scholarly journals Course and outcomes of COVID-19 in patients with immunoinflammatory rheumatic diseases: Preliminary data from the NIIR/APP-COVID-19 registry and literature review

2021 ◽  
Vol 59 (6) ◽  
pp. 666-675
Author(s):  
E. L. Nasonov ◽  
B. S. Belov ◽  
A. M. Lila ◽  
E. S. Aronova ◽  
G. I. Gridneva ◽  
...  
Keyword(s):  
Literature Review ◽  
Rheumatic Diseases ◽  
Musculoskeletal Diseases ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Lung Lesion ◽  
Inflammatory Rheumatic Diseases ◽  
Study Group ◽  
Old Patients ◽  
Stage 1

The materials of the Russian NIIR/ARP-COVID-19 database, which included adult (over 18 years old) patients with immuno-inflammatory rheumatic diseases (IIRD) who underwent COVID-19 (coronavirus disease 2019), and a literature review concerning the course and outcomes of COVID-19 in patients with these diseases, are presented. From July 17, 2020 to April 23, 2021, 156 messages were received and analyzed. The study group was represented mainly by women (75%). The average age of patients was 52.0±14.8 years, of which 53 (33.9%) patients were aged 60 years and older. The most frequent clinical manifestations of COVID-19 were fever (62.2%), cough (40.4%), anosmia (37.8%), shortness of breath (33.3%). During the course of COVID-19, computed tomography of the chest organs was performed in 143 patients. When assessed on an “empirical” visual scale, stage 0 of lung lesion was observed in 49 (34.3%) patients, stage 1 in 40 (28%), stage 2 in 35 (24.5%), stage 3 in 19 (13.2%), stage 4 in 0. In the study group, a favorable outcome was observed in 137 (97.9%) patients. Fatal outcome was registered in 3 patients. The effect of COVID-19 on the course of IIRD was assessed in 131 patients: in 52 (39.7%) patients, the course of IIRD worsened, in 1 (0.8%) it improved, in 78 (59.5%) there was no effect. Literature data on the risk of infection with the SARS-CoV-2 virus, the course and outcomes of COVID-19 in rheumatic and musculoskeletal diseases are contradictory, which dictates the need to continue collecting data on the rheumatological problems of COVID-19 in the Russian patient population, taking into account international experience.

scholarly journals POS1225 INFLUENCE OF COLCHICINE PRESCRIPTION IN COVID19-RELATED HOSPITAL ADMISSIONS: A SURVIVAL ANALYSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 896.2-896
Author(s):  
M. P. Álvarez ◽  
A. Madrid García ◽  
I. Perez-Sancristobal ◽  
J. I. Colomer ◽  
L. León ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Rheumatic Diseases ◽  
Hospital Admissions ◽  
Musculoskeletal Diseases ◽  
Tertiary Care ◽  
Secondary Outcome ◽  
P Value ◽  
Inflammatory Rheumatic Diseases ◽  
Cytokine Storm ◽  
Observation Period

Background:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggers the innate immune system, leading in severe cases, an excessive immune response, which can lead to high levels of pro-inflammatory cytokines promoting a “cytokine storm”.To modulate this exaggerated inflammatory response, several clinical trials with already approved and well-known therapeutic agents that inhibit the inflammatory response, are being carried out. However, none of these drugs seems to achieve the desired results when treating COVID19.Colchicine, a drug often used in the management of patients with Rheumatic and Musculoskeletal diseases (RMDs), is one of the several drugs that are being currently tested for efficacy in COVID19 due to its anti-inflammatory effects.Objectives:To analyze association between colchicine prescription and COVID19-related hospital admissions in patients with Rheumatic and Musculoskeletal diseases (RMDs).Methods:Patients attending a rheumatology outpatient clinic from a tertiary care center in Madrid, Spain, from 1st September 2019 to 29th February 2020 were included.Patients were assigned as exposed or unexposed based on whether they were prescribed with colchicine in their last visit to the clinic during the 6 months before the start of the observation period. Treatment changes during the observation period were also considered. The primary outcome was COVID19-related hospital admissions occurring between March 1st and May 20th, 2020. Secondary outcome included COVID19-related mortality. Several weighting techniques for data balancing, based and non-based on the propensity score, followed by Cox regressions were performed to estimate the association of colchicine prescription on both outcomes.Results:9,379 patients entered in the study, with 406 and 9,002 exposed and unexposed follow-up periods, respectively. Generalized Boosted Models (GBM) and Empirical Balancing Calibration Weighting (EBCW) methods showed the best balance for COVID19-related hospital admissions. Colchicine prescription did not show a statistically significant association after covariable balancing (p-value = 0.195 and 0.059 for GBM and EBCW, respectively). Regarding mortality, the low number of events prevented a success variable balancing and analysis.Conclusion:Colchicine prescription does not play a significant protective or risk role in RMD patients regarding COVID19-related hospital admissions. Our observations could support the maintenance of colchicine prescription in those patients already being treated, as it is not associated with a worse prognosis.References:[1]Fernandez-Gutierrez B. COVID-19 with Pulmonary Involvement. An Autoimmune Disease of Known Cause. Reumatol Clin 2020; 16: 253–254.[2]Coperchini F, Chiovato L, Croce L, et al. The cytokine storm in COVID-19: An overview of the involvement of the chemokine/chemokine-receptor system. Cytokine Growth Factor Rev 2020; 53: 25–32.[3]Shaffer L. 15 drugs being tested to treat COVID-19 and how they would work. Nat Med. Epub ahead of print 15 May 2020. DOI: 10.1038/d41591-020-00019-9.[4]Fernandez-Gutierrez B, Leon L, Madrid A, et al. Hospital admissions in inflammatory rheumatic diseases during the COVID-19 pandemic: incidence and role of disease modifying agents. medRxiv 2020; 2020.05.21.20108696.[5]Freites Nuñez DD, Leon L, Mucientes A, et al. Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 2020; 1–7.Disclosure of Interests:None declared

