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Clara Malagón, Maria Del Pilar Gomez, Catalina Mosquera, Camilo Vargas, Tatiana Gonzalez, Cristine Arango, Lorena Martin, Pilar Perez, Laura Amaya-Uribe, Nicolas Molano-Gonzalez, Juan-Manuel Anaya
Overt polyautoimmunity (PolyA) corresponds to the presence of more than one well-defined autoimmune disease (AD) manifested clinically in a single patient. The current study aimed to describe the main characteristics of juvenile PolyA in a pediatric rheumatology setting and analyze the chronological aspects, index cases, familial autoimmunity, and clustering pattern. This was a cross-sectional and multicenter study in which 313 children with overt PolyA were included. Patients were systematically interviewed and their medical records reviewed using a questionnaire that sought information about demographic, clinical, immunological, and familial characteristics...
February 14, 2019: Autoimmunity Reviews
Eun Hye Park, Vibeke Strand, Yoon Jeong Oh, Yeong Wook Song, Eun Bong Lee
BACKGROUND: Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibrosis of the skin and the involvement of multiple internal organs. Previous studies reported poorer health-related quality of life (HRQoL) in patients with SSc compared with the general population. However, very little is known about how HRQoL in SSc patients compares with that in patients with other systemic autoimmune diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjogren's syndrome (SjS)...
February 15, 2019: Arthritis Research & Therapy
Kari Hansen Berg, Gudrun Rohde, Anne Prøven, Esben Esther Pirelli Benestad, Monika Østensen, Glenn Haugeberg
OBJECTIVE: To explore the relationship between demographic, disease related variables, treatment and sexual quality of life (SQOL) in men and women with Axial Spondyloarthritis (ax-SpA). METHODS: Ax-SpA patients were consecutively recruited from two rheumatology outpatient clinics in Sothern Norway. A broad specter of demographic, disease, treatment and quality of life data were systematically collected. SQOL was assessed using the SQOL-F questionnaire (score range 18-108)...
February 15, 2019: Journal of Rheumatology
Alí Duarte-García, Ying Ying Leung, Laura C Coates, Dorcas Beaton, Robin Christensen, Ethan T Craig, Maarten de Wit, Lihi Eder, Lara Fallon, Oliver FitzGerald, Dafna D Gladman, Niti Goel, Richard Holland, Chris Lindsay, Lara Maxwell, Philip Mease, Ana Maria Orbai, Bev Shea, Vibeke Strand, Douglas J Veale, William Tillett, Alexis Ogdie
OBJECTIVE: The psoriatic arthritis (PsA) core domain set for randomized controlled trials (RCTs) and longitudinal observational studies (LOS) has recently been updated. The joint counts are central to the measurement of the peripheral arthritis component of the musculoskeletal (MSK) disease activity domain. We report the Outcome Measures in Rheumatology (OMERACT) 2018 meeting approaches to seek endorsement of the 66/68-swollen and tender joint count (SJC66/TJC68) for inclusion in the PsA Core Outcome Measurement Set...
February 15, 2019: Journal of Rheumatology
Kathleen M Andersen, Ayano Kelly, Anne Lyddiatt, Clifton O Bingham, Vivian P Bykerk, Adena Batterman, Joan Westreich, Michelle K Jones, Marita Cross, Peter Brooks, Lyn March, Beverley Shea, Peter Tugwell, Lee S Simon, Robin Christensen, Susan J Bartlett
OBJECTIVE: The OMERACT Safety Working Group is identifying core safety domains that matter most to rheumatic disease patients. METHODS: International focus groups were held with 39 inflammatory arthritis patients to identify DMARD experiences and concerns. Themes were identified by pragmatic thematic coding and discussed in small groups by meeting attendees. RESULTS: Patients view DMARD side effects as a continuum and consider cumulative impact on day-to-day function...
