖尿病(HR 2.81, 95% CI 1.99-3.95)、吸烟(HR 1.49, 95% CI 1.18-1.89)和EAMs (HR 1.62, 95% CI 1.24-2.11)病史与死亡风险增加相关。结论。与对照组相比，合并症、EAMs和吸烟的存在增加了住院AS患者全因死亡率的风险。这些结果支持预防或减少AS患者共病和吸烟发生的必要性。
{"title":"Mortality Rates in Patients With Ankylosing Spondylitis With and Without Extraarticular Manifestations and Comorbidities: A Retrospective Cohort Study","authors":"E. Kelty, M. Ognjenovic, W. Raymond, C. Inderjeeth, H. Keen, D. Preen, J. Nossent","doi":"10.3899/jrheum.210909","DOIUrl":"https://doi.org/10.3899/jrheum.210909","url":null,"abstract":"Objective. To examine mortality rates in hospitalized patients with ankylosing spondylitis (AS) and the association of extraarticular manifestations (EAMs) and comorbidities with mortality rates. Methods. This study was a retrospective, population-based cohort study using linked administrative data from patients with AS who were hospitalized (n = 1791) and patients in a matched comparison group (n = 8955). Mortality data for patients were obtained from the Western Australia Death Register. The presence of EAMs and comorbidities was identified from hospital records. Mortality rates were compared between the 2 groups using Cox proportional hazard models overall and stratified by a history of EAMs, comorbidities, and smoking status. Results. Crude mortality rates were significantly higher among patients with AS than among patients in the comparison group (hazard ratio [HR] 1.85, 95% CI 1.62–2.12), with excess mortality in the AS group associated with cardiovascular disease (CVD; HR 5.32, 95% CI 3.84–7.35), cancer (HR 1.68, 95% CI 1.27–2.23), external causes (HR 3.92, 95% CI 2.28–6.77), and infectious diseases (HR 25.92, 95% CI 7.50–89.56). When patients were stratified by history of EAMs, CVD, and smoking, the risk of mortality was elevated in patients both with and without each risk factor. Among patients with AS, histories of CVD (HR 6.33, 95% CI 4.79–8.38), diabetes (HR 2.81, 95% CI 1.99–3.95), smoking (HR 1.49, 95% CI 1.18–1.89), and EAMs (HR 1.62, 95% CI 1.24–2.11) were associated with an increased risk of mortality. Conclusion. The presence of comorbidities, EAMs, and smoking contributes to an increased risk of all-cause mortality among patients with AS who are hospitalized compared to patients in the comparison group. These results support the need to prevent or reduce the occurrence of comorbidities and smoking in patients with AS.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"7 1","pages":"688 - 693"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87851693","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}
Robin Kempin, J. Richter, Anna Schlegel, X. Baraliakos, S. Tsiami, B. Buehring, D. Kiefer, J. Braun, U. Kiltz
Objective To investigate the performance of a health app with respect to usability, adherence, and equivalence of data in daily care of patients with axial spondyloarthritis (axSpA). Methods Consecutive patients with axSpA were asked to export patient-reported outcomes (PRO) electronically with the AxSpA Live App regularly every 2 weeks over a period of 6 months. The first clinical visit was followed by 2 further personal visits after 3 and 6 months. Patients completed paper-based PRO at every visit; they also completed the Mobile App Rating Scale and the System Usability Scale after 3 and 6 months. Results Of 103 patients with axSpA, 69 agreed to participate (67.0%): age 41.5 (11.3) years, 58.0% male, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 4.3 (2.0), and 76.8% treated with biologic disease-modifying antirheumatic drugs. Patients’ adherence to regular app exports was 29.0% and 28.4% after 3 and 6 months, respectively. Significant predictors for good adherence were high disease activity (P = 0.02) and older age (P = 0.04). No systematic differences between digital and paper-based BASDAI scores were found (intraclass correlation coefficients 0.99 [95% CI 0.98-0.99]). Performance of the app was rated as good. Conclusion Collection of digital PROs by AxSpA Live App may be successfully used in patients with axSpA with high disease activity. Our study showed equivalence of digital data, but adherence to the app after 6 months was poor. Higher disease activity and older age resulted in increased adherence to the app. This suggests that the use of health apps like this should concentrate on more severely affected patients.
