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Frequency of Symptomatic Adverse Events in Rheumatoid Arthritis: An Exploratory Online Survey 类风湿关节炎症状性不良事件的频率:一项探索性在线调查
Q2 Medicine Pub Date : 2022-03-01 DOI: 10.3899/jrheum.210688
G. Hazlewood, O. Schieir, V. Bykerk, Kamso Mujaab, P. Tugwell, G. Wells, D. Richards, L. Proulx, Pauline M Hull, S. Bartlett
Objective To generate initial data on the frequency and effect of symptomatic adverse events (AEs) associated with rheumatoid arthritis (RA) drug therapy from the patient perspective. Methods We conducted an exploratory online survey asking patients with RA to indicate whether they currently or had ever experienced the 80 different symptomatic AEs included in the Patient-Reported Outcomes of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Results were summarized to report their frequency, and regression models were used to estimate their associations with RA medication use and overall bother. Results The 560 patients who completed the survey and reported taking ≥ 1 RA medication (disease-modifying antirheumatic drugs [DMARDs], steroids, nonsteroidal antiinflammatory drugs [NSAIDs]), had a mean disease duration of 8 years, and were on a wide range of DMARDs. The number of symptomatic AEs experienced in the past 7 days was none (6%), 1–10 (28%), 11–20 (28%), and > 20 (38%). Overall, most participants reported that side effects bothered them somewhat (28%), quite a bit (24%), or very much (15%). In multivariable regression analyses, current prednisone and NSAID use were associated with the greatest number of current side effects (26 and 22, respectively). Many of the strongest associations between current symptomatic AEs and medication use aligned with known side effect profiles. Conclusion In this exploratory online survey, patients with RA reported frequent symptomatic AEs with their medications that are bothersome. Further work is needed to develop and validate a measure for use in patients with rheumatic disease.
目的从患者角度对类风湿性关节炎(RA)药物治疗相关的症状性不良事件(ae)发生频率和影响进行初步研究。方法:我们进行了一项探索性在线调查,要求RA患者表明他们目前或曾经是否经历过不良事件通用术语标准(PRO-CTCAE)中患者报告的80种不同的症状性不良事件。对结果进行总结以报告其发生频率,并使用回归模型来估计其与RA药物使用和总体麻烦的关系。结果560名完成调查并报告服用≥1种RA药物(改善疾病的抗风湿药物[DMARDs],类固醇,非甾体类抗炎药[NSAIDs])的患者,平均病程为8年,且服用的DMARDs范围广泛。在过去7天内出现症状性不良事件的次数为0(6%)、1-10(28%)、11-20(28%)和bbb20(38%)。总的来说,大多数参与者报告说副作用让他们有些困扰(28%),相当多(24%),或者非常严重(15%)。在多变量回归分析中,目前泼尼松和非甾体抗炎药的使用与目前最大数量的副作用相关(分别为26和22)。目前症状性不良反应与药物使用之间的许多最强关联与已知的副作用概况一致。结论:在这项探索性在线调查中,RA患者报告了频繁的症状性不良反应,这些不良反应伴随着他们的药物治疗。需要进一步的工作来开发和验证用于风湿病患者的测量方法。
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引用次数: 4
Central Obesity in Axial Spondyloarthritis: The Missing Link to Understanding Worse Outcomes in Women? 中枢性肥胖与中枢性脊柱性关节炎:了解女性不良预后的缺失环节?
Q2 Medicine Pub Date : 2022-03-01 DOI: 10.3899/jrheum.211062
S. Maguire, F. Wilson, P. Gallagher, F. O’Shea
Objective. To determine (1) the prevalence of central obesity in axial spondyloarthritis (axSpA) and its effect on disease-related outcomes and (2) how this differs between sexes. Methods. Data were extracted from the Ankylosing Spondylitis Registry of Ireland. Patients with physical measurements for the calculation of anthropometric measures were included. BMI and waist-to-hip ratio (WHR) were used to compare classifications of obesity. Comparison analyses based on sex and central obesity were carried out. Multivariate analysis examined the effects of these factors on the following patient-reported outcomes: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, and the Health Assessment Questionnaire (HAQ). Results. In total, 753 patients were included in the analysis. Of these patients, 29.6% (n = 223) were classified as obese based on their BMI, and 41.3% (n = 311) were classified as centrally obese according to the WHR. The prevalence of central obesity was significantly higher among women with axSpA compared to men (71.6% vs 29.9%, P < 0.01). Central obesity had a clear effect on patient outcomes, regardless of sex. Presence of central obesity was associated with significantly worse BASFI scores (P < 0.01), HAQ scores (P < 0.01), and ASQoL questionnaire scores (P = 0.01), with a nonsignificant trend toward worse BASDAI scores (P = 0.07). Conclusion. There was a high prevalence of central obesity as assessed by the WHR in axSpA, most notably among women with axSpA. This modifiable comorbidity was significantly associated with worse quality of life, greater impairment of functional ability, and a trend toward worse disease activity. Regular use of the WHR to screen for central obesity as part of an axSpA assessment would provide an opportunity for prompt identification and intervention for at-risk patients.
