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Performance of adenosine deaminase in synovial fluid for the diagnosis of tuberculous arthritis: A systematic review and meta-analysis 滑液中腺苷脱氨酶诊断结核性关节炎的性能:系统回顾与荟萃分析
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2024-01-18 DOI: 10.1016/j.reuma.2023.11.003
Juan Carlos Cortes-Quiroz, Jose Bernal, Jose Rosas, Javier Ena

Objectives

Adenosine deaminase (ADA) activity has shown good performance in diagnosing pleural, peritoneal, and meningeal tuberculosis. This meta-analysis aimed to evaluate the performance of measuring ADA activity in synovial fluid for the early diagnosis of joint tuberculosis.

Methods

We searched published information in MEDLINE, Embase, Cochrane Library, Web of Science, and MedRxiv databases, as well as unpublished information in the American College of Rheumatology and European League Against Rheumatism for conference abstracts (2012–2021). We also scanned the reference lists of articles. Two reviewers independently applied the criteria for selection, assessed quality, and extracted data (PROSPERO number CRD42021284472).

Results

Seven independent studies (N = 305 subjects) that compared ADA activity in synovial fluid with a composite reference diagnostic method for tuberculosis were included. Overall, the risk of bias was judged low. Studies were classified as high quality (n = 3; 148 subjects) and low quality (n = 4; 157 subjects). Pooled sensitivity and specificity of ADA activity was 94% (95% confidence interval [CI], 0.89–98; I2 = 23%) and 88% (95% CI, 83–92; I2 = 83%), respectively. The random-effects model for pooled diagnostic Odds ratio was 67.1 (95%CI, 20.3–222.2; I2 = 30%). The receiver operating characteristic curve area was 0.96 (95% CI, 0.92–0.99). Meta-regression did not identify the quality of the study, country of publication, or the type of assay as a source of heterogeneity.

Conclusions

Measuring ADA activity in synovial fluid demonstrates good performance for the early diagnosis of joint tuberculosis.

目的 腺苷脱氨酶(ADA)活性在诊断胸膜、腹膜和脑膜结核方面表现良好。方法我们检索了MEDLINE、Embase、Cochrane图书馆、Web of Science和MedRxiv数据库中已发表的信息,以及美国风湿病学会和欧洲抗风湿病联盟中未发表的会议摘要信息(2012-2021年)。我们还扫描了文章的参考文献目录。结果纳入了 7 项独立研究(N = 305 例受试者),这些研究比较了滑液中 ADA 活性与结核病综合参考诊断方法。总体而言,偏倚风险较低。研究分为高质量(3 项;148 例受试者)和低质量(4 项;157 例受试者)。ADA活性的汇总灵敏度和特异性分别为94%(95% 置信区间[CI],0.89-98;I2 = 23%)和88%(95% CI,83-92;I2 = 83%)。随机效应模型的汇总诊断率为 67.1 (95%CI, 20.3-222.2; I2 = 30%)。接收者操作特征曲线面积为 0.96(95% CI,0.92-0.99)。结论测量滑膜液中的 ADA 活性对关节结核的早期诊断具有良好的效果。
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引用次数: 0
Utilidad de la ecografía reumatológica en la toma de decisiones en la práctica clínica: Estudio unicéntrico longitudinal 风湿病超声波在临床决策中的应用:一项单中心纵向研究。
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2024-01-16 DOI: 10.1016/j.reuma.2023.09.007
Marta Serrano-Warleta , Aliuska Palomeque-Vargas , Rosa Manzo , Boris Blanco-Cáceres , Mónica Vazquez-Díaz , Carlos Guillen-Astete

Objective

The purpose of the present study is to identify the extent to which rheumatological musculoskeletal ultrasound affects clinical decisions in a single-centre observational retrospective study.

Method

The results of 801 requests and 1174 consecutive individual ultrasound examinations performed over 10 months were analysed.

Results

The most frequent indication was diagnostic assistance (39%) followed by assessment of inflammatory activity (34%). By topography, the hand was the most frequently studied region (51%), followed by the foot (18.1%). Of all requests, 67% had an impact on decision-making. The impact on clinical decision-making was associated with a shorter waiting time for the evaluation of the results, being the greatest in those ultrasound scans performed on demand on the same day of the request. In 73% of bilateral ultrasound studies, findings in one of the joints exemplified the overall result reported.

