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Rheumatology
Journal Prestige (SJR): 2.344
Citation Impact (citeScore): 4
Number of Followers: 37  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1462-0324 - ISSN (Online) 1462-0332
Published by Oxford University Press Homepage  [414 journals]
  • Incidence and course of COVID-19 hospitalizations among patients with
           familial Mediterranean fever

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      Authors: Kharouf F; Ishay Y, Kenig A, et al.
      Abstract: ObjectivesTo evaluate the incidence of hospitalization for coronavirus disease 2019 (COVID-19) in patients with FMF, as compared with the general population, and to compare the disease course between FMF inpatients, and age-, sex-, ethnicity- and comorbidity-matched non-FMF COVID-19 inpatients.MethodsWe used electronic medical records to obtain data about the total number of the insured population and the number of FMF patients in the two largest health management organizations in Jerusalem, Clalit and Meuhedet. The total number of COVID-19 inpatients at the Hadassah Medical Center, including those with FMF, for the period between 1 February 2020 and 10March 2021, was retrieved from the electronic medical records of Hadassah. COVID-19 course was compared between the FMF inpatient group and age-, sex-, ethnicity- and comorbidity-matched non-FMF COVID-19 inpatients. Each FMF inpatient was matched with two non-FMF controls.ResultsWe found no statistically significant difference in the odds of hospitalization for COVID-19 between FMF patients and the non-FMF population (0.46% vs 0.41%, P = 0.73). Furthermore, we found similar disease severity and therapeutic approach in FMF COVID-19 inpatients and matched non-FMF COVID-19 inpatients.ConclusionsNeither FMF nor baseline colchicine therapy, appear to affect the incidence of hospitalization for COVID-19 or the disease course, in terms of severity and therapeutic approach.
      PubDate: Thu, 22 Jul 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab577
      Issue No: Vol. 60, No. SI (2021)
       
  • Impact of the COVID-19 pandemic on treat-to-target strategies and physical
           consultations in >7000 patients with inflammatory arthritis

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      Authors: Glintborg B; Jensen D, Terslev L, et al.
      Abstract: ObjectivesTo explore the impact of the COVID-19 pandemic on treat-to-target strategies (disease activity, remission rates) and access to physical consultations in patients with inflammatory rheumatic disease, as well as to explore characteristics of patients with/without physical consultations in the clinic and the impact of early vs established disease.MethodsPatients with RA, PsA or axial SpA (axSpA) prospectively followed in the nationwide DANBIO registry answered online questionnaires and reported patient-reported outcomes (PROs) in June and November 2020. Patient characteristics, disease activity and physical consultations in the clinic before and during the pandemic were identified in DANBIO [all patients and subgroups with early disease (disease duration ≤2 years)]. In individual patients, changes in PROs before and during the pandemic were calculated. Characteristics of patients with/without physical consultations were described (age, gender, education level, comorbidities, disease duration, treatment).ResultsWe included 7836 patients (22% of eligible patients), 12% of which had early disease. PROs were stable before and during the pandemic, with median changes approximating zero, as well as in patients with early disease. Remission rates were stable. The relative decrease in the number of patients with physical consultations was 21–72%, which was highest in axSpA. Characteristics of patients with/without physical consultations were similar. Self-reported satisfaction with treatment options and access was >70%; the preferred contact form was physical consultation (66%).ConclusionIn this nationwide study performed during the first 8 months of the pandemic, patient satisfaction was high and the PROs and remission rates remained stable despite the remarkable reduction in physical consultations, as well as in patients with early disease. Characteristics of patients with/without physical consultations appeared similar.
      PubDate: Sat, 19 Jun 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab500
      Issue No: Vol. 60, No. SI (2021)
       
  • Empathic communication during a pandemic: How can we minimize the
           deficit'

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      Authors: Bukhari M; Robinson S, Adebajo A, et al.
      Abstract: Communication is essential to the management of all chronic diseases including those treated by rheumatologists. To help the patient manage their disease, they need to achieve several things: sufficient understanding of the disease, the pros and cons of different possible interventions and how best to self-manage the disease, including how to cope with flares and when to ask for help. Communication is complex even when all modalities are available, but is severely diminished when done remotely, even with video, as we are all now learning during the COVID-19 pandemic.
      PubDate: Fri, 14 May 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab415
      Issue No: Vol. 60, No. SI (2021)
       
