Calprotectin as a Biomarker for Rheumatoid Arthritis: A Systematic Review

2015 ◽  
Vol 42 (5) ◽  
pp. 760-770 ◽  
Author(s):  
Mads Abildtrup ◽  
Gabrielle H. Kingsley ◽  
David L. Scott
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Longitudinal Data ◽  
Calcium Binding ◽  
Therapeutic Response ◽  
Original Data ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Wide Range ◽  
The Cochrane Library

Objective.Calprotectin (myeloid-related protein 8/14), a heterodimeric complex of calcium-binding proteins, is expressed in granulocytes and monocytes. Calprotectin levels are high in synovial tissue, particularly in activated cells adjacent to the cartilage-pannus junction. This systematic review evaluates the use of calprotectin as an indicator of disease activity, therapeutic response, and prognosis in rheumatoid arthritis (RA).Methods.Medline, Scopus, and the Cochrane Library (1970–2013) were searched for studies containing original data from patients with RA in whom calprotectin levels were measured in plasma/serum and/or synovial fluid (SF). We included studies examining associations between calprotectin levels and clinical and laboratory assessments, disease progression, and therapeutic response. There were no restrictions for sample size, disease duration, or length of followup.Results.We evaluated 17 studies (1988–2013) with 1065 patients enrolled; 11 were cross-sectional and 8 had longitudinal designs with 2 studies reporting cross-sectional and longitudinal data. Systemic and SF levels of calprotectin were raised in RA. There was a wide range of levels and marked interstudy and intrastudy variability. Calprotectin levels were high in active disease and were particularly high in rheumatoid factor (RF)-positive patients. Levels fell with effective treatment. Longitudinal data showed that calprotectin was a significant and independent predictor of erosive progression and therapeutic responses, particularly in patients who received effective biological treatments.Conclusion.SF calprotectin levels are high, suggesting there is substantial local production by inflamed synovium. Blood calprotectin levels, though highly variable, are elevated in active RA and fall with effective therapy. High baseline calprotectin levels predict future erosive damage.

scholarly journals Sedentary behaviour among general practitioners: a systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Richard S. Mayne ◽  
Nigel D. Hart ◽  
Neil Heron
Keyword(s):  
Systematic Review ◽  
Sedentary Behaviour ◽  
General Practitioners ◽  
Sedentary Time ◽  
Grey Literature ◽  
Sitting Time ◽  
Cochrane Library ◽  
Cross Sectional ◽  
The Cochrane Library ◽  
Activity Questionnaire

Abstract Background Sedentary behaviour is when someone is awake, in a sitting, lying or reclining posture and is an independent risk factor for multiple causes of morbidity and mortality. A dose-response relationship has been demonstrated, whereby increasing sedentary time corresponds with increasing mortality rate. This study aimed to identify current levels of sedentary behaviour among General Practitioners (GPs), by examining and synthesising how sedentary behaviour has been measured in the primary care literature. Methods A systematic review was conducted to identify studies relating to levels of sedentary behaviour among GPs. Searches were performed using Medline®, Embase®, PscycINFO, Web of Science and the Cochrane Library, from inception of databases until January 2020, with a subsequent search of grey literature. Articles were assessed for quality and bias, with extraction of relevant data. Results The search criteria returned 1707 studies. Thirty four full texts were reviewed and 2 studies included in the final review. Both were cross-sectional surveys using self-reported estimation of sedentary time within the International Physical Activity Questionnaire (IPAQ). Keohane et al. examined GP trainees and GP trainers in Ireland. 60% reported spending in excess of 7 h sitting each day, 24% between 4 and 7 h, and 16% less than or equal to 4 h. Suija et al. examined female GPs in Estonia. The mean reported daily sitting time was 6 h and 36 min, with 56% sitting for over 6 h per day. Both studies were of satisfactory methodological quality but had a high risk of bias. Conclusion There is a paucity of research examining current levels of sedentary behaviour among GPs. Objective data is needed to determine GPs’ current levels of sedentary behaviour, particularly in light of the increase in remote consulting as a result of the COVID-19 pandemic.