Conclusions

Rheumatological musculoskeletal ultrasound has proven to be a useful decision-making technique, the greater the impact of which is seen the shorter the waiting time before it is performed.

本研究的目的是通过一项单中心观察性回顾研究,确定风湿病肌肉骨骼超声波对临床决策的影响程度。结果最常见的适应症是辅助诊断(39%),其次是炎症活动评估(34%)。从地形图来看,最常检查的部位是手部(51%),其次是足部(18.1%)。在所有请求中,67%对决策产生了影响。对临床决策的影响与等待评估结果的时间缩短有关,在申请当天按需进行的超声波扫描中,等待时间最长。在 73% 的双侧超声波检查中,其中一个关节的检查结果体现了报告的总体结果。结论风湿病学肌肉骨骼超声波检查已被证明是一种有用的决策技术,其影响越大,等待时间越短。
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引用次数: 0
Effect of combined treatment with prednisone and methotrexate versus prednisone alone over laboratory parameters in giant cell arteritis 泼尼松和甲氨蝶呤联合治疗与泼尼松单独治疗对巨细胞动脉炎实验室指标的影响
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2024-01-12 DOI: 10.1016/j.reuma.2023.09.011
Ines Perez-Sancristobal , Paula Alvarez-Hernandez , Cristina Lajas-Petisco , Benjamin Fernandez-Gutierrez

Objective

To compare the effect of combined treatment with prednisone and methotrexate (MTX) versus prednisone alone over laboratory parameters in giant cell arteritis (GCA).

Patients and methods

We performed a double-blind, placebo-controlled, randomized clinical trial about usefulness of treatment with prednisone and MTX versus prednisone and placebo in GCA (Ann Intern Med 2001;134:106–114). As a part of follow-up of patients (n = 42), we performed laboratory analysis in 20 time points during the two-year period of follow-up. To analyze differences, we calculated the area under the curve (AUC) for erythrocyte sedimentation rate (ESR), hemoglobin, and platelets, and compared the results in both groups adjusting by time of follow-up, existence of relapses and dose of prednisone.

Results

A total of 724 laboratory measurements were done. Median value of ESR was 33 [18–56] in patients with placebo and 26 [15–44] in patients with MTX (P = 0.0002). No significant differences were observed in ESR during relapses. The mean ESR value followed a parallel course in both groups, but was lower in the group with MTX than in the group with placebo in 18 of 20 time points of follow-up. The AUC of ESR by time of follow-up was 28,461.7 ± 12,326 in the group with placebo and 19,598.4 ± 8,117 in the group with MTX (mean difference 8,863, 95% CI 1.542–16.184; P = 0.019). The course of other laboratory parameters paralleled, without statistical significance, those observed for ESR.

Conclusions

These data, along with clinical data, suggest that MTX might play a role as a disease-modifying agent in the treatment of GCA.

目的比较泼尼松和甲氨蝶呤(MTX)联合治疗与泼尼松单独治疗对巨细胞动脉炎(GCA)患者实验室指标的影响。患者和方法我们就泼尼松和 MTX 与泼尼松和安慰剂治疗 GCA 的有效性进行了一项双盲、安慰剂对照随机临床试验(Ann Intern Med 2001;134:106-114)。作为患者(42 人)随访的一部分,我们在两年随访期间的 20 个时间点进行了实验室分析。为了分析差异,我们计算了红细胞沉降率(ESR)、血红蛋白和血小板的曲线下面积(AUC),并根据随访时间、是否复发和泼尼松剂量对两组结果进行了比较。安慰剂患者的血沉中位值为 33 [18-56],MTX 患者的血沉中位值为 26 [15-44](P = 0.0002)。复发期间的血沉无明显差异。两组患者的 ESR 平均值呈平行变化,但在 20 个随访时间点中,有 18 个时间点 MTX 组的 ESR 值低于安慰剂组。按随访时间计算,安慰剂组的 ESR AUC 为 28,461.7 ± 12,326,MTX 组为 19,598.4 ± 8,117 (平均差异为 8,863, 95% CI 1.542-16.184; P = 0.019)。这些数据以及临床数据表明,MTX 可在 GCA 的治疗中发挥疾病调节剂的作用。
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引用次数: 0
Comentarios sobre el tratamiento de la osteoporosis por corticoides 关于用类固醇治疗骨质疏松症的评论
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2024-01-11 DOI: 10.1016/j.reuma.2023.07.005
Osvaldo Daniel Messina
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引用次数: 0
Quality of life of patients with rheumatic diseases 风湿病患者的生活质量
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2024-01-11 DOI: 10.1016/j.reuma.2023.06.004
Lourdes Villalobos-Sánchez , Boris Blanco-Cáceres , Javier Bachiller-Corral , María Teresa Rodríguez-Serrano , Mónica Vázquez-Díaz , Pablo Lázaro y de Mercado