  • Cluster analysis reveals three main patterns of beliefs and intention with
           respect to SARS-CoV-2 vaccination in patients with autoimmune and
           inflammatory diseases

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      Authors: Felten R; Dubois M, Ugarte-Gil M, et al.
      Abstract: IntroductionGiven the COVID-19 pandemic, it is crucial to understand the underlying behavioural determinants of SARS-CoV-2 vaccine hesitancy in patients with autoimmune or inflammatory rheumatic diseases (AIIRDs). We aimed to analyse patterns of beliefs and intention regarding SARS-CoV-2 vaccination in AIIRD patients, as a mean of identifying pragmatic actions that could be taken to increase vaccine coverage in this population.MethodsData relating to 1258 AIIRD patients were analysed using univariate and multivariate logistic regression models, to identify variables associated independently with willingness to get vaccinated against SARS-CoV-2. Subsets of patients showing similar beliefs and intention about SARS-CoV-2 vaccination were characterized using cluster analysis.ResultsHierarchical cluster analysis identified three distinct clusters of AIIRD patients. Three predominant patient attitudes to SARS-COV-2 vaccination were identified: voluntary, hesitant and suspicious. While vaccine willingness differed significantly across the three clusters (P < 0.0001), there was no significant difference regarding fear of getting COVID-19 (P = 0.11), the presence of comorbidities (P = 0.23), the use of glucocorticoids (P = 0.21), or immunocompromised status (P = 0.63). However, patients from cluster #2 (hesitant) and #3 (suspicious) were significantly more concerned about vaccination, the use of a new vaccine technology, lack of long-term data in relation to COVID-19 vaccination, and potential financial links with pharmaceutical companies (P < 0.0001 in all) than patients from cluster #1 (voluntary).DiscussionImportantly, the differences between clusters in terms of patient beliefs and intention was not related to the fear of getting COVID-19 or to any state of frailty, but was related to specific concerns about vaccination. This study may serve as a basis for improved communication and thus help increase COVID-19 vaccine coverage among AIIRD patients.
      PubDate: Thu, 13 May 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab432
      Issue No: Vol. 60, No. SI (2021)
       
  • The effect of COVID-19 public health restrictions on the health of people
           with musculoskeletal conditions and symptoms: the CONTAIN study

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      Authors: Macfarlane G; Hollick R, Morton L, et al.
      Abstract: ObjectiveTo quantify the change in quality of life, disease-specific indicators, health and lifestyle before and during the COVID-19 pandemic among people with musculoskeletal diagnoses and symptoms.MethodsWe undertook an additional follow-up of two existing UK registers involving people with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) and participants in a trial in the UK who had regional pain and were identified at high risk of developing chronic widespread pain. Participants completed the study questionnaire between July and December 2020, throughout which time there were public health restrictions in place.ResultsThe number of people taking part in the study was 1054 (596 axSpA, 162 PsA, 296 regional pain). In comparison with their previous (pre-pandemic) assessment, there was an age-adjusted significant, small decrease in quality of life measured by EQ-5D [−0.020 (95% CI −0.030, −0.009)] overall and across all population groups examined. This was primarily related to poorer mental health and pain. There was a small increase in fibromyalgia symptoms, but a small decrease in sleep problems. There was a small deterioration in axSpA disease activity, and disease-specific quality of life and anxiety in PsA participants. Predictors of poor quality of life were similar pre- and during the pandemic. The effect of lockdown on activity differed according to age, gender and deprivation.ConclusionImportant lessons include focusing on addressing anxiety and providing enhanced support for self-management in the absence of normal health care being available, and awareness that all population groups are likely to be affected.
      PubDate: Fri, 23 Apr 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab374
      Issue No: Vol. 60, No. SI (2021)
       
  • Risk of coronavirus disease 2019 hospitalization and mortality in
           rheumatic patients treated with hydroxychloroquine or other conventional
           disease-modifying anti-rheumatic drugs in Italy

