scholarly journals CORRELATION OF BODY MASS INDEX WITH THE HAND GRIP STRENGTH AND ADDUCTOR POLLICIS MUSCLE THICKNESS IN ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERITEMATOSUS IN A BRAZIL NORTHEAST REFERENCE CENTER

2021 ◽  
pp. 85
Author(s):  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Elderly Patients ◽  
Lupus Erythematosus ◽  
Muscle Thickness ◽  
Adductor Pollicis ◽  
Systemic Lupus ◽  
Adductor Pollicis Muscle ◽  
Reference Center ◽  
Hand Grip

Introduction: Rheumatoid arthritis and systemic lupus erythematosus are autoimmune, chronic and progressive diseases, which can be get worst in the presence of muscle mass loss due to physical inactivity and continuous inflammatory. Therefore, estimate body composition can assist in the treatment of these diseases. Objective: To evaluate the correlation of body mass index with handgrip strength and adductor pollicis muscle thickness in elderly patients with rheumatoid arthritis and systemic lupus erythematosus followed in a reference center in Brazil. Material and Methods: Cross-sectional study carried out in a rheumatology outpatient clinic in a reference center in Northeastern Brazil (Recife / PE). Elderly patients with rheumatoid arthritis and systemic lupus erythematosus. Anthropometric measurements of weight, height and Body Mass Index (BMI) were taken, in addition to the measurement of body composition: calf circumference (CC), arm circumference (MUAC), adductor pollicis muscle thickness (APMT) and strength of hand grip (HGS). The data were treated using the SPSS version 17.0 for Windows and Excel 2010. Pearson correlation and the Chi-square test were used for analysis. The level of significance was set at 5%. The IMIP Research Bioethics Committee approved the present study under No. 19163619.1.0000.5201 the participants’ guardians signed the Free and Informed Consent Form (ICF). Results: The study included 19 patients aged 60 to 85 years and a mean age of 70.05 years +/- 8.47 SD, 94.74% of whom were female. The BMI, MUAC, CC, APMT and HGS mean of (26.93g / m2 ± 5.75DP), (28.85 ± 4.06DP), (34.79 ± 3.62DP), (11.52 ± 4.437DP) and (10.81 ± 6.77DP) respectively. The BMI showed that 31.26 were overweight, while HGS showed that 66.7% had a deficit in handgrip strength justified by the high prevalence of depletion of the adductor pollicis muscle, which identified that 97.4% showed signs of depletion of this musculature. There was a moderate correlation between BMI, MUAC and CC (r = 0.453) and (r = 0.426), respectively, while for BMI and APMT the correlation was weak (r = 0.348), as well as the correlation between BMI and HGS was r = 0.005. Conclusions: There was a prevalence of eutrophic and overweight elderly people, however with loss of muscle mass and decreased hand grip strength. This may suggest a greater risk for the development of senile sarcopenia.

scholarly journals Involvement of the wrist and hand joints and tendons in an Egyptian systemic lupus erythematosus cohort

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Omneya Mohamed-Ayman Abdel-Moniem ◽  
Sherine El-Sherif ◽  
Mohamed Sami Barakat ◽  
Diaa Fahmy Mohasseb ◽  
Yousra Hisham Abdel-Fattah
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Negative Correlation ◽  
Lupus Erythematosus ◽  
Power Doppler ◽  
Pinch Strength ◽  
Systemic Lupus ◽  
Hand Grip ◽  
Asymptomatic Patients ◽  
Subclinical Synovitis

Abstract Background Systemic lupus erythematosus (SLE) patients often suffer hand function limitations even in the absence of symptoms related to joint or tendon disorders. Recent researches reported the presence of ultrasonographic (US) subclinical synovitis and tendon involvement in asymptomatic patients. We aimed to assess US patterns in SLE patients and determine their relationship with clinical assessment, disease activity and hand functional status using handheld dynamometry. Results We assessed 30 SLE patients (60 hands) using US; 21 (70%) patient had synovial hypertrophy, 8 (26%) showed a power Doppler (PD) activity, 6 (20%) had erosions and 11 (36.6%) had tendon US abnormality. Both patients with hand arthralgia/arthritis (symptomatic) and patients without arthralgia/arthritis (asymptomatic) had a statistically insignificant difference regarding the global synovitis score (p = 0.2) and disease activity (p = 0.3). However, the symptomatic group had a significantly increased number of joints with effusion (p = 0.04) and tendons involved (p = 0.04). The mean grip strength had a significant negative correlation with SLEDAI-2 K score (rs = − 0.4, p = 0.02) in the total patient group. In the asymptomatic group, a negative correlation was found between both mean grip (rs = − 0.5, p = 0.04) and pinch strength (rs = − 0.6, p = 0.01) with PD index, and mean pinch strength with the Jaccoud’s arthropathy index (rs = − 0.49, p = 0.05). Conclusions SLE patients may have higher subclinical synovitis, erosions and tendon involvement than expected, which may in turn reduce hand grip and pinch strength. Disease activity may also have a negative impact on the hand grip functional strength.

