Rheumatology Commons^™

Measurement Properties Of The Minimal Disease Activity Criteria For Psoriatic Arthritis., Laura C Coates, Vibeke Strand, Hilary Wilson, Dennis Revicki, Brad Stolshek, Ahmed Samad, James B Chung, Dafna Gladman, Philip Mease

Articles, Abstracts, and Reports

Objective: To comprehensively assess evidence on the measurement properties of the minimal disease activity (MDA) criteria, a composite measure of the state of disease activity in psoriatic arthritis (PsA).

Methods: A targeted literature review was conducted to identify studies that informed the validity and/or ability of the MDA to detect change among patients known to have experienced a change in clinical status. The search was conducted using MEDLINE and Embase databases (published as of October 2017). Pertinent articles provided by investigators and identified from select conference proceedings were also evaluated.

Results: A total of 20 publications met the inclusion criteria. …

Does Adjuvant Therapy With Omega-3 Fatty Acids (Fish Oil) Improve Joint Tenderness In Patients With Rheumatoid Arthritis?, Eileen Fauteux

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not adjuvant therapy with Omega-3 fatty acids (fish oil) improves joint tenderness in patients with Rheumatoid Arthritis.

STUDY DESIGN: Review of 3 double-blind, randomized controlled trials from 2010- 2017.

DATA SOURCES: Three peer-reviewed journal articles written in English were found using PubMed. Articles were selected based on their relevance to the question and whether the outcome measured was patient-oriented evidence that matters.

OUTCOME(S) MEASURED: All articles analyzed the effectiveness of adjunctive treatment with omega-3 fatty acids on the improvement of joint tenderness in patients with rheumatoid arthritis. …

Is Hyaluronic Acid Intra-Articular Injection Better Than Corticosteroid Intra Articular Injection At Reducing Pain In Patients With Knee Osteoarthritis?, Madison Cohen

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Hyaluronic Acid intra articular injection is better than Corticosteroid intra articular injection at reducing pain in patients with knee osteoarthritis.”

STUDY DESIGN: Review of three double-blind, randomized control trials published between 2014 and 2016. All studies were published in English language in peer reviewed journals.

DATA SOURCES: All three randomized control trials were found via PubMed.

OUTCOMES MEASURED: The primary outcomes measured by the patient and investigator being improvement of knee pain severity, knee function, and range of motion after hyaluronic acid intra articular (IA) injection …

Can Yoga Therapy Help To Decrease Osteoarthritis-Related Pain In Adults With Knee Osteoarthritis?, Justin Mahr

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not yoga therapy can help to decrease osteoarthritis-related pain in adults with knee osteoarthritis.

Study Design: A review of two randomized controlled trials and one randomized control trial pilot study that were published in English in peer-reviewed journals after 2007.

Data Sources: All articles were selected from peer-reviewed journals and found via PubMed.

Outcome(s) Measured: Patient perception of pain using either a Walking Numerical Rating Scale (WNRS) and/or a Western Ontario and McMaster Universities OA Index scale (WOMAC).

Results: All three studies …

Does Probiotic Supplementation Help Decrease Pain And Number Of Tender Joints In Adults With Rheumatoid Arthritis?, Brittany Snyder

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “probiotic supplementation helps decrease pain and number of tender joints in adults with rheumatoid arthritis?”

STUDY DESIGN: Review of three double-blind, randomized control trials published between 2008 and 2018. All studies were published in English in peer reviewed journals.

DATA SOURCES: Three double-blind, randomized control trials were found via PubMed.

OUTCOMES MEASURED: The outcomes measured included number of tender joints from baseline to end of study counted by an investigator, visual analog scale (VAS) for pain severity, and a Stanford Health Assessment Questionnaire visual analog scale …

Does Secukinumab Improve Self-Reported Quality Of Life In Patients With Moderate-To-Severe Ankylosing Spondylitis When Taken Regularly?, Ryan Yenovkian

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not secukinumab improves self-reported quality of life in patients with moderate-to-severe ankylosing spondylitis when taken regularly.

Study design: A systematic review of three randomized placebo-controlled trials (RCTs), published in peer-reviewed journals between 2013 and 2015, all in the English language. Data sources: All three studies were found and accessed on PubMed.