目的探讨一款健康应用程序在轴性脊柱炎(axSpA)患者日常护理数据的可用性、依从性和等效性方面的表现。方法连续6个月，每2周定期用axSpA Live App电子输出患者报告预后(PRO)。第一次临床访问之后，在3个月和6个月后进行了两次进一步的个人访问。患者在每次就诊时完成纸质PRO;他们还分别在3个月和6个月后完成了手机应用评级量表和系统可用性量表。结果103例axSpA患者中，69例(67.0%)同意参与:年龄41.5(11.3)岁，58.0%为男性，巴斯强直性脊柱炎疾病活动指数(BASDAI) 4.3(2.0)， 76.8%接受生物疾病改善抗风湿药物治疗。3个月和6个月后，患者对常规应用程序输出的依从性分别为29.0%和28.4%。疾病活动性高(P = 0.02)和年龄较大(P = 0.04)是良好依从性的显著预测因子。数字和纸质BASDAI评分之间没有系统差异(类内相关系数0.99 [95% CI 0.98-0.99])。该应用程序的性能被评为良好。结论AxSpA Live App采集数字pro可成功用于疾病活动性高的AxSpA患者。我们的研究显示了数字数据的等效性，但6个月后应用程序的依从性很差。较高的疾病活动量和年龄增加导致对该应用的依从性增加。这表明，像这样的健康应用程序的使用应该集中在受影响更严重的患者身上。
{"title":"Monitoring of Disease Activity With a Smartphone App in Routine Clinical Care in Patients With Axial Spondyloarthritis","authors":"Robin Kempin, J. Richter, Anna Schlegel, X. Baraliakos, S. Tsiami, B. Buehring, D. Kiefer, J. Braun, U. Kiltz","doi":"10.3899/jrheum.211116","DOIUrl":"https://doi.org/10.3899/jrheum.211116","url":null,"abstract":"Objective To investigate the performance of a health app with respect to usability, adherence, and equivalence of data in daily care of patients with axial spondyloarthritis (axSpA). Methods Consecutive patients with axSpA were asked to export patient-reported outcomes (PRO) electronically with the AxSpA Live App regularly every 2 weeks over a period of 6 months. The first clinical visit was followed by 2 further personal visits after 3 and 6 months. Patients completed paper-based PRO at every visit; they also completed the Mobile App Rating Scale and the System Usability Scale after 3 and 6 months. Results Of 103 patients with axSpA, 69 agreed to participate (67.0%): age 41.5 (11.3) years, 58.0% male, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 4.3 (2.0), and 76.8% treated with biologic disease-modifying antirheumatic drugs. Patients’ adherence to regular app exports was 29.0% and 28.4% after 3 and 6 months, respectively. Significant predictors for good adherence were high disease activity (P = 0.02) and older age (P = 0.04). No systematic differences between digital and paper-based BASDAI scores were found (intraclass correlation coefficients 0.99 [95% CI 0.98-0.99]). Performance of the app was rated as good. Conclusion Collection of digital PROs by AxSpA Live App may be successfully used in patients with axSpA with high disease activity. Our study showed equivalence of digital data, but adherence to the app after 6 months was poor. Higher disease activity and older age resulted in increased adherence to the app. This suggests that the use of health apps like this should concentrate on more severely affected patients.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"11 1","pages":"878 - 884"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87658171","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}
A. Ogdie, C. Lindsay, P. Mease, K. Callis Duffin, C. Rosen, S. Siebert
Each year, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) holds a trainee symposium adjacent to the GRAPPA annual meeting. The target audience for this meeting includes trainees in rheumatology, dermatology, and related fields. The 2021 GRAPPA Trainee Symposium focused on challenges in the diagnosis and assessment of psoriatic arthritis (PsA). During the meeting, speakers focused on identification of psoriasis (PsO), the differential diagnosis for both PsO and PsA, diagnostic errors and pitfalls, physical examination in PsA, patient-reported outcomes and composite measures in the assessment of PsA, and the patient perspective on diagnosis and assessment, followed by a panel discussion. This paper summarizes the content discussed at the meeting.
