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Reproductive health and rheumatoid arthritis. 生殖健康与类风湿性关节炎。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-15 DOI: 10.1186/s41927-024-00429-z
Mohammad Erfan Ranjbaran, Maryam Kazemi

Introduction: The prevalence of Rheumatoid Arthritis (RA) has been steadily increasing over the last thirty years, particularly among women. Due to the conflicting results of various studies on the link between rheumatoid arthritis and reproductive health, we have undertaken this study to explore their relationship.

Methods: This cross-sectional study utilized primary data from5557 women involved in the Fasa Persian Cohort in the years 2013 to 2018. The study examined the frequency of RA and its association with various factors related to reproductive health, including age at first pregnancy, number of alive children, history of abortion, and infertility. SPSS software was utilized for data analysis, with the significance level set at p < 0.05.

Results: 5557 women with an average age of 48.6 ± 9.5 years participated. Of these women, 7.2% were diagnosed with rheumatoid disease, with an average onset age of 38.2 ± 15.2. The study did not find a significant correlation between RA and factors such as number of pregnancies, age at first pregnancy, duration of breastfeeding and number of children.

Conclusion: The study suggests that the experience of RA is independent of gynecological, obstetric factors, or reproductive life. This finding may provide reassurance to women affected by RA.

导言:在过去的三十年中,类风湿性关节炎(RA)的发病率一直在稳步上升,尤其是在女性中。由于有关类风湿性关节炎与生殖健康之间关系的各种研究结果相互矛盾,我们开展了这项研究,以探讨两者之间的关系:这项横断面研究利用了 5557 名妇女在 2013 年至 2018 年期间参与法萨波斯队列的原始数据。研究考察了 RA 的频率及其与生殖健康相关的各种因素的关系,包括首次怀孕年龄、存活子女数、流产史和不孕症。数据分析采用 SPSS 软件,显著性水平设为 p 结果:5557 名妇女参加了调查,平均年龄为(48.6±9.5)岁。其中,7.2%的妇女被诊断患有类风湿病,平均发病年龄为(38.2±15.2)岁。研究没有发现 RA 与怀孕次数、首次怀孕年龄、母乳喂养时间和子女数量等因素有明显的相关性:研究表明,RA 与妇科、产科因素或生育期无关。这一发现可让受 RA 影响的妇女放心。
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引用次数: 0
Survey self-report of rheumatoid arthritis and treatments versus specialist clinician confirmation. 类风湿关节炎和治疗方法的自我报告调查与专科临床医生的确认对比。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-09 DOI: 10.1186/s41927-024-00425-3
Shamil Jugnundan, Gabriela Schmajuk, Laura Trupin, Paul D Blanc

Objective: To assess agreement between patient survey report and physician recorded arthritic conditions and medication use in order to validate population-based epidemiologic approaches to auto-immune arthritic conditions.

Methods: Rheumatologists in the U.S. Appalachian region recruited men 50 years or older with a confirmed rheumatoid arthritis (RA) diagnosis. For each participating patient, the treating specialist completed a brief chart abstraction that included rheumatic diagnosis and corresponding treatment. Patients participated in a telephone interview using the same questionnaire as applied in a larger random digit dial survey that queried arthritis diagnosis and treatment. We assessed patient-clinician agreement with the Prevalence Adjusted and Biased Adjusted Kappa (PABAK) statistic.

Results: We included 36 patient-clinician dyads in this analysis. All clinicians and patients concurred in the RA diagnosis (PABAK = 1). For concomitant systemic lupus and scleroderma, we observed generally concordant responses (PABAK 0.89 and 1, respectively). For medication use, for hydroxychloroquine or sulfasalazine was associated with the lowest PABAK (0.39), intermediate values for methotrexate and for the "other conventional synthetic DMARDs" category (0.67), and with the highest agreement PABAK value for the "biologic DMARD or JAK 2 inhibitor" category (0.89).

Conclusion: Survey-based self-report of RA offers a useful approach in epidemiological investigation. This is particularly relevant to population-based approaches to autoimmune arthritis related to occupational and environmental factors.

目的:评估患者调查报告与医生记录的关节炎病情和用药情况之间的一致性:评估患者调查报告与医生记录的关节炎状况和用药情况之间的一致性,以验证基于人群的自身免疫性关节炎流行病学方法:美国阿巴拉契亚地区的风湿病学家招募了50岁或50岁以上确诊为类风湿性关节炎(RA)的男性患者。对于每位参与调查的患者,主治专科医生都会填写一份简短的病历摘要,其中包括风湿病诊断和相应的治疗方法。患者参加了电话访谈,访谈中使用的问卷与一项大型随机数字拨号调查中使用的问卷相同,都是询问关节炎的诊断和治疗情况。我们用患病率调整和偏倚调整卡帕(PABAK)统计法评估了患者与医生之间的一致性:我们在分析中纳入了 36 个患者-医师二元组。所有临床医生和患者对 RA 的诊断结果一致(PABAK = 1)。对于并发的系统性红斑狼疮和硬皮病,我们观察到的反应基本一致(PABAK 分别为 0.89 和 1)。在药物使用方面,羟氯喹或柳氮磺胺吡啶的PABAK值最低(0.39),甲氨蝶呤和 "其他常规合成DMARDs "类别的PABAK值居中(0.67),而 "生物DMARD或JAK 2抑制剂 "类别的PABAK值最高(0.89):基于调查的 RA 自我报告为流行病学调查提供了一种有用的方法。结论:基于调查的自我报告为流行病学调查提供了一种有用的方法,尤其适用于与职业和环境因素相关的基于人群的自身免疫性关节炎调查。
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引用次数: 0
Disabling foot pain and its impact on daily living among people with psoriatic arthritis in Singapore: a cross-sectional observational investigation. 新加坡银屑病关节炎患者致残性足部疼痛及其对日常生活的影响:一项横断面观察调查。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-09 DOI: 10.1186/s41927-024-00409-3
Vanessa H Y Teo, Kai Li Chia, Catherine Bowen, Manjari Lahiri, Peter P M Cheung, Deborah E Turner, Kate Carter