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      Authors: Spila Alegiani S; Crisafulli S, Giorgi Rossi P, et al.
      Abstract: ObjectivesTo ascertain if the use of hydroxychloroquine(HCQ)/cloroquine(CLQ) and other conventional DMARDs (cDMARDs) and rheumatic diseases per se may be associated with COVID-19-related risk of hospitalization and mortality.MethodsThis case–control study nested within a cohort of cDMARD users was conducted in the Lombardy, Veneto, Tuscany and Lazio regions and Reggio Emilia province. Claims databases were linked to COVID-19 surveillance registries. The risk of COVID-19-related outcomes was estimated using a multivariate conditional logistic regression analysis comparing HCQ/CLQ vs MTX, vs other cDMARDs and vs non-use of these drugs. The presence of rheumatic diseases vs their absence in a non-nested population was investigated.ResultsA total of 1275 patients hospitalized due to COVID-19 were matched to 12 734 controls. Compared with recent use of MTX, no association between HCQ/CLQ monotherapy and COVID-19 hospitalization [odds ratio (OR) 0.83 (95% CI 0.69, 1.00)] or mortality [OR 1.19 (95% CI 0.85, 1.67)] was observed. A lower risk was found when comparing HCQ/CLQ use with the concomitant use of other cDMARDs and glucocorticoids. HCQ/CLQ was not associated with COVID-19 hospitalization as compared with non-use. An increased risk for recent use of either MTX monotherapy [OR 1.19 (95% CI 1.05, 1.34)] or other cDMARDs [OR 1.21 (95% CI 1.08, 1.36)] vs non-use was found. Rheumatic diseases were not associated with COVID-19-related outcomes.ConclusionHCQ/CLQ use in rheumatic patients was not associated with a protective effect against COVID-19-related outcomes. The use of other cDMARDs was associated with an increased risk when compared with non-use and, if concomitantly used with glucocorticoids, also vs HCQ/CLQ, probably due to immunosuppressive action.
      PubDate: Thu, 15 Apr 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab348
      Issue No: Vol. 60, No. SI (2021)
       
  • Herpes zoster following BNT162b2 mRNA COVID-19 vaccination in patients
           with autoimmune inflammatory rheumatic diseases: a case series

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      Authors: Furer V; Zisman D, Kibari A, et al.
      Abstract: ObjectivesAs global vaccination campaigns against COVID-19 disease commence, vaccine safety needs to be closely assessed. The safety profile of mRNA-based vaccines in patients with autoimmune inflammatory rheumatic diseases (AIIRD) is unknown. The objective of this report is to raise awareness of reactivation of herpes zoster (HZ) following the BNT162b2 mRNA vaccination in patients with AIIRD.MethodsThe safety of the BNT162b2 mRNA vaccination was assessed in an observational study monitoring post-vaccination adverse effects in patients with AIIRD (n = 491) and controls (n = 99), conducted in two rheumatology departments in Israel.ResultsThe prevalence of HZ was 1.2% (n = 6) in patients with AIIRD compared with none in controls. Six female patients aged 49 ± 11 years with stable AIIRD: RA (n = 4), Sjogren’s syndrome (n = 1), and undifferentiated connective disease (n = 1), developed the first in a lifetime event of HZ within a short time after the first vaccine dose in five cases and after the second vaccine dose in one case. In the majority of cases, HZ infection was mild, except a case of HZ ophthalmicus, without corneal involvement, in an RA patient treated with tofacitinib. There were no cases of disseminated HZ disease or postherpetic neuralgia. All but one patient received antiviral treatment with a resolution of HZ-related symptoms up to 6 weeks. Five patients completed the second vaccine dose without other adverse effects.ConclusionEpidemiologic studies on the safety of the mRNA-based COVID-19 vaccines in patients with AIIRD are needed to clarify the association between the BNT162b2 mRNA vaccination and reactivation of zoster.
      PubDate: Tue, 13 Apr 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab345
      Issue No: Vol. 60, No. SI (2021)
       
  • Onset of dermatomyositis in close association with COVID-19—a first
           case reported

