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Mashup Score: 17The development and initial validation of IgG4-related disease damage index: a consensus report from Chinese IgG4-RD Consortium - 2 month(s) ago
Objective To develop and conduct an initial validation of the Damage Index for IgG4-related disease (IgG4-RD DI). Methods A draft of index items for assessing organ damages in patients with IgG4-RD was generated by experts from the Chinese IgG4-RD Consortium (CIC). The preliminary DI was refined using the Delphi method, and a final version was generated by consensus. 40 IgG4-RD cases representing four types of clinical scenarios were then selected, each with two time points of assessment for at least 3 years of follow-up. 48 rheumatologists from 35 hospitals nationwide were invited to evaluate organ damage using the CIC IgG4-RD DI. The intraclass correlation coefficient (ICC) and the Kendall-W coefficient of concordance (KW) were used to assess the inter-rater reliability. The criterion validity of IgG4-RD DI was tested by calculating the sensitivity and specificity of raters. Results IgG4-RD DI is a cumulative index consisting of 14 domains of organ systems, including a total of 39 it
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Mashup Score: 21
Objectives Biosimilar-originator equivalence has been demonstrated in phase 3 trials in a few indications of infliximab, etanercept and adalimumab. The objective of our study was to compare the persistence and safety of biosimilars versus originators in all the licensed indications of these molecules. Methods We used data from the French National Health Data System (SNDS), covering 99% of the French population, to identify infliximab, etanercept and adalimumab initiators from biosimilar launch (January 2015, May 2016 and October 2018, respectively) to 30 June 2021. Patients were then followed for 1 year. Treatment persistence (duration without treatment discontinuation or modification) and safety (including severe infections, all-cause hospitalisation and death) were compared between originator and biosimilar users by Cox regressions weighting the populations on the inverse probability of treatment. Analyses were performed by molecule, by disease and by biosimilar product. Results From
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Mashup Score: 9Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis - 2 month(s) ago
Objective To evaluate the prevalence of symptoms and factors associated with irritable bowel syndrome (IBS) in axial spondyloarthritis (ax-SpA). Methods In a cross-sectional multicentric study, consecutive patients with ax-SpA treated with biologics in five rheumatology departments were asked for IBS Rome IV criteria. Demographic data, lifestyle behaviours and disease characteristics were recorded. Second, a systematic literature review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Of the 500 patients with ax-SpA included, 124 reported IBS symptoms (25%). Female gender, unemployment, higher Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and worse Bath Ankylosing Spondylitis Functional Index scores, multiple lines of biologics, fibromyalgia, anxiety, depression and lower physical activity were associated with IBS symptoms. In multivariate model, the risk of IBS was associated with anxiety an
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Cross-sectional multicenter study of 500 ax-SpA pts on biologics found 25% w/ Irritable Bowel Syndrome (IBS) that was linked to being Female gender, unemployed, higher BASDAI & BASFI, multiple biologics, FM , anxiety, depression & lower physical activity. https://t.co/RSKVcXZwLt https://t.co/RGsw3fHr3H
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Mashup Score: 2Association between sinusitis and incident rheumatic diseases: a population-based study - 2 month(s) ago
Objectives To determine whether antecedent sinusitis is associated with incident rheumatic disease. Methods This population-based case–control study included all individuals meeting classification criteria for rheumatic diseases between 1995 and 2014. We matched three controls to each case on age, sex and length of prior electronic health record history. The primary exposure was presence of sinusitis, ascertained by diagnosis codes (positive predictive value 96%). We fit logistic regression models to estimate ORs for incident rheumatic diseases and disease groups, adjusted for confounders. Results We identified 1729 incident rheumatic disease cases and 5187 matched controls (mean age 63, 67% women, median 14 years electronic health record history). After adjustment, preceding sinusitis was associated with increased risk of several rheumatic diseases, including antiphospholipid syndrome (OR 7.0, 95% CI 1.8 to 27), Sjögren’s disease (OR 2.4, 95% CI 1.1 to 5.3), vasculitis (OR 1.4, 95% CI
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Mashup Score: 0Eosinopenia and routine inflammatory biomarkers are helpful for the diagnosis of infection in patients treated with IL-6 pathway antagonists - 2 month(s) ago
Patients with inflammatory diseases such as rheumatoid arthritis treated with IL-6 pathway antagonists are particularly prone to potentially serious infections. However, diagnosis of such events can be hindered by the normality of usual inflammatory biomarkers such as C reactive protein (CRP). In this retrospective monocentric study, we included all patients treated with tocilizumab for an inflammatory disease (mostly rheumatoid arthritis) and hospitalised in an unscheduled manner between 2009 and 2020 for any symptoms that raised suspicion of infection to explore the discrimating capacity of easily-accessible biomarkers to diagnose infections in patients treated with anti-IL6 receptor. We showed here for the first time that eosinopenia (eosinophil count (EC) <0.05 G/L) and a low ratio EC/neutrophil count (NC) (EC/NC×1000<11.8) could be relevant biomarkers for the diagnosis of infection in tocilizumab-treated patients. Moreover, despite what was expected, CRP level above 5 mg/L can be