Background: Psoriatic Arthritis (PsA)-related foot involvement has been shown to have a profound impact on daily functioning, with most studies having focused on predominantly Caucasian populations. The aim was to describe disabling foot pain (DFP) and its impact on daily living in PsA in Singapore.

Methods: A cross-sectional, retrospective study was conducted using clinical data collected during a single-visit to a rheumatology clinic in Singapore. Records for adults with physician-diagnosed PsA were reviewed for sociodemographic information, disease characteristics, global disease activity and burden. Foot-specific measures included clinical assessment and the Manchester Foot Pain and Disability Index used to define DFP and evaluate between-group differences.

Results: Forty-two participants with PsA (83% female, 57% Chinese, 31% Malay, 9.5% Indian, mean (SD) age 54-years (16)) attended the rheumatology clinic over the study-period. The median (IQR) disease duration was 2-years (11) and all were taking current DMARDs. Global disease measures demonstrated mild-to-moderate global disease activity and mild functional impairment, and were significantly higher in those with DFP. Despite 90% reporting to be coping well with their condition, self-care and having emotional support (n = 38), this study sample demonstrated high levels of anxiety/depression (29%), sleep disturbance (34%) and fatigue (24%), and a lack of disease- and drug-specific knowledge (64%). Further management was indicated for medication adherence counselling (48%), occupational therapy (43%), physiotherapy (36%) and podiatry (30%). Nearly half had current foot pain with 40% reporting DFP (n = 17), which caused significantly greater difficulty walking 3 km than those without DFP (p < 0.05). Rearfoot enthesitis (plantar fasciitis, Achilles enthesitis) was the most common cause of DFP (67%) with pain lasting longer than 1-year. 72% were overweight or obese, with a high proportion not engaging in any cardiovascular exercise (70%). Three of 42 participants had previously seen a podiatrist.

Conclusions: People with DFP in PsA experience more severe global disease activity, reduced mobility and higher levels of negative impact on their daily lives in Singapore. In the absence of working in a multidisciplinary-team, there is value in comprehensive assessments that have potential to capture a holistic view of personal impact and improve person-centred care in PsA.

背景:与银屑病关节炎(PsA)相关的足部受累已被证明会对日常功能产生深远影响,而大多数研究主要集中在白种人群体中。本研究旨在描述新加坡 PsA 患者的致残性足部疼痛(DFP)及其对日常生活的影响:这项横断面回顾性研究使用了在新加坡一家风湿病诊所单次就诊时收集的临床数据。研究人员查阅了经医生确诊的成年 PsA 患者的病历,以了解其社会人口学信息、疾病特征、总体疾病活动度和负担。足部特异性测量包括临床评估和曼彻斯特足部疼痛和残疾指数,用于定义DFP和评估组间差异:42名PsA患者(83%为女性,57%为华人,31%为马来人,9.5%为印度人,平均(标清)年龄为54岁(16岁))在研究期间前往风湿病诊所就诊。病程中位数(IQR)为2年(11),所有患者目前都在服用DMARDs。总体疾病指标显示,总体疾病活动度为轻度至中度,功能障碍程度为轻度,DFP患者的这一指标明显高于其他患者。尽管90%的患者表示能够很好地应对病情、进行自我护理并获得情感支持(n = 38),但该研究样本显示,焦虑/抑郁(29%)、睡眠障碍(34%)和疲劳(24%)程度较高,且缺乏疾病和药物相关知识(64%)。需要进一步治疗的患者包括药物依从性咨询(48%)、职业治疗(43%)、物理治疗(36%)和足病治疗(30%)。近一半的人目前有足部疼痛,其中 40% 的人报告有 DFP(n = 17),与没有 DFP 的人相比,他们行走 3 公里的难度明显更大(p 结论:PsA 患者中,有 DFP 的人比无 DFP 的人更难行走 3 公里:在新加坡,患有 DFP 的 PsA 患者会经历更严重的全身疾病活动、更低的活动能力和更高程度的日常生活负面影响。在缺乏多学科团队合作的情况下,综合评估很有价值,有可能全面了解个人影响并改善以人为本的 PsA 护理。
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引用次数: 0
Environmental pollution impact on the severity of some rheumatic diseases: a comparative analytical study on inflammatory and non-inflammatory samples. 环境污染对某些风湿病严重程度的影响:对炎症和非炎症样本的比较分析研究。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-08 DOI: 10.1186/s41927-024-00420-8
Adel Elbeialy, Soaad El Sawy, Hala Elzomor, Rana Haddad

Objective: Environmental pollution of heavy metals is increasingly a problem and has become of great concern due to the adverse effects it causes worldwide. Heavy metal exposure has been implicated in health problems, including fibromyalgia and rheumatoid arthritis. We aim to evaluate the rule of chronic heavy metals toxicity on the induction of vitamin D3 (VD) deficiency and parathyroid hormone (PTH) disturbances in an inflammatory disease like rheumatoid arthritis (RA) and non-inflammatory disease like fibromyalgia syndrome (FMS).

