Serological and Progression Differences of Joint Destruction in the Wrist and the Feet in Rheumatoid Arthritis - A Cross-Sectional Cohort Study

Little is known about whether and how two chronic diseases interact with each other in modifying the risk of physical inactivity. The aim of the present study is to identify chronic disease pairs that are associated with compliance or noncompliance with the Dutch PA guideline recommendation and to study whether specific chronic disease pairs indicate an extra effect on top of the effects of the diseases individually. Cross-sectional data from 3,386 participants of cohort study SMILE were used and logistic regression analysis was performed to study the joint effect of the two diseases of each chronic disease pair for compliance with the Dutch PA guideline. For six chronic disease pairs, patients suffering from both diseases belonging to these disease pairs in question show a higher probability of noncompliance to the Dutch PA guideline, compared to what one would expect based on the effects of each of the two diseases alone. These six chronic disease pairs were chronic respiratory disease and severe back problems; migraine and inflammatory joint disease; chronic respiratory disease and severe kidney disease; chronic respiratory disease and inflammatory joint disease; inflammatory joint disease and rheumatoid arthritis; and rheumatoid arthritis and osteoarthritis of the knees, hips, and hands.

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Genetic variants in IL-15 associate with progression of joint destruction in rheumatoid arthritis, a multi cohort study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2011-201236.14 ◽

2012 ◽

Vol 71 (Suppl 1) ◽

pp. A56.3-A57

Author(s):

R Knevel ◽

A Krabben ◽

E Brouwer ◽

Posthumus ◽

A G Wilson ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Genetic Variants ◽

Joint Destruction

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Bone mineral density by digital X-ray radiogrammetry is strongly decreased and associated with joint destruction in long-standing Rheumatoid Arthritis: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-12-242 ◽

2011 ◽

Vol 12 (1) ◽

Cited By ~ 12

Author(s):

Helena Forsblad-d'Elia ◽

Hans Carlsten

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Mineral ◽

Joint Destruction ◽

Cross Sectional Study ◽

Sectional Study ◽

Mineral Density ◽

Cross Sectional ◽

X Ray

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AB1072 ROLE OF ULTRASOUND IN DETECTION OF SHOULDER JOINT PATHOLOGIES IN ASYMPTOMATIC RHEUMATOID ARTHRITIS PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4624 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1825.2-1825

Author(s):

M. G. Abdelzaher ◽

S. Tharwat ◽

A. Abdelkhalek ◽

A. Abdelsalam

Keyword(s):

Rheumatoid Arthritis ◽

Glenohumeral Joint ◽

Biceps Tendon ◽

Joint Destruction ◽

Chronic Inflammatory Disease ◽

University Hospital ◽

High Rate ◽

Subscapularis Tendon ◽

Cross Sectional

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that results in progressive destruction of structural components of the joints1.It commonly affects the shoulder leading to pain, tenderness and decreased range of motion2.Increased shoulder pain has been found to correlate strongly with disease severity3, however there is little information available in the literature regarding shoulder pathologies in asymptomatic RA patients.Objectives:To determine the prevalence of pathologies in asymptomatic shoulders in rheumatoid arthritis patients and role of ultrasound to detect it.Methods:A cross-sectional study including two groups, first group included 36 RA patients, meeting the ACR/EULAR classification criteria for RA with no shoulder complaints. The second group included 36 healthy control subjects of similar age groups and sex, with no shoulder complaints. They were recruited from rheumatology outpatient clinic in Mansoura University Hospital. Only asymptomatic shoulders of both groups were examined clinically by inspection, palpation and special tests, then examined by ultrasound using Toshiba Xario 200 machine with 13 MHz superficial probe including biceps tendon, subscapularis tendon, supraspinatus tendon, subacromial subdeltoid (SASD) bursa, infraspinatus tendon, posterior glenohumeral joint for effusion or synovitis, acromioclavicular joint and humeral head for erosions. Findings of both groups were compared to each other.Results:Asymptomatic shoulders in RA patients showed significant number of pathologies in 72% of the examined patients in comparison with healthy subjects (17%). According to frequency, humeral erosions were detected in 12 patients (33%), acromioclavicular osteoarthritis in 8 patients (22%), biceps tenosynovitis, supraspinatus tendinopathy, glenohumeral effusion in 6 patients (17%), subscapularis tendinopathy in 4 patients (11.%), SASD bursitis in 2 patients (6%), Infraspinatus tendinopathy in 1 patient (3%).The healthy group showed less number of pathologies including supraspinatus tendinopathy 3 (8%), acromioclavicular osteoarthritis 2 (6%), humeral erosions 1 (3%).Conclusion:A significant high rate of different pathologies can be present in shoulders of RA patients despite negative history and normal physical examination. Ultrasound can be used for early detection and better management before irreversible joint destruction.References:[1]Weishaupt D, Schweitzer ME (2004) MR imaging of septic arthritis and rheumatoid arthritis of the shoulder. Magn Reson Imaging Clin N Am 12:111–124[2]Varache S, Cornec D, Morvan J, et al. Diagnostic accuracy of acr/eular 2010 criteria for rheumatoid arthritis in a 2-year cohort. The Journal of rheumatology. 2011; 38(7): 1250-1257.[3]Van de Sande MA, De Groot JH, Rozing PM. Clinical implications of rotator cuff degeneration in the rheumatic shoulder. Arthritis care & research. 2008; 59(3): 317-324.Disclosure of Interests:None declared