scholarly journals Sedentary Behaviour Among General Practitioners: A Systematic Review

2020 ◽  
Author(s):  
Richard S. Mayne ◽  
Nigel D. Hart ◽  
Neil Heron
Keyword(s):  
Systematic Review ◽  
Sedentary Behaviour ◽  
General Practitioners ◽  
Sedentary Time ◽  
Grey Literature ◽  
Sitting Time ◽  
Cochrane Library ◽  
Cross Sectional ◽  
The Cochrane Library ◽  
Activity Questionnaire

Abstract BackgroundSedentary behaviour is when someone is awake, in a sitting, lying or reclining posture and is an independent risk factor for multiple causes of morbidity and mortality. A dose-response relationship has been demonstrated, whereby increasing sedentary time corresponds with increasing mortality rate. This study aimed to identify current levels of sedentary behaviour among General Practitioners (GPs), by examining and synthesising how sedentary behaviour has been measured in the primary care literature.MethodsA systematic review was conducted to identify studies relating to levels of sedentary behaviour among GPs. Searches were performed using Medline®, Embase®, PscycINFO, Web of Science and the Cochrane Library, from inception of databases until January 2020, with a subsequent search of grey literature. Articles were assessed for quality and bias, with extraction of relevant data.ResultsThe search criteria returned 1707 studies. 34 full texts were reviewed and 2 studies included in the final review. Both were cross-sectional surveys using self-reported estimation of sedentary time within the International Physical Activity Questionnaire (IPAQ). Keohane et al. examined GP trainees and GP trainers in Ireland. 60% reported spending in excess of 7 hours sitting each day, 24% between 4 and 7 hours, and 16% less than or equal to 4 hours. Suija et al. examined female GPs in Estonia. The mean reported daily sitting time was 6 hours and 36 minutes, with 56% sitting for over 6 hours per day. Both studies were of satisfactory methodological quality but had a high risk of bias.ConclusionThere is a paucity of research examining current levels of sedentary behaviour among GPs. Objective data is needed to determine GPs’ current levels of sedentary behaviour, particularly in light of the increase in remote consulting as a result of the COVID-19 pandemic.

scholarly journals Dietary Interventions with or without Omega-3 Supplementation for the Management of Rheumatoid Arthritis: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3506
Author(s):  
Tala Raad ◽  
Anne Griffin ◽  
Elena S. George ◽  
Louise Larkin ◽  
Alexander Fraser ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Cochrane Library ◽  
Omega 3 ◽  
Dietary Interventions ◽  
Randomized Controlled ◽  
Joint Tenderness ◽  
Pain Duration ◽  
Autoimmune Condition ◽  
The Cochrane Library

Rheumatoid Arthritis (RA) is a chronic autoimmune condition characterized by symptoms of inflammation and pain in the joints. RA is estimated to have a worldwide prevalence of 0.5–1%, with a predominance in females. Diet may play an important role in the symptoms of RA; however, little is known about the effects of various diets. The aim of this systematic review is to explore the effect of dietary interventions, with or without omega-3 supplementation for the management of RA. The electronic databases MEDLINE, EMBASE, CINAHL, and the Cochrane Library were systematically searched for clinical trials investigating dietary interventions, with or without omega-3 supplementation to retrieve papers from inception to April 2021. Randomized and non-randomized controlled trials of dietary interventions in adults with RA were eligible for inclusion. Twenty studies with a total of 1063 participants were included. The most frequently reported outcomes were pain, duration of morning stiffness, joint tenderness, grip strength and inflammatory markers. Dietary interventions with an anti-inflammatory basis may be an effective way for adults with RA seeking complementary treatments, potentially leading to improvements in certain parameters. However, there is a need for longer duration studies that are well-designed and sufficiently powered to investigate the influence of diet on RA.

scholarly journals Sedentary Behaviour Among General Practitioners: A Systematic Review

2020 ◽  
Author(s):  
Richard S. Mayne ◽  
Nigel D. Hart ◽  
Neil Heron
Keyword(s):  
Systematic Review ◽  
Sedentary Behaviour ◽  
General Practitioners ◽  
Sedentary Time ◽  
Sitting Time ◽  
Cochrane Library ◽  
Cross Sectional ◽  
The Mean ◽  
The Cochrane Library ◽  
Activity Questionnaire

