scholarly journals FRI0342 POST-EFFORT SYNOVIAL AND ENTHESIC RESPONSE IN PATIENTS WITH PSORIATIC ARTHRITIS IN REMISSION OF LOW DISEASE ACTIVITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 765.2-765
Author(s):  
C. Guillén-Astete ◽  
P. Zurita-Prada ◽  
C. Urrego-Laurín
Keyword(s):  
Disease Activity ◽  
Power Doppler ◽  
Control Group ◽  
Healthy Population ◽  
Dominant Hand ◽  
Synovial Joint ◽  
Low Disease Activity ◽  
Post Exercise ◽  
Eular Recommendations ◽  
The Mean

Background:Synovial inflammation is part of the pathophysiological process of PsoA although it is considered secondary to enthesitis. It is of interest to assess the synovial joint, peritendinous and enthesic response of patients with PsoA in remission under controlled mechanical stress.Objectives:Our aim is to present our observational experience in patients with APso in remission or low activity of the disease exposed to controlled manual physical efforts adapted to the own grasping capacity of each subject.Methods:Before-after study of a consecutive cohort of patients with PsoA (CASPAR criteria), of at least two years d evolution and DAPSA≤14 at present. Patients with positive rheumatoid factor, patients with exclusively axial forms and patients on biological therapy at the beginning of the study were excluded. All patients underwent controlled basal ultrasound and post-dynamometric exercise (CAMRY EH101-17) of the dominant hand which included the carpus, MCFs, IFPs and IFDs of the 2nd to 5th fingers. The ultrasound findings were scored according to EULAR recommendations in grey scale (GS) and power Doppler (PD) for synovitis, enthesitis and tenosynovitis (maximum scores 71 and 87, respectively). For statistical analysis, comparisons were made with the results of their baseline and post-exercise ultrasound scores between subjects diagnosed with PsoA and controls. The Student’s T test was used for related and unrelated data according to correspondence.Results:Nineteen patients and controls were included, of which 73.7% were male. Mean age: 42.2 SD 6.6 and 42.21 SD 8.28, respectively. Basal DAPSA among patients: 7.26 SD 4.53. Mean traction strength of patients and controls: 23.8 SD 7.3 and 26.1 SD 6.9 kg, respectively (P=0.336). In the group of patients, the post exercise DAPSA had a mean of 7.52 SD 4.62 (P=0.021, with respect to the basal DAPSA). The mean total GS score in the patient group was 3.94 SD 2.36 and 7.31 SD 3.3, pre- and post-exercise, respectively (P<0.001). The mean total score in the PD study was 0.73 SD 0.73 and 2.57 SD 1.16, respectively (P<0.001). In patients with PsoA there were no detectable enthesic changes. In the control group, no ultrasound changes were statistically significant, although the score for tenosynovitis ranged from 0.1 SD 0.31 to 0.42 SD 0.6 (P=0.055).Conclusion:Patients with APso in clinical remission or low disease activity develop ultrasound changes after controlled exercise. These changes are appreciable in the joint synovium and tendon but not at an enthesic level. Although these changes are also detectable in a healthy population, their prevalence is much lower. Our interpretation is that control of the disease correlates with an absence of enthesic inflammatory activity although synovial susceptibility remains less evident. This reinforces the idea that PsoA is an inflammatory enthesitis with associated arthritis and not its opposite.Disclosure of Interests:None declared

scholarly journals COMPORTAMIENTO DEL INTERVALO QT CORREGIDO EN ARTRITIS TEMPRANA

2016 ◽  
Vol 73 (1) ◽  
Author(s):  
Carla Andrea Gobbi ◽  
D Alessio ◽  
Paula Alba ◽  
P Asbert ◽  
E Albiero ◽  
...  
Keyword(s):  
Disease Activity ◽  
Qt Interval ◽  
Disease Activity Score ◽  
Standard Technique ◽  
Control Group ◽  
Low Disease Activity ◽  
T Wave ◽  
Das 28 ◽  
Rheumatology Unit ◽  
The Mean