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POS0573 IMPACT OF JOINT DESTRUCTION IN THE HANDS, THE WRISTS AND THE ANKLES ON THE ULTRASOUND ASSESSMENT AND THE FUNCTIONAL OUTCOMES IN RHEUMATOID ARTHRITIS IN REMISSION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3601 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 521.1-521

Author(s):

R. Fakhfakh ◽

N. El Amri ◽

K. Baccouche ◽

H. Zeglaoui ◽

E. Bouajina

Keyword(s):

Rheumatoid Arthritis ◽

Functional Outcomes ◽

Bone Erosion ◽

Joint Destruction ◽

Power Doppler ◽

Health Assessment ◽

Cross Sectional ◽

Significant Difference ◽

The Mean ◽

Hands And Feet

Background:Joint destruction is a strong predictive factor for residual synovitis among rheumatoid arthritis (RA) patients in clinical remission. Both of them were associated with functional impairment.Objectives:To assess the ultrasound findings and functional outcomes of RA patients in remission according to the site of joint destruction.Methods:A Cross-sectional study including RA patients in remission DAS28 ESR≤ 2.6 for at least 6 months. A B-mode and power doppler (PD) ultrasound of 42 joints was performed. Synovitis was defined and scored using the combined OMERACT-PDUS (gray scale and power doppler (PD)) scoring system graded from 0 to 3. The health assessment questionnaire (HAQ) and the radiological Sharp score of the wrists, hands and feet were calculated.Results:Thirty-seven patients were included. The sex ratio was 0.37 and the mean age was 54.2 years ± 12.7. The mean disease duration was 8.1 years±5.1. The mean remission duration was 36.5 months ± 32.7. The mean DAS28vs was 2.1 ± 0.5. Rheumatoid factor and anti-citrullinated peptide antibodies were found in 62% and 75% of patients, respectively. The mean HAQ was 0.35 ± 0.38. Bone erosion was found in 81% of patients. In patients with hands and feet erosions (54%), synovitis was found in 90% of cases associated with PD in 70% of cases. The mean total score of synovitis was 7.8 ± 5.4. The mean HAQ was 0.37 ± 0.44. In patients with only erosions in the hands or wrists (18.9%), synovitis was found in 100% of cases associated with PD in 57% of cases. The mean total score of synovitis was 4.5±4.7. The mean HAQ was 0.48 ± 0.34. In patients with only feet erosions (8.1%), synovitis was found in 100% of cases associated with PD in 66.7% of cases. The mean total score of synovitis was 4.6±3.5. The mean HAQ was 0.31 ± 0.26. RA was not erosive in 18.9% of patients. In these patients, synovitis was found in 100% of cases associated with PD in 28.6% of cases. The mean total score of synovitis was 5.6±4.3. The mean HAQ was 0.21 ± 0.23. There is no significant difference between these groups(p>0.05).Conclusion:In RA in remission, PD synovitis and functional incapacity were less frequent in the absence of erosion. PD synovitis was more frequently found in patients with erosions, especially, in the feet. The HAQ was higher in patients with hands erosions.References:[1]Hamamoto Y, Ito H, Furu M, Hashimoto M, Fujii T, Ishikawa M, et al. Serological and Progression Differences of Joint Destruction in the Wrist and the Feet in Rheumatoid Arthritis - A Cross-Sectional Cohort Study. PLoS One. 2015;10(8):e0136611.Disclosure of Interests:None declared

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Real-world experiences of folic acid supplementation (5 versus 30 mg/week) with methotrexate in rheumatoid arthritis patients: a comparison study

Reumatismo ◽

10.4081/reumatismo.2016.872 ◽

2016 ◽

Vol 68 (2) ◽

pp. 90 ◽

Cited By ~ 3

Author(s):

K.T. Koh ◽

C.L. Teh ◽

C.K. Cheah ◽

G.R. Ling ◽

M.C. Yong ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Folic Acid ◽

Disease Activity Score ◽

Folic Acid Supplementation ◽

Observational Cohort Study ◽

Comparison Study ◽

Cross Sectional ◽

Observational Cohort ◽

Lower Disease Activity

The objective of this study was to compare the tolerability of methotrexate in two different regimes of folic acid (FA) supplementation in rheumatoid arthritis (RA). We performed a multicenter, cross-sectional observational cohort study on 240 RA patients with 120 patients each in 5 mg of FA weekly and 30 mg of FA weekly supplementation. There were no significant differences for side effects (14.2 versus 22.5%, P=0.523) and discontinuation of methotrexate (3.6 versus 13.3%, P=0.085). RA patients given 5 mg of FA weekly supplementation had a lower disease activity score 28 compared to 30 mg of FA weekly supplementation [3.44 (1.10) versus 3.85 (1.40), P=0.014]. FA supplementation of 5 mg per week and 30 mg per week was associated with similar tolerability of methotrexate in RA patients.