Abstract BackgroundSedentary behaviour is when someone is awake, in a sitting, lying or reclining posture and is an independent risk factor for multiple causes of morbidity and mortality. A dose-response relationship has been demonstrated, whereby increasing sedentary time corresponds with increasing mortality rate. This study aimed to identify current levels of sedentary behaviour among General Practitioners (GPs), by examining and synthesising how sedentary behaviour has been measured in the primary care literature.MethodsA systematic review was conducted to identify studies relating to levels of sedentary behaviour among GPs. Searches were performed using Medline®, Embase®, PscycINFO, Web of Science and the Cochrane Library, from inception of databases until January 2020. Articles were assessed for quality and bias, with extraction of relevant data.ResultsThe search criteria returned 1707 studies. 34 full texts were reviewed and 2 studies included in the final review. Both were cross-sectional surveys using self-reported estimation of sedentary time within the International Physical Activity Questionnaire (IPAQ). Keohane et al. examined GP trainees and GP trainers in Ireland. 60% reported spending in excess of 7 hours sitting each day, 24% between 4 and 7 hours, and 16% less than or equal to 4 hours. Suija et al. examined female GPs in Estonia. The mean reported daily sitting time was 6 hours and 36 minutes, with 56% sitting for over 6 hours per day. Both studies were of satisfactory methodological quality but had a high risk of bias.ConclusionThere is a paucity of research examining current levels of sedentary behaviour among GPs. Objective data is needed to determine GPs’ current levels of sedentary behaviour, particularly in light of the increase in remote consulting as a result of the COVID-19 pandemic.

scholarly journals Cost-Related Medication Nonadherence in Canada: A Systematic Review of Prevalence, Predictors, and Clinical Impact

2020 ◽  
Author(s):  
Anne Marie Holbrook ◽  
Mei Wang ◽  
Munil Lee ◽  
Zhiyuan Chen ◽  
Michael Garcia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Low Income ◽  
Original Data ◽  
Population Based ◽  
Adverse Outcomes ◽  
Cochrane Library ◽  
Sampling Frame ◽  
One Year ◽  
The Cochrane Library

Abstract Background Cost-related nonadherence to medications (CRNA) is common in many countries and thought to be associated with adverse outcomes. The characteristics of CRNA in Canada, with its patchwork coverage of increasingly expensive medications, is unclear. Objectives Our objective in this systematic review was to summarize the literature evaluating CRNA in Canada in three domains: prevalence, predictors, and effect on clinical outcomes.Methods We searched MEDLINE, Embase, Google Scholar, and the Cochrane Library from 1992 to December 2019 using search terms covering medication adherence, costs, and Canada. Eligible studies, without restriction on design, had to have original data on at least one of the three domains specifically for Canadian participants. Articles were identified and reviewed in duplicate. Risk of bias was assessed using design-specific tools.Results: Twenty-six studies of varying quality (n=483,065 Canadians) were eligible for inclusion. Sixteen studies reported on the overall prevalence of CRNA, with population-based estimates ranging from 5.1% to 10.2%. Factors predicting CRNA included high out of pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health. A single randomized trial of free essential medications with free delivery in Ontario improved adherence but did not find any change in clinical outcomes at one year. Conclusion: CRNA affects many Canadians. The estimated percentage depends on the sampling frame, the main predictors tend to be financial, and its association with clinical outcomes in Canada remains unproven.

scholarly journals Association of parenting with suicidal ideation and attempts in children and youth: protocol for a systematic review and meta-analysis of observational studies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Florence Perquier ◽  
Sarah Hetrick ◽  
Terri Rodak ◽  
Xin Jing ◽  
Wei Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Suicidal Ideation ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Children And Youth ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Wide Range