{"title":"Challenges in the Diagnosis and Assessment of Psoriatic Arthritis.","authors":"A. Ogdie, C. Lindsay, P. Mease, K. Callis Duffin, C. Rosen, S. Siebert","doi":"10.3899/jrheum.211337","DOIUrl":"https://doi.org/10.3899/jrheum.211337","url":null,"abstract":"Each year, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) holds a trainee symposium adjacent to the GRAPPA annual meeting. The target audience for this meeting includes trainees in rheumatology, dermatology, and related fields. The 2021 GRAPPA Trainee Symposium focused on challenges in the diagnosis and assessment of psoriatic arthritis (PsA). During the meeting, speakers focused on identification of psoriasis (PsO), the differential diagnosis for both PsO and PsA, diagnostic errors and pitfalls, physical examination in PsA, patient-reported outcomes and composite measures in the assessment of PsA, and the patient perspective on diagnosis and assessment, followed by a panel discussion. This paper summarizes the content discussed at the meeting.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72412888","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}
N. Verweij, J. de Jongh, M. Wee, G. Zwezerijnen, M. Yaqub, A. Voskuyl, A. Lammertsma, D. van Schaardenburg, M. Boers, W. Lems, C. J. van der Laken
Objective To investigate the potential of whole-body positron emission tomography/computed tomography (PET/CT) with a macrophage tracer to image arthritis in patients with early rheumatoid arthritis (RA). Methods Thirty-five previously untreated, clinically active patients with early RA underwent whole-body PET/CT scanning with the macrophage tracer (R)-[11C]PK11195 in addition to clinical assessment (Disease Activity Score in 44 joints [DAS44]). Tracer uptake was assessed quantitatively as standardized uptake values (SUVs). In addition, 2 readers blinded to clinical assessment visually scored tracer uptake in joints. Clinical and PET variables were compared using Cohen , linear regression/correlation, and t tests, where appropriate. Results All but 1 patient showed enhanced tracer uptake in at least 1 joint. Twelve percent of all joints (171/1470) were visually positive on the PET scan, most frequently the small joints in feet (40%) and hands (37%), followed by wrists (15%). Correlations of visual scores with clinical findings both at patient and joint levels were absent or weak. In contrast, average SUVs in the hands, feet, and whole body showed significant correlations with DAS44 scores, with the best correlation seen in the feet (R2 = 0.29, P < 0.01). Conclusion Clinically active patients with early RA had increased joint uptake of a macrophage PET tracer, especially in the feet. Quantitative, but not visual PET measures of whole body and joint groups, particularly the feet, showed moderate and statistically significant correlations with clinical outcome.
目的探讨巨噬细胞示踪剂全身正电子发射断层扫描/计算机断层扫描(PET/CT)对早期类风湿关节炎(RA)患者关节炎的成像潜力。方法对35例未经治疗、临床活跃的早期RA患者进行巨噬细胞示踪剂(R)-[11C]PK11195的全身PET/CT扫描，并进行临床评估(44个关节疾病活动评分[DAS44])。以标准摄取值(suv)定量评估示踪剂摄取。此外，2名对临床评估不知情的读者对关节的示踪剂摄取进行了视觉评分。使用Cohen、线性回归/相关和t检验比较临床和PET变量。结果除1例患者外，其余患者至少1个关节示踪剂摄取增强。所有关节中有12%(171/1470)在PET扫描中呈视觉阳性，最常见的是脚(40%)和手(37%)的小关节，其次是手腕(15%)。在患者和关节水平上，视觉评分与临床表现的相关性不存在或很弱。相比之下，手、脚和全身的平均suv与DAS44评分呈显著相关，其中足部的相关性最好(R2 = 0.29, P < 0.01)。结论临床活跃的早期RA患者关节对巨噬细胞PET示踪剂的摄取增加，尤其是在足部。全身和关节组(尤其是足部)的定量(而非视觉)PET测量显示与临床结果有中度且统计学上显著的相关性。
{"title":"Whole-Body Macrophage Positron Emission Tomography Imaging for Disease Activity Assessment in Early Rheumatoid Arthritis","authors":"N. Verweij, J. de Jongh, M. Wee, G. Zwezerijnen, M. Yaqub, A. Voskuyl, A. Lammertsma, D. van Schaardenburg, M. Boers, W. Lems, C. J. van der Laken","doi":"10.3899/jrheum.210928","DOIUrl":"https://doi.org/10.3899/jrheum.210928","url":null,"abstract":"Objective To investigate the potential of whole-body positron emission tomography/computed tomography (PET/CT) with a macrophage tracer to image arthritis in patients with early rheumatoid arthritis (RA). Methods Thirty-five previously untreated, clinically active patients with early RA underwent whole-body PET/CT scanning with the macrophage tracer (R)-[11C]PK11195 in addition to clinical assessment (Disease Activity Score in 44 joints [DAS44]). Tracer uptake