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Open Journal of Rheumatology and Autoimmune Diseases
Number of Followers: 5

This is an Open Access Journal

Open Access journal
ISSN (Print) 2163-9914 - ISSN (Online) 2164-005X
Published by Scientific Research Publishing

[243 journals]

Rituximab for interstitial pneumonia with autoimmune features at two
medical centres
- Authors: D’Silva K; Ventura I, Bolster M, et al.
  Pages: ii1 - ii9
  Abstract: AbstractObjectivesMany patients with interstitial lung disease (ILD) have autoimmune manifestations but do not meet criteria for a systemic rheumatic disease. A subset meets criteria for interstitial pneumonia with autoimmune features (IPAF) and have ILD requiring therapy. We conducted a multicentre observational study to examine the use of rituximab (RTX) in IPAF.MethodsPatients from Mass General Brigham (MGB) and University of Chicago Medicine (UCM) were included if they were ≥18 years old, met the 2015 classification criteria for IPAF and were treated with RTX. Clinical improvement was defined as improvement in four out of four domains at 1 year after RTX initiation: documented clinician global assessment; oxygen requirement; need for respiratory-related hospitalization; and survival.ResultsAt MGB, 36 IPAF patients (mean age 61 years, 44% female) were treated with RTX. At 1 year, 18 (50%) were clinically improved, 12 (33%) were stable, and 6 (17%) died from progressive respiratory failure. At UCM, 14 IPAF patients (mean age 53 years, 71% female) were treated with RTX. At 1 year, eight (57%) were improved, two (14%) were stable, three (21%) died from progressive respiratory failure, and one (7%) was lost to follow-up. Two patients experienced minor infusion reactions, and two patients discontinued therapy owing to adverse events (infections).ConclusionIn patients with IPAF treated with RTX at two medical centres, the majority (40 [80%]) demonstrated improvement/stability at 1 year. These findings call for prospective studies, including randomized clinical trials, to determine the risks, benefits and cost effectiveness of RTX in IPAF.
  PubDate: Fri, 05 Nov 2021 00:00:00 GMT
  DOI: 10.1093/rap/rkab051
  Issue No: Vol. 5, No. Supplement_2 (2021)
Ultrasound features of Achilles enthesitis in psoriatic arthritis: a
systematic review
- Authors: Patience A; Steultjens M, Hendry G.
  Pages: ii19 - ii34
  Abstract: AbstractObjectivesThe objectives were to evaluate the methodological and reporting quality of ultrasound (US) studies of Achilles enthesitis in people with psoriatic arthritis (PsA), to identify the definitions and scoring systems adopted and to estimate the prevalence of ultrasound features of Achilles enthesitis in this population.MethodsA systematic literature review was conducted using the AMED, CINAHL, MEDLINE, ProQuest and Web of Science databases. Eligible studies had to measure US features of Achilles enthesitis in people with PsA. Methodological quality was assessed using a modified Downs and Black Quality Index tool. US protocol reporting was assessed using a checklist informed by the European League Against Rheumatism (EULAR) recommendations for the reporting of US studies in rheumatic and musculoskeletal diseases.ResultsFifteen studies were included. One study was scored as high methodological quality, 9 as moderate and 5 as low. Significant heterogeneity was observed in the prevalence, descriptions, scoring of features and quality of US protocol reporting. Prevalence estimates (% of entheses) reported included hypoechogenicity [mean 5.9% (s.d. 0.9)], increased thickness [mean 22.1% (s.d. 12.2)], erosions [mean 3.3% (s.d. 2.5)], calcifications [mean 42.6% (s.d. 15.6)], enthesophytes [mean 41.3% (s.d. 15.6)] and Doppler signal [mean 11.8% (s.d. 10.1)].ConclusionsThe review highlighted significant variations in prevalence figures that could potentially be explained by the range of definitions and scoring criteria available, but also due to the inconsistent reporting of US protocols. Uptake of the EULAR recommendations and using the latest definitions and validated scoring criteria would allow for a better understanding of the frequency and severity of individual features of pathology.
  PubDate: Fri, 05 Nov 2021 00:00:00 GMT
  DOI: 10.1093/rap/rkab056
  Issue No: Vol. 5, No. Supplement_2 (2021)
The perception of stakeholders on the applicability of nurse-led clinics
in the management of rheumatoid arthritis
- Authors: Doumen M; Westhovens R, Vandeputte M, et al.
  Pages: ii45 - ii52
  Abstract: AbstractObjectivesRA should be treated to target in a process of shared decision-making with patients. Person-centred care is essential to meeting specific patient needs. Nurse-led clinics, where a nurse is responsible for care, have demonstrated added value in some countries but are still not implemented widely. This study aimed to explore stakeholders’ perceptions of advantages, disadvantages and conditions for the implementation of nurse-led clinics for RA in Belgium.MethodsWe performed a cross-sectional qualitative study consisting of five semi-structured focus group interviews. Rheumatology nurses, patients with RA and rheumatologists were interviewed as stakeholders. The analysis was carried out by three researchers according to the Qualitative Analysis Guide of Leuven (QUAGOL), formulating a conceptual framework of overarching themes and deconstructing this into perceived advantages, disadvantages and conditions.ResultsTwo focus groups with nurses (total n = 16), two with patients (n = 17) and one with rheumatologists (n = 9) were conducted. The interview synthesis resulted in five overarching themes across stakeholders: efficiency of care, disease management, legal and organizational requirements, the conventional role of the nurse and the extended role of the nurse. All stakeholders perceived additional education for nurses as essential, but rheumatologists debated nurses’ abilities to lead a rheumatology clinic. Furthermore, patients preferred care protocols to guide nurses, and care providers approached this reluctantly. Generally, patients with a well-controlled disease were perceived as the ideal candidates for nurse-led care.ConclusionNurse-led clinics could provide many benefits but require additional nurse education and a legal and organizational framework before being implemented widely and successfully.
