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Mashup Score: 1
Objective To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset. Methods Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire–Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment. Results For the first TNFi, median pain score was reduced by approximately 50%, from 6 to 3, 3, and 2; as were fatigue scores, from 6 to 4, 4, and 3; PtGA scores, from 6 to 3, 3, and 2; and HAQ-DI scores, from 0.9 to 0.5, 0.5, and 0.4 at baseline, 6, 12, and 24 months, respectively. Six-month Lund
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Mashup Score: 5Stakeholder Perspectives on the Use of Exercise for Knee Osteoarthritis: Panoramas From a Patient, a Payer, and Healthcare Providers - 8 day(s) ago
Public health organizations advocate that people with osteoarthritis (OA) should engage in physical activity because it can improve their mental and physical well-being without worsening their OA progression.1 Further, most clinical practice guidelines strongly endorse individualized or tailored exercise programs for people with OA.2,3 Unfortunately, what looks good on paper can be challenging to implement. Moreover, some have cast doubt on the effectiveness of exercise for knee OA, but they often focus on the … Address correspondence to Dr. J.B. Driban, PhD, ATC, CSCS, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA. Email: jeffrey.driban{at}umassmed.edu.
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Mashup Score: 1The Association of Stair Climbing Behaviors With Hazard of All-Cause Mortality in Adults With or At Risk of Knee Osteoarthritis - 11 day(s) ago
Objective To investigate the association of stair climbing difficulty and stair climbing frequency with the risk of all-cause mortality over 13 years in adults with or at high risk for knee OA. Methods We used data from the Osteoarthritis Initiative (OAI), a prospective cohort study of community-dwelling adults with or at high risk for symptomatic knee OA. The exposures were stair climbing difficulty and frequency, assessed at baseline using self-report questionnaires. The outcome was all-cause mortality, assessed from baseline through 13 years of follow-up. Kaplan-Meier survival curves and Cox proportional hazards regression were used to investigate the association between stair climbing exposures and all-cause mortality. Results Three hundred seven (6.81%) and 310 (6.84%) participants in the difficulty and frequency samples, respectively, died during 13 years of follow-up. Those who were limited in any capacity in terms of their stair climbing ability had 54% to 84% greater hazard of
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Mashup Score: 2
Objective Using Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) juvenile idiopathic arthritis (JIA) registry data, we describe (1) clinical characteristics of patients with JIA transitioning to adult care, (2) prevalence of disease-related damage and complications, and (3) changes in disease activity during the final year prior to transfer. Methods Registry participants who turned 17 years between February 2017 and November 2021 were included. Clinical characteristics and patient-reported outcomes (PROs) at the last recorded pediatric rheumatology visit, and changes observed in the year prior to that visit were analyzed. Physicians completed an additional questionnaire characterizing cumulative disease-related damage and adverse events by age 17 years. Results At their last visit, 88 of 131 participants (67%) had inactive and 42 (32%) had active disease. Overall, 96 (73%) were on medications and 41 (31%) were on biologic disease-modifying antirheumatic drugs. Among 80
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Mashup Score: 4An Atypical Heel Pain - 15 day(s) ago
Kaposi sarcoma (KS) is an angioproliferative neoplasm induced by human herpesvirus 8 (HHV8) targeting the cutaneous and lymphatic systems, with possible involvement of other organs such as lower limb bones.1 A 72-year-old male patient of Senegalese origin with a 10-year history of rheumatoid arthritis (RA) taking methotrexate (MTX) consulted regarding a 1-year history of chronic mechanical pain of the left heel. Examination revealed calcaneus pain with a swollen ankle, without fever, weight loss, or skin lesion. The patient underwent a first magnetic resonance imaging (MRI; Figure 1A). The initial diagnosis was a stress …
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Mashup Score: 2Cancer Risk and Mortality in Hospitalized Patients With Idiopathic Inflammatory Myopathies in Western Australia - 16 day(s) ago
Objective To compare cancer incidence, type, and survival between patients with idiopathic inflammatory myopathies (IIMs) in Western Australia (WA) and the general population. Methods Administrative health data for hospitalized patients with incident IIM (n = 803, 56.5% female, median age 62.0 yrs), classified by a validated algorithm as polymyositis (PM; 36.2%), dermatomyositis (DM; 27.4%), inclusion body myositis (IBM; 17.1%), overlap myositis (OM; 10.7%), and other IIM (8.6%), were linked to WA cancer and death registries for the period of 1980 to 2014. Cancer incidence rates (CIRs) before and after IIM diagnosis as well as cancer mortality were compared with age-, sex-, and calendar year–matched controls (n = 3225, 54.9% female, median age 64 yrs) by rate ratios (RRs) and Kaplan-Meier survival estimates. Results The prediagnosis CIR was similar for patients with IIM and controls (6.57 vs 5.95; RR 1.11, 95% CI 0.88-1.39) and for patients evolving to DM (n = 220) or other IIM subtype
