C. Stober, I. McInnes, S. Raychaudhuri, P. Mease, S. Pennington, J. Scher, V. Chandran, A. Armstrong, M. D. de Wit, A. Cauli, D. Jadon, T. Löve, A. Ogdie, D. O'Sullivan, L. V. van Mens, C. Ritchlin, O. FitzGerald
At the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)- Collaborative Research Network (CRN) annual meeting, the GRAPPA-CRN group presented a number of project updates, including a pilot investigator-initiated study to evaluate liquid and tissue biomarkers associated with axial involvement in psoriatic arthritis (PsA). The GRAPPA-CRN session updated progress made with 3 parallel international research initiatives based on 3 previously defined unmet needs in PsA. The Health Initiatives in Psoriasis and PsOriatic arthritis ConsoRTium European States (HIPPOCRATES) is a European research consortium formed to address unmet clinical needs in PsA. The Preventing Arthritis in a Multi-Center Psoriasis At-Risk Population (PAMPA) is a US-based organization that has defined consensus terminology for preclinical phases of PsA and is interested in the transition process from psoriasis to PsA. An overview of the Accelerating Medicines Partnership Autoimmune and Immune-Mediated Diseases (AMP AIM) program 2.0, a consortium including GRAPPA-CRN members that addressed these 3 unmet needs in PsA, was also presented.
{"title":"Proceedings of the 2021 GRAPPA-Collaborative Research Network (CRN) Meeting.","authors":"C. Stober, I. McInnes, S. Raychaudhuri, P. Mease, S. Pennington, J. Scher, V. Chandran, A. Armstrong, M. D. de Wit, A. Cauli, D. Jadon, T. Löve, A. Ogdie, D. O'Sullivan, L. V. van Mens, C. Ritchlin, O. FitzGerald","doi":"10.3899/jrheum.211336","DOIUrl":"https://doi.org/10.3899/jrheum.211336","url":null,"abstract":"At the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)- Collaborative Research Network (CRN) annual meeting, the GRAPPA-CRN group presented a number of project updates, including a pilot investigator-initiated study to evaluate liquid and tissue biomarkers associated with axial involvement in psoriatic arthritis (PsA). The GRAPPA-CRN session updated progress made with 3 parallel international research initiatives based on 3 previously defined unmet needs in PsA. The Health Initiatives in Psoriasis and PsOriatic arthritis ConsoRTium European States (HIPPOCRATES) is a European research consortium formed to address unmet clinical needs in PsA. The Preventing Arthritis in a Multi-Center Psoriasis At-Risk Population (PAMPA) is a US-based organization that has defined consensus terminology for preclinical phases of PsA and is interested in the transition process from psoriasis to PsA. An overview of the Accelerating Medicines Partnership Autoimmune and Immune-Mediated Diseases (AMP AIM) program 2.0, a consortium including GRAPPA-CRN members that addressed these 3 unmet needs in PsA, was also presented.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82803619","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}
Systemic sclerosis (SSc) is characterized by excess collagen deposition in multiple organs, resulting in dilatation of intestine, delayed transit, chronic intestinal pseudoobstruction (CIPO), and bacterial overgrowth.1 A 58-year-old woman with a 2-year history of SSc presented with alternating diarrhea and constipation.
{"title":"Hide-bound Bowel Sign in Systemic Sclerosis","authors":"A. Hokama","doi":"10.3899/jrheum.210964","DOIUrl":"https://doi.org/10.3899/jrheum.210964","url":null,"abstract":"Systemic sclerosis (SSc) is characterized by excess collagen deposition in multiple organs, resulting in dilatation of intestine, delayed transit, chronic intestinal pseudoobstruction (CIPO), and bacterial overgrowth.1 A 58-year-old woman with a 2-year history of SSc presented with alternating diarrhea and constipation.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79828302","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. Power, A. Perruccio, J. Paterson, M. Canizares, C. Veillette, P. Coyte, E. Badley, N. N. Mahomed, Y. R. Rampersaud
Objective. To examine the magnitude and costs of ambulatory primary care, specialist physician care, and hospital service use for musculoskeletal disorders (MSDs) in Canada’s largest province, Ontario. Methods. Administrative health databases were analyzed for fiscal year 2013–2014 for adults aged ≥ 18 years, including data on physician services, emergency department (ED) visits, and hospitalizations. International Classification of Diseases diagnostic codes were used to identify MSD services. A validated algorithm was used to estimate direct medical costs. Person-visit rates and numbers of persons and visits were tabulated by care setting, age, sex, and physician specialty. Data were examined for all MSDs combined, as well as for specific diagnostic groupings. Results. Overall, 3.1 million adult Ontarians (28.5%) made over 8 million outpatient physician visits associated with MSDs. These included 5.6 million primary care visits. MSDs accounted for 560,000 (12.3%) of all adult ED visits. Total costs for MSD-related care were $1.6 billion, with 12.6% of costs attributed to primary care, 9.2% to specialist care, 8.6% to ED care, 8.5% to day surgery, and 61.2% associated with inpatient hospitalizations. Costs due to arthritis accounted for 40% of total MSD care costs ($639 million). MSD-related imaging costs were $169 million, yielding a total cost estimate of $1.8 billion for MSDs overall. Conclusion. MSDs place a significant and costly burden on the healthcare system. Health system planning needs to consider the large and escalating demand for care to reduce both the individual and population burden.