Objective

Health-related quality of life (HRQoL) is an important indicator of population health and can measure the impact of medical actions. The main objective of this study was to determine the HRQoL of patients with rheumatic diseases (RD) and compare it with that of the general population.

Methods

Observational, cross-sectional, single-center study, with consecutive inclusion of outpatients over 18 years of age seen at a Rheumatology hospital-based outpatient clinic in Madrid. Sociodemographic, clinical variables and HRQoL were recorded. HRQoL was measured with the 5-dimension, 5-level EuroQoL (EQ-5D-5L), which includes the EQ-Index (0–1 scale) and a visual analog scale (VAS, 0–100 scale). A descriptive analysis and a comparison with the HRQoL of the Spanish general population were performed.

Results

1144 patients were included, 820 (71.68%) women, with a mean age of 56.1 years (range 18–95), of whom 241 (25.44%) were new patients. In patients with RD, the HRQoL measured with the EQ-Index and with the VAS, was 0.186 and 12 points lower, respectively, than in the general population. The decrease in HRQoL affected the 5 health dimensions, especially “pain/discomfort”, followed by “daily activities” and “mobility”. This reduction in HRQoL was observed in both men and women, and in all age ranges, although it was greater between 18 and 65 years of age. The reduction in HRQoL affected all RD subtypes, especially the “peripheral and axial mechanical pathology” and the “soft tissue pathology” group.

Conclusions

Patients with rheumatic diseases report worse HRQoL when compared to the general population in all dimensions of HRQoL.

目的健康相关生活质量(HRQoL)是衡量人群健康状况的重要指标,可以衡量医疗行为的影响。本研究的主要目的是确定风湿病(RD)患者的 HRQoL,并将其与普通人群的 HRQoL 进行比较。方法:观察性、横断面、单中心研究,连续纳入在马德里一家风湿病医院门诊就诊的 18 岁以上门诊患者。研究记录了社会人口学、临床变量和 HRQoL。HRQoL采用5维5级EuroQoL(EQ-5D-5L)进行测量,其中包括EQ-Index(0-1级)和视觉模拟量表(VAS,0-100级)。结果 共纳入 1144 名患者,其中 820 名(71.68%)为女性,平均年龄 56.1 岁(18-95 岁不等),其中 241 名(25.44%)为新患者。在 RD 患者中,用 EQ-Index 和 VAS 测量的 HRQoL 分别比普通人群低 0.186 分和 12 分。HRQoL 的下降影响到 5 个健康维度,尤其是 "疼痛/不适",其次是 "日常活动 "和 "活动能力"。男性和女性以及所有年龄段的人都出现了 HRQoL 下降的情况,但 18 岁至 65 岁之间的人下降幅度更大。所有风湿性关节炎亚型,尤其是 "周围和轴向机械病变 "组和 "软组织病变 "组的患者的 HRQoL 都有所下降。
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引用次数: 0
Tuberculosis pleural y endocarditis como complicaciones de origen multifactorial en granulomatosis con poliangítis. Reporte de caso clínico 胸膜结核和心内膜炎是肉芽肿伴多血管炎的多因素并发症。临床病例报告
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2023-12-29 DOI: 10.1016/j.reuma.2023.08.002
Jesús Anguamea-Maldonado, Eduardo Sanchez-Zazueta, Rene Vidal-Morales

We present the case of a 36-year-old woman with a history of granulomatosis with polyangiitis, chronic kidney disease, and systemic arterial hypertension. Debut with dyspnea, weakness, and hemoptysis, she was suspected in atypical pneumonia, discarded, persisting with tachypnea, tachycardia, and chest pain. The protocol for pulmonary tuberculosis was started with negative sputum samples, positive blood culture for Staphylococcus haemolyticus, chest tomography with left pneumothorax and ipsilateral pleural effusion, exudate-type pleural fluid was obtained, acid-fast staining, negative PCR for Mycobacterium tuberculosis. A follow-up echocardiogram was performed due to a new murmur, reporting valvular vegetation, concluding a diagnosis of pleural tuberculosis and endocarditis as complications of multifactorial origin associated with immunosuppression in granulomatosis with polyangiitis.