目标。确定(1)中枢性肥胖在中枢性脊柱炎(axSpA)中的患病率及其对疾病相关结局的影响,以及(2)这在性别之间的差异。方法。数据来自爱尔兰强直性脊柱炎登记处。计算人体测量值的体格测量患者也包括在内。BMI和腰臀比(WHR)被用来比较肥胖的分类。进行了基于性别和中心性肥胖的比较分析。多变量分析检查了这些因素对以下患者报告结果的影响:强直性脊柱炎疾病活动指数(BASDAI)、强直性脊柱炎功能指数(BASFI)、强直性脊柱炎生活质量(ASQoL)问卷和健康评估问卷(HAQ)。结果。共有753例患者被纳入分析。其中,29.6% (n = 223)的患者根据BMI被归类为肥胖,41.3% (n = 311)的患者根据WHR被归类为中心肥胖。患有axSpA的女性中心性肥胖的患病率明显高于男性(71.6% vs 29.9%, P < 0.01)。中心性肥胖对患者的预后有明显的影响,与性别无关。中心性肥胖与较差的BASFI评分(P < 0.01)、HAQ评分(P < 0.01)和ASQoL问卷评分(P = 0.01)显著相关,但与较差的BASDAI评分无显著相关性(P = 0.07)。结论。经腰宽比评估,axSpA患者中枢性肥胖的患病率很高,尤其是在患有axSpA的女性中。这种可改变的共病与更差的生活质量、更大的功能损害以及更严重的疾病活动性趋势显著相关。作为axSpA评估的一部分,定期使用腰宽比来筛查中心性肥胖,将为高危患者提供及时识别和干预的机会。
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引用次数: 4
Association of Health Literacy and Numeracy With Lupus Knowledge and the Creation of the Lupus Knowledge Assessment Test 健康素养、算术与狼疮知识的关系及狼疮知识评估测验的创设
Q2 Medicine Pub Date : 2022-03-01 DOI: 10.3899/jrheum.210708
Mithu Maheswaranathan, A. Eudy, A. C. Barr, C. Howe, J. Doss, R. Sadun, Lisa G. Criscione-Schreiber, K. Sun, Eliana M. Perrin, S. Bailey, S. Hastings, M. Clowse, Jennifer L Rogers
Objective. Limited health literacy and numeracy are associated with worse patient-reported outcomes and higher disease activity in systemic lupus erythematosus (SLE), but which factors may mediate this association is unknown. We sought to determine the association of health literacy and numeracy with SLE knowledge. Methods. Patients with SLE were recruited from an academic center clinic. Participants completed validated assessments of health literacy (Newest Vital Sign [NVS]; n = 96) and numeracy (Numeracy Understanding in Medicine Instrument, Short Version [S-NUMI]; n = 85). They also completed the Lupus Knowledge Assessment Test (LKAT), which consists of 4 questions assessing SLE knowledge that were determined through consensus expert opinion for their wide applicability and importance related to self-management of the disease. Descriptive statistics and multivariable logistic regression modeling were used to analyze the results. Results. In our SLE cohort (n = 125), 33% (32/96) had limited health literacy and 76% (65/85) had limited numeracy. The majority correctly identified that hydroxychloroquine prevented SLE flares (91%); however, only 23% of participants correctly answered a numeracy question assessing which urine protein to creatinine (UPC) ratio was > 1000 mg/g. The mean LKAT score was 2.7 out of 4.0. Limited health literacy, but not numeracy, was associated with lower knowledge about SLE as measured by the LKAT, even after adjusting for education. Conclusion. Patients with SLE with limited health literacy had lower knowledge about SLE. The LKAT could be further refined and/or used as a screening tool to identify patients with knowledge gaps. Further work is needed to improve patients’ understanding of proteinuria and investigate whether literacy-sensitive education can improve care.