was assessed quantitatively as standardized uptake values (SUVs). In addition, 2 readers blinded to clinical assessment visually scored tracer uptake in joints. Clinical and PET variables were compared using Cohen , linear regression/correlation, and t tests, where appropriate. Results All but 1 patient showed enhanced tracer uptake in at least 1 joint. Twelve percent of all joints (171/1470) were visually positive on the PET scan, most frequently the small joints in feet (40%) and hands (37%), followed by wrists (15%). Correlations of visual scores with clinical findings both at patient and joint levels were absent or weak. In contrast, average SUVs in the hands, feet, and whole body showed significant correlations with DAS44 scores, with the best correlation seen in the feet (R2 = 0.29, P < 0.01). Conclusion Clinically active patients with early RA had increased joint uptake of a macrophage PET tracer, especially in the feet. Quantitative, but not visual PET measures of whole body and joint groups, particularly the feet, showed moderate and statistically significant correlations with clinical outcome.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"59 1","pages":"871 - 877"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86123964","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}
M. Kuwana, N. Wakasugi, Toshinori Furuya, S. Uno, T. Suda
Objective. The calcineurin inhibitor tacrolimus has been approved in Japan for the treatment of interstitial pneumonia (IP) in patients with polymyositis (PM) and dermatomyositis (DM). Postmarketing surveillance was initiated to examine long-term outcomes of immunosuppressive regimens containing tacrolimus in real-world settings. Methods. Observational, prospective, postmarketing surveillance is ongoing in 179 patients with PM/DM-associated IP initiating treatment with tacrolimus. We report interim findings after 2 years of follow-up. Cumulative overall survival was assessed using Kaplan-Meier analysis. Potential prognostic factors for mortality were assessed by univariate Cox proportional hazards analysis. Results. A total of 170 patients were included in this analysis. At the time of starting treatment with tacrolimus, almost all patients were receiving corticosteroids (98.8%), and cyclophosphamide was additionally used in 42 patients (24.7%). Forty-nine patients (28.8%) discontinued tacrolimus during follow-up, mainly due to loss to follow-up, patient death, and adverse events. Mean (SD) oral corticosteroid dose decreased from 32.4 (21.6) mg/day at baseline to 7.6 (4.2) mg/day at 2 years. Overall survival at 2 years was 90.3%; corresponding progression-free survival was 62.5%. Factors found to be associated with all-cause mortality included diagnosis of clinically amyopathic DM (hazard ratio [HR] 9.04, 95% CI 1.18-69.51 vs PM), ferritin level 500 to < 1500 ng/mL (HR 8.61, 95% CI 2.51-29.45 vs < 500 ng/mL), and presence of antimelanoma differentiation-associated gene 5 antibodies (HR 8.16, 95% CI 1.03–64.47 vs absence). Conclusion. Immunosuppressive regimens containing tacrolimus appear useful for the management of IP in patients with PM/DM. [ClinicalTrials.gov: NCT02159651]
目标。钙调磷酸酶抑制剂他克莫司在日本被批准用于治疗多发性肌炎(PM)和皮肌炎(DM)患者的间质性肺炎(IP)。上市后监测是为了在现实环境中检查含有他克莫司的免疫抑制方案的长期结果。方法。179例开始使用他克莫司治疗的PM/ dm相关IP患者正在进行观察性、前瞻性、上市后监测。我们报告2年随访后的中期结果。累积总生存期采用Kaplan-Meier分析评估。通过单因素Cox比例风险分析评估死亡率的潜在预后因素。结果。本分析共纳入170例患者。在开始他克莫司治疗时，几乎所有患者(98.8%)接受皮质类固醇，42例患者(24.7%)额外使用环磷酰胺。49名患者(28.8%)在随访期间停用他克莫司，主要原因是随访失败、患者死亡和不良事件。平均(SD)口服皮质类固醇剂量从基线时的32.4 (21.6)mg/天下降到2年后的7.6 (4.2)mg/天。2年总生存率为90.3%;相应的无进展生存率为62.5%。发现与全因死亡率相关的因素包括临床诊断为淀粉性糖尿病(风险比[HR] 9.04, 95% CI 1.18-69.51 vs PM)，铁蛋白水平500至< 1500 ng/mL(风险比[HR] 8.61, 95% CI 2.51-29.45 vs < 500 ng/mL)，以及抗黑色素瘤分化相关基因5抗体的存在(风险比[HR] 8.16, 95% CI 1.03-64.47 vs缺乏)。结论。含有他克莫司的免疫抑制方案似乎对PM/DM患者的IP管理有用。[ClinicalTrials.gov: NCT02159651]