February 15, 2019: Journal of Rheumatology
Maarten Boers, Dorcas E Beaton, Beverley J Shea, Lara J Maxwell, Susan J Bartlett, Clifton O Bingham, Philip G Conaghan, Maria Antonietta D'Agostino, Maarten P de Wit, Laure Gossec, Lyn March, Lee S Simon, Jasvinder A Singh, Vibeke Strand, George A Wells, Peter Tugwell
OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) Filter 2.0 framework was developed in 2014 to aid core outcome set development by describing the full universe of "measurable aspects of health conditions" from which core domains can be selected. This paper provides elaborations and updated concepts (OMERACT Filter 2.1). METHODS: At OMERACT 2018, we discussed challenges in the framework application caused by unclear or ambiguous wording and terms and incompletely developed concepts...
February 15, 2019: Journal of Rheumatology
Tim Pickles, Rieke Alten, Maarten Boers, Vivian Bykerk, Jared Christensen, Robin Christensen, Hubert van Hoogstraten, Lee S Simon, Lai-Shan Tam, Ernest H Choy
OBJECTIVE: Adaptive trial design was developed initially for oncology to improve trial efficiency. If optimized for rheumatology, it may improve trial efficiency by reducing sample size and time. METHODS: A systematic review assessed design of phase II clinical trials in rheumatoid arthritis. RESULTS: Fifty-six trials were reviewed. Most trials had 4 groups (1 control and 3 intervention), with an average group size of 34 patients. American College of Rheumatology 20 measured at 16 weeks was the most commonly used primary endpoint...
February 15, 2019: Journal of Rheumatology
Susan Humphrey-Murto, Richard Crew, Beverley Shea, Susan J Bartlett, Lyn March, Peter Tugwell, Lara J Maxwell, Dorcas Beaton, Shawna Grosskleg, Maarten de Wit
OBJECTIVE: Developing international consensus on outcome measures for clinical trials is challenging. The following paper will review consensus building in Outcome Measures in Rheumatology (OMERACT), with a focus on the Delphi. METHODS: Based on the literature and feedback from delegates at OMERACT 2018, a set of recommendations is provided in the form of the OMERACT Delphi Consensus Checklist. RESULTS: The OMERACT delegates generally supported the use of the checklist as a guide...
February 15, 2019: Journal of Rheumatology
Jessie J Tao, Linda T Hiraki, Deborah M Levy, Earl D Silverman
OBJECTIVE: Currently there are 2 different classification criteria for systemic lupus erythematosus (SLE): American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC). The aim of this study was to compare the sensitivities of ACR and SLICC criteria in childhood-onset SLE (cSLE) using a large, multiethnic cohort. METHODS: We conducted a retrospective study of 722 patients diagnosed with cSLE at The Hospital for Sick Children (SickKids)...
February 15, 2019: Journal of Rheumatology
Ulf Sundin, Mikkel Østergaard, Daniel Glinatsi, Anna-Birgitte Aga, Kim Hørslev-Petersen, Merete L Hetland, Kristian Stengard-Pedersen, Peter Junker, Bo J Ejbjerg, Paul Bird, Philip G Conaghan, Siri Lillegraven, Espen A Haavardsholm
OBJECTIVE: The RAMRIS [Outcome Measures in Rheumatology rheumatoid arthritis (RA) magnetic resonance imaging (MRI) Scoring system] is used in clinical RA trials. We have investigated methods to combine the RAMRIS features into valid and responsive scores for inflammation and joint damage. METHODS: We used data from 3 large randomized early RA trials to assess 5 methods to develop a combined score for inflammation based on RAMRIS bone marrow edema, synovitis, and tenosynovitis scores, and a combined joint damage score based on erosions and joint space narrowing...