scholarly journals Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: a systematic literature review

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000684 ◽  
Author(s):  
Matthieu Lavielle ◽  
Déborah Puyraimond-Zemmour ◽  
Xavier Romand ◽  
Laure Gossec ◽  
Eric Senbel ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Literature Review ◽  
Rheumatic Diseases ◽  
Systematic Literature Review ◽  
Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Educational Interventions ◽  
Inflammatory Rheumatic Diseases ◽  
Improve Medication Adherence ◽  
Chronic Inflammatory Rheumatic Diseases

ObjectiveLack of adherence to treatment is frequent in chronic inflammatory rheumatic diseases and is associated with poorer outcomes. The objective of this study was to describe and evaluate interventions that have been proposed to enhance medication adherence in these conditions.MethodsA systematic literature review was performed in Pubmed, Cochrane, Embase and clinicaltrials.gov databases completed by the rheumatology meeting (ACR, EULAR and SFR) abstracts from last 2 years. All studies in English or French evaluating an intervention to improve medication adherence in chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondyloarthritis (SpA), crystal related diseases, connective tissue diseases, vasculitis and Still’s disease) were included. Interventions on adherence were collected and classified in five modalities (educational, behavioural, cognitive behavioural, multicomponent interventions or others).Results1325 abstracts were identified and 22 studies were finally included (18 studies in RA (72%), 4 studies in systemic lupus erythematosus (16%), 2 studies in SpA (8%) and 1 study in gout (4%)). On 13 randomised controlled trials (RCT) (1535 patients), only 5 were positive (774 patients). Educational interventions were the most represented and had the highest level of evidence: 8/13 RCT (62%, 1017 patients) and 4/8 were positive (50%). In these studies, each patient was individually informed or educated by different actors (physicians, pharmacists, nurses and so on). Supports and contents of these educational interventions were heterogenous.ConclusionDespite the importance of medication adherence in chronic inflammatory rheumatic disorders, evidence on interventions to improve medication adherence is scarce.

Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative

2016 ◽  
Vol 75 (6) ◽  
pp. 965-973 ◽  
Author(s):  
Athan Baillet ◽  
Laure Gossec ◽  
Loreto Carmona ◽  
Maarten de Wit ◽  
Yvonne van Eijk-Hustings ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Literature Review ◽  
Rheumatic Diseases ◽  
Daily Practice ◽  
Gastrointestinal Diseases ◽  
Inflammatory Rheumatic Diseases ◽  
Dissemination And Implementation ◽  
Consensus Process ◽  
European League Against Rheumatism ◽  
Chronic Inflammatory Rheumatic Diseases