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      Authors: Borges N; Godoy T, Kahlow B.
      Abstract: A 36-year-old woman diagnosed with COVID-19 after presenting with a dry cough, sore throat, asthenia and fatigue. After 15 days of infectious condition and disappearance of the symptoms, she presented hyperaemic lesions and itching at the root of the left thigh. It progressed to the patient’s right back and thigh, followed by the hands, elbows and knees, being handled as an allergic condition. Two months after, there was an inability to perform exercises associated with tiredness and night awakenings due to pain and Raynaud’s presence. On examination, the dorsum of the hand showed Gottron’s papules, characterized by multiple erythematous and hyperkeratotic lesions over the IP and MCP joints, without the involvement of the interphalangeal skin (Fig. 1). Her proximally muscle power was 4/5 bilateral on the upper and lower limbs. Laboratory antibodies showed positive fine speckled pattern ANA (1/640) and anti-Mi2, associated with significant increase of muscle enzymes (creatinine phosphokinase 3518U/l). Skin biopsy showed lamellar keratosis with foci of vascular changes in the epidermal layer and dilated vessels with a thickened wall and perivascular lymphocytic infiltrate, consistent with the diagnosis of DM [1, 2]. The patient improved with a 5-day pulse of methylprednisolone. To our knowledge, this is the first reported case of a DM in close association with COVID-19.
      PubDate: Tue, 23 Mar 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab290
      Issue No: Vol. 60, No. SI (2021)
       
  • COVID-19 in patients with autoimmune diseases: characteristics and
           outcomes in a multinational network of cohorts across three countries

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      Authors: Tan E; Sena A, Prats-Uribe A, et al.
      Abstract: ObjectivePatients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization with COVID-19 among patients with prevalent autoimmune diseases, and compared outcomes after hospital admissions among similar patients with seasonal influenza.MethodsA multinational network cohort study was conducted using electronic health records data from Columbia University Irving Medical Center [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017–18 were included. Outcomes were death and complications within 30 days of hospitalization.ResultsWe studied 133 589 patients diagnosed and 48 418 hospitalized with COVID-19 with prevalent autoimmune diseases. Most patients were female, aged ≥50 years with previous comorbidities. The prevalence of hypertension (45.5–93.2%), chronic kidney disease (14.0–52.7%) and heart disease (29.0–83.8%) was higher in hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2–4.3% vs 6.32–24.6%).ConclusionCompared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.
      PubDate: Tue, 16 Mar 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab250
      Issue No: Vol. 60, No. SI (2021)
       
  • The influence of the SARS-CoV-2 lockdown on patients with inflammatory
           rheumatic diseases on their adherence to immunomodulatory medication: a
           cross sectional study over 3 months in Germany

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      Authors: Hasseli R; Müller-Ladner U, Keil F, et al.
      Abstract: ObjectivesTo evaluate the influence of the SARS-CoV-2 pandemic on the adherence of patients with inflammatory rheumatic diseases (IRD) to their immunomodulatory medication during the three-month lockdown in Germany.MethodsFrom 16th March until 15th June 2020, IRD patients from private practices and rheumatology departments were asked to answer a questionnaire addressing their behaviour with respect to their immunomodulating therapy. Eight private practices and nine rheumatology departments that included rheumatology primary care centres and university hospitals participated. A total of 4252 questionnaires were collected and evaluated.ResultsThe majority of patients (54%) were diagnosed with RA, followed by psoriatic arthritis (14%), ankylosing spondylitis (10%), connective tissue diseases (12%) and vasculitides (6%). Most of the patients (84%) reported to continue their immunomodulatory therapy. Termination of therapy was reported by only 3% of the patients. The results were independent from the type of IRD, the respective immunomodulatory therapy and by whom the patients were treated (private practices vs rheumatology departments). Younger patients (<60 years) reported just as often as older patients to discontinue their therapy.ConclusionThe data show that most of the patients continued their therapy in spite of the pandemic. A significant change in behaviour with regard to their immunomodulatory therapy was not observed during the three months of observation. The results support the idea that the immediate release of recommendations of the German Society of Rheumatology were well received, supporting the well-established physician–patient relationship in times of a crisis.
      PubDate: Thu, 11 Mar 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab230
      Issue No: Vol. 60, No. SI (2021)
       