Methods: This comparative analytical study was conducted on sixty adults (age ≥ 18 years). Participants were divided into three groups. Group I: twenty patients diagnosed with RA according to the specific ACR/EULAR criteria for RA. Group II: twenty patients diagnosed with FMS according to the specific 2010 (ACR) criteria for FMS. Group III: twenty healthy adults. All patients and controls were subjected to routine laboratory tests as well as the measurement of PTH, VD and estimation of serum levels of lead, cadmium, and chromium.

Results: VD was significantly inversely correlated to PTH, lead, cadmium, chromium, and activity scores in the RA and FMS groups. Lead, Cadmium and Chromium had a significant independent risk on the VD level in RA patients, while lead had a significant independent risk on the VD level in FMS patients.

Conclusion: Heavy metals may affect VD synthesis, leading to hypovitaminosis D and secondary hyperparathyroidism in RA and FMS patients. Heavy metals play a key role in the pathogenesis of RA, FMS, and their disease activity.

目的:重金属环境污染问题日益严重,在全球范围内造成的不良影响已引起人们的极大关注。重金属暴露与纤维肌痛和类风湿性关节炎等健康问题有关。我们的目的是评估慢性重金属毒性对诱发类风湿性关节炎(RA)等炎症性疾病和纤维肌痛综合征(FMS)等非炎症性疾病中维生素 D3(VD)缺乏和甲状旁腺激素(PTH)紊乱的影响:这项比较分析研究以 60 名成年人(年龄≥ 18 岁)为对象。参与者分为三组。第一组:20 名根据 ACR/EULAR RA 特定标准诊断为 RA 的患者。第二组:20 名根据 2010 年(ACR)FMS 特定标准诊断为 FMS 的患者。第三组:20 名健康成人。所有患者和对照组均接受了常规实验室检查、PTH、VD测量以及血清中铅、镉和铬水平的评估:在 RA 组和 FMS 组中,VD 与 PTH、铅、镉、铬和活动评分呈明显的反比关系。铅、镉和铬对RA患者的VD水平有明显的独立风险,而铅对FMS患者的VD水平有明显的独立风险:重金属可能会影响VD的合成,导致RA和FMS患者维生素D不足和继发性甲状旁腺功能亢进。重金属在RA和FMS的发病机制及其疾病活动中起着关键作用。
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引用次数: 0
The potential role of fatigue in difficult-to-treat rheumatoid arthritis. 疲劳在难以治疗的类风湿关节炎中的潜在作用。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-09-30 DOI: 10.1186/s41927-024-00423-5
Leticia Leon, Dalifer Freites-Núñez, Alfredo Madrid, María Rodriguez-Mariblanca, Benjamín Fernandez-Gutierrez, Lydia Abasolo

Objectives: A subset of patients with rheumatoid arthritis (RA) who remains symptomatic after failing to multiple drugs are deemed to have "difficult-to-treat RA" (D2T RA). Fatigue is a burdensome symptom for RA patients, hindering their improvement. Our purpose was to evaluate the role of fatigue in D2T RA.

Methods: This cross-sectional study included rheumatoid arthritis (RA) patients between 2018 and 2022, treated with biological agents or targeted synthetic disease-modifying antirheumatic drugs. D2T RA was defined attending EULAR criteria. Independent variable was fatigue (dimensions and impact) assessed by the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire and Numerical Rating Scales. Covariables: sociodemographic, clinical and treatment. To identify factors independently associated to D2T RA, multivariable logistic regression was run.

Results: The study included 145 patients and 38 (26.21%) developed D2T RA. D2T RA group were older, with more comorbidity and disability. D2T RA patients scored higher for global fatigue (p = 0.003), and almost for all their dimensions except for cognitive fatigue (p = 0.06) and fatigue coping (p = 0.07). Females with D2T RA showed more fatigue than those with non-D2T RA. In the adjusted models, all fatigue dimensions were associated with D2T RA: global fatigue RA (OR: 1.03; p = 0.007), physical (OR: 1.09; p = 0.008), living (OR: 1.09; p = 0.016), cognitive (OR: 1.1; p = 0.046) and emotional (OR: 1.18; p = 0.012).

Conclusions: Despite the absence of an explicit mention of fatigue in the definition of D2T RA, it appears to be associated to this outcome. Fatigue should be evaluated in a multidimensional perspective, and gender-specific differences should be considered.