Introducción: La  dispersión del  intervalo QT  ha sido descripta en  pacientes con artritis reumatoidea (AR) y  puede ser un marcador útil de morbi-mortalidad cardiovascular.Objetivos: Conocer el comportamiento del intervalo QT corregido (iQTc) en pacientes con AT y evaluar la asociación con  actividad de la enfermedad (AE).Material y Métodos:  Se realizó un estudio comparativo de corte transversal que incluyó pacientes mayores de 16 años, con diagnóstico de artritis temprana (AT) , atendidos en la  Unidad de Reumatología del Hospital Córdoba, desde enero de 2010 a diciembre de 2013. El grupo control se apareó por edad, sexo y antecedentes patológicos.  Los criterios de exclusión fueron evidencias  de IAM,  arritmia, potasemia>5mEq/L,  ingesta de fármacos que afecten el QT. Se recolectaron datos demográficos, la actividad de la enfermedad se midió por DiseaseActivity Score (DAS 28), clasificando la actividad de la enfermedad en Baja AE, DAS 28 menor a 3,2,  Moderada/ Alta mayor de 3.2;   y se realizó ECG con técnica  estándar. El  intervalo QT fue medido desde el comienzo del complejo QRS hasta el final de la onda T. Para obtener el valor del iQTc, se utilizó la fórmula de Bazett.Resultados: El número de pacientes fue de 31, 83.9 % de sexo femenino y con edad media de 41.9 años, el DAS 28 promedio de 5.09. El grupo control incluyo 31 individuos con  una edad media de 42.2. El intervalo QT fue de 0.376 mm/s y el iQTc de 0.408 en AT y el QT fue de 0.381 mm/s y el iQTc de 0.415mm/s en el grupo control (p NS, p NS). El QT y el iQTc fueron de 0.39 y 0.38mm/s en los pacientes con baja  AE; 0.37mm/s y 0.411en Moderada / Alta AE (p=NS).Conclusión: El iQTc no demostró alteraciones ni se relacionó con actividad de la enfermedad en  AT   Background: The QT interval modification has been described in patients with Rheumatoid Arthritis (RA) and it could be a useful marker of cardiovascular morbidity and mortality.Aims: To evaluate the QT interval modifications in patients with early arthritis (EA) and its association with disease activity (DA).METHODS: We studied patients with diagnosis of EA attended to Rheumatology Unit at Córdoba Hospital from January 2010 to December 2013. Control group was population age, gender and cardiovascular risk factors matched. Exclusion criteria were: myocardial infarction, arrhythmia, K level >5, or anti-arrhythmia treatment. ECG was performed by standard technique and QT interval was measured from the beginning of QRS to the end of T wave. QTC value was calculated by Bazzet formula.  The activity disease was measured by Disease Activity Score (DAS 28), and was considered low disease activity below 3.2, and moderate / high disease activity more than 3,2.RESULTS: 31 patients were included with 83.9 % of females and the mean age was  41.9 years old and DAS 28 was 5.09.  31 persons were included as a control group with a mean age of 42.2 years old.  QT interval was  0.376 mm/s  and l QTC  0.408  in EA and  QT was  0.381 mm/s and  QTC  0.415 mm/s  in the control group ( p= NS, p= NS).  QT interval and  QTC were  0.39 and 0.38 in low DA patients; 0.37 and  0.411 in Moderate / High DA ( p=NS)CONCLUSIONS: The QT interval  was not modified and it was not related with DA in EA. 

scholarly journals Corneal Biomechanical Parameters and Central Corneal Thickness in Glaucoma Patients, Glaucoma Suspects, and a Healthy Population

2021 ◽  
Vol 10 (12) ◽  
pp. 2637
Author(s):  
Mª. Ángeles del Buey-Sayas ◽  
Elena Lanchares-Sancho ◽  
Pilar Campins-Falcó ◽  
María Dolores Pinazo-Durán ◽  
Cristina Peris-Martínez
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Mean Difference ◽  
The Other ◽  
Control Group ◽  
Healthy Population ◽  
Diagnostic Categories ◽  
Significant Difference ◽  
Biomechanical Parameters ◽  
The Mean

