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Mashup Score: 29Prognostic insights from symptom clustering analysis in systemic lupus erythematosus - 2 month(s) ago
Objective Systemic lupus erythematosus (SLE), a systemic autoimmune disease with heterogeneous severity, poses a challenge in classifying patients due to its dynamic phenotype. We therefore aimed to identify clinical clusters at diagnosis and at the last available visit to define subgroups with different disease trajectories.Methods This retrospective study included 278 SLE patients fulfilling the 2019 EULAR/American College of Rheumatology classification criteria. Data were extracted from the patient’s medical record, encompassing demographic, clinical and immunological features. Two hierarchical clustering analyses were performed: one at diagnosis and the other at the last available visit based on 23 clinical manifestations. We assessed the distribution of autoantibodies among clusters, and survival analyses compared prognosis using the Cox regression model.Results Three symptom clusters were identified at diagnosis and confirmed at the last available visit, with consistent clinical
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet
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Mashup Score: 1
Objective To analyse work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs), namely rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and ANCA-associated vasculitis (AAV). Methods A cross-sectional sample of 16 421 patients from the National Database of the German Collaborative Arthritis Centers, aged <65 years were analysed. For each diagnosis, yearly rates of absenteeism, employment and disability pensions were analysed from 2010 to 2022. Population data were used to calculate standardised employment ratios (SERs), adjusted for age, sex, federal state and vocational qualification. The analysis was additionally stratified by sex, adjusting for other factors. Results Over the observed time span, large employment increases were found across all diagnoses, namely in RA (54%–68%), PsA (58%–72%), SSc (47%–66%), AAV (43%–61%), SLE (48%–60%) and axSpA (65%
Source: rmdopen.bmj.comCategories: General Medicine News, General HCPsTweet-
German database shows since 2010, work participation has improved for rheum pts, reflected in higher employment, reduced absenteeism and less disability retirement. However, patients have not reached population employment rates. https://t.co/B8VKBgGNGe https://t.co/OOMNym3XrR
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Mashup Score: 10Biomechanical determinants of rheumatoid arthritis severity and excess cardiovascular disease: common origins of two complex diseases - 7 month(s) ago
Objectives The determinants of rheumatoid arthritis (RA) severity and excess cardiovascular disease (CVD) are incompletely understood. Biomechanical factors are known to influence RA severity. Articular stiffness correlates with arterial and skin stiffness. This study explored the hypothesis that constitutional stiffness is a common determinant of RA severity and excess CVD. Methods Fifty-eight patients with anti-CCP antibody (ACPA) positive RA and 57 controls were enrolled noting age, sex, body mass index, alcohol and tobacco exposure, Shared Epitope status and in RA disease duration, disease activity, ACPA titre and radiographic damage. Severe RA was defined as radiographic progression >1.3 mSharp points/year or requiring biological disease-modifying antirheumatic drugs (bDMARDs). Articular stiffness (Beighton Score and right 5th metacarpophalangeal (MCP) joint stress–strain responses), carotid-femoral pulse wave velocity and skin extensibility (percent increase distance two dots wit
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
#RheumatoidArthritis with higher radiographic progression or requiring bDMARDs had greater stiffness in ▶️Joint ▶️Artery ▶️Skin ➡️Greater microstructural damage leading to more severe inflammatory #arthritis & #cardiovascular disease 👉🏽https://t.co/ozokVusS9P via @bmj_rmdopen https://t.co/nbKuGWRDYo
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Mashup Score: 12Biological use influences the impact of inflammation on risk of major adverse cardiovascular events in rheumatoid arthritis - 10 month(s) ago
Objectives Chronic inflammation promotes cardiovascular risk in rheumatoid arthritis (RA). Biological disease-modifying antirheumatic drugs (bDMARDs) improve disease activity and cardiovascular disease outcomes. We explored whether bDMARDs influence the impact of disease activity and inflammatory markers on long-term cardiovascular risk in RA. Methods We studied 4370 participants without cardiovascular disease in a 10-country observational cohort of patients with RA. Endpoints were (1) major adverse cardiovascular events (MACE) encompassing myocardial infarction, stroke and cardiovascular death; and (2) any ischaemic cardiovascular events (iCVE) including MACE plus revascularisation, angina, transient ischaemic attack and peripheral arterial disease. Results Over 26 534 patient-years, 239 MACE and 362 iCVE occurred. The interaction between 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and bDMARD use was significant for MACE (p=0.017), suggesting the effect of DAS2
Source: rmdopen.bmj.comCategories: General Medicine News, General HCPsTweet-
Study of 4370 RA pts (26534 PYs) saw 362 MACE (CV) events. RA activity & inflammatory markers assoc w/ MACE risk in bDMARD non-users (not those on bDMARDs). 515 bDMARD vs 3855 non-users (n=3855). Each DAS28-CRP unit incr MACE risk (HR 1.21)https://t.co/lRaHxTHzqe https://t.co/usEiJctVYk