目标:在类风湿性关节炎(RA)患者中,有一部分人在服用多种药物无效后仍无症状,他们被认为患有 "难治性 RA"(D2T RA)。疲劳是类风湿关节炎患者的一个沉重负担,阻碍了他们病情的改善。我们的目的是评估疲劳在 D2T RA 中的作用:这项横断面研究纳入了2018年至2022年间接受生物制剂或靶向合成改善病情抗风湿药物治疗的类风湿关节炎(RA)患者。D2T RA是根据EULAR标准定义的。自变量为疲劳(维度和影响),由布里斯托尔类风湿关节炎疲劳多维问卷和数字评分量表评估。协变量:社会人口学、临床和治疗。为确定与D2T RA独立相关的因素,进行了多变量逻辑回归:研究共纳入 145 名患者,其中 38 人(26.21%)发展为 D2T RA。D2T RA组患者年龄较大,合并症和残疾情况较多。D2T RA 患者的整体疲劳得分较高(p = 0.003),除认知疲劳(p = 0.06)和疲劳应对(p = 0.07)外,几乎所有方面的得分都较高。女性D2T RA患者比非D2T RA患者表现出更多的疲劳。在调整模型中,所有疲劳维度均与D2T RA相关:全面疲劳RA(OR:1.03;p = 0.007)、身体(OR:1.09;p = 0.008)、生活(OR:1.09;p = 0.016)、认知(OR:1.1;p = 0.046)和情绪(OR:1.18;p = 0.012):结论:尽管D2T RA的定义中没有明确提及疲劳,但疲劳似乎与这一结果有关。疲劳应从多维角度进行评估,并应考虑性别差异。
{"title":"The potential role of fatigue in difficult-to-treat rheumatoid arthritis.","authors":"Leticia Leon, Dalifer Freites-Núñez, Alfredo Madrid, María Rodriguez-Mariblanca, Benjamín Fernandez-Gutierrez, Lydia Abasolo","doi":"10.1186/s41927-024-00423-5","DOIUrl":"10.1186/s41927-024-00423-5","url":null,"abstract":"<p><strong>Objectives: </strong>A subset of patients with rheumatoid arthritis (RA) who remains symptomatic after failing to multiple drugs are deemed to have \"difficult-to-treat RA\" (D2T RA). Fatigue is a burdensome symptom for RA patients, hindering their improvement. Our purpose was to evaluate the role of fatigue in D2T RA.</p><p><strong>Methods: </strong>This cross-sectional study included rheumatoid arthritis (RA) patients between 2018 and 2022, treated with biological agents or targeted synthetic disease-modifying antirheumatic drugs. D2T RA was defined attending EULAR criteria. Independent variable was fatigue (dimensions and impact) assessed by the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire and Numerical Rating Scales. Covariables: sociodemographic, clinical and treatment. To identify factors independently associated to D2T RA, multivariable logistic regression was run.</p><p><strong>Results: </strong>The study included 145 patients and 38 (26.21%) developed D2T RA. D2T RA group were older, with more comorbidity and disability. D2T RA patients scored higher for global fatigue (p = 0.003), and almost for all their dimensions except for cognitive fatigue (p = 0.06) and fatigue coping (p = 0.07). Females with D2T RA showed more fatigue than those with non-D2T RA. In the adjusted models, all fatigue dimensions were associated with D2T RA: global fatigue RA (OR: 1.03; p = 0.007), physical (OR: 1.09; p = 0.008), living (OR: 1.09; p = 0.016), cognitive (OR: 1.1; p = 0.046) and emotional (OR: 1.18; p = 0.012).</p><p><strong>Conclusions: </strong>Despite the absence of an explicit mention of fatigue in the definition of D2T RA, it appears to be associated to this outcome. Fatigue should be evaluated in a multidimensional perspective, and gender-specific differences should be considered.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"49"},"PeriodicalIF":2.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Menopausal state and rheumatoid arthritis: a systematic review and meta-analysis. 更年期状态与类风湿性关节炎:系统回顾与荟萃分析。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-09-30 DOI: 10.1186/s41927-024-00418-2
Negin Namavari, Mohammad Jokar, Arnoosh Ghodsian, Hossein Kargar Jahromi, Vahid Rahmanian

Background: Rheumatoid arthritis (RA) is a chronic inflammatory condition primarily affecting the joints. The higher prevalence of RA among females, combined with the known effects of sex hormones on immune function, has led researchers to investigate the potential relationship between menopausal status and the risk, severity, or progression of RA. This systematic review and meta-analysis aimed to determine the association between menopause and rheumatoid arthritis.

Methods: In 2023, we conducted a comprehensive search across multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest. The search aimed to identify studies exploring the association between menopause and rheumatoid arthritis.

Results: Our analysis revealed that post-menopausal women had a higher risk of developing rheumatoid arthritis compared to pre-menopausal women, with an estimated odds ratio of 1.35 (95% CI: 1.04-1.67). Additionally, women who experienced early menopause (defined as onset before age 45) showed significantly higher odds of developing RA, with an odds ratio of 2.97 (95% CI: 1.73-4.22).

Conclusion: These findings highlight the importance of considering menopausal status when assessing the risk of RA development in women. The results suggest that post-menopausal women, particularly those who experience early menopause, may be at higher risk for developing RA. Further research in this area could provide valuable insights into potential preventive measures and targeted interventions for high-risk individuals.