我们介绍了一例 36 岁女性的病例,她曾患有肉芽肿伴多血管炎、慢性肾病和系统性动脉高血压。因呼吸困难、乏力和咯血而首次就诊,被怀疑为非典型肺炎,后被排除,并持续出现呼吸急促、心动过速和胸痛。痰标本阴性,溶血性葡萄球菌血培养阳性,胸部断层扫描显示左侧气胸和同侧胸腔积液,获得渗出型胸腔积液,酸性染色,结核分枝杆菌 PCR 阴性。由于出现了新的杂音,患者接受了超声心动图复查,结果显示存在瓣膜植被,最终诊断为胸膜结核和心内膜炎,这是肉芽肿伴多血管炎免疫抑制引起的多因素并发症。
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引用次数: 0
External validation of the 2017 ACR/EULAR classification criteria for inflammatory myopathies in a Mexican cohort: Role of autoantibodies in the diagnosis and classification of patients with inflammatory myopathies 2017年ACR/EULAR炎症性肌病分类标准在墨西哥队列中的外部验证:自身抗体在炎症性肌病患者诊断和分类中的作用
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2023-12-22 DOI: 10.1016/j.reuma.2023.11.002
Grisel Guadalupe Sánchez-Mendieta, David Vega-Morales, Miguel Ángel Villarreal-Alarcón, Jesús Eduardo Compean-Villegas, Ilse Andrea Moreno-Arquieta, Dionicio Ángel Galarza-Delgado

Objective

This retrospective study aimed to perform the first external validation of the ACR/EULAR classification criteria for inflammatory myopathy (IIM) in a Mexican dynamic cohort where the patients were evaluated with clinical and laboratory values. As secondary objectives, we presented the clinical characteristics of the patients and included antibodies other than anti Jo1 to evaluate their impact on our population.

Methodology

This study included 70 patients with IIM and 70 patients with differential diagnoses of IIM, according to the absolute score of the classification criteria. We obtained sensitivity and specificity in the modality without biopsy, and as an exploratory analysis, we added other antibodies from the myositis extended panel. We analyzed the area under the curve (AUC) of three models: score without antibodies, with anti Jo1 and with any antibody.

Results

The ACR/EULAR criteria showed increased specificity and at least similar sensitivity to that of the original cohort (85% sensitivity and 92% specificity), with a cohort point of >55%. When we classified patients into definite, probable, possible, and no IIM categories, by adding the extended myopathy panel, 6 of the 10 patients initially classified as “no IIM” changed their classification to “Probable IIM” and 4 to “Definite IIM”; of the 16 patients classified as “probable IIM,” 15 changed their classification to “Definite IIM.”

Conclusion

Considering the limitations of this study, we concluded that the 2017 EULAR/ACR criteria for IIM classification are sensitive and specific for classifying patients with IIM in the Mexican population. Additionally, the addition of antibodies other than anti-Jo1 may improve performance in certain populations.