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Mashup Score: 17Is there a role for novel supplements in the management of fatigue in rheumatic diseases? - 11 month(s) ago
Fatigue is a common symptom of rheumatic diseases and frequently persists even when patients are in a near-remission state. In seeking options to manage troublesome symptoms such as fatigue, complementary and alternative medicines (CAM) are often used by patients despite a lack of evidence base behind such treatment strategies. CAM use is further promoted by social media and ‘influencer’ marketing without rigorous process to ensure scientific accuracy. One mechanism of recent interest in the CAM market is enhancing cellular pathways of nicotinamide adenine dinucleotide (NAD+), purported to restore mitochondrial function. However, clinical trials of NAD+ pathway supplements lack rigorous trial design, many declare conflicts of interest, and safety data is limited. Ultimately, CAM use by our patients is unavoidable. To adequately inform patients about CAM, we need to keep updated on both the latest scientific literature and social media trends. In so doing, we can then propose to patient
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
Read our latest viewpoint: Is there a role for novel supplements in the management of fatigue in rheumatic diseases? @bmj_rmdopen @MeghnaJani @UoMMskResearch @ManchesterBRC @NCAresearchNHS https://t.co/LMc7A2EHsd
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Mashup Score: 1Is there a role for novel supplements in the management of fatigue in rheumatic diseases? - 11 month(s) ago
Fatigue is a common symptom of rheumatic diseases and frequently persists even when patients are in a near-remission state. In seeking options to manage troublesome symptoms such as fatigue, complementary and alternative medicines (CAM) are often used by patients despite a lack of evidence base behind such treatment strategies. CAM use is further promoted by social media and ‘influencer’ marketing without rigorous process to ensure scientific accuracy. One mechanism of recent interest in the CAM market is enhancing cellular pathways of nicotinamide adenine dinucleotide (NAD+), purported to restore mitochondrial function. However, clinical trials of NAD+ pathway supplements lack rigorous trial design, many declare conflicts of interest, and safety data is limited. Ultimately, CAM use by our patients is unavoidable. To adequately inform patients about CAM, we need to keep updated on both the latest scientific literature and social media trends. In so doing, we can then propose to patient
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
RT @bmj_rmdopen: Is there a role for novel supplements in the management of fatigue in rheumatic diseases? https://t.co/SRRTeV3JaG
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Mashup Score: 5What role do socioeconomic and clinical factors play in disease activity states in rheumatoid arthritis? Data from a large UK early inflammatory arthritis audit - 11 month(s) ago
Background Persistently active rheumatoid arthritis (pactiveRA) may be due to the interplay between biological and non-biological factors. The role of socioeconomic factors remains unclear. Objectives To explore which biological and non-biological factors associate with pactiveRA. Methods Adults with early RA in the National Early Inflammatory Arthritis Audit, recruited from May 2018 to October 2022, were included if having pactiveRA or persistently low RA (plowRA). The pactiveRA was defined as three consecutive Disease Activity Score-28 joints (DAS28) of >3.2 at baseline, 3 and 12 months. The plowRA was defined as DAS28 ≤3.2 at 3 and 12 months. Stepwise forward logistic regression was used to explore associations with pactiveRA (outcome). Age and gender were included a priori, with socioeconomic factors and comorbidities as exposure variables. Results 682 patients with pactiveRA and 1026 plowRA were included. Compared with plowRA, patients with pactiveRA were younger (58, IQR: 49–67)
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
UK Natl Early Inflammatory Arthritis Audit (5/18-10/22) compared 682 persistently active vs 1026 low activity RA pts. pactiveRA were younger, more women. pactiveRA assoc. w/ Age, gender, smoking, depression, lung dz, gastric ulcers, baseline steroids https://t.co/QGuUZmSBHD https://t.co/TDlPFmTQEn
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Mashup Score: 11Twenty-year trajectories of morbidity in individuals with and without osteoarthritis - 11 month(s) ago
Objectives To identify multimorbidity trajectories over 20 years among incident osteoarthritis (OA) individuals and OA-free matched references. Methods Cohort study using prospectively collected healthcare data from the Skåne region, Sweden (~1.4 million residents). We extracted diagnoses for OA and 67 common chronic conditions. We included individuals aged 40+ years on 31 December 2007, with incident OA between 2008 and 2009. We selected references without OA, matched on birth year, sex, and year of death or moving outside the region. We employed group-based trajectory modelling to capture morbidity count trajectories from 1998 to 2019. Individuals without any comorbidity were included as a reference group but were not included in the model. Results We identified 9846 OA cases (mean age: 65.9 (SD 11.7), female: 58%) and 9846 matched references. Among both cases and references, 1296 individuals did not develop chronic conditions (no-chronic-condition class). We identified four classes.