Abstract Background Suicide is a leading cause of death in children and youth, with suicidal thoughts and suicide attempts (referred to as non-fatal suicidal behaviors (NFSB)) being among its strongest predictors. Positive parenting (e.g., warmth, responsiveness), negative parenting (e.g., control, hostility), and parent-child relationship quality (e.g., trust, communication) have been reported to be associated with differences in NFSB in this population. To date, no comprehensive systematic review has considered together the wide range of parenting factors studied in relation to NFSB, and no meta-analysis of existing findings has been conducted. The present study will critically appraise and synthesize the existing evidence from observational studies that examine the relationships between parenting factors and (i) suicidal ideation and (ii) suicide attempt in children and youth. Methods Studies will be retrieved from APA PsycInfo, MEDLINE, CINAHL, Embase, Scopus, and the Cochrane Library databases. Retrospective, cross-sectional, and longitudinal studies, conducted in clinical and population settings, among youth aged less than 25 years and published as articles and dissertations in English or French will be eligible. Two reviewers will select articles using the Covidence Software after title and abstract screening and full-text assessment, will extract information using double data entry, and will appraise studies’ quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Any disagreements will be discussed with a third reviewer. Publication bias will be evaluated using funnel plots and Egger’s test. In addition to a narrative summary of results, meta-analyses will be conducted using results from at least three studies. Three-level random effect models will allow to derive pooled estimates from dependent effect sizes (from the same sample or study). In case of significant heterogeneity, moderation analyses will be performed considering participants’ characteristics and methodological aspects of studies. The results will be reported according to the PRISMA guidelines, and the certainty of evidence will be assessed using the GRADE approach. Discussion In highlighting parenting factors associated with NFSB and in estimating the overall strength of these associations in children and youth, our results will inform further intervention and prevention strategies designed for young people experiencing NFSB and their families. Systematic review registration PROSPERO CRD42020165345

scholarly journals Methotrexate dosage as a source of bias in biological trials in rheumatoid arthritis: a systematic review

2016 ◽  
Vol 75 (9) ◽  
pp. 1595-1598 ◽  
Author(s):  
Josefina Durán ◽  
Margarita Bockorny ◽  
Deepan Dalal ◽  
Michael LaValley ◽  
David T Felson
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Optimal Dose ◽  
Cochrane Library ◽  
Maximal Dose ◽  
Biologic Drugs ◽  
Suboptimal Dose ◽  
Randomised Controlled ◽  
The Cochrane Library ◽  
Injectable Form

ObjectivesTo evaluate if optimal dose of either oral or injectable regimens of methotrexate (MTX) of 25 mg/week was used in the comparator arms of studies comparing biologic drugs with MTX in rheumatoid arthritis (RA).MethodsA systematic literature search was carried out in MEDLINE, EMBASE and the Cochrane Library databases for randomised controlled trials comparing biologics with MTX in RA. A systematic review was performed among studies that met predefined criteria focusing on assessment of dose of MTX used in the comparator arm. Study authors were contacted when necessary. Study quality was assessed.ResultsA total of 3276 references were identified and 13 trials were included. We obtained maximal dose and regimen for all. The maximal dose of MTX used in the comparator arm of the trials was no more than 20 mg/week in any trial and for all but one trial, MTX was given orally and not by injection. The trial that used an injectable form reached a maximum of 15 mg/week.ConclusionsA suboptimal dose of MTX was used in biological clinical trials performed in RA, particularly regarding route of administration. This may have biased findings in favour of biological agents.

scholarly journals Examining the relationship between rheumatoid arthritis, multimorbidity and adverse health-related outcomes: A systematic review protocol

2020 ◽  
Vol 10 ◽  
pp. 2235042X2090665
Author(s):  
Jordan Canning ◽  
Stefan Siebert ◽  
Bhautesh D Jani ◽  
Frances S Mair ◽  
Barbara I Nicholl
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Autoimmune Disorder ◽  
Cochrane Library ◽  
Systemic Complications ◽  
Registration Number ◽  
Health Related ◽  
Review Protocol ◽  
Meta Analyses ◽  
The Cochrane Library

