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Il-1 Inhibitor Anakinra Is An Effective Alternative To Standard Treatments For Reducing Pain Due To Acute Gout Flare, Cheryl Craig 2020 Wayne State University School of Medicine

Il-1 Inhibitor Anakinra Is An Effective Alternative To Standard Treatments For Reducing Pain Due To Acute Gout Flare, Cheryl Craig

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Janssen CA, Voshaar MAHO, Vonkeman HE, et al. Anakinra for the treatment of acute gout flares: a randomized, double-blind, placebo-controlled, active-comparator, non-inferiority trial. Rheumatology. 2019;58(8):1344-1352. https://doi.org/10.1093/rheumatology/key402 for a patient with an acute gouty attack refractory to standard treatment.


Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen 2020 Sacred Heart University

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed ...


Primary Care Physician Perspectives On Barriers To Diagnosing Axial Spondyloarthritis: A Qualitative Study, Kate L. Lapane, Sara Khan, Divya Shridharmurthy, Ariel Beccia, Catherine E. Dube, Esther Yi, Jonathan Kay, Shao-Hsien Liu 2020 University of Massachusetts Medical School

Primary Care Physician Perspectives On Barriers To Diagnosing Axial Spondyloarthritis: A Qualitative Study, Kate L. Lapane, Sara Khan, Divya Shridharmurthy, Ariel Beccia, Catherine E. Dube, Esther Yi, Jonathan Kay, Shao-Hsien Liu

Open Access Articles

BACKGROUND: The average delay in diagnosis for patients with axial spondyloarthritis (axSpA) is 7 to 10 years. Factors that contribute to this delay are multifactorial and include the lack of diagnostic criteria (although classification criteria exist) for axSpA and the difficulty in distinguishing inflammatory back pain, a key symptom of axSpA, from other highly prevalent forms of low back pain. We sought to describe reasons for diagnostic delay for axSpA provided by primary care physicians.

METHODS: We conducted a qualitative research study which included 18 US primary care physicians, balanced by gender. Physicians provided informed consent to participate in an ...


Evaluation Of Sodium Valproate Low Dose Efficacy In Radicular Pain Management And It’S Relation With Pharmacokinetics Parameters, Mona Ghasemian, Mohammad Bagher Owlia, Mohammad Hossein Mosaddegh, Masoud Nakhaie nejad, Seyed Mojtaba Sohrevardi 2020 Department of clinical pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Evaluation Of Sodium Valproate Low Dose Efficacy In Radicular Pain Management And It’S Relation With Pharmacokinetics Parameters, Mona Ghasemian, Mohammad Bagher Owlia, Mohammad Hossein Mosaddegh, Masoud Nakhaie Nejad, Seyed Mojtaba Sohrevardi

BioMedicine

Background: Radiculopathy due to lumbar or cervical disc disease is the most common chronic neuropathic pain in adults. The aim of present study was evaluation of low dose of sodium valproate on radicular pain and determining VPA pharmacokinetics.

Materials and Methods: In this double blind randomized placebo control clinical study, 80 patients with established lumbar or cervical radicular pain, have been randomly allocated into two study groups: 40 have received sodium valproate 200 mg/day and Celecoxib 100 mg/day and acetaminophen 500 mg PRN as rescue medication, and second group has received placebo, Celecoxib and acetaminophen. Quantitative assessment of ...


Osteoblast-Osteoclast Communication And Bone Homeostasis, Jung-Min Kim, Chujiao Lin, Zheni Stavre, Matthew B. Greenblatt, Jae-Hyuck Shim 2020 University of Massachusetts Medical School

Osteoblast-Osteoclast Communication And Bone Homeostasis, Jung-Min Kim, Chujiao Lin, Zheni Stavre, Matthew B. Greenblatt, Jae-Hyuck Shim

Open Access Articles

Bone remodeling is tightly regulated by a cross-talk between bone-forming osteoblasts and bone-resorbing osteoclasts. Osteoblasts and osteoclasts communicate with each other to regulate cellular behavior, survival and differentiation through direct cell-to-cell contact or through secretory proteins. A direct interaction between osteoblasts and osteoclasts allows bidirectional transduction of activation signals through EFNB2-EPHB4, FASL-FAS or SEMA3A-NRP1, regulating differentiation and survival of osteoblasts or osteoclasts. Alternatively, osteoblasts produce a range of different secretory molecules, including M-CSF, RANKL/OPG, WNT5A, and WNT16, that promote or suppress osteoclast differentiation and development. Osteoclasts also influence osteoblast formation and differentiation through secretion of soluble factors, including S1P ...