  PubDate: Fri, 05 Nov 2021 00:00:00 GMT
  DOI: 10.1093/rap/rkab052
  Issue No: Vol. 5, No. Supplement_2 (2021)
Clinical profile and treatment outcomes in antisynthetase syndrome: a
tertiary centre experience
- Authors: Sreevilasan S; Devarasetti P, Narahari N, et al.
  Pages: ii10 - ii18
  Abstract: AbstractObjectivesThe aim was to describe the clinical profile and outcomes in patients with antisynthetase syndrome (ASS) from a tertiary care centre.MethodsThe clinical data and investigations of all patients classified as ASS by Connors criteria over 5 years were recorded, and they were followed up prospectively. The median (interquartile range) was used for descriptive statistics. Clinical variables between the Jo-1 and non-Jo-1 groups and between patients with and without anti-Ro52 antibodies were compared using the χ2 test. Survival analysis was done using the log rank test.ResultsThe 28 patients (23 females) had a median age of 42.5 (34.8–52.3) years, with a disease duration of 1.75 (0.6–3.8) years at diagnosis, and had a follow-up of 2 (0.25–4.25) years. Seronegative arthritis was seen in 23 of 28 patients. Non-specific interstitial pneumonia was seen in 19 patients with interstitial lung disease (ILD). Antibodies to Jo-1 (n = 17) were more frequent than non-Jo-1 antibodies (n = 11; five anti-PL-12, four anti-PL-7 and two anti-EJ). There was no significant difference in the prevalence of myositis (P = 0.07) or ILD (P = 0.11) between groups. Anti-Ro52 antibodies were more frequently found in the non-Jo-1 group (P = 0.006, ϕ = 0.51). A partial or complete improvement with treatment was seen in three-quarters of the patients. Five patients succumbed to the illness. Better survival was seen in the Jo-1 group (P = 0.05).ConclusionThe most typical presenting manifestation of ASS in our cohort was isolated seronegative arthritis. Non-specific interstitial pneumonia was the commonest ILD pattern. Patients with antibodies to Jo-1 had better survival compared with non-Jo-1. The non-Jo-1 aminoacyl-transfer RNA synthetases had a strong association with anti-Ro52 antibodies.
  PubDate: Fri, 05 Nov 2021 00:00:00 GMT
  DOI: 10.1093/rap/rkab054
  Issue No: Vol. 5, No. Supplement_2 (2021)
Foreword from the judges
- Authors: Tan A; Westhovens R, Ndosi M.
  Pages: iia - iia
  Abstract: We have been thrilled by the response to the Rheumatology Advances in Practice Trainee Publishing Programme, which aimed to encourage and celebrate the publication of research from rheumatology trainees around the world.
  PubDate: Fri, 05 Nov 2021 00:00:00 GMT
  DOI: 10.1093/rap/rkab080
  Issue No: Vol. 5, No. Supplement_2 (2021)
Factors associated with patient activation in inflammatory arthritis: a
multisite cross-sectional study
- Authors: Jones B; Ndosi M, Hunt A, et al.
  Pages: ii35 - ii44
  Abstract: AbstractObjectivesPatient activation covers the skills, abilities and behaviour that impact how able and willing someone is to take an active role in self-managing their health. This study explored clinical and psychosocial factors associated with patient activation in rheumatology patients.MethodsThis was a cross-sectional study using postal survey methods. Participants with inflammatory rheumatic conditions were from six rheumatology centres in England. Patient activation was captured using the Patient Activation Measure (PAM). Twenty-nine explanatory factors were tested for potential association with patient activation in univariable and multivariable analyses. In preliminary multivariable analyses, factors found to have an association with patient activation at a P < 0.1 level were entered into the final multivariable model. Those that remained significant at a P < 0.05 level were considered associated with patient activation.ResultsThe sample comprised 251 participants (74% female) with a mean age of 59.31 years (s.d. 12.69), disease duration of 14.48 years (s.d. 12.52) and a PAM score of 58.3 (s.d. 11.46). Of the 29 candidate factors, 25 were entered into a preliminary multivariable analysis. In the final multivariable analysis, four factors (self-efficacy, the illness belief that treatment will control participants’ condition and two dimensions of health literacy) were significantly associated with patient activation. This final model accounted for 40.4% of the variance in PAM scores [F(4, 246) = 41.66, P < 0.001].ConclusionsPatient activation is important in managing rheumatic conditions. Our data confirm that self-efficacy and health literacy are particular targets for patient activation interventions.
  PubDate: Fri, 05 Nov 2021 00:00:00 GMT
  DOI: 10.1093/rap/rkab053
  Issue No: Vol. 5, No. Supplement_2 (2021)

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