scholarly journals FRI0651-HPR A RANDOMIZED PROSPECTIVE OPEN-LABEL CONTROLLED TRIAL COMPARING THE PERFORMANCE OF A CONNECTED MONITORING INTERFACE IN PATIENTS WITH RHEUMATOID ARTHRITIS VERSUS PHYSICAL ROUTINE MONITORING

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 929.1-930
Author(s):  
Y. M. Pers ◽  
V. Valsecchi ◽  
T. Mura ◽  
S. Aouinti ◽  
N. Filippi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Rheumatic Diseases ◽  
Tight Control ◽  
Link Type ◽  
Functional Scores ◽  
Monitoring Group ◽  
Disease Modifying

Background:Telemedicine has found wider application in chronic diseases for encouraging tight home-monitoring in order to improve patients’ outcome (Smolen et al. 2017).In previous studies, a high feasibility and high patient-satisfaction rate was found as well as the evidence for a superior or equal effectiveness of telemedicine compared to the standard face-to-face approach, however the results were weakened by some methodological biases and wide heterogeneity of interventions, thus preventing to draw definitive conclusions (Piga et al. 2017; Najm, Gossec, et al. 2019).Objectives:In rheumatoid arthritis (RA), telemedicine may allow a tight control of disease activity while reducing hospital visits. We developed a smartphone application connected with a physician’s interface to monitor RA patients. We aimed to assess the performance of this e-Health solution in comparison with routine practice in the management of patients with RA.Methods:A 6-month pragmatic, randomized, controlled, prospective, clinical trial was conducted in RA patients with high to moderate disease activity starting a new Disease Modifying Anti-Rheumatic Drug (DMARD) therapy. Two groups were established: “connected monitoring” and “conventional monitoring”. The primary outcome was the number of physical visits between baseline and 6 months. Secondary outcomes included adherence, satisfaction, changes in clinical, functional, and health status scores (SF-12).Results:Of the 94 randomized patients, 89 completed study: 44 in the “conventional monitoring” arm and 45 in the “connected monitoring” arm. The total number of physical visits between baseline and 6 month was significantly lower in the “connected monitoring” group (0.42 ± 0.58 versus 1.93 ± 0.55; p<0.05). No differences between groups were observed in the clinical and functional scores. A better quality of life for SF-12 subscores (Role-Physical, Social-Functioning and Role-Emotional) were found in the “connected monitoring” group.Conclusion:According to our results, a connected monitoring reduces the number of physical visits while maintaining a tight control of disease activity and improving quality of life in patients with RA starting a new treatment.References:[1] Najm, Aurelie, Laure Gossec, Catherine Weill, David Benoist, Francis Berenbaum, and Elena Nikiphorou. 2019. “Mobile Health Apps for Self-Management of Rheumatic and Musculoskeletal Diseases: Systematic Literature Review.”JMIR MHealth and UHealth7 (11): e14730.https://doi.org/10.2196/14730.[2] Piga, Matteo, Ignazio Cangemi, Alessandro Mathieu, and Alberto Cauli. 2017. “Telemedicine for Patients with Rheumatic Diseases: Systematic Review and Proposal for Research Agenda.”Seminars in Arthritis and Rheumatism47 (1): 121–28.https://doi.org/10.1016/j.semarthrit.2017.03.014.[3] Smolen, Josef S, Robert Landewe, Johannes Bijlsma, Gerd Burmester, Katerina Chatzidionysiou, Maxime Dougados, Jackie Nam, et al. 2017. “EULAR Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: 2016 Update.”Annals of the Rheumatic Diseases76 (6): 960–77.https://doi.org/10.1136/annrheumdis-2016-210715.Disclosure of Interests:None declared

A randomized prospective open-label controlled trial comparing the performance of a connected monitoring interface versus physical routine monitoring in patients with rheumatoid arthritis

Rheumatology ◽  
2020 ◽  
Author(s):  
Yves-Marie Pers ◽  
Verushka Valsecchi ◽  
Thibault Mura ◽  
Safa Aouinti ◽  
Nathalie Filippi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Short Form ◽  
Controlled Trial ◽  
Routine Practice ◽  
Tight Control ◽  
Open Label ◽  
Functional Scores ◽  
Monitoring Group

Abstract Objectives In RA, telemedicine may allow tight control of disease activity while reducing hospital visits. We developed a smartphone application connected with a physician’s interface to monitor RA patients. We aimed to assess the performance of this e-Health solution in comparison with routine practice in the management of patients with RA. Methods A six-month pragmatic, randomized, controlled, prospective, clinical trial was conducted in RA patients with high to moderate disease activity starting a new DMARD therapy. Two groups were established: ‘connected monitoring’ and ‘conventional monitoring’. The primary outcome was the number of physical visits between baseline and six months. Secondary outcomes included adherence, satisfaction, changes in clinical, functional and health status scores (Short-Form 12). Results Of the 94 randomized patients, 89 completed study: 44 in the ‘conventional monitoring’ arm and 45 in the ‘connected monitoring’ arm. The total number of physical visits between required baseline and six-month visits was significantly lower in the ‘connected monitoring’ group [0.42 (0.58) vs 1.93 (0.55); P &lt;0.05]. No differences between groups were observed in the clinical and functional scores. A better quality of life for Short-Form 12 subscores (Role-Physical and Role-Emotional) were found in the ‘connected monitoring’ group. Conclusion Our results suggest that connected monitoring reduces the number of physical visits while maintaining a tight control of disease activity and improving quality of life in patients with RA starting a new treatment. Trial registration ClinicalTrials.gov, https://clinicaltrials.gov, NCT03005925.