Purpose: To evaluate and compare corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT), measurements were taken between a healthy population (controls), patients diagnosed with glaucoma (DG), and glaucoma suspect patients due to ocular hypertension (OHT), family history of glaucoma (FHG), or glaucoma-like optic discs (GLD). Additionally, Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated IOP (IOPcc) were compared between the different groups of patients. Methods: In this prospective analytical-observational study, a total of 1065 patients (one eye of each) were recruited to undergo Ocular Response Analyzer (ORA) testing, ultrasound pachymetry, and clinical examination. Corneal biomechanical parameters (CH, CRF), CCT, IOPg, and IOPcc were measured in the control group (n = 574) and the other groups: DG (n = 147), FHG (n = 78), GLD (n = 90), and OHT (n = 176). We performed a variance analysis (ANOVA) for all the dependent variables according to the different diagnostic categories with multiple comparisons to identify the differences between the diagnostic categories, deeming p < 0.05 as statistically significant. Results: The mean CH in the DG group (9.69 mmHg) was significantly lower compared to controls (10.75 mmHg; mean difference 1.05, p < 0.001), FHG (10.70 mmHg; mean difference 1.00, p < 0.05), GLD (10.63 mmHg; mean difference 0.93, p < 0.05) and OHT (10.54 mmHg; mean difference 0.84, p < 0.05). No glaucoma suspects (FHG, GLD, OHT groups) presented significant differences between themselves and the control group (p = 1.00). No statistically significant differences were found in the mean CRF between DG (11.18 mmHg) and the control group (10.75 mmHg; mean difference 0.42, p = 0.40). The FHG and OHT groups showed significantly higher mean CRF values (12.32 and 12.41 mmHg, respectively) than the DG group (11.18 mmHg), with mean differences of 1.13 (p < 0.05) and 1.22 (p < 0.001), respectively. No statistically significant differences were found in CCT in the analysis between DG (562 μ) and the other groups (control = 556 μ, FHG = 576 μ, GLD = 569 μ, OHT = 570 μ). The means of IOPg and IOPcc values were higher in the DG patient and suspect groups than in the control group, with statistically significant differences in all groups (p < 0.001). Conclusion: This study presents corneal biomechanical values (CH, CRF), CCT, IOPg, and IOPcc for diagnosed glaucoma patients, three suspected glaucoma groups, and a healthy population, using the ORA. Mean CH values were markedly lower in the DG group (diagnosed with glaucoma damage) compared to the other groups. No significant difference was found in CCT between the DG and control groups. Unexpectedly, CRF showed higher values in all groups than in the control group, but the difference was only statistically significant in the suspect groups (FHG, GLD, and OHT), not in the DG group.

scholarly journals POS1405 OPTICAL SPECTRAL TRANSMISSION (HANDSCAN) IN PATIENTS WITH PSORIATIC ARTHRITIS: FIRST DATA ON DIAGNOSTIC VALUE AND ASSOCIATIONS WITH CLINICAL AND ULTRASOUND DISEASE ACTIVITY MARKERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 985.1-985
Author(s):  
K. Triantafyllias ◽  
S. Liverakos ◽  
C. Noack ◽  
A. Schwarting
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Power Doppler ◽  
Patient Characteristics ◽  
Diagnostic Value ◽  
Control Group ◽  
Spectral Transmission ◽  
Grey Scale ◽  
Assessment Of Disease Activity

Background:Valid assessment of disease activity leads to improvement of long-term outcomes in patients with inflammatory arthritis (1). Optical spectral transmission (OST) is a modern diagnostic tool able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with rheumatoid arthritis (RA) (commercial device: HandScan – Demcon/Hemics, The Netherlands) (2). Even though an increasing number of studies have evaluated diagnostic value of this new technology in RA patients (2,3), no data exist regarding psoriatic arthritis (PsA).Objectives:To examine for the first time the diagnostic value of OST in detecting inflammation in patients with PsA and to evaluate its relationship with disease activity markers and various epidemiological and anthropometric patient characteristics.Methods:OST-Measurements were performed in a group of PsA patients and a group of healthy controls. The difference between OST in the two groups was statistically examined and relationships of OST with clinical (tender / swollen joint counts, disease activity on a visual analogue scale) and serological disease activity markers were evaluated. Moreover, joint ultrasound (US) examinations were performed in a subgroup of PsA patients and OST associations with a Power Doppler- and a Grey Scale-US score were examined. Finally, relationships of OST with various anthropometric and epidemiologic parameters (BMI, hand-size, gender, age) were assessed.Results:We recruited 49 PsA patients [65.3% female; mean age 53.3 years (± 11.8 SD)] and 114 control subjects [77.2% female; mean age 46 years (± 12.8 SD)]. OST was statistically significantly higher in the patient group, compared to the control group [14.95 (12.04 - 17.18, IQR) vs. 10.31 (7.84 – 13.79, IQR); p<0.001]. OST correlated moderately-strongly with both examined US scores (Power Doppler-score: r = 0.5; p = 0.026 and Grey Scale-score: r = 0.52; p = 0.028). Moreover, OST showed a moderate, statistically significant association with C-reactive protein (CRP) (r = 0,298; p = 0,037). Finally, males had significantly higher OST values than females and OST associated moderately-weakly with body mass index (BMI) in the control group (rho = 0.24; p< 0.001).Conclusion:This is the first report of a possible diagnostic value of OST in patients with PsA. OST correlated with ultrasound and serological activity markers and may thus prove to be a useful tool of disease activity assessment, next to well established diagnostic modalities, such as the joint US. Correlations of OST with patient characteristics implicate the need to take also anthropometric and epidemiological patient characteristics into account when interprenting OST results in order to avoid confounding.References:[1]Katchamart W, et al. Systematic monitoring of disease activity using an outcome measure improves outcomes in rheumatoid arthritis. J Rheumatol 2010;37:1411–1415.[2]Triantafyllias, et al. Diagnostic value of optical spectral transmission in rheumatoid arthritis: associations with clinical characteristics and comparison with joint ultrasonography. J Rheumatol 2020 1;47(9):1314-1322.[3]Onna M Van, et al. Assessment of disease activity in patients with rheumatoid arthritis using optical spectral transmission measurements, a non-invasive imaging technique. Ann Rheum Dis 2016;75:511–518.Disclosure of Interests:Konstantinos Triantafyllias Speakers bureau: Pfizer, Novartis, Janssen, Chugai, Stefanie Liverakos: None declared, Claudia Noack: None declared, Andreas Schwarting: None declared