{"title":"Healthcare Utilization and Costs for Musculoskeletal Disorders in Ontario, Canada","authors":"J. Power, A. Perruccio, J. Paterson, M. Canizares, C. Veillette, P. Coyte, E. Badley, N. N. Mahomed, Y. R. Rampersaud","doi":"10.3899/jrheum.210938","DOIUrl":"https://doi.org/10.3899/jrheum.210938","url":null,"abstract":"Objective. To examine the magnitude and costs of ambulatory primary care, specialist physician care, and hospital service use for musculoskeletal disorders (MSDs) in Canada’s largest province, Ontario. Methods. Administrative health databases were analyzed for fiscal year 2013–2014 for adults aged ≥ 18 years, including data on physician services, emergency department (ED) visits, and hospitalizations. International Classification of Diseases diagnostic codes were used to identify MSD services. A validated algorithm was used to estimate direct medical costs. Person-visit rates and numbers of persons and visits were tabulated by care setting, age, sex, and physician specialty. Data were examined for all MSDs combined, as well as for specific diagnostic groupings. Results. Overall, 3.1 million adult Ontarians (28.5%) made over 8 million outpatient physician visits associated with MSDs. These included 5.6 million primary care visits. MSDs accounted for 560,000 (12.3%) of all adult ED visits. Total costs for MSD-related care were $1.6 billion, with 12.6% of costs attributed to primary care, 9.2% to specialist care, 8.6% to ED care, 8.5% to day surgery, and 61.2% associated with inpatient hospitalizations. Costs due to arthritis accounted for 40% of total MSD care costs ($639 million). MSD-related imaging costs were $169 million, yielding a total cost estimate of $1.8 billion for MSDs overall. Conclusion. MSDs place a significant and costly burden on the healthcare system. Health system planning needs to consider the large and escalating demand for care to reduce both the individual and population burden.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77338467","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}
Saman Darabian, J. Wade, J. Kur, S. Wade, E. C. Sayre, M. Badii
Objective. Methotrexate (MTX) is often the primary medication to treat various rheumatic diseases (RDs) because of its low cost and its demonstrated efficacy in controlling disease activity. However, a concern has been the potential for hepatic fibrosis associated with long-term MTX usage. This study investigated the association between cumulative MTX intake and development of liver fibrosis by utilizing noninvasive transient elastography (FibroScan). Methods. All patients with inflammatory arthritis treated with MTX were offered screening with FibroScan. A certified technician measured liver stiffness after patients adhered to a fast. Relevant clinical information was obtained by patient survey and medical records review. The population was divided into quartiles based on participants’ cumulative dosage of MTX. Results. Five hundred twenty patients with RD were included in this study. The prevalence of stages F3 or F4 liver fibrosis was 13.3% in the control group and 12.7% in the entire sample. Compared with subgroup 1 (control with cumulative MTX exposure of ≤ 499 mg), MTX subgroups 2 to 4 were not significantly correlated with higher FibroScan scores (P = 0.82, 0.59, and 0.18, respectively). In multivariable linear regression analysis, statistically significant factors for liver stiffness were BMI, waist circumference, male sex, and age. Conclusion. No significant correlation between the cumulative MTX dosage and liver stiffness, even at high MTX doses, was observed. The analyses showed significant correlations between the FibroScan score and BMI. These findings were reassuring in that current rheumatology practice appears to be safe and effective in screening for liver fibrosis in patients on long-term low-dose MTX therapy.
