-
Mashup Score: 12Biological use influences the impact of inflammation on risk of major adverse cardiovascular events in rheumatoid arthritis - 3 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
-
Mashup Score: 17Is there a role for novel supplements in the management of fatigue in rheumatic diseases? - 4 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
-
-
Mashup Score: 1Is there a role for novel supplements in the management of fatigue in rheumatic diseases? - 4 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
-
-
Mashup Score: 5
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
-
-
Mashup Score: 11Twenty-year trajectories of morbidity in individuals with and without osteoarthritis - 5 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
-
-
Mashup Score: 30MRI of shoulder girdle in polymyalgia rheumatica: inflammatory findings and their diagnostic value - 5 month(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
-
-
Mashup Score: 15Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid - 6 month(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
-
-
Mashup Score: 7
Objective To assess the risk of serious infection associated with different targeted therapies for psoriatic arthritis (PsA) in real-world settings. Methods This nationwide cohort study used the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database to identify all adults with PsA who were new users of targeted therapies (adalimumab, etanercept, golimumab, certolizumab pegol, infliximab, secukinumab, ixekizumab, ustekinumab, and tofacitinib) from 1 January 2015 to 30 June 2021. The primary outcome was a serious infection (ie, requiring hospitalisation), in a time-to-event analysis using propensity score-weighted Cox models, with adalimumab as the comparator, estimating weighted HRs (wHRs) and their 95% CIs. Results A total of 12 071 patients were included (mean age 48.7±12.7 years; 6965 (57.7%) women). We identified 367 serious infections (3.0% of patients), with a crude incidence rate of 17.0 per 1000 person-years (95% CI, 15
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
French insurance claims study of 12071 #PsA pts on biologics (2015-2021) found total of 367 serious infections (3%; IR 1.7/100PY). SIR risk significantly lower for new users of etanercept (wHR 0.72) & ustekinumab (wHR 0.57) (vs ADA new users https://t.co/CutqoxA05e https://t.co/OUCUbrKnFF
-
-
Mashup Score: 24High prevalence of radiographic erosions in early, untreated PsA: results from the SpARRO cohort - 8 month(s) ago
Aims To investigate the prevalence and distribution of bone erosions in an early psoriatic arthritis (PsA) population using conventional radiography (CR) and to explore the agreement between CR and ultrasound (US) detected bone erosions. Methods Newly diagnosed, treatment naïve PsA patients fulfilling the ClASsification for Psoriatic Arthritis (CASPAR) classification criteria of ≤5 years symptom duration were recruited as part of the Leeds Spondyloarthropathy Register for Research and Observation and underwent CR and US examination of hands and feet. Results Overall, 4655 hand and feet joints were assessed in 122 patients. CR erosions were detected in 24.6% (n=30) with lowest prevalence seen below 8 months of symptoms (17.5% vs 24.3%>24 months). The number of erosions was higher on CR (1.55% (63/4,655); US 1.04% (34/3,270)), with 5th metatarsophalangeal (MTP) joint being the most affected site in both CR (5.21% (11/211)) and US (7.14% (15/210)). Erosions in CR were more evenly distribu
Source: rmdopen.bmj.comCategories: General Medicine News, RheumatologyTweet-
📢Our new paper just published! ▶️Erosions seen in 25% of patients with newly diagnosed untreated #PsoriaticArthritis ➡️A focused #ultrasound of the wrist, 2nd MCP & 5th MTP joints may be useful to detect bone #erosions in early #Psoriatic #Arthritis 👉🏽https://t.co/YfN0NBLvIu https://t.co/sgNHub4F9Y
-
-
Mashup Score: 1Medication utilisation trends during pregnancy and factors influencing adverse pregnancy outcomes in patients with rheumatoid arthritis - 8 month(s) ago
Objectives We aimed to investigate medication utilisation trends during pregnancy and identify factors associated with adverse pregnancy outcomes (APOs) in patients with rheumatoid arthritis (RA). Methods Female patients with RA aged 20–50 years were identified from the Korean national health insurance database between 2010 and 2020. Pregnancy episodes were divided into two groups according to pregnancy outcome: the delivery group and the APO group (abortion and stillbirth). The characteristics and medication utilisation patterns were compared between the two groups, and multivariable logistic regression analysis was conducted to identify the factors associated with APOs. Results A total of 5728 pregnancy episodes were included, comprising 4576 delivery episodes and 1152 APO episodes. The mean maternal age for all pregnancy episodes was 33.7 years; 33.3 years in the delivery group and 33.7 years in the APO group. Hydroxychloroquine was the most commonly used conventional synthetic dise
Source: rmdopen.bmj.comCategories: General Medicine News, General HCPsTweet-
Korean claims study of #RA & pregnancy (& adverse preg outcomes (APO), shows MTX or LEF use w/in 3 mos of conception assoc w/ incr. in APOs (aOR 2.14-.68). In 5728 preg: 1152 APOs, HCQ most commonly used, DMARD use decreased during preg. https://t.co/7UBsNdpRgx https://t.co/cY1N73FG8Q
-
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