Thyroid Nodules in Patients with Acromegaly: Frequency According to the ACR TI-RADS Classification and its Relationship with Disease Activity

2021 ◽  
Author(s):  
Mustafa Can ◽  
Muhammet Kocabaş ◽  
Melia Karakose ◽  
Hatice Caliskan Burgucu ◽  
Zeliha Yarar ◽  
...  
Keyword(s):  
Disease Activity ◽  
Thyroid Nodules ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Control Subjects ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Abstract Purpose: In our study, we aimed to determine the frequency of thyroid nodules in patients with acromegaly according to the American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) classification and its relationship with acromegaly disease activity. Methods: A total of 56 patients with acromegaly and age, sex, and body mass index matched with 56 healthy control subjects were included in our study. Thyroid-stimulating hormone, free thyroxine, and anti-thyroperoxidase antibody levels of patients and control subjects were measured. In addition, patients and healthy controls were evaluated by ultrasonography to determine thyroid structure, thyroid volume, and thyroid nodules and to make ACR TI-RADS classification. Results: Thyroid nodules were present in 31 (55.4%) of 56 patients in the acromegaly group and 20 (35.7%) of 56 subjects in the control group, and the frequency of thyroid nodules was significantly higher in the acromegaly group (p=0.038). The mean number of nodules in the acromegaly group and control group was 1.27±1.43 and 0.48±0.73, respectively, and the mean number of nodules was significantly higher in the acromegaly group (p=0.003). The number of patients with TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules in the acromegaly group was higher than the control group (p=0.026, p=0.049, p=0.007, respectively). No difference was found in terms of cytological findings between those who have undergone FNAB in the acromegaly group and control group. Conclusion: In our study, we found that the frequency of thyroid nodules, the number of thyroid nodules, and the number of TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules increased in patients with acromegaly. There was no significant difference between acromegaly disease activity and thyroid nodule frequency, number of thyroid nodules, and TI-RADS classifications.

scholarly journals Real-World Comparative Effectiveness and Safety of Tofacitinib and Baricitinib in Patients with Rheumatoid Arthritis

2021 ◽  
Author(s):  
Naoki Iwamoto ◽  
Shuntaro Sato ◽  
Shota Kurushima ◽  
Toru Michitsuji ◽  
Shinya Nishihata ◽  
...  
Keyword(s):  
Disease Activity ◽  
Clinical Response ◽  
Real World ◽  
Oral Steroid ◽  
Baseline Characteristic ◽  
Low Disease Activity ◽  
Logistic Analysis ◽  
Significant Difference ◽  
Synthetic Dmards ◽  
The Mean