{"title":"Using FibroScan to Assess for the Development of Liver Fibrosis in Patients With Arthritis on Methotrexate: A Single-center Experience","authors":"Saman Darabian, J. Wade, J. Kur, S. Wade, E. C. Sayre, M. Badii","doi":"10.3899/jrheum.211281","DOIUrl":"https://doi.org/10.3899/jrheum.211281","url":null,"abstract":"Objective. Methotrexate (MTX) is often the primary medication to treat various rheumatic diseases (RDs) because of its low cost and its demonstrated efficacy in controlling disease activity. However, a concern has been the potential for hepatic fibrosis associated with long-term MTX usage. This study investigated the association between cumulative MTX intake and development of liver fibrosis by utilizing noninvasive transient elastography (FibroScan). Methods. All patients with inflammatory arthritis treated with MTX were offered screening with FibroScan. A certified technician measured liver stiffness after patients adhered to a fast. Relevant clinical information was obtained by patient survey and medical records review. The population was divided into quartiles based on participants’ cumulative dosage of MTX. Results. Five hundred twenty patients with RD were included in this study. The prevalence of stages F3 or F4 liver fibrosis was 13.3% in the control group and 12.7% in the entire sample. Compared with subgroup 1 (control with cumulative MTX exposure of ≤ 499 mg), MTX subgroups 2 to 4 were not significantly correlated with higher FibroScan scores (P = 0.82, 0.59, and 0.18, respectively). In multivariable linear regression analysis, statistically significant factors for liver stiffness were BMI, waist circumference, male sex, and age. Conclusion. No significant correlation between the cumulative MTX dosage and liver stiffness, even at high MTX doses, was observed. The analyses showed significant correlations between the FibroScan score and BMI. These findings were reassuring in that current rheumatology practice appears to be safe and effective in screening for liver fibrosis in patients on long-term low-dose MTX therapy.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80178390","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. Russell, D. Nagra, Benjamin D. Clarke, Sathiyaa Balachandran, April Buazon, Amy Boalch, K. Bechman, M. Adas, E. Alveyn, A. Rutherford, J. Galloway
Objective. To identify predictors of admission following emergency department (ED) attendances for gout flares and to describe barriers to optimal inpatient gout care. Methods. ED attendances and hospital admissions with primary diagnoses of gout were analyzed at 2 UK-based hospitals between January 1, 2017, and December 31, 2020. Demographic and clinical predictors of ED disposition (admission or discharge) and reattendance for gout flares were identified using logistic regression and survival models, respectively. Case note reviews (n = 59), stakeholder meetings, and process mapping were performed to capture detailed information on gout management and to identify strategies to optimize care. Results. Of 1220 emergency attendances for gout flares, 23.5% required hospitalization (median length of stay: 3.6 days). Recurrent attendances for flares occurred in 10.4% of patients during the study period. In multivariate logistic regression models, significant predictors of admission from ED were older age, overnight ED arrival time, higher serum urate (SU), higher C-reactive protein, and higher total white cell count at presentation. Detailed case note reviews showed that only 22.6% of patients with preexisting gout were receiving urate-lowering therapy (ULT) at presentation. Initial diagnostic uncertainty was common, yet rheumatology input and synovial aspirates were rarely obtained. By 6 months postdischarge, 43.6% were receiving ULT; however, few patients had treat-to-target dose optimization, and only 9.1% achieved SU levels ≤ 360 μmol/L. Conclusion. We identified multiple predictors of hospitalization for acute gout. Treat-to-target optimization of ULT following hospitalization remains inadequate and must be improved if admissions are to be prevented.