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterised by articular inflammation and systemic complications. Multimorbidity (the presence of two or more long-term health conditions) is highly prevalent in people with RA but the effect of multimorbidity on mortality and other health-related outcomes is poorly understood. Objective: To determine what is known about the effect, if any, of multimorbidity on mortality and health-related outcomes in individuals with RA. Design: Systematic review of the literature. The following electronic medical databases will be searched: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, The Cochrane Library and Scopus. Included studies will be quality appraised using the Quality in Prognostic Studies tool developed by the Cochrane Prognosis Methods Group. A narrative synthesis of findings will be undertaken and meta-analyses considered, if appropriate. This protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 guidelines, ensuring the quality of the review. Conclusions: Understanding the influence of multimorbidity on mortality and other health-related outcomes in RA will provide an important basis of knowledge with the potential to improve future clinical management of RA. PROSPERO registration number: CRD42019137756.

scholarly journals Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Anne M. Holbrook ◽  
Mei Wang ◽  
Munil Lee ◽  
Zhiyuan Chen ◽  
Michael Garcia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Low Income ◽  
Original Data ◽  
Population Based ◽  
Adverse Outcomes ◽  
Cochrane Library ◽  
Sampling Frame ◽  
Financial Flexibility ◽  
The Cochrane Library

Abstract Background Cost-related nonadherence to medications (CRNA) is common in many countries and thought to be associated with adverse outcomes. The characteristics of CRNA in Canada, with its patchwork coverage of increasingly expensive medications, are unclear. Objectives Our objective in this systematic review was to summarize the literature evaluating CRNA in Canada in three domains: prevalence, predictors, and effect on clinical outcomes. Methods We searched MEDLINE, Embase, Google Scholar, and the Cochrane Library from 1992 to December 2019 using search terms covering medication adherence, costs, and Canada. Eligible studies, without restriction on design, had to have original data on at least one of the three domains specifically for Canadian participants. Articles were identified and reviewed in duplicate. Risk of bias was assessed using design-specific tools. Results Twenty-six studies of varying quality (n = 483,065 Canadians) were eligible for inclusion. Sixteen studies reported on the overall prevalence of CRNA, with population-based estimates ranging from 5.1 to 10.2%. Factors predicting CRNA included high out-of-pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health. A single randomized trial of free essential medications with free delivery in Ontario improved adherence but did not find any change in clinical outcomes at 1 year. Conclusion CRNA affects many Canadians. The estimated percentage depends on the sampling frame, the main predictors tend to be financial, and its association with clinical outcomes in Canada remains unproven.

scholarly journals Cost-Related Medication Nonadherence in Canada: A Systematic Review of Prevalence, Predictors, and Clinical Impact

2020 ◽  
Author(s):  
Anne Marie Holbrook ◽  
Mei Wang ◽  
Munil Lee ◽  
Zhiyuan Chen ◽  
Michael Garcia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Low Income ◽  
Original Data ◽  
Population Based ◽  
Adverse Outcomes ◽  
Cochrane Library ◽  
Sampling Frame ◽  
One Year ◽  
The Cochrane Library

Abstract Background Cost-related nonadherence to medications (CRNA) is common in many countries and thought to be associated with adverse outcomes. The characteristics of CRNA in Canada, with its patchwork coverage of increasingly expensive medications, is unclear. Objectives Our objective in this systematic review was to summarize the literature evaluating CRNA in Canada in three domains: prevalence, predictors, and effect on clinical outcomes. Methods We searched MEDLINE, Embase, Google Scholar, and the Cochrane Library from 1992 to December 2019 using search terms covering medication adherence, costs, and Canada. Eligible studies, without restriction on design, had to have original data on at least one of the three domains specifically for Canadian participants. Articles were identified and reviewed in duplicate. Risk of bias was assessed using design-specific tools. Results: Twenty-six studies of varying quality (n=483,065 Canadians) were eligible for inclusion. Sixteen studies reported on the overall prevalence of CRNA, with population-based estimates ranging from 5.1% to 10.2%. Factors predicting CRNA included high out of pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health. A single randomized trial of free essential medications with free delivery in Ontario improved adherence but did not find any change in clinical outcomes at one year. Conclusion: CRNA affects many Canadians. The estimated percentage depends on the sampling frame, the main predictors tend to be financial, and its association with clinical outcomes in Canada remains unproven.

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