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Burden and trajectory of multimorbidity in rheumatoid arthritis: a matched cohort study from 2006 to 2015

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-218282 ◽

2020 ◽

pp. annrheumdis-2020-218282 ◽

Cited By ~ 1

Author(s):

Bryant R England ◽

Punyasha Roul ◽

Yangyuna Yang ◽

Harlan Sayles ◽

Fang Yu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Chronic Conditions ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Sensitivity Analyses ◽

Cross Sectional ◽

Diagnostic Codes ◽

Binomial Regression

ObjectivesTo compare the onset and trajectory of multimorbidity between individuals with and without rheumatoid arthritis (RA).MethodsA matched, retrospective cohort study was completed in a large, US commercial insurance database (MarketScan) from 2006 to 2015. Using validated algorithms, patients with RA (overall and incident) were age-matched and sex-matched to patients without RA. Diagnostic codes for 44 preidentified chronic conditions were selected to determine the presence (≥2 conditions) and burden (count) of multimorbidity. Cross-sectional comparisons were completed using the overall RA cohort and conditional logistic and negative binomial regression models. Trajectories of multimorbidity were assessed within the incident RA subcohort using generalised estimating equations.ResultsThe overall cohort (n=277 782) and incident subcohort (n=61 124) were female predominant (76.5%, 74.1%) with a mean age of 55.6 years and 54.5 years, respectively. The cross-sectional prevalence (OR 2.29, 95% CI 2.25 to 2.34) and burden (ratio of conditions 1.68, 95% CI 1.66 to 1.70) of multimorbidity were significantly higher in RA than non-RA in the overall cohort. Within the incident RA cohort, patients with RA had more chronic conditions than non-RA (β 1.13, 95% CI 1.10 to 1.17), and the rate of accruing chronic conditions was significantly higher in RA compared with non-RA (RA × follow-up year, β 0.21, 95% CI 0.20 to 0.21, p<0.001). Results were similar when including the pre-RA period and in several sensitivity analyses.ConclusionsMultimorbidity is highly prevalent in RA and progresses more rapidly in patients with RA than in patients without RA during and immediately following RA onset. Therefore, multimorbidity should be aggressively identified and targeted early in the RA disease course.

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161 Cross Sectional Study of Pharmacological Management of Rheumatoid Arthritis in Patients over the age of 70

Age and Ageing ◽

10.1093/ageing/afz103.94 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Catriona Reddin ◽

Maria Costello ◽

Bernadette Lynch

Keyword(s):

Rheumatoid Arthritis ◽

Therapeutic Potential ◽

Joint Destruction ◽

Joint Damage ◽

Joint Disease ◽

Older Population ◽

Record System ◽

Cross Sectional ◽

Therapeutic Benefits ◽

Conventional Dmards

Abstract Background Rheumatoid arthritis (RA) is a common inflammatory joint disease. It can lead to joint destruction resulting in joint deformity, functional impairment and reduced mobility. With a growing older population, prevalence of RA is increasing and due to the associated morbidity it is essential to prioritise disease control. Conventional treatment of RA has comprised of disease modifying anti rheumatic drugs (DMARDs) along with analgesia and corticosteroids. Recently, the development of biologics has revolutionised management of inflammatory arthritis. We now strive for tighter control to prevent joint damage and preserve function. However, studies have shown that uptake of biologic medications in the older population has been slower than their younger counterparts. (1) Methods Our departmental electronic record system, Cellma, was interrogated for patients aged 70 and over with a diagnosis of RA. Deceased patients were excluded. The current medication list was reviewed using the online rheumatology outpatient system. Results A total of 514 patients over the age of 70 were identified with a diagnosis of RA [(67% (n=343) female, 33% (n=171) male)], 24.5% (n=126) were on biologic therapy, 13% (n=68) patients were on a single DMARD in combination with a biologic, 42% (n=217) of patients were on a single conventional DMARD alone and 9.7% (n=50) were on analgesia alone. Conclusion The management of RA in the older population poses its own challenges but this should not prohibit the thoughtful use of newer agents. Awareness of the therapeutic potential and associated adverse events is necessary for maximizing therapeutic benefits while minimizing adverse effects from conventional DMARDs and biologic therapies.

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