{"title":"Hospitalizations for Acute Gout: Process Mapping the Inpatient Journey and Identifying Predictors of Admission","authors":"M. Russell, D. Nagra, Benjamin D. Clarke, Sathiyaa Balachandran, April Buazon, Amy Boalch, K. Bechman, M. Adas, E. Alveyn, A. Rutherford, J. Galloway","doi":"10.3899/jrheum.211203","DOIUrl":"https://doi.org/10.3899/jrheum.211203","url":null,"abstract":"Objective. To identify predictors of admission following emergency department (ED) attendances for gout flares and to describe barriers to optimal inpatient gout care. Methods. ED attendances and hospital admissions with primary diagnoses of gout were analyzed at 2 UK-based hospitals between January 1, 2017, and December 31, 2020. Demographic and clinical predictors of ED disposition (admission or discharge) and reattendance for gout flares were identified using logistic regression and survival models, respectively. Case note reviews (n = 59), stakeholder meetings, and process mapping were performed to capture detailed information on gout management and to identify strategies to optimize care. Results. Of 1220 emergency attendances for gout flares, 23.5% required hospitalization (median length of stay: 3.6 days). Recurrent attendances for flares occurred in 10.4% of patients during the study period. In multivariate logistic regression models, significant predictors of admission from ED were older age, overnight ED arrival time, higher serum urate (SU), higher C-reactive protein, and higher total white cell count at presentation. Detailed case note reviews showed that only 22.6% of patients with preexisting gout were receiving urate-lowering therapy (ULT) at presentation. Initial diagnostic uncertainty was common, yet rheumatology input and synovial aspirates were rarely obtained. By 6 months postdischarge, 43.6% were receiving ULT; however, few patients had treat-to-target dose optimization, and only 9.1% achieved SU levels ≤ 360 μmol/L. Conclusion. We identified multiple predictors of hospitalization for acute gout. Treat-to-target optimization of ULT following hospitalization remains inadequate and must be improved if admissions are to be prevented.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77473357","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}
Objective. Rheumatoid arthritis (RA) is more common in females, and although the cause of RA is unknown, it is characterized by the production of autoantibodies. The aims of this study were to determine whether RA-associated autoantibodies are more often found in females than males and to identify factors that influence the relationship between sex and seropositivity. Methods. Databases were searched and studies of RA (N ≥ 100) were included if they reported proportion of seropositive patients with RA by sex. Metaanalyses and metaregression were conducted using the random-effects model. Covariates regressed were smoking, age, BMI, Health Assessment Questionnaire–Disability Index (HAQ-DI), and the Disease Activity Score in 28 joints (DAS28). Results. Eighty-four studies with a total of 141,381 subjects with rheumatoid factor (RF) seropositivity and 95,749 subjects with anticitrullinated protein antibody (ACPA) seropositivity met inclusion criteria. The mean age of participants ranged from 37 to 68 years and the proportion of female subjects ranged from 9% to 92%. Results indicated that females were less likely than males to be seropositive: odds ratio (OR) 0.84 [95% CI 0.77–0.91] for RF and OR 0.88 [95% CI 0.81–0.95] for ACPA. BMI, smoking, mean age, DAS28, and HAQ-DI did not affect the relationship between sex and seropositivity. Conclusion. Although studies report that females have higher RA disease activity than males and that seropositivity predicts worse outcomes, females were less likely to be seropositive than males.
目标。类风湿性关节炎(RA)在女性中更为常见，虽然RA的病因尚不清楚，但其特点是产生自身抗体。本研究的目的是确定ra相关自身抗体在女性中是否比男性更常见，并确定影响性别和血清阳性之间关系的因素。方法。检索数据库，纳入按性别报告血清阳性RA患者比例的RA研究(N≥100)。采用随机效应模型进行meta分析和回归分析。回归的协变量为吸烟、年龄、BMI、健康评估问卷-残疾指数(HAQ-DI)和28个关节的疾病活动评分(DAS28)。结果。84项研究共141,381例类风湿因子(RF)血清阳性和95,749例抗纤氨酸蛋白抗体(ACPA)血清阳性符合纳入标准。参与者的平均年龄在37 - 68岁之间，女性受试者的比例在9% - 92%之间。结果显示，女性血清阳性的可能性低于男性:RF的比值比(OR)为0.84 [95% CI 0.77-0.91]， ACPA的比值比(OR)为0.88 [95% CI 0.81-0.95]。BMI、吸烟、平均年龄、DAS28和HAQ-DI不影响性别与血清阳性的关系。结论。尽管研究报告称女性比男性有更高的类风湿性关节炎疾病活动性，血清阳性预示着更糟糕的结果，但女性血清阳性的可能性低于男性。
{"title":"Presence of Autoantibodies in Males and Females With Rheumatoid Arthritis: A Systematic Review and Metaanalysis","authors":"B. Hadwen, Richard Yu, E. Cairns, Lillian Barra","doi":"10.3899/jrheum.211020","DOIUrl":"https://doi.org/10.3899/jrheum.211020","url":null,"abstract":"Objective. Rheumatoid arthritis (RA) is more common in females, and although the cause of RA is unknown, it is characterized by the production of autoantibodies. The aims of this study were to determine whether RA-associated autoantibodies are more often found in females than males and to identify factors that influence the relationship between sex and seropositivity. Methods. Databases were searched and studies of RA (N ≥ 100) were included if they reported proportion of seropositive patients with RA by sex. Metaanalyses and metaregression were conducted using the random-effects model. Covariates regressed were smoking, age, BMI, Health Assessment Questionnaire–Disability Index (HAQ-DI), and the Disease Activity Score in 28 joints (DAS28). Results. Eighty-four studies with a total of 141,381 subjects with rheumatoid factor (RF) seropositivity and 95,749 subjects with anticitrullinated protein antibody (ACPA) seropositivity met inclusion criteria. The mean age of participants ranged from 37 to 68 years and the proportion of female subjects ranged from 9% to 92%. Results indicated that females were less likely than males to be seropositive: odds ratio (OR) 0.84 [95% CI 0.77–0.91] for RF and OR 0.88 [95% CI 0.81–0.95] for ACPA. BMI, smoking, mean age, DAS28, and HAQ-DI did not affect the relationship between sex and seropositivity. Conclusion. Although studies report that females have higher RA disease activity than males and that seropositivity predicts worse outcomes, females were less likely to be seropositive than males.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82717574","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}