Source: rmdopen.bmj.comCategories: General Medicine News, General HCPsTweet-
Osteoarthritis—a condition in which the protective cartilage on the ends of bones breaks down—may more than double the risk of speedy progression to accumulating severe long term conditions (multimorbidity), finds a study in RMD Open @ARD_BMJ. Link: https://t.co/ORTktAomtb https://t.co/PglaqVuyPt
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Mashup Score: 30MRI of shoulder girdle in polymyalgia rheumatica: inflammatory findings and their diagnostic value - 1 year(s) ago
Background Non-synovial inflammation as detected by MRI is characteristic in polymyalgia rheumatica (PMR) with potentially high diagnostic value. Objective The objective is to describe inflammatory MRI findings in the shoulder girdle of patients with PMR and discriminate from other causes of shoulder girdle pain. Methods Retrospective study of 496 contrast-enhanced MRI scans of the shoulder girdle from 122 PMR patients and 374 non-PMR cases. Two radiologists blinded to clinical and demographic information evaluated inflammation at six non-synovial plus three synovial sites for the presence or absence of inflammation. The prevalence of synovial and non-synovial inflammation, both alone and together with clinical information, was tested for its ability to differentiate PMR from non-PMR. Results A high prevalence of non-synovial inflammation was identified as striking imaging finding in PMR, in average 3.4±1.7, mean (M)±SD, out of the six predefined sites were inflamed compared with 1.1±1
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
PMR has distinct patterns on MRI shoulder, possibly helping Dx. #EULAR2024 OP0248 @drdavidliew also @bmj_rmdopen https://t.co/0J3xUmb9yt where they say: "Similar to our prior findings... the target of inflammation in PMR is the outer covering of a tendon, the peritendineum" https://t.co/AzWkg3z2vR
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Mashup Score: 15Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid - 1 year(s) ago
Objectives Fibromyalgia is frequently treated with opioids due to limited therapeutic options. Long-term opioid use is associated with several adverse outcomes. Identifying factors associated with long-term opioid use is the first step in developing targeted interventions. The aim of this study was to evaluate risk factors in fibromyalgia patients newly initiated on opioids using machine learning. Methods A retrospective cohort study was conducted using a nationally representative primary care dataset from the UK, from the Clinical Research Practice Datalink. Fibromyalgia patients without prior cancer who were new opioid users were included. Logistic regression, a random forest model and Boruta feature selection were used to identify risk factors related to long-term opioid use. Adjusted ORs (aORs) and feature importance scores were calculated to gauge the strength of these associations. Results In this study, 28 552 fibromyalgia patients initiating opioids were identified of which 736
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
Pleased to share our new paper ✨ We used #machinelearning to identify risk factors of long-term opioid use in patients with fibromyalgia using national primary care data. Could help tailor better access to pain management support & closer monitoring 🔍 https://t.co/7aExNbvMTB
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3 symptom clusters of systemic #lupus identified 1⃣Lower visceral involvement, early joint & mucocutaneous manifestations 2⃣More severe phenotype (renal, anti-DNA, anti-Sm), poor outcomes 3⃣Mixed connective tissue disease phenotype 👉🏽https://t.co/hUVlmSTsqd via @bmj_rmdopen https://t.co/3h4gWoRrhd