目标。有限的健康素养和计算能力与系统性红斑狼疮(SLE)患者报告的较差结果和较高的疾病活动性相关,但哪些因素可能介导这种关联尚不清楚。我们试图确定健康素养和计算能力与SLE知识的关系。方法。SLE患者从一个学术中心诊所招募。参与者完成有效的健康素养评估(最新生命体征[NVS];n = 96)和计算能力(《医学仪器计算能力理解》简版[S-NUMI]);N = 85)。他们还完成了狼疮知识评估测试(LKAT),该测试由4个问题组成,评估SLE知识,这些问题是通过专家共识确定的,因为它们具有广泛的适用性和与疾病自我管理相关的重要性。采用描述性统计和多变量logistic回归模型对结果进行分析。结果。在我们的SLE队列(n = 125)中,33%(32/96)的健康素养有限,76%(65/85)的计算能力有限。大多数人正确识别羟氯喹可以预防SLE发作(91%);然而,只有23%的参与者正确回答了一个评估尿蛋白与肌酐(UPC)比值为1000mg /g的计算问题。平均LKAT得分为2.7分(满分为4.0分)。根据LKAT测量,即使在调整了教育因素后,有限的健康素养(而非计算能力)与SLE知识水平较低相关。结论。健康素养有限的SLE患者对SLE的认知水平较低。LKAT可以进一步完善和/或用作筛查工具,以识别有知识差距的患者。需要进一步的工作来提高患者对蛋白尿的认识,并调查识字敏感教育是否可以改善护理。
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引用次数: 2
Immunogenicity of COVID-19 Vaccination in Patients With Axial Spondyloarthritis: A Monocentric Prospective Belgian Cohort Study COVID-19疫苗接种对轴型脊柱炎患者的免疫原性:一项单中心前瞻性比利时队列研究
Q2 Medicine Pub Date : 2022-03-01 DOI: 10.3899/jrheum.211313
T. Vandergraesen, L. Mekkaoui, H. Dahma, M. Soyfoo, L. Tant
Vaccination is cardinal in restraining the pandemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The increased risk of severe COVID-19 infection in patients with inflammatory rheumatic diseases (IRD) makes vaccination particularly relevant in this population (1).
预防接种是遏制由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的COVID-19大流行的关键。炎症性风湿病(IRD)患者严重感染COVID-19的风险增加,使得这一人群尤其需要接种疫苗(1)。
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引用次数: 1
COVID-19 Update for the GRAPPA 2021 Annual Meeting: Focus on COVID-19 Vaccination. GRAPPA 2021年年会的COVID-19更新:重点关注COVID-19疫苗接种。
Q2 Medicine Pub Date : 2022-03-01 DOI: 10.3899/jrheum.211319
P. Mease, K. Winthrop, W. Olsder, J. Curtis
The efficacy and safety of coronavirus disease 2019 (COVID-19) vaccination in patients with autoimmune inflammatory diseases (AIRDs) who are treated with immunomodulatory therapies was the focus of a symposium at the 2021 virtual annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). The keynote address was delivered by Dr. Jeffrey Curtis, chair of the American College of Rheumatology COVID-19 Vaccine Clinical Guidance task force, detailing what we do and do not know about vaccine efficacy and safety in patients with AIRDs and providing guidance about the need for modification of dosing in some immunomodulatory medications for optimal vaccine response. A consensus of the task force was that all patients with AIRDs should be vaccinated as soon as it is allowed in their respective locations, since the benefits of increased protection against COVID-19 infection outweigh the potential for vaccination reactions, including flares of underlying disease, or for reduced efficacy of vaccination because of disease state or medications. Key issues among patient research partners with psoriatic disease expressed in the premeeting survey and panel discussion/question-and-answer period included: vaccine efficacy and safety, the need to continue safe social habits and masking, how to assess efficacy of vaccination, how to deal with vaccine hesitancy among social contacts, medication management relative to vaccination, and concerns about the adequacy of ongoing telehealth visits vs the convenience of that technology.