背景:类风湿性关节炎(RA)是一种主要影响关节的慢性炎症。女性的风湿性关节炎发病率较高,加上性激素对免疫功能的已知影响,促使研究人员调查更年期状态与风湿性关节炎的风险、严重程度或进展之间的潜在关系。本系统综述和荟萃分析旨在确定更年期与类风湿关节炎之间的关系:2023 年,我们对多个数据库进行了全面检索,包括 Google Scholar、Scopus、PubMed/MEDLINE、Science Direct、Web of Science、EMBASE、Springer 和 ProQuest。搜索的目的是找出探讨更年期与类风湿性关节炎之间关系的研究:我们的分析表明,与绝经前妇女相比,绝经后妇女患类风湿性关节炎的风险更高,估计的几率比为 1.35(95% CI:1.04-1.67)。此外,更年期提前(定义为 45 岁之前发病)的女性患 RA 的几率明显更高,几率比为 2.97(95% CI:1.73-4.22):这些发现强调了在评估女性罹患 RA 的风险时考虑绝经状态的重要性。结果表明,绝经后的女性,尤其是绝经较早的女性,患 RA 的风险可能较高。在这一领域的进一步研究可为潜在的预防措施和针对高危人群的干预措施提供有价值的见解。
{"title":"Menopausal state and rheumatoid arthritis: a systematic review and meta-analysis.","authors":"Negin Namavari, Mohammad Jokar, Arnoosh Ghodsian, Hossein Kargar Jahromi, Vahid Rahmanian","doi":"10.1186/s41927-024-00418-2","DOIUrl":"10.1186/s41927-024-00418-2","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic inflammatory condition primarily affecting the joints. The higher prevalence of RA among females, combined with the known effects of sex hormones on immune function, has led researchers to investigate the potential relationship between menopausal status and the risk, severity, or progression of RA. This systematic review and meta-analysis aimed to determine the association between menopause and rheumatoid arthritis.</p><p><strong>Methods: </strong>In 2023, we conducted a comprehensive search across multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest. The search aimed to identify studies exploring the association between menopause and rheumatoid arthritis.</p><p><strong>Results: </strong>Our analysis revealed that post-menopausal women had a higher risk of developing rheumatoid arthritis compared to pre-menopausal women, with an estimated odds ratio of 1.35 (95% CI: 1.04-1.67). Additionally, women who experienced early menopause (defined as onset before age 45) showed significantly higher odds of developing RA, with an odds ratio of 2.97 (95% CI: 1.73-4.22).</p><p><strong>Conclusion: </strong>These findings highlight the importance of considering menopausal status when assessing the risk of RA development in women. The results suggest that post-menopausal women, particularly those who experience early menopause, may be at higher risk for developing RA. Further research in this area could provide valuable insights into potential preventive measures and targeted interventions for high-risk individuals.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"48"},"PeriodicalIF":2.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence of serious infection among etanercept and infliximab initiators: safety comparison between biosimilars and bio-originators with Canadian population-based data. 依那西普和英夫利昔单抗启动者的严重感染发生率:生物仿制药和生物原研药与加拿大人群数据的安全性比较。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-09-27 DOI: 10.1186/s41927-024-00415-5
Marina G Birck, Luck Lukusa, Denis Choquette, Gilles Boire, Walter P Maksymowych, Harminder Singh, Waqqas Afif, Sasha Bernatsky

Background: Safety remains a significant concern for biologic drugs, and studies are needed to ensure a comparable safety profile for biosimilars and their legacy treatments. Using Canadian administrative health data from 2015-2019, we compared the incidence of serious infection between biosimilars and bio-originators initiators for etanercept and infliximab, two of the most commonly used biologics during this time.

Methods: We performed a retrospective cohort study using pan-Canadian data (except Quebec) from the National Prescription Drug Utilization Information System linked to hospitalization data. We studied new users of infliximab or etanercept (January/2015-December/2019) and compared incidence rates of serious infection, defined as those which required hospitalization, by using Cox regression models adjusted by biological sex, age at treatment initiation, prior corticosteroid or biologic, province, and calendar year.

Results: We studied 6,583 etanercept users (mean age 62) and 7,202 infliximab users (mean age 45). Hospitalization with infections occurred in 7% of infliximab and 2% of etanercept users. Comparing the risk of infection between biosimilar to bio-originator, the adjusted hazard ratio (95% confidence interval) was 1.33 (0.77, 2.30) for etanercept and 0.93 (0.72, 1.18) for infliximab.

Conclusions: Our study found no clear difference between etanercept and infliximab biosimilars and their bio-originators for infection incidence, suggesting a similar safety profile.

背景:安全性仍然是生物制药的一个重大问题,需要进行研究以确保生物仿制药及其传统疗法具有可比的安全性。我们利用 2015-2019 年的加拿大行政健康数据,比较了生物仿制药和生物原研药启动者在依那西普(etanercept)和英夫利昔单抗(infliximab)严重感染的发生率,依那西普和英夫利昔单抗是这一时期最常用的两种生物制剂:我们使用国家处方药使用信息系统(National Prescription Drug Utilization Information System)中与住院数据相关联的泛加拿大(魁北克除外)数据进行了一项回顾性队列研究。我们研究了英夫利昔单抗或依那西普(etanercept)的新用户(2015 年 1 月至 2019 年 12 月),并比较了严重感染(定义为需要住院治疗的感染)的发生率,采用 Cox 回归模型,根据生物性别、开始治疗时的年龄、之前使用的皮质类固醇或生物制剂、省份和日历年进行调整:我们对 6583 名依那西普使用者(平均年龄 62 岁)和 7202 名英夫利西单抗使用者(平均年龄 45 岁)进行了研究。因感染住院的英夫利昔单抗使用者占 7%,依那西普使用者占 2%。比较生物仿制药和生物原研药的感染风险,依那西普的调整后危险比(95% 置信区间)为 1.33(0.77, 2.30),英夫利西单抗为 0.93(0.72, 1.18):我们的研究发现,依那西普和英夫利昔单抗生物仿制药与其生物原研药在感染发生率方面没有明显差异,这表明它们具有相似的安全性。
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引用次数: 0
Socioeconomic status, reserve capacity, and depressive symptoms predict pain in Rheumatoid Arthritis: an examination of the reserve capacity model. 社会经济地位、储备能力和抑郁症状可预测类风湿关节炎患者的疼痛:对储备能力模型的研究。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-09-20 DOI: 10.1186/s41927-024-00416-4
Desiree R Azizoddin, Richard Olmstead, Kris-Ann Anderson, Alanna E Hirz, Michael R Irwin, Shadi Gholizadeh, Michael Weisman, Mariko Ishimori, Daniel Wallace, Perry Nicassio