Outcomes measured: Patient quality of life was assessed in all three studies using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire and reported as mean change from baseline. ASQoL is scored from 0-18 with a higher …

Rheumatoid Meningitis Sine Arthritis., Cathy Lee-Ching, Lawrence C. Kenyon, Matthew Berk, Chantel Park

Department of Medicine Faculty Papers

Rheumatoid meningitis is a rare and very serious extra-articular manifestation of rheumatoid arthritis. We present a case of a 7()year-old female with no history of arthritis who developed stroke-like symptoms, seizures, psychosis and compulsive behavior. Serial brain magnetic resonance images (MRI) over four months demonstrated progressive interhemispheric meningeal thickening. She had mild lymphocytic pleocytosis on the cerebrospinal fluid analysis and serum anti-cyclic citrullinated peptide antibodies resulted positive in high titers. She underwent a brain biopsy showing necrotizing granulomas consistent with rheumatoid meningitis. Her symptoms resolved with treatment with glucocorticoids and cyclophosphamide. She has not been diagnosed with rheumatoid arthritis even …

Factors Associated With Participant Attrition In A Longitudinal, Survey-Based Rheumatic Disease Databank, Kathryn A. Grafel

Capstone Experience: Master of Public Health

Introduction: Participant attrition is a problem common to many longitudinal studies, and when it occurs nonrandomly, it can impact the study’s validity and generalizability. Identifying factors associated with attrition can help to detect bias and aid in developing targeted interventions to reduce attrition. Methods: Logistic regression and Cox proportional hazards regression models were constructed separately for patients with rheumatoid arthritis, systemic lupus erythematosus, and other rheumatic diseases who participated in the FORWARD study between 1998 and 2018. Results: Patient characteristics associated with attrition included male sex, younger age, non-White race, and less education, each of which was identified in multiple …

Sapho: A Challenging Diagnosis In A Young Woman With Recurrent Osteomyelitis, Kourtney Erickson Do, Grace Berlin Do, Yehia Y. Mishriki Md

Department of Medicine

No abstract provided.

The Importance Of Early Arthritis In Patients With Rheumatoid Arthritis, Georgiana Iftimie, Ana Maria Alexandra Stanescu, Mihaela A. Iancu, Anca Pantea Stoian, Razvan Hainarosie, Bogdan Socea, Gheorghita Isvoranu, Dragos Marcu, Tiberiu P. Neagu, Camelia C. Diaconu

Journal of Mind and Medical Sciences

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that manifests predominantly in the synovial joint, where it causes a chronic inflammatory process, leading to early osteoarticular destructions. These destructions are progressive and irreversible, generating a significant functional deficiency. During the last years, the diagnostic approach of RA has focused on early arthritis. Early arthritis can develop into established RA or another established arthropathy, like systemic lupus erythematosus or psoriatic arthritis. It can have a spontaneous resolution or may remain undifferentiated for indefinite periods of time.

The management of early arthritis has changed considerably in the past few years, under the …

Correction: Secukinumab In The Treatment Of Psoriatic Arthritis: Efficacy And Safety Results Through 3 Years From The Year 1 Extension Of The Randomised Phase Iii Future 1 Trial., Philip Mease, A Kavanaugh, A Reimold

Articles, Abstracts, and Reports

No abstract provided.

Outcomes Of Shoulder Arthroplasty Performed For Postinfectious Arthritis., Eric M. Padegimas, Thema A. Nicholson, Stephen Silva, Matthew L. Ramsey, Gerald R. Williams, Mark D. Lazarus, Surena Namdari

Rothman Institute Papers

Background: The purpose of this study was to evaluate the functional outcomes, infection rate, and complications associated with shoulder arthroplasty for sequelae of prior septic arthritis.

Methods: This is a retrospective cohort study of 17 patients who underwent shoulder arthroplasty for sequelae of septic arthritis. Patients were analyzed for patient-reported outcomes, complications, and reoperations.