Prosthetic Temporomandibular Joint Reconstruction In A Cohort Of Adolescent Females With Juvenile Idiopathic Arthritis., Michael Lypka, Karina Shah, Jordan T. Jones 2020 Children's Mercy Hospital

Prosthetic Temporomandibular Joint Reconstruction In A Cohort Of Adolescent Females With Juvenile Idiopathic Arthritis., Michael Lypka, Karina Shah, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Temporomandibular joint (TMJ) arthritis and involvement is commonly seen in Juvenile Idiopathic Arthritis (JIA). Therapy includes conservative measures, but also includes intraarticular corticosteroid injections (IASI) and systemic immunosuppressive therapy. Despite aggressive medical therapy, some patients develop arthritic changes and frank TMJ ankylosis that can result in persistent pain and limitation in range of motion (ROM). A surgical option is prosthetic TMJ replacement with concurrent correction of dentofacial deformities, which can be performed simultaneously. The objective of this study was to evaluate the outcomes of prosthetic TMJ replacement in a cohort of adolescent females with JIA and severe TMJ involvement ...


African League Against Rheumatism (Aflar) Preliminary Recommendations On The Management Of Rheumatic Diseases During The Covid-19 Pandemic, Richard Oluyinka Akintayo, Rachid Bahiri, Yasser El Miedany, Hakeem Olaosebikan, Asgar Ali Kalla, Adewale Olukayode Adebajo, Angela Migowa, Samy Slimani, Ouma Devi Koussougbo, Ben Abdelghani Kawther 2020 Dumfries and Galloway Royal Infirmary, Cargenbridge

African League Against Rheumatism (Aflar) Preliminary Recommendations On The Management Of Rheumatic Diseases During The Covid-19 Pandemic, Richard Oluyinka Akintayo, Rachid Bahiri, Yasser El Miedany, Hakeem Olaosebikan, Asgar Ali Kalla, Adewale Olukayode Adebajo, Angela Migowa, Samy Slimani, Ouma Devi Koussougbo, Ben Abdelghani Kawther

Paediatrics and Child Health, East Africa

Objectives: To develop recommendations for the management of rheumatic and musculoskeletal diseases (RMDs) during the COVID-19 pandemic.

Method: A task force comprising of 25 rheumatologists from the 5 regions of the continent was formed and operated through a hub-and-spoke model with a central working committee (CWC) and 4 subgroups. The subgroups championed separate scopes of the clinical questions and formulated preliminary statements of recommendations which were processed centrally in the CWC. The CWC and each subgroup met by several virtual meetings, and two rounds of voting were conducted on the drafted statements of recommendations. Votes were online-delivered and recommendations were ...


Physical Activity For Rheumatoid Arthritis Patients: Benchmark Study, Lauren Nicholson 2020 University of Texas at Tyler

Physical Activity For Rheumatoid Arthritis Patients: Benchmark Study, Lauren Nicholson

MSN Capstone Projects

Rheumatoid arthritis (RA) is an autoimmune inflammatory condition that affects the joints; without proper treatment and management, RA leads to the destruction of joint function. The standard of care for RA includes medications such as biologic therapy and disease-modifying anti-rheumatic drugs. An often-overlooked area of disease management is the implementation of exercise programs for patients with RA. Exercise is known to decrease systemic inflammation, symptoms of depression, and combat fatigue – all common symptoms reported by patients with RA.

Standard of care for patients with RA does not currently include lifestyle management factors such as diet, exercise, and cessation of habits ...


Disease Activity And Patient-Reported Outcomes In Patients With Rheumatoid Arthritis And Sjogren's Syndrome Enrolled In A Large Observational Us Registry, Leslie R. Harrold, Ying Shan, Sabrina Rebello, Neil Kramer, Sean E. Connolly, Evo Alemao, Sheila Kelly, Joel M. Kremer, Elliot D. Rosenstein 2020 University of Massachusetts Medical School

Disease Activity And Patient-Reported Outcomes In Patients With Rheumatoid Arthritis And Sjogren's Syndrome Enrolled In A Large Observational Us Registry, Leslie R. Harrold, Ying Shan, Sabrina Rebello, Neil Kramer, Sean E. Connolly, Evo Alemao, Sheila Kelly, Joel M. Kremer, Elliot D. Rosenstein

Open Access Articles

The objective of this study was to compare rheumatoid arthritis (RA) disease activity and patient-reported outcomes (PROs) in a national sample of patients with RA with/without Sjogren's syndrome (SS). Adults with RA from a large observational US registry (Corrona RA) with known SS status between 22 April 2010 and 31 July 2018 and a visit 12 (+/- 3) months after index date were identified (n = 36,256/52,757). SS status: determined from a yes/no variable reported at enrolment into the Corrona RA registry and follow-up visits. Index date: date that SS status was recorded (yes/no). Patients ...


