Outcome Measures in Rheumatoid Arthritis

2014 ◽  
pp. 127-140
Author(s):  
Yusuf Yazici ◽  
Hilal Maradit Kremers
Keyword(s):  
Rheumatoid Arthritis ◽  
Outcome Measures

scholarly journals Patterns of multimorbidity and their effects on adverse outcomes in rheumatoid arthritis: a study of 5658 UK Biobank participants

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038829
Author(s):  
Ross McQueenie ◽  
Barbara I Nicholl ◽  
Bhautesh D Jani ◽  
Jordan Canning ◽  
Sara Macdonald ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Outcome Measures ◽  
Primary Outcome ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Uk Biobank ◽  
Long Term Conditions ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Clinical Records

ObjectiveTo investigate how the type and number of long-term conditions (LTCs) impact on all-cause mortality and major adverse cardiovascular events (MACE) in people with rheumatoid arthritis (RA).DesignPopulation-based longitudinal cohort study.SettingUK Biobank.ParticipantsUK Biobank participants (n=502 533) aged between 37 and 73 years old.Primary outcome measuresPrimary outcome measures were risk of all-cause mortality and MACE.MethodsWe examined the relationship between LTC count and individual comorbid LTCs (n=42) on adverse clinical outcomes in participants with self-reported RA (n=5658). Risk of all-cause mortality and MACE were compared using Cox’s proportional hazard models adjusted for lifestyle factors (smoking, alcohol intake, physical activity), demographic factors (sex, age, socioeconomic status) and rheumatoid factor.Results75.7% of participants with RA had multimorbidity and these individuals were at increased risk of all-cause mortality and MACE. RA and >4 LTCs showed a threefold increased risk of all-cause mortality (HR 3.30, 95% CI 2.61 to 4.16), and MACE (HR 3.45, 95% CI 2.66 to 4.49) compared with those without LTCs. Of the comorbid LTCs studied, osteoporosis was most strongly associated with adverse outcomes in participants with RA compared with those without RA or LTCs: twofold increased risk of all-cause mortality (HR 2.20, 95% CI 1.55 to 3.12) and threefold increased risk of MACE (HR 3.17, 95% CI 2.27 to 4.64). These findings remained in a subset (n=3683) with RA diagnosis validated from clinical records or medication reports.ConclusionThose with RA and other LTCs, particularly comorbid osteoporosis, are at increased risk of adverse outcomes, although the role of corticosteroids could not be evaluated in this study. These results are clinically relevant for the monitoring and management of RA across the healthcare system, and future clinical guidelines for RA should acknowledge the importance of multimorbidity.

scholarly journals EFFECT OF AEROBIC EXERCISE ON FATIGUE AND DEPRESSION IN INDIVIDUALS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 8 (6) ◽  
pp. 3674-3679
Author(s):  
Sanjeev Kumar Singh ◽  
◽  
Afsha Mulla ◽  
Farheen Farooque Khan ◽  
Ronika Agrawal ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Aerobic Exercise ◽  
Outcome Measures ◽  
Exercise Intervention ◽  
Depression Scale ◽  
Joint Disease ◽  
Exercise Session ◽  
P Value ◽  
Target Heart Rate ◽  
Convenience Sample

Background: Rheumatoid arthritis (RA) is an autoimmune, systemic, inflammatory condition causing pain, disability, and psychological distress. It is the most common chronic inflammatory joint disease, affecting 0.1-1% of the population. Women are affected 3 times more than men. Because of its chronic, painful, and disabling character, RA tends to have a profound impact on health-related quality of life (HRQOL). Materials and methods: In the present study a convenience sample of 30 individuals between 30 to 60 years of age group according to the inclusion and exclusion criteria. The exercise intervention was participation in aerobic exercise session 3 times weekly for 6 weeks. The session consisted of 3 phases –1)Warm-up phase 2).Aerobic period 3) Cool down phase.Subjects were given their target heart rate for 40% and 60% of their HRmax. They were instructed to start exercising at 40% and progress to 60% as tolerated given their subjective exertion using the Talk Test (being able to talk while exercising without being short of breath). Global Fatigue Index Of The Multidimensional Assessment Of Fatigue Questionnaire (GFI) and The Center for Epidemiologic Studies- Depression Scale (CES-D)were used as outcome measures for evaluating fatigue and severity of depression respectively in the subjects and the data was statistically analysed. Results: Paired t-test was done for pre and post mean values for MAF-GFI scale. The results showed statistically significant values for both the outcome measures (p value < 0.05). Conclusion: The present study concludes that 6 weeks of aerobic exercise showed significant effect in decreasing fatigue and depression in individuals with rheumatoid arthritis. KEY WORDS: Rheumatoid Arthritis, Fatigue, Depression, Aerobic Exercise.