February 15, 2019: Journal of Rheumatology
Malin Regardt, Christopher A Mecoli, Jin Kyun Park, Ingrid de Groot, Catherine Sarver, Merrilee Needham, Marianne de Visser, Beverly Shea, Clifton O Bingham, Ingrid E Lundberg, Yeong W Song, Lisa Christopher-Stine, Helene Alexanderson
OBJECTIVE: To present and vote on a myositis modified patient-reported outcome core domain set in the life impact area at the Outcome Measures in Rheumatology (OMERACT) 2018. METHODS: Based on results from international focus groups and Delphi surveys, a draft core set was developed. RESULTS: Domains muscle symptoms, fatigue, level of physical activity, and pain reached ≥ 70% consensus and were mandatory to assess in all trials. Domains lung, joint, and skin symptoms were mandatory in specific circumstances...
February 15, 2019: Journal of Rheumatology
Lara J Maxwell, Dorcas E Beaton, Beverley J Shea, George A Wells, Maarten Boers, Shawna Grosskleg, Clifton O Bingham, Philip G Conaghan, Maria Antonietta D'Agostino, Maarten P de Wit, Laure Gossec, Lyn March, Lee S Simon, Jasvinder A Singh, Vibeke Strand, Peter Tugwell
OBJECTIVE: To describe the Outcome Measures in Rheumatology (OMERACT) Filter 2.1 methodology for core domain set selection. METHODS: The "OMERACT Way for Core Domain Set selection" framework consists of 3 stages: first, generating candidate domains through literature reviews and qualitative work, then a process of consensus to obtain agreement from those involved, and finally formal voting on the OMERACT Onion. The OMERACT Onion describes the placement of domains in layers/circles: mandatory in all trials/mandatory in specific circumstances (inner circle); important but optional (middle circle); or research agenda (outer circle)...
February 15, 2019: Journal of Rheumatology
L Arkin, K Buhr, H Brandling-Bennett, Y Chiu, B Chong, M Curran, R Hunt, A S Paller, V Werth, M Klein-Gitelman, E von Scheven, K Ardalan
BACKGROUND: Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care of children with DLE. OBJECTIVES: We compared practice patterns among pediatric dermatologists/rheumatologists treating pediatric DLE. METHODS: An online survey was sent to 292 pediatric rheumatologists in the Childhood Arthritis & Rheumatology Research Alliance (CARRA) and 200 pediatric dermatologists in the Pediatric Dermatology Research Alliance (PeDRA)...
February 15, 2019: British Journal of Dermatology
Aimée Wattiaux, Brittany Bettendorf, Laura Block, Andrea Gilmore-Bykovskyi, Edmond Ramly, Megan E Piper, Ann Rosenthal, Jane Sadusky, Elizabeth Cox, Betty Chewning, Christie M Bartels
OBJECTIVE: Although smoking is a risk factor for cardiovascular and rheumatic disease severity, only 10% of rheumatology visits document cessation counseling. After implementing a rheumatology clinic protocol that increased tobacco quitline referrals 20-fold, current objectives were to 1) examine patients' barriers and facilitators to smoking cessation based on prior rheumatology experiences, 2) solicit reactions to the new cessation protocol, and 3) identify patient-centered outcomes or "signs of cessation progress" following improved care...
February 15, 2019: Arthritis Care & Research
Wenhan Huang, Feifeng Ren, Qian Wang, Lei Luo, Jun Zhou, Dongmei Huang, Zhuma Pan, Lin Tang
OBJECTIVES: To investigate the clinical characteristics of patients positive for anti-melanoma differentiation-associated gene 5 (MDA5) antibodies, and to analyse the potential pathogenesis of anti-MDA5 antibodies. METHODS: The clinical manifestations, serological tests, imaging features, treatments, and prognoses of 32 anti-MDA5 antibody-positive patients diagnosed in the Rheumatology and Immunology Department of the Second Affiliated Hospital of Chongqing Medical University from September 2015 to August 2018 were analysed...