Background: Guided by the reserve capacity model, we evaluated the unique relationships between socioeconomic status (SES), reserve capacity (helplessness, self-efficacy, social support), and negative emotions on pain in patients with Rheumatoid Arthritis (RA).

Methods: The secondary analysis used baseline, cross-sectional data from 106 adults in a clinical trial comparing behavioral treatments for RA. Patients were eligible if they were ≥ 18 years old, met the ACR criteria for RA (determined by study rheumatologist), had stable disease and drug regimens for 3 months, and did not have a significant comorbid condition. Structural equation modeling evaluated the direct effects of SES, reserve capacity (helplessness- Arthritis Helplessness Index, self-efficacy -Personal Mastery Scale, social support- Social Provisions Scale) and negative emotions (stress and depressive symptoms- Perceived Stress Scale and Hamilton Depression Rating Scale) on pain (Rapid Assessment of Disease Activity in Rheumatology-RADAR & visual analog scale-VAS), and the indirect effects of SES as mediated by reserve capacity and negative emotions. The SEM model was evaluated using multiple fit criteria: χ2 goodness-of-fit statistic, the comparative fit index (CFI), the standardized root mean square residual (SRMR), and the root mean square error of approximation (RMSEA).

Results: Participants were mostly female (85%), 55.45 years old on average, self-identified as white (61%), Hispanic (16%), black (13%), and other (10%), and had RA for an average of 10.63 years. Results showed that low SES contributed to worse pain, through lower reserve capacity and higher negative emotions. Mediational analyses showed that reserve capacity and negative emotions partially mediated the effect of SES on pain. The final model explained 39% of the variance in pain.

Conclusions: The findings indicate that lower SES was related to worse clinical pain outcomes and negative emotions and reserve capacity (helplessness, social support, and self-efficacy) mediated the effect of SES on pain. A primary limitation is the small sample size; future studies should evaluate this model further in larger, longitudinal approaches. Interventions that target negative emotions in patients with low SES may facilitate better pain control with RA.

Trial registration: clinicaltrials.gov NCT00072657 01/02/2004 20/03/2009.