Sumaya Aden, Stephen Q. Wong, Claire Yang, T. Bui, Travis Higa, Joshua Scheck, R. Iyer, M. Egbert, A. Lindberg, Yongdong Zhao
Objective Chronic nonbacterial osteomyelitis (CNO) is a rare autoinflammatory bone disease that is gaining recognition from clinicians and researchers. We aim to publish data from our cohort of patients with CNO living in the northwestern United States to increase the awareness of specific demographics, characteristics, and presentation of this rare disease. Methods A retrospective chart review was performed of our electronic medical records. Patients with complete chart records who met criteria for a diagnosis of CNO from 2005 to 2019 were included. Extracted data including patient demographics, bone biopsy results, and lesion locations on advanced imaging were analyzed. King County census data were used to calculate the annual new case rate within our center. Results A total of 215 CNO cases were diagnosed at our large tertiary pediatric hospital. The majority of cases were of White race residing in Washington’s most populous county, King County. Most cases were diagnosed in 2016 to 2019, showing a significant increase in the annual case rate from 8 to 23 per million children in King County, though there did not appear to be a seasonal predilection. Biopsy rate decreased from 75% to 52%. One hundred fifty-two (71%) children had family history of autoimmunity. With increasing use of whole-body magnetic resonance imaging (WB-MRI), results showed 68% had multiple lesions. Conclusion CNO has been diagnosed at an increased rate in recent years. WB-MRI may assist in identifying other lesions that may be asymptomatic on presentation. Bone biopsy is still required in some children at the time of diagnosis.
{"title":"Increasing Cases of Chronic Nonbacterial Osteomyelitis in Children: A Series of 215 Cases From a Single Tertiary Referral Center","authors":"Sumaya Aden, Stephen Q. Wong, Claire Yang, T. Bui, Travis Higa, Joshua Scheck, R. Iyer, M. Egbert, A. Lindberg, Yongdong Zhao","doi":"10.3899/jrheum.210991","DOIUrl":"https://doi.org/10.3899/jrheum.210991","url":null,"abstract":"Objective Chronic nonbacterial osteomyelitis (CNO) is a rare autoinflammatory bone disease that is gaining recognition from clinicians and researchers. We aim to publish data from our cohort of patients with CNO living in the northwestern United States to increase the awareness of specific demographics, characteristics, and presentation of this rare disease. Methods A retrospective chart review was performed of our electronic medical records. Patients with complete chart records who met criteria for a diagnosis of CNO from 2005 to 2019 were included. Extracted data including patient demographics, bone biopsy results, and lesion locations on advanced imaging were analyzed. King County census data were used to calculate the annual new case rate within our center. Results A total of 215 CNO cases were diagnosed at our large tertiary pediatric hospital. The majority of cases were of White race residing in Washington’s most populous county, King County. Most cases were diagnosed in 2016 to 2019, showing a significant increase in the annual case rate from 8 to 23 per million children in King County, though there did not appear to be a seasonal predilection. Biopsy rate decreased from 75% to 52%. One hundred fifty-two (71%) children had family history of autoimmunity. With increasing use of whole-body magnetic resonance imaging (WB-MRI), results showed 68% had multiple lesions. Conclusion CNO has been diagnosed at an increased rate in recent years. WB-MRI may assist in identifying other lesions that may be asymptomatic on presentation. Bone biopsy is still required in some children at the time of diagnosis.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81346073","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}
L. Coates, N. Corp, D. A. van der Windt, D. O'Sullivan, E. Soriano, A. Kavanaugh
Since its inception, one of the central missions of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has been the development of treatment recommendations for patients with psoriatic arthritis (PsA). The initial guidelines, developed in 2009, were updated in 2015. Because of the abundance of new data concerning the therapeutic approach to PsA, GRAPPA members have been working throughout 2020-2021 to once again update the recommendations. At the GRAPPA 2021 annual meeting, the full committee presented proposals from each of the treatment domain groups, including the comorbidities and related conditions groups, based on previous systematic literature reviews. Overarching principles and summary evidence tables were presented, including results from a GRAPPA membership survey of patients and clinicians to assess levels of agreement. A draft of the figure for the treatment recommendations was presented and discussed with the wider membership.