Abstract Objective: To compare the efficacy and safety of tofacitinib and baricitinib in patients with RA in a real-world setting.Methods: A total of 242 patients with RA who were treated with tofacitinib (n=161) or baricitinib (n=81) were enrolled. To avoid confounding, we performed propensity score matching based on multiple baseline characteristic variables, and then 80 baricitinib-treated patients and 57 tofacitinib-treated patients were extracted for direct comparison. Their clinical disease activity and AEs were evaluated for 24 weeks. Results: The mean DAS28-ESR change from baseline to 24 weeks were 1.60 (tofacitinib) and 1.46 (baricitinib). There was no significant difference in the clinical response between two groups. The efficacy was not significantly changed in the patients without concomitant MTX use in both groups, but the concomitant MTX use showed better clinical efficacy in the cases of baricitinib treatment. In both groups, the most common AE was herpes zoster infection, and the AE rates were similar between the two groups. However, the predictive factors contributing to clinical response as revealed by a multivariable logistic analysis differed. The concomitant oral steroid use was independently associated with the achievement of DAS-low disease activity in both groups, whereas in the baricitinib group, the number of biological and/or targeted synthetic DMARDs previously used was also associated. Conclusions: Our findings indicate that tofacitinib and baricitinib had comparable continuing efficacies and safety profiles. However, the influence of clinical characteristics on the treatment response differed. Direct comparison provides useful information to optimal use of JAK inhibitors in real-world settings.

scholarly journals Effect of Long Term Use of Carbamazepine on Lipid Profile in Adult Epileptic Patients

2014 ◽  
Vol 30 (1) ◽  
pp. 27-34
Author(s):  
Md Khairul Kabir Patwary ◽  
Shakila Sultana ◽  
- Md Salahuddin ◽  
Abu Jafor Md Salahuddin ◽  
Mohammed Sayeed Hassan ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Focal Epilepsy ◽  
Serum Triglyceride ◽  
Control Group ◽  
Case Group ◽  
Healthy Population ◽  
Female Patients ◽  
Epileptic Patients ◽  
The Mean

Objective: To evaluate the effect of long term use of carbamazepine on lipid profile in adult epileptic patients Methodology: The study was conducted in the Department of Neurology at BSMMU, Dhaka over a period of 2 years from January 2010 to December 2011. Adult epileptic patients taking carbamazepine as anticonvulsant and attending the Epilepsy Clinic and Neurology OPD of BSMMU, Dhaka were the study population. A total of 107 cases and 107 controls were included in the study. Data were collected by interview of the patients, clinical examination and laboratory investigations using the research instrument Result: The mean age of case and control groups were almost identical (23.3 ± 6.8 vs. 23.8 ± 6.4 years, p = 0.972). The proportion of male and female patients was similar in both the study groups. Of the 107 cases, more than 70% had generalized epilepsy and the rest (29%) focal epilepsy. Of the 107 cases, 8% had family history of epilepsy. The prevalence of raised triglycerides and raised LDL were observed to be significantly higher in the case group than those in the control group (35.5% vs. 23.4%, p = 0.049 and 15% vs. 0.9%, p < 0.001 respectively). The prevalence of low HDL was also significantly higher in the former group than that in the latter group (43.9% vs. 18.7%, p < 0.001). The mean serum triglyceride and LDL were higher and mean HDL was lower in the case group than those in the control group. Over half (51.4%) of the case group exhibited dyslipidemia compared to the control group (27.1%). The risk of developing dyslipidemia in epileptic patients receiving carbamazepine for longer duration was nearly three-fold (95% of CI = 1.6 – 5.0) higher than that in the control group (p < 0.001). There is positive correlation between duration of carbamazepine treatment and lipid profile. Serum total cholesterol and triglycerides bear linear relationship with duration of treatment with carbamazepine (r = 0.201, p = 0.038 and r = 0.223, p = 0.021 respectively). The association of dyslipidemia with sex in epileptic patients receiving carbamazepine for more than 2 years. The proportion of dyslipdemia was considerably higher in the female patients than their male counterparts, although the difference was not statistically significant (55.3% vs. 41.9%, p < 0.211). Conclusion: A conclusion can be made from the above mentioned result that long-term use of carbamazepine in epileptic patients may cause dyslipidemia and the risk of having dyslipidemia in such patients is 3 times greater than the normal healthy population. Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 27-34

scholarly journals EP31 Musculoskeletal ultrasound of rheumatoid arthritis pregnancy: a single centre experience

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Charles Raine ◽  
Jessica Manson ◽  
Coziana Ciurtin ◽  
Ian Giles
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Single Case ◽  
Post Partum ◽  
Power Doppler ◽  
Musculoskeletal Ultrasound ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Low Disease Activity ◽  
In Pregnancy