2019冠状病毒病(COVID-19)疫苗接种对接受免疫调节疗法治疗的自身免疫性炎症性疾病(AIRDs)患者的有效性和安全性是银屑病和银屑病关节炎研究与评估小组(GRAPPA) 2021年虚拟年会研讨会的焦点。美国风湿病学会COVID-19疫苗临床指导工作组主席Jeffrey Curtis博士发表了主题演讲,详细介绍了我们对AIRDs患者疫苗功效和安全性的了解和不了解,并提供了关于需要修改某些免疫调节药物剂量以获得最佳疫苗反应的指导。工作组的一项共识是,所有aird患者应尽快在各自地区接种疫苗,因为加强对COVID-19感染的保护的好处超过了疫苗接种反应的可能性,包括潜在疾病的爆发,或由于疾病状态或药物而降低疫苗接种效果。在会前调查和小组讨论/问答环节中,银屑病患者研究伙伴表达的关键问题包括:疫苗有效性和安全性、继续保持安全的社会习惯和掩盖的必要性、如何评估疫苗接种的有效性、如何处理社会接触者对疫苗的犹豫、与疫苗接种相关的药物管理,以及对正在进行的远程医疗访问的充足性与该技术的便利性的担忧。
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引用次数: 2
Looking Back and Marching Forward: New Features in 2022 回顾与前进:2022年的新特点
Q2 Medicine Pub Date : 2022-03-01 DOI: 10.3899/jrheum.211412
Non Picart Riola, Lindsay E. Madden, E. Silverman
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引用次数: 0
Correlation of Fibromyalgia Survey Questionnaire and Quantitative Sensory Testing Among Patients With Active Rheumatoid Arthritis 活动期类风湿关节炎患者纤维肌痛调查问卷与定量感觉测试的相关性
Q2 Medicine Pub Date : 2021-07-20 DOI: 10.21203/RS.3.RS-715260/V1
M. N. Moore, Beth I Wallace, Jing Song, L. Muhammad, Andrew C. Heisler, D. Clauw, M. Bolster, W. Marder, T. Neogi, Alyssa Wohlfahrt, D. Dunlop, Yvonne C. Lee
Objective Patients with rheumatoid arthritis (RA) commonly demonstrate disordered pain processing associated with high pain sensitization. Pain sensitization is often assessed using quantitative sensory testing (QST), which is burdensome to patients. The self-administered Fibromyalgia Survey Questionnaire (FSQ) has been proposed as a low-burden, surrogate measure of central pain sensitization. We examined the correlation between FSQ and QST in patients with active RA. Methods Participants in the Central Pain in Rheumatoid Arthritis (CPIRA) cohort underwent FSQ and QST evaluation at enrollment. QST measures included pressure pain threshold (PPT) at the thumb, trapezius, wrist, and knee; temporal summation (TS) at the wrist and arm; and conditioned pain modulation (CPM). Partial Spearman correlation between FSQ and each QST measure was assessed, adjusted for demographic factors, study site, disease characteristics, and pain catastrophizing. Sensitivity analyses included (1) stratified analysis by sex and (2) evaluation of how each component of FSQ associates with the QST measures. Results Among 285 participants with active RA, FSQ was weakly but statistically significantly correlated with PPT (r range = –0.31 to –0.21), and TS (r range = 0.13-0.15) at all sites in unadjusted analyses. After adjustment, statistically significant correlations persisted for TS at the wrist and PPT at all sites (except the thumb). Sensitivity analyses did not identify differences in association based on sex or with individual FSQ components. Conclusion FSQ and QST were correlated among participants with active RA, but the strength of association was weak. QST and FSQ are not interchangeable measures of pain sensitization.
目的类风湿关节炎(RA)患者通常表现出与高疼痛致敏相关的疼痛处理紊乱。通常使用定量感觉测试(QST)来评估疼痛致敏性,这对患者来说是一种负担。自我管理的纤维肌痛调查问卷(FSQ)已被提议作为中枢性疼痛致敏的低负担替代措施。我们研究了活动期RA患者FSQ和QST之间的相关性。方法类风湿性关节炎中枢性疼痛(cira)队列的参与者在入组时进行FSQ和QST评估。QST测量包括拇指、斜方肌、手腕和膝盖的压痛阈值(PPT);手腕和手臂颞统(TS);和条件疼痛调节(CPM)。评估FSQ与每项QST测量之间的部分Spearman相关性,并根据人口统计学因素、研究地点、疾病特征和疼痛灾变进行调整。敏感性分析包括(1)按性别分层分析和(2)评估FSQ的每个组成部分与QST测量的关联。结果在285名RA活动期患者中,FSQ与PPT (r范围= -0.31 ~ -0.21)和TS (r范围= 0.13 ~ 0.15)在所有部位呈弱相关,但具有统计学意义。调整后,腕部TS和所有部位PPT(拇指除外)的统计学显著相关性仍然存在。敏感性分析没有发现基于性别或个体FSQ成分的关联差异。结论FSQ和QST在活动期RA患者中存在相关性,但相关性较弱。QST和FSQ不能互换测量疼痛致敏。
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引用次数: 3
Report of the Skin Research Working Groups From the GRAPPA 2020 Annual Meeting. GRAPPA 2020年年会皮肤研究工作组报告
Q2 Medicine Pub Date : 2021-06-01 DOI: 10.3899/jrheum.201668
Lourdes M Perez-Chada, Alison Kohn, Alice B Gottlieb, April W Armstrong, Lihi Eder, Philip J Mease, Alexis Ogdie, Vibeke Strand, Joseph F Merola

At the 2020 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), the International Dermatology Outcome Measures (IDEOM) Initiative Psoriasis (PsO) Working Group presented an update on its work to agree on meaningful, valid, and feasible outcome measures for PsO randomized controlled trials and longitudinal observational studies. The Treatment Satisfaction Working Group presented the development of a treatment satisfaction instrument to be utilized in PsO clinical trials. The Musculoskeletal Symptoms Working Group presented an overview of their work conducted to date to define how to best measure musculoskeletal symptoms in PsO clinical studies, and discussed next steps during an open-panel discussion, which included PsO and psoriatic arthritis experts.