scholarly journals AB0165 CENTRAL SENSITIZATION IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1109.2-1109
Author(s):  
E. Filatova ◽  
E. Pogozheva ◽  
V. Amirdzhanova ◽  
A. Karateev ◽  
A. Lila
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Disease Activity ◽  
Rheumatic Diseases ◽  
Central Sensitization ◽  
Nociceptive Pain ◽  
The Central Nervous System ◽  
Clinically Significant

Background:Central Sensitization (CS) is a proposed physiological phenomenon in which dysregulation in the central nervous system causes neuronal dysregulation and hyperexcitability, resulting in hypersensitivity to both noxious and non-noxious stimuli. The term Central Sensitivity Syndrome (CSS) describes a group of medically indistinct (or nonspecific) disorders, such as fibromyalgia (FM) (1, 2).The prevalence of FM has been estimated at 2-7% in general population, but 10-30% patients with several rheumatic diseases fulfill the FM criteria, which suggests that they have not only nociceptive pain, but signs of CS or nocyplastic pain. (3)Objectives:to identify the signs of central sensitization (CS) in patients with rheumatoid arthritis (RA) with the central sensitization inventory (CSI).Methods:We examined 43 RA patients (mean age 45.5 [29.0; 53.0] years) with chronic pain. The patients underwent rheumatological examinations; CS was diagnosed using the CSI(4).; inflammation severity (DAS28 index), pain intensity (VAS), affective disorders (HADS), and quality of life (EQ-5D) were assessed.Results:We recruited 36 women and 7 men, mostly with moderate and high disease activity according to the DAS28 index.Using the CSI subclinical CS was found in 9 patients (20.9%), mild in 7 (16.3%), moderate in 8 (18.6%), severe in 16 (37.2%), and extremely severe sensitization in 3 (6.7%). Thus, 62.5% of patients with RA had had clinically significant CS (CS>40 points according to the CSI questionnaire).Patients with the presence of CS were characterized by more severe anxiety (10.0 [7.0; 11.0] vs 5.0 [3.0; 6.0], p=0.001) and lower quality of life (0.52 [-0.02; 0.52] vs 0.52 [0.52; 0.69], p= 0.02).The CSI tests not only pain but also other diseases associated with CS. Comorbid disorders associated with CS were found in patients with RA: 34.9% had cognitive impairment, 39.5% had signs of depression.Conclusion:Central sensitization was detected in 62.5% of patients with RA using the CSI questionnaire. CS is associated with anxiety and depression and negatively affects the patients’ quality of life. Chronic pain in RA can be of a mixed nature: nociceptive and neoplastic, which must be taken into account in the selection of personalized therapy.References:[1]Wolfe F. Fibromyalgianess. Arthritis Rheum. 2009; 61: 715-6.[2]Martins Rocha T, Pimenta S, Bernardo A, et al. Determinants of non-nociceptive pain in Rheumatoid Arthritis. Acta Reumatol Port. 2018 Oct-Dec;43(4):291-303.[3]Halioglu S, Carlioglu A., Akdeniz D., Karaaslan Y., Kosar A. Fibromyalgia in patients user rheumatic patients with several rheumatic diseases: prevalence and relationship with disease activity. Reumatol. Int. 2014 Sep; 34(90:1275-80 doi:10.1007/s00296-014-2972.Disclosure of Interests:None declared

scholarly journals Level of stress, measured through the Perceived Stress Scale (EEP-10), and its association with disease activity in patients with Rheumatoid Arthritis

2019 ◽  
pp. 10-13
Author(s):  
Alejandro Martínez Muñoz ◽  
Juan M. Bande ◽  
Silvia B. Papasidero ◽  
Maximiliano Machado Escobar ◽  
María S. Yacuzzi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Risk Factor ◽  
Disease Activity ◽  
Perceived Stress ◽  
Rheumatic Diseases ◽  
Anxiety And Depression ◽  
Stress Scale ◽  
Autoimmune Rheumatic Diseases

Stress is a risk factor in the pathogenesis of autoimmune rheumatic diseases. Objective: to evaluate the association between disease activity in patients with RA. Secondary: to evaluate the association of perceived stress levels with other activity indexes (SDAI, CDAI, DAS28 and IAS) as well as with disability, anxiety and depression and quality of life.

Evaluating the efficacy of intra-articular injections of platelet rich plasma (PRP) in rheumatoid arthritis patients and its impact on inflammatory cytokines, disease activity and quality of life.

2020 ◽  
Vol 16 ◽  
Author(s):  
Dalia S. Saif ◽  
Nagwa N. Hegazy ◽  
Enas S. Zahran
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Inflammatory Cytokines ◽  
Platelet Rich Plasma ◽  
Joint Inflammation ◽  
Monthly Interval ◽  
Post Injection ◽  
Tnf Α

Background: Among rheumatoid arthritis patients (RA), general disease activity is well regulated by diseasemodifying anti-rheumatic medications (DMARDS), but sometimes local inflammation still persists among a few joints. Adjuvant modern molecular interventions as Platelet Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a proven effect in management of RA. We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and their impact on inflammatory cytokines IL1B , TNF α, local joint inflammation, disease activity and quality of life (QL). Methods: Open labeled parallel randomized control clinical trial was carried out on 60 RA patients randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections of PRP at monthly interval, Group 2: included 30 patients received single intra-articular injection of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline and at 3, 6 months post injection. Results: Patients of both groups showed improvements in their scores of evaluating tools at 3months post injection and this improvement was persistent in the PRP group up to 6 months post injection while it was continued only for 3 months in the steroid group. Conclusions: PRP is a safe, effective and useful therapy in treating RA patients who had insufficient response and persistent pain and inflammation in just one or two joints through its down regulating effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint inflammation, disease activity and QL.

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