Assessing The Effect Of Interventions For Axial Spondyloarthritis According To The Endorsed Asas/Omeract Core Outcome Set: A Meta-Research Study Of Trials Included In Cochrane Reviews., Rikke A Andreasen, Lars E Kristensen, Xenofon Baraliakos, Vibeke Strand, Philip Mease, Maarten de Wit, Torkell Ellingsen, Inger Marie J Hansen, Jamie Kirkham, George A Wells, Peter Tugwell, Lara Maxwell, Maarten Boers, Kenneth Egstrup, Robin Christensen 2020 Swedish Medical Centre/Providence St. Joseph Health and University of Washington, Seattle, USA.

Assessing The Effect Of Interventions For Axial Spondyloarthritis According To The Endorsed Asas/Omeract Core Outcome Set: A Meta-Research Study Of Trials Included In Cochrane Reviews., Rikke A Andreasen, Lars E Kristensen, Xenofon Baraliakos, Vibeke Strand, Philip Mease, Maarten De Wit, Torkell Ellingsen, Inger Marie J Hansen, Jamie Kirkham, George A Wells, Peter Tugwell, Lara Maxwell, Maarten Boers, Kenneth Egstrup, Robin Christensen

Articles, Abstracts, and Reports

The Assessment of SpondyloArthritis international Society (ASAS) has defined core sets for (i) symptom-modifying anti-rheumatic drugs (SM-ARD), (ii) clinical record keeping, and (iii) disease-controlling anti-rheumatic therapy (DC-ART). These include the following domains for all three core sets: "physical function," "pain," "spinal mobility," "spinal stiffness," and "patient's global assessment" (PGA). The core set for clinical record keeping further includes the domains "peripheral joints/entheses" and "acute phase reactants," and the core set for DC-ART further includes the domains "fatigue" and "spine radiographs/hip radiographs." The Outcome Measures in Rheumatology (OMERACT) endorsed the core sets in 1998.Using empirical evidence from ...


Long-Term Safety And Tolerability Of Apremilast Versus Placebo In Psoriatic Arthritis: A Pooled Safety Analysis Of Three Phase Iii, Randomized, Controlled Trials., Philip Mease, Dafna D Gladman, Juan J Gomez-Reino, Stephen Hall, Arthur Kavanaugh, Eric Lespessailles, Georg Schett, Maria Paris, Nikolay Delev, Lichen Teng, Jürgen Wollenhaupt 2020 Swedish Medical Center/Providence St. Joseph Health, Seattle, Washington

Long-Term Safety And Tolerability Of Apremilast Versus Placebo In Psoriatic Arthritis: A Pooled Safety Analysis Of Three Phase Iii, Randomized, Controlled Trials., Philip Mease, Dafna D Gladman, Juan J Gomez-Reino, Stephen Hall, Arthur Kavanaugh, Eric Lespessailles, Georg Schett, Maria Paris, Nikolay Delev, Lichen Teng, Jürgen Wollenhaupt

Articles, Abstracts, and Reports

OBJECTIVE: Psoriatic arthritis (PsA) requires long-term treatment, yet safety concerns and monitoring requirements make maintenance a challenge. This analysis of pooled Psoriatic Arthritis Long-term Assessment of Clinical Efficacy (PALACE) 1, 2, and 3 data describes 3-year apremilast safety and tolerability in PsA.

METHODS: Patients with active PsA were randomized (1:1:1) to placebo, apremilast 30 mg twice daily, or apremilast 20 mg twice daily. Placebo patients were re-randomized to apremilast 30 mg twice daily or 20 mg twice daily at week 16 (early escape) or 24. Double-blind treatment continued to week 52; patients could continue apremilast during an open-label ...