Rheumatoid Arthritis Patient Priorities in Pharmacological Interventions Outcome Measures

2016 ◽  
Author(s):  
Tessa Sanderson ◽  
John Kirwan ◽  
Celia Almeida ◽  
Marianne Morris ◽  
Robert Noddings ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Arthritis Patient ◽  
Outcome Measures ◽  
Pharmacological Interventions

scholarly journals Systematic review of the psychometric properties of patient-reported outcome measures for rheumatoid arthritis in the foot and ankle

2019 ◽  
Vol 33 (11) ◽  
pp. 1788-1799 ◽  
Author(s):  
Ana Belen Ortega-Avila ◽  
Laura Ramos-Petersen ◽  
Pablo Cervera-Garvi ◽  
Christopher J Nester ◽  
José Miguel Morales-Asencio ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Psychometric Properties ◽  
Outcome Measures ◽  
Methodological Quality ◽  
Measurement Properties ◽  
Foot And Ankle ◽  
Inclusion Criteria ◽  
Patient Reported

Objective: To identify self-reported outcome measures specific to the foot and ankle in patients with rheumatoid arthritis and to investigate the methodological quality and psychometric properties of these measures. Method: A systematic review focusing on patients with rheumatoid arthritis. Setting: The search was conducted in the PubMed, SCOPUS, CINAHL, PEDro and Google Scholar databases, based on the following inclusion criteria: population (with rheumatoid arthritis) > 18 years; psychometric or clinimetric validation studies of patient-reported outcomes specific to the foot and ankle, in different languages, with no time limit. Two of the present authors independently assessed the quality of the studies located and extracted the relevant data. Terwee’s criteria and the COSMIN checklist were employed to ensure adequate methodological quality. Results: Of the initial 431 studies considered, 14 met the inclusion criteria, representing 7,793 patients (56.8 years). These instruments were grouped into three dimensions (pain, perceived health status and quality of life and disability). The time to complete any of the PROMs varies around 15 minutes. PROMs criterias with the worst scores by COSMIN, 92.85% and 85.71% were criterion validity, measurement error, internal consistency and responsiveness. 28.57% of PROMs were compared with the measurement properties. Conclusion: the Self-Reported Foot and Ankle Score achieved the highest number of positive criteria (according to Terwee and COSMIN), and is currently the most appropriate for patients with Rheumatoid arthritis.

scholarly journals Tuberculosis among patients treated with TNF inhibitors for rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis in Slovenia: a cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034356 ◽  
Author(s):  
Ziga Rotar ◽  
Petra Svetina ◽  
Matija Tomsic ◽  
Alojzija Hočevar ◽  
Sonja Prapotnik
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Outcome Measures ◽  
Latent Tuberculosis ◽  
Incidence Rates ◽  
Secondary Outcome ◽  
Ltbi Screening ◽  
Slovenian Population ◽  
Exposure Windows

ObjectivesThis study aimed to assess the risk of tuberculosis (TB) in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with any of the commercially available tumour necrosis factor inhibitors (TNFis) in Slovenia.DesignThis is a cohort, registry (biorx.si) cross-linked with the Slovenian National TB Registry.SettingNational, involving all Slovenian rheumatology centres (six secondary and two secondary/tertiary).Participants2429 patients with RA, AS or PsA exposed to at least one TNFi participated in the study.Primary and secondary outcome measuresThe primary outcome measures were age-adjusted and sex-adjusted TB incidence rates (IRs) and the standardised incidence ratios (SIRs) compared with the general population exploring different TNFi exposure windows. The secondary outcome measures were a detailed characterisation of the national latent tuberculosis infection (LTBI) screening and TB chemoprophylaxis protocol implementation.ResultsAmong the 2429 patients exposed to at least one TNFi for a total of 10 445 (49% RA, 33% AS and 18% PsA) person-years (PY), 99% completed LTBI screening and 6% required TB chemoprophylaxis. Six RA (three adalimumab, three certolizumab), two PsA (two golimumab) and zero AS patients developed TB. Five out of eight had miliary TB, three out of eight had pulmonary TB and two patients died. The age-standardised and sex-standardised TB IR (95% CI) per 100 000 PYs/SIRs (95% CI) compared with the general Slovenian population for the current TNFi exposure were 52 (0 to 110)/6.7 (0.6 to 80), 47 (0 to 110)/6.1 (0.3 to 105), 45 (0 to 109)/5.8 (0.3 to 112) overall, in RA and PsA, respectively.ConclusionsThe TB IR in the Slovenian patients with RA, AS and PsA treated with TNFi was comparable with TB IRs in TB non-endemic countries with less than a tenth of the patients requiring TB chemoprophylaxis.

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