背景:在储备能力模型的指导下,我们评估了类风湿关节炎(RA)患者的社会经济地位(SES)、储备能力(无助感、自我效能感、社会支持)和负面情绪对疼痛的独特影响:二次分析使用了一项比较类风湿性关节炎行为疗法的临床试验中 106 名成人的基线横截面数据。患者年龄≥18岁,符合ACR的RA标准(由研究中的风湿病学家确定),病情和用药方案稳定3个月,且无严重并发症,即符合条件。结构方程模型评估了社会经济地位、储备能力(无助感-关节炎无助感指数、自我效能-个人掌握量表、社会支持-社会供给量表)和负面情绪(压力和抑郁症状-感知压力量表和汉密尔顿抑郁评分量表)对疼痛(风湿病学疾病活动性快速评估-RADAR和视觉模拟量表-VAS)的直接影响,以及社会经济地位在储备能力和负面情绪中介下的间接影响。采用多种拟合标准对 SEM 模型进行了评估:χ2 拟合度统计量、比较拟合指数(CFI)、标准化均方根残差(SRMR)和均方根近似误差(RMSEA):参与者大多为女性(85%),平均年龄 55.45 岁,自我认同为白人(61%)、西班牙裔(16%)、黑人(13%)和其他(10%),平均患有 RA 10.63 年。研究结果表明,低社会经济地位通过较低的储备能力和较高的负面情绪导致疼痛加剧。中介分析表明,储备能力和消极情绪部分中介了社会经济地位对疼痛的影响。最终模型解释了39%的疼痛变异:研究结果表明,较低的社会经济地位与较差的临床疼痛结果有关,而消极情绪和储备能力(无助感、社会支持和自我效能感)是社会经济地位对疼痛影响的中介。该研究的主要局限性在于样本量较小;未来的研究应采用更大规模的纵向方法来进一步评估该模型。针对低社会经济地位患者负面情绪的干预措施可能有助于更好地控制RA疼痛。试验注册:clinicaltrials.gov NCT00072657 01/02/2004 20/03/2009。
{"title":"Socioeconomic status, reserve capacity, and depressive symptoms predict pain in Rheumatoid Arthritis: an examination of the reserve capacity model.","authors":"Desiree R Azizoddin, Richard Olmstead, Kris-Ann Anderson, Alanna E Hirz, Michael R Irwin, Shadi Gholizadeh, Michael Weisman, Mariko Ishimori, Daniel Wallace, Perry Nicassio","doi":"10.1186/s41927-024-00416-4","DOIUrl":"10.1186/s41927-024-00416-4","url":null,"abstract":"<p><strong>Background: </strong>Guided by the reserve capacity model, we evaluated the unique relationships between socioeconomic status (SES), reserve capacity (helplessness, self-efficacy, social support), and negative emotions on pain in patients with Rheumatoid Arthritis (RA).</p><p><strong>Methods: </strong>The secondary analysis used baseline, cross-sectional data from 106 adults in a clinical trial comparing behavioral treatments for RA. Patients were eligible if they were ≥ 18 years old, met the ACR criteria for RA (determined by study rheumatologist), had stable disease and drug regimens for 3 months, and did not have a significant comorbid condition. Structural equation modeling evaluated the direct effects of SES, reserve capacity (helplessness- Arthritis Helplessness Index, self-efficacy -Personal Mastery Scale, social support- Social Provisions Scale) and negative emotions (stress and depressive symptoms- Perceived Stress Scale and Hamilton Depression Rating Scale) on pain (Rapid Assessment of Disease Activity in Rheumatology-RADAR & visual analog scale-VAS), and the indirect effects of SES as mediated by reserve capacity and negative emotions. The SEM model was evaluated using multiple fit criteria: χ<sup>2</sup> goodness-of-fit statistic, the comparative fit index (CFI), the standardized root mean square residual (SRMR), and the root mean square error of approximation (RMSEA).</p><p><strong>Results: </strong>Participants were mostly female (85%), 55.45 years old on average, self-identified as white (61%), Hispanic (16%), black (13%), and other (10%), and had RA for an average of 10.63 years. Results showed that low SES contributed to worse pain, through lower reserve capacity and higher negative emotions. Mediational analyses showed that reserve capacity and negative emotions partially mediated the effect of SES on pain. The final model explained 39% of the variance in pain.</p><p><strong>Conclusions: </strong>The findings indicate that lower SES was related to worse clinical pain outcomes and negative emotions and reserve capacity (helplessness, social support, and self-efficacy) mediated the effect of SES on pain. A primary limitation is the small sample size; future studies should evaluate this model further in larger, longitudinal approaches. Interventions that target negative emotions in patients with low SES may facilitate better pain control with RA.</p><p><strong>Trial registration: </strong>clinicaltrials.gov NCT00072657 01/02/2004 20/03/2009.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"46"},"PeriodicalIF":2.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A higher body mass index and increased syndesmophytes volume are associated with facet joints ankylosis on thoracic spine in patients with ankylosing spondylitis: a retrospective cohort study 强直性脊柱炎患者胸椎面关节强直与体重指数升高和联合韧带体积增大有关:一项回顾性队列研究
IF 2.2 Q3 RHEUMATOLOGY Pub Date : 2024-09-18 DOI: 10.1186/s41927-024-00408-4
Simin Liao, Jian Shang, Liuquan Cheng, Jian Zhu, Feng Huang
To investigate the association between syndesmophytes and facet joint (FJ) lesions in patients with ankylosing spondylitis (AS), and to identify clinical factors associated with FJ ankylosis (FJA) in thoracic segment. Ninety-seven patients with AS who underwent thoracic spine computed tomography (CT) or chest CT and without completely thoracic spine fusion were included. FJ lesions were analyzed for the numbers and distribution of normal, ankylosis, erosions, joint-space narrowing, osteophytes, and subchondral sclerosis. The volume of vertebral syndesmophtes unit (VSU) and total thoracic syndesmophtes volume were separately calculated by Mimics software. Clinical factors associated with FJA were investigated using generalized estimation equation (GEE). The association between syndesmophtes volume and numbers of FJ structural lesions was analyzed using generalized additive mixed model (GAMM). 