Assessment And Treatment Of Down Syndrome-Associated Arthritis: A Survey Of Pediatric Rheumatologists., Anna Nicek, Nasreen Talib, Daniel Lovell, Chelsey Smith, Mara L. Becker, Jordan T. Jones 2020 Children's Mercy Hospital

Assessment And Treatment Of Down Syndrome-Associated Arthritis: A Survey Of Pediatric Rheumatologists., Anna Nicek, Nasreen Talib, Daniel Lovell, Chelsey Smith, Mara L. Becker, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

Background: Inflammatory arthritis in children with Down syndrome (DS) was first described in 1984 and is now termed Down syndrome-associated arthritis (DA). Studies have shown that DA is under-recognized with a 19-month average delay in diagnosis. Additionally, most patients present with polyarticular, rheumatoid factor (RF) and anti-nuclear antibody (ANA) negative disease. Current therapies for juvenile idiopathic arthritis (JIA) have been used, but appear to be poorly tolerated, more toxic and less effective in patients with DA. There is currently no standardized approach to the assessment or management of DA. The objective of this study was to describe provider perspectives toward ...


Multifocal Bone Pain, Recurrent Fevers And Anemia In A 15-Year-Old, Anna M. Martens, Catherine Ezzio, Amanda Goddard, Leah Mallory 2020 Tufts University School of Medicine, Maine Track

Multifocal Bone Pain, Recurrent Fevers And Anemia In A 15-Year-Old, Anna M. Martens, Catherine Ezzio, Amanda Goddard, Leah Mallory

Journal of Maine Medical Center

Introduction: Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disorder that primarily affects children with recurrent episodes of sterile osteomyelitis in one or more bones. Patients usually present with recurrent bone pain, though it is often a diagnosis of exclusion with most patients undergoing extensive work-up to arrive at a diagnosis.

Clinical Findings: This 15-year-old female presented with months of progressive multifocal bone pain, 22-pound weight loss and recurrent fevers. Work-up as an outpatient included a positive screening assay and IgM Western blot Panel positive for Lyme disease, treated with a 28-day course doxycycline without resolution of the symptoms ...


A Case Of Systemic Sclerosis Sine Scleroderma, Adrian Lugo MD, Andrew Cappiello MD, Nemer Dabage MD, Guruswamy Ramamurthy MD 2020 HCA Healthcare

A Case Of Systemic Sclerosis Sine Scleroderma, Adrian Lugo Md, Andrew Cappiello Md, Nemer Dabage Md, Guruswamy Ramamurthy Md

West Florida Division Virtual Research Day

  • Scleroderma and systemic sclerosis are autoimmune phenomena that can cause progressive and permanent damage to the organs of the human body.
  • They can cause fibrosis of various internal organs, including the kidneys, lungs, GI tract, and heart
  • Rarely, the only manifestation of systemic sclerosis is severe hypertension with renal failure, a subset known as systemic sclerosis sine scleroderma.


Characterization Of Patients With Axial Spondyloarthritis By Enthesitis Presence: Data From The Corrona Psoriatic Arthritis/Spondyloarthritis Registry., Philip Mease, Mei Liu, Sabrina Rebello, Winnie Hua, Robert R McLean, Esther Yi, Yujin Park, Alexis Ogdie 2020 Swedish Medical Center/Providence St. Joseph Health

Characterization Of Patients With Axial Spondyloarthritis By Enthesitis Presence: Data From The Corrona Psoriatic Arthritis/Spondyloarthritis Registry., Philip Mease, Mei Liu, Sabrina Rebello, Winnie Hua, Robert R Mclean, Esther Yi, Yujin Park, Alexis Ogdie

Articles, Abstracts, and Reports

OBJECTIVE: To compare the characteristics of patients with axial spondyloarthritis (axSpA) who had enthesitis versus those without enthesitis.

METHODS: This study included adult patients with axSpA enrolled in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry (March 2013 to August 2018). Enthesitis was assessed at enrollment via the Spondyloarthritis Research Consortium of Canada Enthesitis Index. Characteristics were compared between patients with and without enthesitis using t tests or Wilcoxon rank-sum tests for continuous variables and χ

RESULTS: Of 477 patients with axSpA, 121 (25.4%) had enthesitis (mean, 3.9 sites) at enrollment. Higher proportions of patients with enthesitis were female and ...