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Mashup Score: 1Systemic Sclerosis in Individuals With Exposure to World Trade Center Ground Zero Rescue and Recovery Efforts: A Case Series - 17 day(s) ago
Objective The World Trade Center (WTC) attack in New York resulted in a dust plume containing silica, hydrocarbons, and asbestos. Autoimmune disorders have been reported among those with WTC site exposure. The characteristics of individuals developing systemic sclerosis (SSc) have not been previously described. The purpose of this study was to describe the features of patients with SSc with WTC exposure. Methods Data were collected from 11 patients with SSc or SSc spectrum conditions who reported exposure to the WTC site. Seven patients completed an exposure assessment. Results Of the 11 patients, the majority (n = 8) were female. The median (range) for age at diagnosis was 46 (36-75) years, time between exposure and first non-Raynaud phenomenon SSc symptom was 8 (1-19) years, and time between exposure and diagnosis was 11 (2-18) years. Fifty-five percent had SSc onset > 5 years from WTC exposure. Five patients had limited cutaneous SSc, 3 patients had diffuse cutaneous SSc, 1 patient
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Mashup Score: 1
Objective To study changes in retention of first biologic disease-modifying antirheumatic drug (DMARD) therapy over a period of 15 years in an inception cohort of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Methods We assessed patient and disease characteristics and drug survival of patients starting a biologic (tumor necrosis factor inhibitor [TNFi]) therapy between 2004 and 2019 in routine care at the Amsterdam Rheumatology and Immunology Center, Reade, the Netherlands. Starts were classified as early (2004-2008), intermediate (2009-2013), and recent (2014-2018). Kaplan-Meier plots and log-rank tests assessed the overall difference in drug survival between the 3 observation groups and between diagnoses, followed by Cox regression to estimate hazard ratios (HRs). Results We included 1938 consecutive patients starting TNFi therapy, 63% with RA, 19% with PsA, and 19% with AS; 65% were female. Drug survival decreased significantly
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Mashup Score: 1Right Care, Right Time, Right Level: With Evidence - 18 day(s) ago
As the Chief Medical Officer for Highmark Inc. and having been on the health insurance side of medicine since 2008 while actively practicing rural family medicine in Kentucky, I have seen the effect chronic diseases can have on healthcare delivery. From a patient perspective, pain and reduced ability to ambulate cause a reduced quality of life (QOL), which is never acceptable. From a provider perspective, the ability to effectuate a change on many chronic diseases is limited at best. From both a payer and society’s perspectives, the effect of chronic disease is profound. Its effects are felt economically from days of lost work, and treatment costs of medication and interventions. I will focus this discussion on osteoarthritis (OA) from a payer’s perspective. Patients with OA often require frequent medical attention with medication, diagnostic tests such as radiographs, physical therapy, pain management, and, less frequently, surgical intervention. The direct medical costs associated wi
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Mashup Score: 1Successfully Treating Patients With Osteoarthritis: How Physical Therapy Can Generate the Best Outcomes - 18 day(s) ago
An evidence-based treatment approach is well supported in the literature for patients with osteoarthritis (OA). Physical therapists (PT) have clinical practice guidelines that clearly direct the care we provide our patients. There is strong evidence to support supervised exercise by both the American Physical Therapy Association and the American Academy of Orthopaedic Surgeons. The 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee was updated and once again concluded that exercise interventions were strongly recommended, with better outcomes when the exercise is supervised. Less clear is what type and how much exercise is right for everyone. This is when the skills and contributions of an effective PT can help. A PT, for example, will look at the patient holistically, with an eye toward each patient’s unique history with health and well-being, social and cultural influences, functional objectives, and ba
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Editor's Picks Spotlight PROs & Remission Rates in Patients With PsA Treated With TNFi ➡️ Read the full article https://t.co/x5olVpMT9b Watch the video https://t.co/NmKRu4cktT