scholarly journals POS0719 ADVERSE OUTCOMES AND REHOSPITALIZATION AFTER DELIVERY AMONG WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS OR RHEUMATOID ARTHRITIS AND THEIR INFANTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 609.1-609
Author(s):  
J. Sabo ◽  
N. Singh ◽  
D. A. Crane ◽  
D. R. Doody ◽  
M. A. Schiff ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Hospital Discharge ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Lupus Erythematosus ◽  
Adverse Outcomes ◽  
Systemic Lupus ◽  
Cesarean Deliveries

Background:Women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) have greater risk of adverse obstetric and birth outcomes than women without these conditions. Infant outcomes are less well-studied. It is unknown whether re-hospitalization after delivery occurs more often for affected mothers and their infants.Objectives:We compared obstetric outcomes among women with and without RA or SLE, and birth outcomes among their infants. Maternal and infant rehospitalizations <2 years of delivery were also compared.Methods:This population-based cohort study used linked birth-hospital discharge data from Washington State for 1987-2014. International Classification of Disease 9th revision (ICD9) codes identified all women with RA (ICD9 714.X, 725.X) and SLE (ICD9 710, 710.0, 710.1) in the hospital discharge record at delivery, and a 10:1 comparison group of women without these codes. Analyses were restricted to singleton live births (1,223 RA; 1,354 SLE). Poisson regression with robust standard errors estimated relative risks (RR) and 95% confidence intervals (CI) for selected outcomes, accounting for delivery year, maternal age, and parity.Results:Many adverse outcomes were more common among RA and SLE cases than among comparison women. Preeclampsia occurred more often during pregnancies of women with RA (RR 1.42, 95% CI 1.17-1.71) or SLE (RR 2.33, 95% CI 2.01-2.70), as did preterm rupture of membranes (PROM, RR 2.85, 95% CI 2.20-3.72 for RA; RR 3.28, 95% CI 2.54-4.23 for SLE). Cesarean deliveries were more common among nulliparous women in both groups (RR 1.32, 95% CI 1.18-1.48 for both conditions). Infants of women with RA or SLE were more likely to weigh <2500 g (RR 2.08, 95% CI 1.72-2.52 for RA; RR 4.88, 95% CI 4.27-5.58 for SLE), be small for gestational age (RR 1.25, 95% CI 1.07-2.50; RR 2.30; 2.04-2.59, respectively), delivered at <32 weeks gestation (RR 1.83, 95% CI 1.13-2.97; RR 5.13, 95% CI 3.75-7.01, respectively), and require neonatal intensive care unit admission (NICU, RR 1.89, 95% CI 1.56-2.30; RR 2.71, 95% CI 2.25-3.28, respectively). Infants of women with SLE were more likely to have a malformation (RR 1.46, 95% CI 1.21-1.75) or die within 2 years (RR 2.11, 95% CI 1.21-3.67). Rehospitalization levels among both women with RA (RR 2.22; 1.62-3.04) and SLE (RR 2.78, 95% CI 2.15-3.59) were greatest <6 months of delivery and declined over time. Infants of women with SLE had increased rehospitalization <6 months (RR 1.64, 95% CI 1.36-1.98).Conclusion:Consistent with prior literature, we found women with RA or SLE experienced many adverse outcomes. In our data, these included preeclampsia, PROM, and cesarean deliveries, with increased risks more notable among women with SLE. Infants of women with either condition were more likely to weigh <2500g, be <32 weeks gestation, small for gestational age, and require NICU admission than infants of comparison women. Only infants of women with SLE had increased malformations. Maternal rehospitalization after delivery was more common in both groups; most marked at <6 months. Infant rehospitalizations were increased in both cohorts to a lesser extent. Close follow-up during this time period is crucial to minimize adverse outcomes.Disclosure of Interests:Julianna Sabo: None declared, Namrata Singh: None declared, Deborah A. Crane: None declared, David R. Doody: None declared, Melissa A. Schiff: None declared, Beth A. Mueller Shareholder of: Household owns shares in AstraZeneca