Examining Treatment Decision-Making Among Patients With Axial Spondyloarthritis: Insights From A Conjoint Analysis Survey, Woojin Joo, Christopher V. Almario, Mariko Ishimori, Yujin Park, Alma Jusufagic, Benjamin Noah, Lianne S. Gensler, R. Swamy Venuturupalli, Jonathan Kay, Michael H. Weisman, Brennan M. R. Spiegel 2020 Cedars-Sinai Medical Center

Examining Treatment Decision-Making Among Patients With Axial Spondyloarthritis: Insights From A Conjoint Analysis Survey, Woojin Joo, Christopher V. Almario, Mariko Ishimori, Yujin Park, Alma Jusufagic, Benjamin Noah, Lianne S. Gensler, R. Swamy Venuturupalli, Jonathan Kay, Michael H. Weisman, Brennan M. R. Spiegel

Open Access Articles

OBJECTIVE: The number of therapies for axial spondyloarthritis (axSpA) is increasing. Thus, it has become more challenging for patients and physicians to navigate the risk-benefit profiles of the various treatment options. In this study, we used conjoint analysis-a form of trade-off analysis that elucidates how people make complex decisions by balancing competing factors-to examine patient decision-making surrounding medication options for axSpA.

METHODS: We conducted an adaptive choice-based conjoint analysis survey for patients with axSpA to assess the relative importance of medication attributes (eg, chance of symptom improvement, risk of side effects, route of administration, etc) in their decision-making. We also ...


Body Mass Index And Treatment Survival In Patients With Ra Starting Treatment With Tnfalpha-Inhibitors: Long-Term Follow-Up In The Real-Life Meteor Registry, Sytske Anne Bergstra, Cornelia F. Allaart, David Vega-Morales, Marieke De Buck, Elizabeth Murphy, Karen I. Salomon-Escoto, Tom W. J. Huizinga 2020 Leiden University Medical Center

Body Mass Index And Treatment Survival In Patients With Ra Starting Treatment With Tnfalpha-Inhibitors: Long-Term Follow-Up In The Real-Life Meteor Registry, Sytske Anne Bergstra, Cornelia F. Allaart, David Vega-Morales, Marieke De Buck, Elizabeth Murphy, Karen I. Salomon-Escoto, Tom W. J. Huizinga

Open Access Articles

OBJECTIVES: To study whether there is an association between body mass index (BMI) category and survival of various tumour necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA) patients in a real-life longitudinal international registry.

METHODS: Data from 5230 patients with RA starting treatment with any TNFi were selected from the METEOR registry. Patients were divided into six BMI categories: 3.7% underweight, BMI < 18.5 kg/m(2); 46% normal weight, BMI 18.5-25 kg/m(2); 32% pre-obesity, BMI 25-30 kg/m(2); 13% obesity class I, BMI 30-35 kg/m(2); 3.4% obesity class II, BMI 35-40 kg/m(2); and 1.6% obesity class III, BMI > 40 kg/m(2). Time on treatment in the different BMI categories was compared for all TNFi combined and for the infliximab, adalimumab and etanercept separately, using Kaplan-Meier curves and Cox regression analyses. Cox regression analyses were ...


Secukinumab Provides Sustained Low Rates Of Radiographic Progression In Psoriatic Arthritis: 52-Week Results From A Phase 3 Study, Future 5., Désirée van der Heijde, Philip Mease, Robert B M Landewé, Proton Rahman, Hasan Tahir, Atul Singhal, Elke Boettcher, Sandra Navarra, Xuan Zhu, Gregory Ligozio, Aimee Readie, Shephard Mpofu, Luminita Pricop 2020 Swedish Medical Center/Providence St Joseph Health

Secukinumab Provides Sustained Low Rates Of Radiographic Progression In Psoriatic Arthritis: 52-Week Results From A Phase 3 Study, Future 5., Désirée Van Der Heijde, Philip Mease, Robert B M Landewé, Proton Rahman, Hasan Tahir, Atul Singhal, Elke Boettcher, Sandra Navarra, Xuan Zhu, Gregory Ligozio, Aimee Readie, Shephard Mpofu, Luminita Pricop

Articles, Abstracts, and Reports

OBJECTIVE: To evaluate the effect of secukinumab on radiographic progression through 52 weeks in patients with PsA from the FUTURE 5 study.