Abstract Background The utility of musculoskeletal ultrasound (MSK-US) in the measurement of disease activity of rheumatoid arthritis (RA) is well established. However, it has not been formally studied in pregnancy, with the literature limited to a single case report. Standard disease activity assessment in RA pregnancy comprises measurement of the DAS28(3) CRP score, which removes the visual analogue score (VAS) and replaces ESR with CRP, as both of these components may be confounded by pregnancy. Use of this modified score remains problematic as the tender joint count may be affected by non-specific musculoskeletal pain in pregnancy, and the swollen joint count may be obscured by peripheral oedema, especially late in pregnancy. No study of RA in pregnancy has used MSK-US to measure disease activity. Our objective was to conduct a pilot study of MSK-US in RA pregnancy, and compare findings with clinical assessment using the DAS28(3)CRP score. Methods We offered MSK-US to pregnant RA patients attending the UCLH obstetric rheumatology clinic from September 2018 to September 2019. Patients were assessed longitudinally through pregnancy/post-partum where possible. Examination was undertaken using a Logiq S8 US machine. The standard protocol comprised 22-joint assessment of hands (dorsal longitudinal and transverse views of wrists, metacarpophalangeal and proximal interphalangeal joints). In the feet, bilateral MTP joints were scanned with longitudinal views. Quantification of Power Doppler (PD) signal and grey scale (GS) synovitis was made as per the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) US definitions. PD and GS scores were calculated as mean scores of all joints scanned. Results To date, 17 pregnant RA patients have undergone a total of 35 MSK-US studies. Disease activity assessments showed 10/17 patients with persistent low activity through pregnancy, 5/17 with moderate or good response, 1/17 with no response and 1/17 with a moderate flare. Overall, PD scores correlated well with DAS28(3) CRP assessment (R2 = 0.68). All patients at moderate or high disease activity by DAS28(3) CRP had ≥1 joint with detectable PD signal, but 2/21 patients clinically in ‘remission’ and 3/7 patients in ‘low disease activity’ had detectable PD. One patient with only 2 tender and 1 swollen joints (and normal CRP; DAS28 3.17) had very extensive PD signal and contributed to the decision to recommence anti-TNF treatment in the 3rd trimester. It was noted that increased vascularity in pregnancy can complicate the assessment of synovial PD signal. MSK-US was particularly helpful in distinguishing true joint synovitis from subcutaneous oedema in the feet. Conclusion This is the first series of MSK-US in pregnant RA patients. The detection of active joint synovitis (by PD signal) in clinical remission/low disease activity states suggests a potential role for MSK-US in confirming apparent low disease activity in pregnancy, and thus guiding stratification of treatment. Disclosures C. Raine None. J. Manson None. C. Ciurtin None. I. Giles None.

Comparing Tapering Strategy to Standard Dosing Regimen of Tumor Necrosis Factor Inhibitors in Patients with Spondyloarthritis in Low Disease Activity

2015 ◽  
Vol 42 (9) ◽  
pp. 1638-1646 ◽  
Author(s):  
Chamaida Plasencia ◽  
Eva L. Kneepkens ◽  
Gertjan Wolbink ◽  
Charlotte L.M. Krieckaert ◽  
Samina Turk ◽  
...  
Keyword(s):  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Control Group ◽  
Tnf Inhibitor ◽  
Dosing Regimen ◽  
Standard Regimen ◽  
Low Disease Activity ◽  
Number Of Patients ◽  
Necrosis Factor

Objective.To compare clinical outcomes, incidence of flares, and administered drug reduction between patients with spondyloarthritis (SpA) under TNF inhibitor (TNFi) tapering strategy with patients receiving a standard regimen.Methods.In this retrospective study, 74 patients with SpA from Spain on tapering strategy (tapering group; TG) were compared with 43 patients from the Netherlands receiving a standard regimen (control group; CG). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was measured at visit 0 (prior to starting the TNFi), visit 1 (prior to starting tapering strategy in TG and at least 6 months with BASDAI < 4 after starting the TNFi in the TG and CG), visit 2 (6 mos after visit 1), visit 3 (1 year after visit 1), and visit 4 (the last visit available after visit 1).Results.An overall reduction of the administered drug was seen at visit 4 in the TG [dose reduction of 22% for infliximab (IFX) and an interval elongation of 28.7% for IFX, 45.2% for adalimumab, and 51.5% for etanercept] without significant differences in the BASDAI between the groups at visit 4 (2.15 ± 1.55 in TG vs 2.11 ± 1.31 in CG, p = 0.883). The number of patients with flares was similar in both groups [22/74 (30%) in the TG vs 8/43 (19%) in the CG, p = 0.184].Conclusion.The tapering strategy in SpA results in an important reduction of the drug administered, and the disease control remains similar to that of the patients with SpA receiving the standard regimen.