在2020年银屑病和银屑病关节炎研究和评估小组(GRAPPA)年会上,国际皮肤病结局测量(IDEOM)倡议银屑病(PsO)工作组提交了其工作的最新进展,以商定PsO随机对照试验和纵向观察研究的有意义、有效和可行的结局测量。治疗满意度工作组提出了一种治疗满意度仪器的发展,用于PsO临床试验。肌肉骨骼症状工作组概述了他们迄今为止所做的工作,以确定如何在PsO临床研究中最好地测量肌肉骨骼症状,并在包括PsO和银屑病关节炎专家的开放式小组讨论中讨论了下一步。
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引用次数: 3
GRAPPA Trainee Symposium 2020: A Summary of Oral and Poster Presentations. 2020年GRAPPA培训生研讨会:口头和海报报告总结。
Q2 Medicine Pub Date : 2021-06-01 DOI: 10.3899/jrheum.201670
Christopher T Ritchlin, April Armstrong, Hanna Johnsson, Michelle L M Mulder

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) held a trainee symposium at its 2020 virtual meeting. Dermatology and rheumatology trainees presented their work on psoriasis and psoriatic arthritis. This report briefly reviews the 5 oral presentations and 25 posters presented at the event.

银屑病和银屑病关节炎研究与评估小组(GRAPPA)在其2020年虚拟会议上举行了一次培训生研讨会。皮肤病学和风湿病学学员介绍了他们在银屑病和银屑病关节炎方面的工作。本报告简要回顾了本次活动的5个口头报告和25张海报。
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引用次数: 0
Magnetic Resonance Imaging of Axial and Peripheral Disease in Psoriatic Arthritis: A Report From the 2020 GRAPPA Annual Meeting. 银屑病关节炎中轴和外周疾病的磁共振成像:来自2020年GRAPPA年会上的报告
Q2 Medicine Pub Date : 2021-06-01 DOI: 10.3899/jrheum.201676
Walter P Maksymowych, Mikkel Østergaard

Psoriatic arthritis (PsA) presents with diverse features of musculoskeletal inflammation that affect both axial and peripheral joints as well as entheses, tenosynovium, and bursae. Magnetic resonance imaging (MRI) is the imaging modality that is uniquely capable of identifying pathology in all these structures. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Magnetic Resonance Imaging Working Group has increasingly explored diverse MRI methodologies for the purposes of quantifying inflammatory and structural abnormalities in clinical trials and research. The 2020 GRAPPA virtual workshop presented an opportunity to review progress in the field, summarize the status of MRI scoring systems developed for PsA, and review representative patient cases.

银屑病关节炎(PsA)表现为肌肉骨骼炎症的多种特征,可影响轴关节和外周关节以及关节囊、腱鞘和滑囊。磁共振成像(MRI)是一种独特的成像方式,能够识别所有这些结构的病理。银屑病和银屑病关节炎研究和评估小组(GRAPPA)磁共振成像工作组在临床试验和研究中越来越多地探索了多种MRI方法,以量化炎症和结构异常。2020年GRAPPA虚拟研讨会提供了一个回顾该领域进展的机会,总结了PsA MRI评分系统的现状,并回顾了具有代表性的患者病例。
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引用次数: 0
期刊
The Journal of rheumatology. Supplement
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