In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in patients with chronic inflammatory rheumatic diseases. We also aimed to develop a pragmatic reporting form to foster the implementation of the points to consider. In accordance with the EULAR Standardised Operating Procedures, the process comprised (1) a systematic literature review of existing recommendations on reporting, screening for or preventing six selected comorbidities: ischaemic cardiovascular diseases, malignancies, infections, gastrointestinal diseases, osteoporosis and depression and (2) a consensus process involving 21 experts (ie, rheumatologists, patients, health professionals). Recommendations on how to treat the comorbidities were not included in the document as they vary across countries. The literature review retrieved 42 articles, most of which were recommendations for reporting or screening for comorbidities in the general population. The consensus process led to three overarching principles and 15 points to consider, related to the six comorbidities, with three sections: (1) reporting (ie, occurrence of the comorbidity and current treatments); (2) screening for disease (eg, mammography) or for risk factors (eg, smoking) and (3) prevention (eg, vaccination). A reporting form (93 questions) corresponding to a practical application of the points to consider was developed. Using an evidence-based approach followed by expert consensus, this EULAR initiative aims to improve the reporting and prevention of comorbidities in chronic inflammatory rheumatic diseases. Next steps include dissemination and implementation.

scholarly journals Mortality in Inflammatory Rheumatic Diseases: Lithuanian National Registry Data and Systematic Review

2021 ◽  
Vol 18 (23) ◽  
pp. 12338
Author(s):  
Jolanta Dadonienė ◽  
Greta Charukevič ◽  
Gabija Jasionytė ◽  
Karolina Staškuvienė ◽  
Dalia Miltinienė
Keyword(s):  
General Population ◽  
Life Expectancy ◽  
Literature Review ◽  
Rheumatic Diseases ◽  
Systematic Literature Review ◽  
Causes Of Death ◽  
Connective Tissue Diseases ◽  
Standardized Mortality Ratio ◽  
Inflammatory Rheumatic Diseases ◽  
Total Cohort

Despite significant improvement in survival, rheumatic diseases (RD) are associated with premature mortality rates comparable to cardiovascular and neoplastic disorders. The aim of our study was to assess mortality, causes of death, and life expectancy in an inflammatory RD retrospective cohort and compare those with the general population as well as with the results of previously published studies in a systematic literature review. Patients with the first-time diagnosis of inflammatory RD during 2012–2019 were identified and cross-checked for their vital status and the date of death. Sex- and age-standardized mortality ratios (SMR) as well as life expectancy for patients with inflammatory RDs were calculated. The results of a systematic literature review were included in meta-standardized mortality ratio calculations. 11,636 patients with newly diagnosed RD were identified. During a total of 43,064.34 person-years of follow-up, 950 death cases occurred. The prevailing causes of death for the total cohort were cardiovascular diseases and neoplasms. The age- and sex-adjusted SMR for the total cohort was calculated to be 1.32 (1.23; 1.40). Patients with rheumatoid arthritis if diagnosed at age 18–19 tend to live for 1.63 years less than the general population, patients with spondyloarthritis—for 2.7 years less, patients with connective tissue diseases—for almost nine years less than the general population. The findings of our study support the hypothesis that patients with RD have a higher risk of mortality and lower life expectancy than the general population.

scholarly journals Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001035 ◽  
Author(s):  
Christien Rondaan ◽  
Victoria Furer ◽  
Marloes W Heijstek ◽  
Nancy Agmon-Levin ◽  
Marc Bijl ◽  
...  
Keyword(s):  
Literature Review ◽  
Rheumatic Diseases ◽  
Systematic Literature Review ◽  
Immunosuppressive Agents ◽  
Adult Patients ◽  
Cochrane Library ◽  
Inflammatory Rheumatic Diseases ◽  
Immunomodulating Therapy ◽  
Eular Recommendations ◽  
Household Members

AimTo present a systematic literature review (SLR) on efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD), aiming to provide a basis for updating the EULAR evidence-based recommendations.MethodsAn SLR was performed according to the standard operating procedures for EULAR-endorsed recommendations. Outcome was determined by efficacy, immunogenicity and safety of vaccination in adult patients with AIIRD, including those receiving immunomodulating therapy. Furthermore, a search was performed on the effect of vaccinating household members of patients with AIIRD on the occurrence of vaccine-preventable infections in patients and their household members (including newborns). The literature search was performed using Medline, Embase and the Cochrane Library (October 2009 to August 2018).ResultsWhile most investigated vaccines were efficacious and/or immunogenic in patients with AIIRD, some were less efficacious than in healthy control subjects, and/or in patients receiving immunosuppressive agents. Adverse events of vaccination were generally mild and the rates were comparable to those in healthy persons. Vaccination did not seem to lead to an increase in activity of the underlying AIIRD, but insufficient power of most studies precluded arriving at definite conclusions. The number of studies investigating clinical efficacy of vaccination is still limited. No studies on the effect of vaccinating household members of patients with AIIRD were retrieved.ConclusionEvidence on efficacy, immunogenicity and safety of vaccination in patients with AIIRD was systematically reviewed to provide a basis for updated recommendations.

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