{"title":"GRAPPA Treatment Recommendations: 2021 Update.","authors":"L. Coates, N. Corp, D. A. van der Windt, D. O'Sullivan, E. Soriano, A. Kavanaugh","doi":"10.3899/jrheum.211331","DOIUrl":"https://doi.org/10.3899/jrheum.211331","url":null,"abstract":"Since its inception, one of the central missions of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has been the development of treatment recommendations for patients with psoriatic arthritis (PsA). The initial guidelines, developed in 2009, were updated in 2015. Because of the abundance of new data concerning the therapeutic approach to PsA, GRAPPA members have been working throughout 2020-2021 to once again update the recommendations. At the GRAPPA 2021 annual meeting, the full committee presented proposals from each of the treatment domain groups, including the comorbidities and related conditions groups, based on previous systematic literature reviews. Overarching principles and summary evidence tables were presented, including results from a GRAPPA membership survey of patients and clinicians to assess levels of agreement. A draft of the figure for the treatment recommendations was presented and discussed with the wider membership.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86013983","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}
Axial spondyloarthritis (axSpA) and diffuse idiopathic skeletal hyperostosis (DISH) involve tendon and ligament ossification showing similarity on spinal radiographs. Differentiating axSpA from DISH facilitates proper treatment and improves inflammatory pain; however, the overlap between axSpA and DISH delays its diagnosis.
{"title":"Axial Spondyloarthritis in Diffuse Idiopathic Skeletal Hyperostosis","authors":"K. Aso, M. Kato, T. Atsumi","doi":"10.3899/jrheum.220082","DOIUrl":"https://doi.org/10.3899/jrheum.220082","url":null,"abstract":"Axial spondyloarthritis (axSpA) and diffuse idiopathic skeletal hyperostosis (DISH) involve tendon and ligament ossification showing similarity on spinal radiographs. Differentiating axSpA from DISH facilitates proper treatment and improves inflammatory pain; however, the overlap between axSpA and DISH delays its diagnosis.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74685327","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}
L. Amezcua-Guerra, M. Mora-Ramírez, G. Vancini, V. Jiménez-Rojas, R. Márquez-Velasco
Systemic sclerosis (SSc) is a devastating disease associated with lung involvement, primarily interstitial lung disease (ILD) and pulmonary hypertension (PH).1 Although computed tomography (CT) and right heart catheterization accurately identify cardiopulmonary injury,2 their high cost and technical complexity make them inaccessible to most nonspecialized health centers. Thus, the timely detection of lung involvement remains a challenge in real-world settings.
{"title":"Fibroblast Growth Factor 23 Levels in Pulmonary Involvement Associated With Systemic Sclerosis: A Proof-of-concept Study","authors":"L. Amezcua-Guerra, M. Mora-Ramírez, G. Vancini, V. Jiménez-Rojas, R. Márquez-Velasco","doi":"10.3899/jrheum.211156","DOIUrl":"https://doi.org/10.3899/jrheum.211156","url":null,"abstract":"Systemic sclerosis (SSc) is a devastating disease associated with lung involvement, primarily interstitial lung disease (ILD) and pulmonary hypertension (PH).1 Although computed tomography (CT) and right heart catheterization accurately identify cardiopulmonary injury,2 their high cost and technical complexity make them inaccessible to most nonspecialized health centers. Thus, the timely detection of lung involvement remains a challenge in real-world settings.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76079623","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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