February 11, 2019: Clinical and Experimental Rheumatology
Daniel M Hartung, Kirbee Johnston, Atul Deodhar, Dennis N Bourdette, David M Cohen
Despite little evidence supporting its superiority to glucocorticoid therapy, use and expenditures for repository corticotropin (rACTH) injection (H.P. Acthar Gel; Mallinckrodt) have increased dramatically in the last 5 years, particularly among a small number of nephrologists, rheumatologists, and neurologists. Recently, the manufacturer justified the extremely high and rapidly increasing cost of rACTH by citing the ongoing need to generate clinical data to support its use. We test this assertion by investigating the quality and provenance of the evidence likely to emerge in the foreseeable future...
February 11, 2019: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Olha Halyabar, Margaret H Chang, Michelle L Schoettler, Marc A Schwartz, Ezgi H Baris, Leslie A Benson, Catherine M Biggs, Mark Gorman, Leslie Lehmann, Mindy S Lo, Peter A Nigrovic, Craig D Platt, Gregory P Priebe, Jared Rowe, Robert P Sundel, Neeraj K Surana, Katja G Weinacht, Alison Mann, Jenny Chan Yuen, Patricia Meleedy-Rey, Amy Starmer, Taruna Banerjee, Fatma Dedeoglu, Barbara A Degar, Melissa M Hazen, Lauren A Henderson
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS) were historically thought to be distinct entities, often managed in isolation. In fact, these conditions are closely related. A collaborative approach, which incorporates expertise from subspecialties that previously treated HLH/MAS independently, is needed. We leveraged quality improvement (QI) techniques in the form of an Evidence-Based Guideline (EBG) to build consensus across disciplines on the diagnosis and treatment of HLH/MAS...
February 14, 2019: Pediatric Rheumatology Online Journal
Volkan Aydin, Ahmet Akici, Fatma Isli, Mesil Aksoy, Mehtap Aydin, Hakki Gursoz
WHAT IS KNOWN AND OBJECTIVE: Anti-tumour necrosis factor-alpha (anti-TNF-α) therapy is known to raise the risk of granulomatous infections, leading to development of risk management strategies at national or global level. This study aimed to determine the relative risk (RR) of tuberculosis (TB) due to anti-TNF-α usage in patients with rheumatologic diseases (RDs) in a nationwide basis. METHOD: This retrospective cohort study included patients with rheumatoid arthritis (RA), ankylosing spondylitis, juvenile idiopathic arthritis or psoriatic arthritis (PsA) that treated with or without anti-TNF-α agents, as registered in the national prescription information system between years 2013 and 2015...
February 14, 2019: Journal of Clinical Pharmacy and Therapeutics
Kerr Brogan, David Lockington, Kanna Ramaesh
INTRODUCTION: Temporal headache often results in an Ophthalmology referral to rule out giant cell arteritis (GCA). When clinical suspicion of GCA is low, alternative diagnoses should be considered. Temporomandibular disorder (TMD) commonly causes a temporal headache. MATERIALS AND METHODS: Patients referred with a temporal headache attending the Friday emergency ophthalmology clinic from February to July 2017 were assessed for GCA using the American College of Rheumatology (ACR) diagnostic criteria and TMD using a validated screening questionnaire...
February 14, 2019: Seminars in Ophthalmology
Sizheng Zhao, Kazuki Yoshida, Gareth T Jones, David M Hughes, Sara K Tedeschi, Houchen Lyu, Robert J Moots, Daniel H Solomon, Nicola J Goodson
OBJECTIVE: Observational data facilitate examination of treatment-effect heterogeneity, but the risk of bias is substantial. We highlight methodological considerations through an analysis of whether smoking affects response to TNF inhibitors (TNFi) in axial spondyloarthritis (axSpA). METHODS: We used longitudinal data from the British Society for Rheumatology Biologics Register for Ankylosing Spondylitis. Participants fulfilling the ASAS criteria for axSpA, who started their first TNFi were eligible for analysis...
February 14, 2019: Arthritis Care & Research
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