这项回顾性研究旨在对墨西哥动态队列中的炎症性肌病(IIM)的 ACR/EULAR 分类标准进行首次外部验证,通过临床和实验室数值对患者进行评估。作为次要目标,我们介绍了患者的临床特征,并纳入了除抗Jo1以外的其他抗体,以评估它们对我们人群的影响。方法这项研究根据分类标准的绝对值,纳入了70例IIM患者和70例IIM鉴别诊断患者。我们在不进行活组织检查的情况下获得了敏感性和特异性,作为探索性分析,我们还加入了肌炎扩展面板中的其他抗体。我们分析了三种模型的曲线下面积(AUC):无抗体评分、有抗 Jo1 抗体评分和有任何抗体评分。结果 ACR/EULAR 标准显示出更高的特异性和至少与原始队列相似的敏感性(85% 的敏感性和 92% 的特异性),队列点为 55%。当我们将患者分为明确、可能、可能和无IIM类别时,通过添加扩展肌病面板,最初被归类为 "无IIM "的10名患者中有6人将其分类改为 "可能的IIM",4人将其分类改为 "明确的IIM";在被归类为 "可能的IIM "的16名患者中,15人将其分类改为 "明确的IIM"。"结论考虑到本研究的局限性,我们认为2017年EULAR/ACR IIM分类标准对于墨西哥人群中IIM患者的分类具有敏感性和特异性。此外,添加抗Jo1抗体以外的其他抗体可能会改善某些人群的表现。
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引用次数: 0
Evento cardiovascular en una cohorte de pacientes con artritis reumatoide en Castilla-La Mancha, utilidad de la ecografía carotídea 卡斯蒂利亚-拉曼恰地区一组类风湿性关节炎患者的心血管事件,颈动脉超声的作用。
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2023-12-19 DOI: 10.1016/j.reuma.2023.11.001
Marco Aurelio Ramírez Huaranga , David Velasco Sánchez , Luis Ángel Calvo Pascual , David Castro Corredor , María Dolores Mínguez Sánchez , Verónica Salas Manzanedo , Eva Revuelta Evrard , Rocío Arenal López , Joaquín Anino Fernández , Marina González Peñas , Lourdes Martin de la Sierra López , Laura María Jiménez Rodríguez , Alberto López Menchero Mora , Marcos Paulino Huertas

Rheumatoid arthritis (RA) has a mortality rate 1.3–3 times higher than the general population, with cardiovascular mortality accounting for 40%–50% of cases. Currently, cardiovascular disease is considered an extra-articular manifestation of RA (OR: 1.5–4.0). Ultrasound measurement of the intima-media thickness (IMT) of the common carotid artery and the presence of atherosclerotic plaques is a non-invasive method and a surrogate marker of subclinical arteriosclerosis.

Objective

To determine if subclinical arteriosclerosis findings through carotid ultrasound can serve as a good predictor of cardiovascular events (CVE) development in a cohort of RA patients over a 10-year period.

Methodology

A cohort of RA patients seen in the rheumatology outpatient clinic of a hospital in Castilla-La Mancha in 2013 was evaluated. A prospective evaluation for the development of CVE over the following 10 years was conducted, and its correlation with previous ultrasound findings of IMT and atherosclerotic plaques was analyzed.

Results

Eight (24%) patients experienced a CVE. Three (9%) had heart failure, three (9%) had a stroke, and two (6%) experienced acute myocardial infarction. RA patients who developed a CVE had a higher IMT (0.97 ± 0.08 mm) compared to the RA patients without cardiovascular complications (0.74 ± 0.15 mm) (P = .003). The presence of IMT  0.9 mm and atherosclerotic plaques had a relative risk of 12.25 (P = .012) and 18.66 (P = .003), respectively, for the development of a CVE.

Conclusions

Carotid ultrasound in RA patients may allow for early detection of subclinical atherosclerosis before the development of CVE, with IMT  0.9 mm being the most closely associated finding with CVE, unaffected by age.

类风湿性关节炎(RA)的死亡率是普通人群的 1.3-3 倍,其中心血管疾病死亡率占 40%-50%。目前,心血管疾病被认为是 RA 的关节外表现(OR:1.5-4.0)。超声测量颈总动脉内膜中层厚度(IMT)和动脉粥样硬化斑块的存在是一种非侵入性方法,也是亚临床动脉硬化的替代标志物。方法对2013年在卡斯蒂利亚-拉曼恰一家医院风湿病门诊就诊的一组RA患者进行了评估。结果8名(24%)患者出现了CVE。其中三人(9%)出现心力衰竭,三人(9%)中风,两人(6%)发生急性心肌梗死。与未出现心血管并发症的 RA 患者(0.74 ± 0.15 mm)相比,出现 CVE 的 RA 患者的 IMT 较高(0.97 ± 0.08 mm)(P = .003)。结论RA患者颈动脉超声检查可在CVE发生前早期发现亚临床动脉粥样硬化,IMT≥0.9 mm是与CVE关系最密切的发现,不受年龄影响。
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引用次数: 0
Is the use of secukinumab after anti-TNF therapy greater than expected for the risk of developing inflammatory bowel disease? 抗肿瘤坏死因子治疗后使用secukinumab是否会增加患炎症性肠病的风险?
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2023-12-19 DOI: 10.1016/j.reuma.2023.11.004
Fatih Albayrak , Mustafa Gür , Ahmet Karataş , Süleyman Serdar Koca , Bünyamin Kısacık

Objective

In this study, our objective was to present real-life data on the incidence of inflammatory bowel disease (IBD) among patients receiving secukinumab treatment.