scholarly journals POS0608 SWITCHING OF TREATMENT FROM REFERENCE ETANERCEPT TO SANDOZ ETANERCEPT BIOSIMILAR IN PATIENTS WITH RHEUMATIC DISEASES: AN INTERIM ANALYSIS OF REAL-WORLD DATA FROM THE COMPACT STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 540.1-540
Author(s):  
M. Schmalzing ◽  
A. Askari ◽  
T. Sheeran ◽  
D. Walsh ◽  
J. De Toro Santos ◽  
...  
Keyword(s):  
Disease Activity ◽  
Real World ◽  
Targeted Therapies ◽  
Clinical Remission ◽  
Interim Analysis ◽  
Disease Activity Score ◽  
Research Support ◽  
Low Disease Activity ◽  
Group A ◽  
The Mean

Background:Sandoz etanercept (SDZ ETN) is a biosimilar of etanercept (ETN). COMPACT is an ongoing, non-interventional study, evaluating the effectiveness, safety, and quality of life with SDZ ETN treatment in patients (pts) with rheumatoid arthritis (RA), axial-spondyloarthritis (axSpA) or psoriatic arthritis (PsA) in real-world conditions.Objectives:We have reported an interim analysis, with the effectiveness and safety data focusing on pts who were in clinical remission or low disease activity under treatment with reference ETN or biosimilar ETN other than SDZ ETN (initial ETN; iETN) and switched to SDZ ETN.Methods:Pts aged ≥18 years for whom treatment with SDZ ETN were initiated are being enrolled. Pts were categorized under four treatment groups based on prior treatment status: Group A,pts on clinical remission or low disease activity under treatment with iETN and switched to SDZ ETN; Group B, pts who received targeted therapies and switched to SDZ ETN; Group C, biologic naïve considered uncontrolled with conventional therapy; Group D, DMARD naïve with recent diagnosis of RA considered suitable for treatment initiation with a biologic and started on treatment with SDZ ETN. Effectiveness assessments included Disease Activity Score 28-joint count Erythrocyte Sedimentation Rate (DAS28-ESR) or Ankylosing Spondylitis Disease Activity Score (ASDAS) until Week 24 after enrollment (baseline; BL) in the study. Functional disability was measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). The effectiveness and safety results are reported for the pts who switched from iETN (Group A).Results:Of the 1437 pts recruited (analysis cut-off date: 16 Oct, 2020), 567 pts were switched from iETN, 163 were switched from other targeted therapies, 697 were biologic-naïve, and 10 were RA DMARD-naïve. Among pts who switched from iETN, 51.5% had RA, followed by axSpA (28.0%) and PsA (20.5%). Comorbidities were more frequent in pts with RA (70.2%) followed by PsA (58.6%) and axSpA (49.7%); musculoskeletal and connective tissue disorders were reported in 31.8% and 15.7% of pts with RA and axSpA, respectively. At BL, whilst receiving iETN, the mean (SD) DAS28-ESR scores were 2.5 (1.1) and 2.1 (1.1) in pts with RA and PsA, respectively (figure 1). The mean change from BL in DAS28-ESR score at Week 24 after switch to SDZ ETN was -0.1 (1.1) and 0 (1.0) in pts with RA and PsA, respectively. In pts with axSpA, the mean (SD) ASDAS score was 1.5 (0.7) at BL; mean change from BL in ASDAS score at Week 24 was 0.1 (0.5). At BL, the mean (SD) HAQ-DI scores were 0.8 (0.7), 0.5 (0.7) and 0.5 (0.6) in pts with RA, PsA and axSpA, respectively. Overall, the proportion of patients with at least one adverse event (AE) was 37.3%, 33.6% and 25.8% in pts with RA, PsA and axSpA, respectively. Serious AEs were reported in 6.5%, 1.7% and 3.1% of pts with RA, PsA, and axSpA, respectively. Injections site reactions were reported in 2.7%, 0.9% and 1.3% of pts with RA, PsA and axSpA, respectively.Figure 1.Disease activity in patients who switched from iETN to SDZ ETNConclusion:The interim analysis results shows that switch from iETN to SDZ ETN does not impact the effectiveness of ETN in pts with RA, axSpA or PsA, without any new safety signals.Disclosure of Interests:Marc Schmalzing Speakers bureau: Novartis, AbbVie, Chugai/Roche, Janssen-Cilag, Lilly, Consultant of: AstraZeneca, Chugai/Roche, Hexal/Sandoz, Gilead, AbbVie, Janssen-Cilag, Boehringer/Ingelheim, Grant/research support from: Travel grants: Chugai/Roche, Boehringer/Ingelheim, Celgene, Medac, Ayman Askari: None declared, Tom Sheeran Speakers bureau: Pfizer, UCB, Roche, Consultant of: Novartis, Pfizer, Grant/research support from: Novartis, UCB, Roche, David Walsh: None declared, Javier de Toro Santos: None declared, JULIO CESAR VAZQUEZ PEREZ-COLEMAN Speakers bureau: Sandoz, Abbvie, Sanofi, Fresenius, Charlotte Both Employee of: Sandoz employee Global Medical Affairs, Fabricio Furlan Employee of: Sandoz employee Global Medical Affairs, Sohaib HACHAICHI Employee of: Sandoz employee Global Medical Affairs, Herbert Kellner: None declared