METHODS: Patients with active PsA, stratified by prior anti-TNF use (naïve or inadequate response), were randomized to s.c. secukinumab 300 mg load (300 mg), 150 mg load (150 mg), 150 mg no load regimens or placebo at baseline, at weeks 1, 2 and 3 and every 4 weeks starting at week 4. Radiographic progression was assessed by change in van der Heijde-modified total Sharp score (vdH-mTSS; mean of two readers). Statistical analysis used a linear mixed-effects model ...


Prevalence Of Sjogren's Syndrome Associated With Rheumatoid Arthritis In The Usa: An Observational Study From The Corrona Registry, Leslie R. Harrold, Ying Shan, Sabrina Rebello, Neil Kramer, Sean E. Connolly, Evo Alemao, Sheila Kelly, Joel M. Kremer, Elliot D. Rosenstein 2020 University of Massachusetts Medical School

Prevalence Of Sjogren's Syndrome Associated With Rheumatoid Arthritis In The Usa: An Observational Study From The Corrona Registry, Leslie R. Harrold, Ying Shan, Sabrina Rebello, Neil Kramer, Sean E. Connolly, Evo Alemao, Sheila Kelly, Joel M. Kremer, Elliot D. Rosenstein

Open Access Articles

The objectives of this analysis were to assess the prevalence of Sjogren's syndrome (SS) associated with rheumatoid arthritis (RA) and to compare baseline characteristics of patients with RA with and without SS. Adult patients with RA from a large observational US registry (Corrona RA), with > /= 1 visit for assessment of SS status between 22 April 2010 and 28 February 2018, were considered. Patients with RA with versus without SS were compared. SS status was determined from a yes/no variable and reported at enrollment into the Corrona RA registry and follow-up visits. Outcomes were unadjusted prevalence of SS in ...


Risk Factors And The Natural History Of Accelerated Knee Osteoarthritis: A Narrative Review, Jeffrey B. Driban, Matthew S. Harkey, Mary F. Barbe, Robert J. Ward, James W. MacKay, Julie E. Davis, Bing Lu, Lori Lyn Price, Charles B. Eaton, Grace H. Lo, Timothy E. McAlindon 2020 Tufts Medical Center

Risk Factors And The Natural History Of Accelerated Knee Osteoarthritis: A Narrative Review, Jeffrey B. Driban, Matthew S. Harkey, Mary F. Barbe, Robert J. Ward, James W. Mackay, Julie E. Davis, Bing Lu, Lori Lyn Price, Charles B. Eaton, Grace H. Lo, Timothy E. Mcalindon

Open Access Articles

BACKGROUND: Osteoarthritis is generally a slowly progressive disorder. However, at least 1 in 7 people with incident knee osteoarthritis develop an abrupt progression to advanced-stage radiographic disease, many within 12 months. We summarize what is known - primarily based on findings from the Osteoarthritis Initiative - about the risk factors and natural history of accelerated knee osteoarthritis (AKOA) - defined as a transition from no radiographic knee osteoarthritis to advanced-stage disease < 4 years - and put these findings in context with typical osteoarthritis (slowly progressing disease), aging, prior case reports/series, and relevant animal models. Risk factors in the 2 to 4 years before radiographic manifestation of AKOA (onset) include older age, higher body mass index, altered joint alignment, contralateral osteoarthritis, greater pre-radiographic disease burden (structural, symptoms, and function), or low fasting glucose. One to 2 years before AKOA onset people often exhibit rapid articular cartilage loss, larger bone marrow lesions and effusion-synovitis, more meniscal pathology, slower chair-stand or walking pace, and increased global impact of arthritis than adults with typical knee osteoarthritis. Increased joint symptoms predispose a person to new joint trauma, which for someone who develops AKOA is often characterized by a destabilizing meniscal tear (e.g., radial or root tear). One in 7 people with AKOA onset subsequently receive a knee replacement during a 9-year period. The median time from any increase in radiographic severity to knee replacement is only 2.3 years. Despite some similarities, AKOA is different than other rapidly progressive arthropathies and collapsing these phenomena together or extracting results from one type of osteoarthritis to another should be avoided until further research comparing these types of osteoarthritis is conducted. Animal models that induce meniscal damage in the presence of other risk factors or create an incongruent distribution of loading on joints create an accelerated form of osteoarthritis compared to other models and may offer insights into AKOA.

CONCLUSION: Accelerated knee osteoarthritis is unique from typical knee osteoarthritis. The incidence of AKOA in the Osteoarthritis Initiative and Chingford Study is substantial. AKOA needs to be taken into account and studied ...


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