  • The impact of the COVID-19 pandemic on people with rheumatic and
           musculoskeletal diseases: insights from patient-generated data on social
           media

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      Authors: Reuter K; Deodhar A, Makri S, et al.
      Abstract: ObjectivesDuring the COVID-19 pandemic, much communication occurred online, through social media. This study aimed to provide patient perspective data on how the COVID-19 pandemic impacted people with rheumatic and musculoskeletal diseases (RMDs), using Twitter-based patient-generated health data (PGHD).MethodsA convenience sample of Twitter messages in English posted by people with RMDs was extracted between 1 March and 12 July 2020 and examined using thematic analysis. Included were Twitter messages that mentioned keywords and hashtags related to both COVID-19 (or SARS-CoV-2) and select RMDs. The RMDs monitored included inflammatory-driven (joint) conditions (ankylosing spondylitis, RA, PsA, lupus/SLE and gout).ResultsThe analysis included 569 tweets by 375 Twitter users with RMDs across several countries. Eight themes emerged regarding the impact of the COVID-19 pandemic on people with RMDs: (i) lack of understanding of SARS-CoV-2/COVID-19; (ii) critical changes in health behaviour; (iii) challenges in healthcare practice and communication with healthcare professionals; (iv) difficulties with access to medical care; (v) negative impact on physical and mental health, coping strategies; (vi) issues around work participation; (vii) negative effects of the media; and (viii) awareness-raising.ConclusionThe findings show that Twitter serves as a real-time data source to understand the impact of the COVID-19 pandemic on people with RMDs. The platform provided ‘early signals’ of potentially critical health behaviour changes. Future epidemics might benefit from the real-time use of Twitter-based PGHD to identify emerging health needs, facilitate communication and inform clinical practice decisions.
      PubDate: Thu, 25 Feb 2021 00:00:00 GMT
      DOI: 10.1093/rheumatology/keab174
      Issue No: Vol. 60, No. SI (2021)
       
  • Incidence and severeness of COVID-19 hospitalization in patients with
           inflammatory rheumatic disease: a nationwide cohort study from Denmark

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      Authors: Cordtz R; Lindhardsen J, Soussi B, et al.
      Abstract: ObjectivesTo estimate the incidence of COVID-19 hospitalization in patients with inflammatory rheumatic disease (IRD); in patients with RA treated with specific DMARDs; and the incidence of severe COVID-19 infection among hospitalized patients with RA.MethodsA nationwide cohort study from Denmark between 1 March and 12 August 2020. The adjusted incidence of COVID-19 hospitalization was estimated for patients with RA; spondyloarthritis including psoriatic arthritis; connective tissue disease; vasculitides; and non-IRD individuals. Further, the incidence of COVID-19 hospitalization was estimated for patients with RA treated and non-treated with TNF-inhibitors, HCQ or glucocorticoids, respectively. Lastly, the incidence of severe COVID-19 infection (intensive care, acute respiratory distress syndrome or death) among hospital-admitted patients was estimated for RA and non-IRD sp - individudals.ResultsPatients with IRD (n = 58 052) had an increased partially adjusted incidence of hospitalization with COVID-19 compared with the 4.5 million people in the general population [hazard ratio (HR) 1.46, 95% CI: 1.15, 1.86] with strongest associations for patients with RA (n = 29 440, HR 1.72, 95% CI: 1.29, 2.30) and vasculitides (n = 4072, HR 1.82, 95% CI: 0.91, 3.64). There was no increased incidence of COVID-19 hospitalization associated with TNF-inhibitor, HCQ nor glucocorticoid use. COVID-19 admitted patients with RA had a HR of 1.43 (95% CI: 0.80, 2.53) for a severe outcome.ConclusionPatients with IRD were more likely to be admitted with COVID-19 than the general population, and COVID-19 admitted patients with RA could be at higher risk of a severe outcome. Treatment with specific DMARDs did not affect the risk of hospitalization.
      PubDate: Mon, 28 Dec 2020 00:00:00 GMT
      DOI: 10.1093/rheumatology/keaa897
      Issue No: Vol. 60, No. SI (2020)
       
 
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