scholarly journals AB0158 COMPARISON OF CLINICAL EXAMINATION AND ULTRASOUND OF HAND AND WRIST JOINTS IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1106.1-1106
Author(s):  
S. Bouden ◽  
B. D. Siwar ◽  
A. Ben Tekaya ◽  
O. Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Examination ◽  
Disease Activity Score ◽  
Power Doppler ◽  
Doppler Signal ◽  
Left Wrist ◽  
The Mean ◽  
The Right ◽  
Power Doppler Signal

Background:Ultrasound (US) is an accessible and non-invasive tool to assess joint involvement in rheumatoid arthritis (RA). It is used for diagnostic and prognosis purposes and for following of RA patients by evaluating the disease activity and therefore the response to treatment.Objectives:This study investigates agreement between US of hand and wrist findings and the clinical examination and biological inflammatory parameters in RA patients.Methods:We performed a cross sectional study including patients responding to the ACR/EULAR 2010 criteria for RA diagnosis. We collected US findings assessing synovitis and doppler signal in wrist, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) articulations, and concomitant clinical examination assessing synovitis and pain in the same joints along with C reactive protein (CRP) levels and disease activity score (DAS28). The power Doppler US score (PDUS) from 6 simplified synovial sites (wrists, bilateral second and third MCP joints) was calculated [1].Results:Forty-three patients were included with 91.7% of women. The mean age was 62±12.95 years old. The mean age at diagnosis was 52±14.79 years with a mean disease evolution of 8±8.57 years. Rheumatoid factor and anti-citrullinated antibodies were positive in respectively 78% and 83.9% of cases.The mean disease activity (DAS28) was 1,52 with levels ranging from 1.5 to 7.33.Right wrist was the articulation in which US synovitis was most frequently detected (60.5% of patients), followed by the left wrist (53.5%). Power doppler signal was detected as frequently in the right as in the left wrist articulations (41.9%). Subsequently, clinical synovitis was most frequently detected in right and left wrist with 39,5% and 41,5% respectively. These joints were the most frequently painful, in 51.2% and 48.8% at right and left respectively.US synovitis of the first interphalangeal joint was found in only 2.3% and 4.7% in the right and left hand respectively, with positive power doppler signal in 2.3% of the patients in the same articulations.The overall agreement between US and clinical examination in detecting synovitis of wrist, MCP and PIP joints was of 67.3%. It was of 71.4% in wrists, 54.7% in MCP joints and 87% in PIP joints. This suggests the presence of infra-clinical synovitis. All sites combined, US synovitis were correlated to clinical synovitis (p=0.03).A positive correlation was found between PDUS from 6 simplified joint sites and CRP levels (p value of 0.02). No correlation was found with disease activity score (DAS28).Conclusion:US of hands and wrist articulations is more performant than clinical examination in detecting synovitis. The most frequently involved joints with clinical and US synovitis, pain and positive power doppler signal were the wrist joints. CRP level is predictive of the presence of a high simplified power doppler score which is related to clinical activity of the disease as reported by Kawashiri et al. [1].References:[1]Kawashiri S, Kawakami A, Iwamoto N, Fujikawa K, Satoh K, Tamai M, et al. The power Doppler ultrasonography score from 24 synovial sites or 6 simplified synovial sites, including the metacarpophalangeal joints, reflects the clinical disease activity and level of serum biomarkers in patients with rheumatoid arthritis. Rheumatology (Oxford). mai 2011;50(5):962-5.Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document