Results: The 17 patients in this cohort were an average age of 65.4 ± 12.2 years old, were 58.8% male, and had an average body mass index of 27.9 ± 4.1 kg/m

Conclusions: Shoulder arthroplasty after septic arthritis had inconsistent functional outcomes and high complication rates …

Prevalence Rates Of Arthritis Among Us Older Adults With Varying Degrees Of Depression: Findings From The 2011 To 2014 National Health And Nutrition Examination Survey, Jessica L. Brooks, Alexander J. Titus, Courtney A. Polenick, Nicole M. Orzechowski, Manney Carrington Reid, Todd A. Mackenzie, Stephen J. Bartels, John A. Batsis

Dartmouth Scholarship

Arthritis and depressive symptoms often interact and negatively influence one another to worsen mental and physical health outcomes. Better characterization of arthritis rates among older adults with different levels of depressive symptoms is an important step toward informing mental health professionals of the need to detect and respond to arthritis and related mental health complications. The primary objective is to determine arthritis rates among US older adults with varying degrees of depression. Using National Health and Nutrition Examination Survey 2011 to 2014 data (N = 4792), we first identified participants aged ≥50 years. Measures screened for depressive symptoms and …

Consensus Treatment Plans For Chronic Nonbacterial Osteomyelitis Refractory To Nonsteroidal Antiinflammatory Drugs And/Or With Active Spinal Lesions., Yongdong Zhao, Eveline Y. Wu, Melissa S. Oliver, Ashley M. Cooper, Matthew L. Basiaga, Sheetal S. Vora, Tzielan C. Lee, Emily Fox, Gil Amarilyo, Sara M. Stern, Jeffrey A. Dvergsten, Kathleen A. Haines, Kelly A. Rouster-Stevens, Karen B. Onel, Julie Cherian, Jonathan S. Hausmann, Paivi Miettunen, Tania Cellucci, Farzana Nuruzzaman, Angela Taneja, Karyl S. Barron, Matthew C. Hollander, Sivia K. Lapidus, Suzanne C. Li, Seza Ozen, Hermann Girschick, Ronald M. Laxer, Fatma Dedeoglu, Christian M. Hedrich, Polly J. Ferguson, Chronic Nonbacterial Osteomyelitis/Chronic Recurrent Multifocal Osteomyelitis Study Group And The Childhood Arthritis And Rheumatology Research Alliance Scleroderma, Vasculitis, Autoinflammatory And Rare Diseases Subcommittee

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To develop standardized treatment regimens for chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis (CRMO), to enable comparative effectiveness treatment studies.

METHODS: Virtual and face-to-face discussions and meetings were held within the CNO/CRMO subgroup of the Childhood Arthritis and Rheumatology Research Alliance (CARRA). A literature search was conducted, and CARRA membership was surveyed to evaluate available treatment data and identify current treatment practices. Nominal group technique was used to achieve consensus on treatment plans for CNO refractory to nonsteroidal antiinflammatory drug (NSAID) monotherapy and/or with active spinal lesions.

RESULTS: Three consensus treatment plans (CTPs) were developed …

A Case Of Eosinophilic Granulomatosis With Polyangiitis, Anita Modi, Md, Lily Ackermann, Md

The Medicine Forum

INTRODUCTION

Eosinophilic granulomatosis with polyangiitis (eGPA) is a small- and medium-sized-vessel vasculitis with multi-organ manifestations. Given the rarity of eGPA, patients are often misdiagnosed for decades and may initially present with life-threatening manifestations of late-stage disease. Therefore, it is important to raise awareness of this condition and its associated signs and symptoms. This case report serves to describe a classic presentation of a patient with eGPA, as well as to delineate the diagnostic workup, acute management, and early outpatient follow-up required.

KEY POINTS

Given the life-threatening complications of this rare condition, it is important to raise awareness about eGPA. This …

Frequency Of Cd19, Qianzi Zhao, Lawrence K Jung

Medicine Faculty Publications

BACKGROUND: To understand the relationship between regulatory B cells (Bregs) and juvenile idiopathic arthritis (JIA), we analyzed the percentages of Bregs and their function in peripheral blood (PB) and synovial fluid (SF) of JIA patients.

METHODS: Twenty-one JIA patients and 11 children with growing pain but without known rheumatic diseases as controls were included. The B cell phenotype and intracellular production of IL-10 of Bregs were assessed by flow cytometry. Mononuclear cells from PB and SF were stimulated to produce IL-10 in vitro for the identification of IL-10- producing regulatory B cells.