Methods

The study consisted of 209 patients who had prior exposure to anti-tumor necrosis factor (TNF) or were biologically naive. Patients with a pre-existing history of IBD were excluded from the study.

Results

Of the 209 patients in the study, 176 (84.3%) had ankylosing spondylitis, while 33 (15.7%) had psoriatic arthritis. 112 (53.6%) patients had prior exposure to at least one anti-TNF treatment before initiating secukinumab. IBD developed in 10 (4.8%) of the 209 patients. The incidence of IBD among patients who initiated secukinumab as their first biologic agent was 1%. For patients who had previously received any anti-TNF treatment and subsequently transitioned to secukinumab, the incidence of IBD was 8% (p = 0.018, odds ratio (OR): 8.38, 95% CI: 1.04–67.45). A mean of 3.67 months (±4.3) after anti-TNF use, whereas IBD symptoms developed in the biologically naive patient after 15 months.

Conclusion

Our study observed IBD incidence in 4.8% of patients using secukinumab. Patients who initiated secukinumab after previous anti-TNF treatment exhibited a significantly higher rate and risk of developing IBD. The onset of IBD occurred earlier in these patients (mean 3.67 months), whereas a single case of IBD showed a longer duration (15 months). Further studies with larger patient numbers are warranted to provide a more comprehensive understanding of our findings.

目的在这项研究中,我们的目的是提供有关接受secukinumab治疗的患者中炎症性肠病(IBD)发病率的真实数据。在209名患者中,176人(84.3%)患有强直性脊柱炎,33人(15.7%)患有银屑病关节炎。112名(53.6%)患者在开始使用secukinumab前至少接受过一种抗肿瘤坏死因子治疗。209名患者中有10人(4.8%)患上了IBD。在首次使用secukinumab作为生物制剂的患者中,IBD的发病率为1%。对于之前接受过任何抗肿瘤坏死因子治疗,随后转用secukinumab的患者,IBD发病率为8%(p = 0.018,几率比(OR):8.38,95% CI:1.04-67.45)。使用抗肿瘤坏死因子后平均3.67个月(±4.3),而生物幼稚型患者在15个月后才出现IBD症状。既往接受过抗 TNF 治疗后再开始使用 secukinumab 的患者患 IBD 的比例和风险明显更高。这些患者的 IBD 发病时间较早(平均 3.67 个月),而一例 IBD 病例的病程较长(15 个月)。为了更全面地了解我们的研究结果,有必要对更多的患者进行进一步研究。
{"title":"Is the use of secukinumab after anti-TNF therapy greater than expected for the risk of developing inflammatory bowel disease?","authors":"Fatih Albayrak ,&nbsp;Mustafa Gür ,&nbsp;Ahmet Karataş ,&nbsp;Süleyman Serdar Koca ,&nbsp;Bünyamin Kısacık","doi":"10.1016/j.reuma.2023.11.004","DOIUrl":"10.1016/j.reuma.2023.11.004","url":null,"abstract":"<div><h3>Objective</h3><p>In this study, our objective was to present real-life data on the incidence of inflammatory bowel disease (IBD) among patients receiving secukinumab treatment.</p></div><div><h3>Methods</h3><p>The study consisted of 209 patients who had prior exposure to anti-tumor necrosis factor (TNF) or were biologically naive. Patients with a pre-existing history of IBD were excluded from the study.</p></div><div><h3>Results</h3><p>Of the 209 patients in the study, 176 (84.3%) had ankylosing spondylitis, while 33 (15.7%) had psoriatic arthritis. 112 (53.6%) patients had prior exposure to at least one anti-TNF treatment before initiating secukinumab. IBD developed in 10 (4.8%) of the 209 patients. The incidence of IBD among patients who initiated secukinumab as their first biologic agent was 1%. For patients who had previously received any anti-TNF treatment and subsequently transitioned to secukinumab, the incidence of IBD was 8% (<em>p</em> <!-->=<!--> <!-->0.018, odds ratio (OR): 8.38, 95% CI: 1.04–67.45). A mean of 3.67 months (±4.3) after anti-TNF use, whereas IBD symptoms developed in the biologically naive patient after 15 months.</p></div><div><h3>Conclusion</h3><p>Our study observed IBD incidence in 4.8% of patients using secukinumab. Patients who initiated secukinumab after previous anti-TNF treatment exhibited a significantly higher rate and risk of developing IBD. The onset of IBD occurred earlier in these patients (mean 3.67 months), whereas a single case of IBD showed a longer duration (15 months). Further studies with larger patient numbers are warranted to provide a more comprehensive understanding of our findings.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 3","pages":"Pages 123-127"},"PeriodicalIF":1.5,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139017561","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}
引用次数: 0
Patient-journey of fibromyalgia patients: A scoping review 纤维肌痛患者的病程:范围综述
IF 1.5 Q4 RHEUMATOLOGY Pub Date : 2023-12-11 DOI: 10.1016/j.reuma.2023.07.006
Teresa Otón , Loreto Carmona , Javier Rivera