{"title":"Tacrolimus in Patients With Interstitial Pneumonia Associated With Polymyositis or Dermatomyositis: Interim Report of Postmarketing Surveillance in Japan","authors":"M. Kuwana, N. Wakasugi, Toshinori Furuya, S. Uno, T. Suda","doi":"10.3899/jrheum.210322","DOIUrl":"https://doi.org/10.3899/jrheum.210322","url":null,"abstract":"Objective. The calcineurin inhibitor tacrolimus has been approved in Japan for the treatment of interstitial pneumonia (IP) in patients with polymyositis (PM) and dermatomyositis (DM). Postmarketing surveillance was initiated to examine long-term outcomes of immunosuppressive regimens containing tacrolimus in real-world settings. Methods. Observational, prospective, postmarketing surveillance is ongoing in 179 patients with PM/DM-associated IP initiating treatment with tacrolimus. We report interim findings after 2 years of follow-up. Cumulative overall survival was assessed using Kaplan-Meier analysis. Potential prognostic factors for mortality were assessed by univariate Cox proportional hazards analysis. Results. A total of 170 patients were included in this analysis. At the time of starting treatment with tacrolimus, almost all patients were receiving corticosteroids (98.8%), and cyclophosphamide was additionally used in 42 patients (24.7%). Forty-nine patients (28.8%) discontinued tacrolimus during follow-up, mainly due to loss to follow-up, patient death, and adverse events. Mean (SD) oral corticosteroid dose decreased from 32.4 (21.6) mg/day at baseline to 7.6 (4.2) mg/day at 2 years. Overall survival at 2 years was 90.3%; corresponding progression-free survival was 62.5%. Factors found to be associated with all-cause mortality included diagnosis of clinically amyopathic DM (hazard ratio [HR] 9.04, 95% CI 1.18-69.51 vs PM), ferritin level 500 to < 1500 ng/mL (HR 8.61, 95% CI 2.51-29.45 vs < 500 ng/mL), and presence of antimelanoma differentiation-associated gene 5 antibodies (HR 8.16, 95% CI 1.03–64.47 vs absence). Conclusion. Immunosuppressive regimens containing tacrolimus appear useful for the management of IP in patients with PM/DM. [ClinicalTrials.gov: NCT02159651]","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"19 1","pages":"707 - 718"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79391434","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}
The rheumatology workforce faces a deficit of physicians trained to provide high-quality care to patients with rheumatic diseases, and this deficit is projected to worsen over the next 10 to 15 years in many countries and regions around the world. Rheumatology workforce studies carried out in the US, Canada, and in Europe have revealed expected shortages driven by projections for increased demand; changes in demographics among providers, including increasing proportions of women and part-time clinicians as well as high levels of expected retirements; and geographic maldistribution of providers.1,2,3,4,5 In the last 2 years, practice changes caused by the coronavirus disease 2019 (COVID-19) pandemic have affected, and likely exacerbated, workforce limitations.
{"title":"The Challenge of Addressing the Rheumatology Workforce Shortage","authors":"E. Miloslavsky, Bethany Marston","doi":"10.3899/jrheum.220300","DOIUrl":"https://doi.org/10.3899/jrheum.220300","url":null,"abstract":"The rheumatology workforce faces a deficit of physicians trained to provide high-quality care to patients with rheumatic diseases, and this deficit is projected to worsen over the next 10 to 15 years in many countries and regions around the world. Rheumatology workforce studies carried out in the US, Canada, and in Europe have revealed expected shortages driven by projections for increased demand; changes in demographics among providers, including increasing proportions of women and part-time clinicians as well as high levels of expected retirements; and geographic maldistribution of providers.1,2,3,4,5 In the last 2 years, practice changes caused by the coronavirus disease 2019 (COVID-19) pandemic have affected, and likely exacerbated, workforce limitations.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"53 1","pages":"555 - 557"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73880762","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}
We would like to share ideas on the article, "A Case of Chilblains-like Lesions Post SARS-CoV-2 Vaccine?"1 Meara et al reported a female case and concluded, "The chilblains-like lesions suggest that she had an antibody response from either 1 vaccine dose or a previous PCR-negative COVID-19 [coronavirus disease 2019] infection."1.