RESULTS: The percentage of CD24

CONCLUSIONS: The inability …

Comparative Effectiveness Of Secukinumab And Etanercept In Biologic-Naïve Patients With Psoriatic Arthritis Assessed By Matching-Adjusted Indirect Comparison., Philip Mease, Ernest Choy, Peter Nash, Chrysostomos Kalyvas, Matthias Hunger, Luminita Pricop, Kunal K Gandhi, Steffen M Jugl, Howard Thom

Articles, Abstracts, and Reports

OBJECTIVE: Matching-adjusted indirect comparison (MAIC) can be used to assess the comparative effectiveness of two treatments indirectly using data from randomized placebo-controlled trials. This MAIC assessed the comparative effectiveness of secukinumab (an anti-interleukin-17A) and etanercept (a tumor necrosis factor inhibitor) in a target population of biologic-naïve patients with psoriatic arthritis (PsA).

METHODS: Individual patient data pooled from FUTURE 2 (NCT01752634), FUTURE 3 (NCT01989468), and FUTURE 5 (NCT02404350) (secukinumab: 150 mg, n=458 and 300 mg, n=461) were matched to data from the population in the NCT00317499 trial (etanercept 25 mg, n=101) using MAIC methodology, by adjusting for clinical and demographic baseline …

Secukinumab Improves Active Psoriatic Arthritis Symptoms And Inhibits Radiographic Progression: Primary Results From The Randomised, Double-Blind, Phase Iii Future 5 Study., Philip Mease, Désirée Van Der Heijde, Robert Landewé, Shephard Mpofu, Proton Rahman, Hasan Tahir, Atul Singhal, Elke Boettcher, Sandra Navarra, Karin Meiser, Aimee Readie, Luminita Pricop, Ken Abrams

Articles, Abstracts, and Reports

OBJECTIVES: To evaluate the effect of subcutaneous (s.c.) secukinumab, an interleukin-17A inhibitor, on clinical signs and symptoms and radiographic progression in patients with psoriatic arthritis (PsA).

METHODS: Adults (n=996) with active PsA were randomised 2:2:2:3 to s.c. secukinumab 300 mg or 150 mg with loading dose (LD), 150 mg without LD or placebo. All groups received secukinumab or placebo at baseline, weeks 1, 2 and 3 and then every 4 weeks from week 4. The primary endpoint was the proportion of patients achieving an American College of Rheumatology 20 (ACR20) response at week 16.

RESULTS: Significantly more patients achieved an …

Secukinumab Versus Adalimumab For Psoriatic Arthritis: Comparative Effectiveness Up To 48 Weeks Using A Matching-Adjusted Indirect Comparison., Peter Nash, Iain B Mcinnes, Philip Mease, Howard Thom, Matthias Hunger, Andreas Karabis, Kunal Gandhi, Shephard Mpofu, Steffen M Jugl

Articles, Abstracts, and Reports

INTRODUCTION: Secukinumab and adalimumab are approved for adults with active psoriatic arthritis (PsA). In the absence of direct randomized controlled trial (RCT) data, matching-adjusted indirect comparison can estimate the comparative effectiveness in anti-tumor necrosis factor (TNF)-naïve populations.

METHODS: Individual patient data from the FUTURE 2 RCT (secukinumab vs. placebo; N = 299) were adjusted to match baseline characteristics of the ADEPT RCT (adalimumab vs. placebo; N = 313). Logistic regression determined adjustment weights for age, body weight, sex, race, methotrexate use, psoriasis affecting ≥ 3% of body surface area, Psoriasis Area and Severity Index score, Health Assessment Questionnaire Disability Index …

Assistive Utensil: A Spork For Hand Tremors And Spatial Awareness, Ana Font Hernandez, Jacob Kabariti, Troy Taylor

Publications and Research

In this poster, we present a 3D printed solution for hand tremors and special awareness. Our spork is an assistive device designed and 3D printed for patients suffering from scleroderma, systemic sclerosis, Parkinson's, multiple sclerosis, drug withdrawal, etc. The scale-based handle will act as a counterweight to offset the contents on the other end and reduce shakiness. The larger grip allows an easy and comfortable hold. The product will be 3D printed for a customizable fit and at an affordable price. Lastly, the product will include a haptic feedback sensor to assist the visually impaired in locating food contents on …