Background

Fibromyalgia (FM) is a chronic disease characterized by widespread pain. Although much is known about this disease, research has focused on diagnosis and treatment, leaving aside factors related to patient's experience and the relationship with healthcare system.

Objectives

The aim was to analyze the available evidence on the experience of FM patients from the first symptoms to diagnosis, treatment, and follow-up.

Methods

A scoping review was carried out. Medline and the Cochrane Library were searched for original studies or reviews dealing with FM and focusing on “patient journey”. Results were organized using a deductive classification of themes.

Results

Fifty-four articles were included in the qualitative synthesis. Five themes were identified: the patient journey, the challenge for the health systems, a complex doctor–patient relationship, the importance of the diagnosis, and the difficulty of standardizing the treatment.

Conclusions

This scoping review confirms the negative impact of FM on the patient, their social environment, and health systems. It is necessary to minimize the difficulties encountered throughout the diagnosis and follow-up of patients with FM.

背景纤维肌痛(FM)是一种以广泛性疼痛为特征的慢性疾病。尽管人们对这种疾病有很多了解,但研究主要集中在诊断和治疗方面,而忽略了与患者经历以及与医疗系统的关系有关的因素。方法进行了范围界定综述。在 Medline 和 Cochrane 图书馆中搜索了与 FM 相关并关注 "患者历程 "的原始研究或综述。结果54篇文章被纳入定性综述。确定了五个主题:患者历程、医疗系统面临的挑战、复杂的医患关系、诊断的重要性以及标准化治疗的困难。有必要尽量减少在诊断和随访调频患者过程中遇到的困难。
{"title":"Patient-journey of fibromyalgia patients: A scoping review","authors":"Teresa Otón ,&nbsp;Loreto Carmona ,&nbsp;Javier Rivera","doi":"10.1016/j.reuma.2023.07.006","DOIUrl":"https://doi.org/10.1016/j.reuma.2023.07.006","url":null,"abstract":"<div><h3>Background</h3><p>Fibromyalgia (FM) is a chronic disease characterized by widespread pain. Although much is known about this disease, research has focused on diagnosis and treatment, leaving aside factors related to patient's experience and the relationship with healthcare system.</p></div><div><h3>Objectives</h3><p>The aim was to analyze the available evidence on the experience of FM patients from the first symptoms to diagnosis, treatment, and follow-up.</p></div><div><h3>Methods</h3><p>A scoping review was carried out. Medline and the Cochrane Library were searched for original studies or reviews dealing with FM and focusing on “patient journey”. Results were organized using a deductive classification of themes.</p></div><div><h3>Results</h3><p>Fifty-four articles were included in the qualitative synthesis. Five themes were identified: the patient journey, the challenge for the health systems, a complex doctor–patient relationship, the importance of the diagnosis, and the difficulty of standardizing the treatment.</p></div><div><h3>Conclusions</h3><p>This scoping review confirms the negative impact of FM on the patient, their social environment, and health systems. It is necessary to minimize the difficulties encountered throughout the diagnosis and follow-up of patients with FM.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 2","pages":"Pages 96-103"},"PeriodicalIF":1.5,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473206","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}
引用次数: 0
期刊
Reumatologia Clinica
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