{"title":"Post SARS-CoV-2 Vaccine Chilblains-like Lesions","authors":"R. Mungmunpuntipantip, V. Wiwanitkit","doi":"10.3899/jrheum.210996","DOIUrl":"https://doi.org/10.3899/jrheum.210996","url":null,"abstract":"We would like to share ideas on the article, \"A Case of Chilblains-like Lesions Post SARS-CoV-2 Vaccine?\"1 Meara et al reported a female case and concluded, \"The chilblains-like lesions suggest that she had an antibody response from either 1 vaccine dose or a previous PCR-negative COVID-19 [coronavirus disease 2019] infection.\"1.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"28 1","pages":"859 - 859"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89327301","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}
Proliferative lupus nephritis (PLN) is associated with significant morbidity, mortality, and kidney failure, especially in childhood-onset PLN (cPLN). Therefore, it is important to treat it promptly and aggressively, while being cognizant of the risk-benefit ratio and side effects of therapies.
{"title":"Treatment of Childhood-onset Proliferative Lupus Nephritis in the 21st Century: A Call to Catch Up With the Evidence","authors":"D. Noone, E. Silverman","doi":"10.3899/jrheum.220196","DOIUrl":"https://doi.org/10.3899/jrheum.220196","url":null,"abstract":"Proliferative lupus nephritis (PLN) is associated with significant morbidity, mortality, and kidney failure, especially in childhood-onset PLN (cPLN). Therefore, it is important to treat it promptly and aggressively, while being cognizant of the risk-benefit ratio and side effects of therapies.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"240 1","pages":"552 - 554"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73105008","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}
J. Waddington, Orla Coleman, P. Mease, V. Chandran, D. O'Sullivan, O. FitzGerald, S. Pennington
The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has identified several priority areas for biomarker development, including biomarkers to predict at baseline which patients may progress to develop joint damage and whether a patient will respond to a specific targeted therapy. Two industry-GRAPPA projects were initiated in 2020 on these biomarker research areas: (1) the Pfizer-GRAPPA project, focused on biomarkers of treatment response to tofacitinib in the Oral Psoriatic Arthritis TriaL program; and (2) the Lilly-GRAPPA project, focused on biomarkers of damage in the ixekizumab SPIRIT-P1 randomized controlled trial. Preliminary results from these 2 projects were presented by the GRAPPA team, with both studies showing promising initial results. Data from these studies will be published when the studies have been completed. Large-scale validation studies are required and are under discussion.
{"title":"Basic Science Session 1. Biomarkers for Psoriatic Arthritis Treatment Response and Joint Damage Progression: An Update on 2 Industry-GRAPPA Projects.","authors":"J. Waddington, Orla Coleman, P. Mease, V. Chandran, D. O'Sullivan, O. FitzGerald, S. Pennington","doi":"10.3899/jrheum.211320","DOIUrl":"https://doi.org/10.3899/jrheum.211320","url":null,"abstract":"The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has identified several priority areas for biomarker development, including biomarkers to predict at baseline which patients may progress to develop joint damage and whether a patient will respond to a specific targeted therapy. Two industry-GRAPPA projects were initiated in 2020 on these biomarker research areas: (1) the Pfizer-GRAPPA project, focused on biomarkers of treatment response to tofacitinib in the Oral Psoriatic Arthritis TriaL program; and (2) the Lilly-GRAPPA project, focused on biomarkers of damage in the ixekizumab SPIRIT-P1 randomized controlled trial. Preliminary results from these 2 projects were presented by the GRAPPA team, with both studies showing promising initial results. Data from these studies will be published when the studies have been completed. Large-scale validation studies are required and are under discussion.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81653546","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}
{"title":"Who Are We to Decide That the Unvaccinated Don’t Deserve Care?","authors":"C. Barnabe","doi":"10.3899/jrheum.220110","DOIUrl":"https://doi.org/10.3899/jrheum.220110","url":null,"abstract":"","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"44 1","pages":"434 - 435"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83279570","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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