scholarly journals AB0818 ADVERSE EVENTS UNDER B-CELL DIRECTED THERAPIES IN A LARGE SINGLE-CENTER COHORT OF PATIENTS WITH RHEUMATOID ARTHRITIS, SYSTEMIC LUPUS ERYTHEMATOSUS, ANCA-ASSOCIATED VASCULITIS AND RENAL DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1433.1-1433
Author(s):  
J. G. Rademacher ◽  
V. Korendovych ◽  
P. Korsten
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Adverse Events ◽  
B Cell ◽  
Clinical Data ◽  
Lupus Erythematosus ◽  
Infectious Complications ◽  
Single Center ◽  
Systemic Lupus ◽  
Anca Associated Vasculitis

Background:The anti-CD20 antibody rituximab (RTX) is approved for the treatment of rheumatoid arthritis (RA) and ANCA-associated vasculitis (AAV). In addition, RTX is used in a wide range of autoimmune diseases. Belimumab (BEL) is an anti-BAFF antibody approved for the treatment of non-renal systemic lupus erythematosus (SLE) in Europe. These agents are generally well-tolerated but severe adverse events (AEs) can occur. The frequency of and factors associated with AEs are currently unknown.Objectives:To identify adverse events with the use of B-cell directed therapies in a large population of RA, AAV, and SLE.Methods:This is a single-center retrospective cohort study using routine clinical data over a ten-year period (2010-2020). We recorded epidemiological and clinical data of patients receiving either BEL or RTX. Data included age, gender, type of disease, number and efficacy of infusions, patient-years and concomitant treatment. Patient records were screened for AEs, such as infections, anaphylaxis, occurrence of malignant disease, laboratory abnormalities and immunoglobulin (Ig) deficiency. Between group comparisons were performed.Results:Database screening yielded 445 patients treated with RTX and 23 with BEL. After exclusion of patients with incomplete data, 425 RTX and 23 BEL patients were analyzed.Our preliminary analysis of a sample of 60 of these 448 patients (184 patient-years) resulted in 43 patients (72%) with RA, 8 patients with AAV (13%), 5 patients with a renal disease, and 4 patients with mixed connective tissue disease, as well 23 SLE patients. 46 (77%) were female. In RA, a median of 13 treatments of 1000 mg were administered, corresponding to 3.37 patient-years per patient. Primary non-response occurred in 2 patients, secondary non-response in 13 patients. For AAV, a median of 8.4 treatments were given (3.3 patient-years), no treatment failure was detected. SLE patients received a median of 15 treatments.15 patients had infectious complications during treatment, 11 needed treatment. Herpes zoster infection occurred in 3 patients with RA. Three of the 8 patients with AAV had an infection requiring treatment. In SLE patients, only 2 developed infectious complications, and no Ig-deficiency occurred.Lymphopenia was the most common laboratory abnormality detected in 25 patients with RTX, 19 of whom had RA. Ig deficiency was common in RA, affecting 30% of patients. Deficiency of IgM and IgG was recognized in 5 patients each; 1 patient had low levels IgA.Neither the maintenance prednisolone dosage nor Ig deficiency were associated with risk for infection. However, lymphopenia appeared to be associated with risk for infection.Conclusion:Our preliminary data observe a 184 patient-year period. RTX and BEL were generally associated with few AEs. RA patients frequently had laboratory abnormalities (lymphopenia, Ig-deficiency) which did not necessarily translate to clinical events. Infections were more common in AAV, BEL was the best tolerated B-cell directed agent. Overall, our data are reassuring, but we suggest a more careful vigilance in AAV patients.Disclosure of Interests:Jan-Gerd Rademacher: None declared, Viktor Korendovych: None declared, PETER KORSTEN Speakers bureau: Abbvie, Sanofi Aventis, GSK, Chugai, Boehringer-Ingelheim, Novartis, Consultant of: Lilly, Gilead, Boehringer-Ingelheim, Novartis, GSK, Grant/research support from: GSK

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