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Mashup Score: 28Entry point of machine learning in axial spondyloarthritis - 3 month(s) ago
Axial spondyloarthritis (axSpA) is a globally prevalent and challenging autoimmune disease. Characterised by insidious onset and slow progression, the absence of specific clinical manifestations and biomarkers often leads to misdiagnosis, thereby complicating early detection and diagnosis of axSpA. Furthermore, the high heterogeneity of axSpA, its complex pathogenesis and the lack of specific drugs means that traditional classification standards and treatment guidelines struggle to meet the demands of personalised treatment. Recently, machine learning (ML) has seen rapid advancements in the medical field. By integrating large-scale data with diverse algorithms and using multidimensional data, such as patient medical records, laboratory examinations, radiological data, drug usage and molecular biology information, ML can be modelled based on real-world clinical issues. This enables the diagnosis, stratification, therapeutic efficacy prediction and prognostic evaluation of axSpA, positio
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Mashup Score: 35
Objective Interim analysis of the RELIANCE registry, an on-going, non-interventional, open-label, multicentre, prospective study evaluating the long-term safety, dosing regimens and effectiveness of canakinumab in patients with cryopyrin-associated periodic syndromes (CAPS), familial Mediterranean fever (FMF), tumour-necrosis factor receptor-associated periodic syndrome (TRAPS) or mevalonate-kinase deficiency (MKD)/hyperimmunoglobulin-D syndrome (HIDS). Methods From September 2017 for patients with CAPS, and June 2018 for patients with FMF, TRAPS or MKD/HIDS, the registry enrolled paediatric (aged ≥2 years) and adult patients (aged ≥18 years) receiving canakinumab as part of their routine medical care. Safety, canakinumab dose, disease activity and quality of life outcome measures were evaluated at baseline and every 6 months until end of study visit. Results At the analysis cut-off date (December 2020), 168 patients (91 CAPS, 54 FMF, 16 TRAPS and 7 MKD/HIDS) were enrolled. 85 (50.9%)
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Mashup Score: 37Intensive training programme for ultrasound-guided minimally invasive synovial tissue biopsy on knees and wrists in different phases of inflammation - 3 month(s) ago
Objectives To develop an intensive training programme for ultrasound (US)-guided synovial tissue (ST) biopsy on knees and wrists in inflammatory arthritis and to assess the learning curve, patient tolerability, sample quality and trainees’ expectations. Methods Active or remission rheumatoid arthritis patients were enrolled. Nine trainees joined the 4-month programme in a centre experienced in performing US-guided ST biopsies consisting of four sequential phases: (1) observation, (2) performance of guided step-by-step phases, (3) execution of the whole procedure on paired joints (knees or wrists) of the same patient in parallel with the trainer and (4) performance of the procedure autonomously. Sample representativity was assessed by histology, and procedure-related adverse events were recorded. Before and after the programme, trainees’ expectations and perceptions were collected. Results 328 ST biopsy procedures were included. The rate of trainees’ informative samples was: (1) compara
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Mashup Score: 39Metabolic and molecular imaging in inflammatory arthritis - 3 month(s) ago
It is known that metabolic shifts and tissue remodelling precede the development of visible inflammation and structural organ damage in inflammatory rheumatic diseases such as the inflammatory arthritides. As such, visualising and measuring metabolic tissue activity could be useful to identify biomarkers of disease activity already in a very early phase. Recent advances in imaging have led to the development of so-called ‘metabolic imaging’ tools that can detect these changes in metabolism in an increasingly accurate manner and non-invasively. Nuclear imaging techniques such as 18F-D-glucose and fibroblast activation protein inhibitor-labelled positron emission tomography are increasingly used and have yielded impressing results in the visualisation (including whole-body staging) of inflammatory changes in both early and established arthritis. Furthermore, optical imaging-based bedside techniques such as multispectral optoacoustic tomography and fluorescence optical imaging are advanci
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Mashup Score: 66Safety and efficacy of colchicine in crystal-induced arthritis flare in 54 patients with severe chronic kidney disease - 3 month(s) ago
Introduction Colchicine, commonly used in gout flare, is contraindicated in severe chronic kidney disease (CKD) (estimated glomerular filtration rate <30 mL/min). However, in this context, there are few alternatives, and colchicine use persists. We evaluated the tolerance of colchicine and its efficacy in patients with severe CKD. Patients and methods All prescriptions of colchicine for managing crystal-induced arthritis flare (gout or calcium pyrophosphate deposition (CPPD) disease) in a hospitalised patient with severe CKD were screened from September 2020 to September 2021. After patient consent and treatment information, clinical and biological safety and efficacy data were prospectively collected from day 1 (D1) to D11. Results We included 54 patients (median age 75 years (IQR 67–83)) with 62 colchicine prescriptions (cases). Twelve (22%) patients were on dialysis. The main reason for hospitalisation was heart failure (31.5%), acute renal failure (22.2%), infection (18.5%) or an a
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Check out our recent publication on an IgG4-related disease damage index: ▶️ cumulative index consisting of 14 domains ▶️ high criterion valicity and inter-rater reliabilitys ▶️ useful for therapeutic trials and prognosis assessment 🔗 https://t.co/yyUOPgVnpz https://t.co/wTHXaDl8rg