2328 FJ and 1164 VSUs in thoracic spine were assessed. The majority FJ structural lesions were ankylosis (32.39%). FJA was more frequently seen in vertebrae with syndesmophytes formation (p < 0.001). GEE showed that patients with normal BMI (18.5–24.9 kg/m2) and high BMI (> 24.9 kg/m2) were more likely to have FJA in thoracic spine (odds rations [95% confidence interval]: 0.27(0.12–0.59), 1.45(1.03–8.57), respectively). GAMM showed that syndesmophytes volume increase the numbers of FJA (standard β = 0.009, p < 0.05) and decreased the numbers of normal FJ (standard β = -0.07, p < 0.01). FJA was the most common FJ structural lesion in thoracic spine, and it increases linearly with syndesmophytes before the bridging syndesmophytes formed. A higher BMI (especially > 24.9 kg/m2) and increased syndesmophytes volume are associated with FJA in thoracic spine.
目的:研究强直性脊柱炎(AS)患者的联合骨赘与面关节(FJ)病变之间的关联,并确定与胸椎面关节强直(FJA)相关的临床因素。研究纳入了97名接受过胸椎计算机断层扫描(CT)或胸部CT检查且未进行完全胸椎融合术的强直性脊柱炎患者。对FJ病变的数量和分布进行了分析,包括正常、强直、侵蚀、关节间隙狭窄、骨质增生和软骨下硬化。用 Mimics 软件分别计算了椎体联合单位(VSU)的体积和胸椎联合总体积。使用广义估计方程(GEE)研究了与 FJA 相关的临床因素。采用广义相加混合模型(GAMM)分析了胸廓联合容积与 FJ 结构性病变数量之间的关系。对胸椎的 2328 个 FJ 和 1164 个 VSU 进行了评估。大多数 FJ 结构性病变为强直(32.39%)。FJA更多见于有联合骨赘形成的椎体(P 24.9 kg/m2),胸椎更有可能出现FJA(几率[95%置信区间]:0.27(0.12-0.8 kg/m2)):分别为 0.27(0.12-0.59)、1.45(1.03-8.57))。GAMM显示,椎体联合体积会增加FJA的数量(标准β=0.009,P 24.9 kg/m2),椎体联合体积的增加与胸椎的FJA有关。
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引用次数: 0
Beliefs of Moroccan patients with chronic inflammatory rheumatic diseases regarding medication: related factors and correlation with therapeutic adherence 摩洛哥慢性炎症性风湿病患者的用药观念:相关因素及与坚持治疗的关系
IF 2.2 Q3 RHEUMATOLOGY Pub Date : 2024-09-18 DOI: 10.1186/s41927-024-00419-1
Fatima Zahrae Taik, Noema El Mansouri, Rajaa Bensaid, Anass Adnine, Amine Amar, Maryam Fourtassi, Fatima Ezzahra Abourazzak
Medication adherence is one of the key elements of the management of patients with chronic inflammatory rheumatic diseases (CIRDs), adherence/medication regimes are prone to being influenced by beliefs about medicines; such beliefs can influence the management and quality of life of patients. Several factors may be associated with these beliefs, including demographic and clinical factors, as well as socio-psychological factors. The aim of this study is to assess beliefs regarding medications among Moroccan patients with CIRDs, the factors associated with these beliefs, and the correlation of these factors with medication adherence. This cross-sectional study included patients with CIRDs. Sociodemographic data, comorbidities, and information about CIRDs (type, disease duration, pain evaluation, disease activity and treatments) were collected. Beliefs regarding medication were assessed by the Belief about Medicine Questionnaire (BMQ). Therapeutic adherence was assessed using the Arabic version of the Compliance Questionnaire in Rheumatology (CQR). Sociopsychological factors, such as catastrophism and trust in physicians, were assessed by the Pain Catastrophizing Scale (PCS) and the Trust in Physicians Scale (TPS), respectively. Our sample included 189 patients. The average age was 47.49 ± 13.7; 52.4% had comorbidities; and 49.2% had a low level of education. Of the patients, 49.7% were on glucocorticoids, 61.9% on conventional synthetic disease-modifying antirheumatic drugs and 6.3% on biologics. The median necessity-concern differential was 6 [1–12]. Of the patients, 67.4% strongly believed that medication was essential to maintain their health. The long-term side effects were the main concerns about medicines (51.3%). In a multivariate analysis, there was a statistically significant association between low level of education, catastrophizing, methotrexate use, and trust in the physician as independent factors and the BMQ necessity-concern differential as the dependent factor. There was also a significant correlation between CQR and the BMQ necessity score. Moroccan patients with CIRDs have a rather positive perception of their medication. This perception seems to influence their adherence to treatment. Low levels of education, catastrophizing, methotrexate use, and trust in physicians are the most important factors associated with patients’ beliefs regarding medication.
坚持用药是慢性炎症性风湿病(CIRDs)患者管理的关键要素之一,坚持用药/用药方案很容易受到药物信仰的影响;这种信仰会影响患者的管理和生活质量。这些信念可能与多种因素有关,包括人口统计和临床因素以及社会心理因素。本研究旨在评估摩洛哥 CIRD 患者的用药信念、与这些信念相关的因素以及这些因素与坚持用药的相关性。这项横断面研究包括 CIRD 患者。研究人员收集了社会人口学数据、合并症和有关 CIRD 的信息(类型、病程、疼痛评估、疾病活动和治疗方法)。对药物治疗的信念通过 "医学信念问卷"(BMQ)进行评估。治疗依从性采用阿拉伯语版风湿病学依从性问卷(CQR)进行评估。疼痛灾难化量表(PCS)和医生信任量表(TPS)分别评估了灾难化和医生信任等社会心理因素。我们的样本包括 189 名患者。平均年龄为(47.49±13.7)岁;52.4%的患者患有合并症;49.2%的患者受教育程度较低。患者中,49.7%服用糖皮质激素,61.9%服用常规合成的改善病情抗风湿药物,6.3%服用生物制剂。必要性-关注度差异的中位数为 6 [1-12]。67.4%的患者坚信药物治疗对维持他们的健康至关重要。长期副作用是患者对药物的主要担忧(51.3%)。在多变量分析中,教育程度低、灾难化、使用甲氨蝶呤和对医生的信任作为独立因素与 BMQ 必要性-担忧差异作为因果因素之间存在统计学意义上的显著关联。CQR 与 BMQ 必要性评分之间也存在明显的相关性。摩洛哥的 CIRD 患者对自己的用药有相当积极的看法。这种看法似乎影响了他们对治疗的依从性。教育水平低、灾难化、甲氨蝶呤的使用以及对医生的信任是与患者用药观念相关的最重要因素。
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BMC Rheumatology
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