Seminars in arthritis and rheumatism
-
Semin. Arthritis Rheum. · Aug 2020
Review Meta AnalysisThe experience of a gout flare: a meta-synthesis of qualitative studies.
Gout flares are an important concern for people with gout and an understanding of patients' experiences with gout flares is central in developing meaningful outcome measures for clinical trials. This study aimed to systematically review and thematically synthesize the qualitative literature reporting the patient experience of gout flares, to inform the development of flare-specific outcome measures. ⋯ Gout flares impact many aspects of patients' lives, including physical and psychological and social and family life. The patient experience of gout flares goes beyond what is routinely measured in research settings. Measurement and reporting methods that capture these aspects of patients' experiences with gout flares would provide more meaningful outcome measures in clinical trials of flare prevention.
-
Semin. Arthritis Rheum. · Oct 2019
Meta AnalysisNonsurgical medical treatment in the management of pain due to lumbar disc prolapse: A network meta-analysis.
Evaluate the comparative effectiveness of treatment strategies for patients with pain due to lumbar disc prolapse (LDP). ⋯ No treatment stands out as superior when compared on multiple outcomes and time periods but TESIs show promise as an effective short-term treatment. High quality studies are needed to confirm many nodes of this network meta-analysis.
-
Semin. Arthritis Rheum. · Aug 2018
Review Meta AnalysisEvidence of reduced parasympathetic autonomic regulation in inflammatory joint disease: A meta-analyses study.
Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are inflammatory joint disorders (IJD) with increased risk of cardiovascular disease (CVD). Autonomic dysfunction (AD) is a risk factor for CVD, and parasympathetic AD is linked to key features of IJD such as inflammation, physical inactivity and pain. Heart-rate variability (HRV) is a marker of cardiac AD. The study objective was to compare parasympathetic cardiac AD, measured by HRV, between patients with IJD and healthy controls, using meta-analysis methodology, and to examine the impact of inflammation, physical inactivity and pain on HRV in IJD. ⋯ Patients with IJD have cardiac parasympathetic AD which is related to inflammation.
-
Semin. Arthritis Rheum. · Jun 2018
Review Meta AnalysisPresence of comorbidities and prognosis of clinical symptoms in knee and/or hip osteoarthritis: A systematic review and meta-analysis.
(i) To determine the association between the presence of comorbidities and severity of pain and physical dysfunction in people with knee and/or hip osteoarthritis; (ii) to explore associations between specific comorbidities (cardiac disease and/or hypertension, diabetes, depression, and back pain) and symptom severity. ⋯ Greater comorbidity burden contributes to worse pain and performance-based physical function in people with knee and/or hip osteoarthritis. Suffering comorbid cardiac disease including hypertension, back pain or diabetes may have differential effects on symptom severity.
-
Semin. Arthritis Rheum. · Aug 2017
Review Meta AnalysisPrevalence of neuropathic pain in knee or hip osteoarthritis: A systematic review and meta-analysis.
Discordance between radiographic and pain severity in osteoarthritis (OA) has led researchers to investigate other pain mechanisms, including neuropathic pain. Accurate identification of any neuropathic pain in hip or knee OA is important for appropriate management, but neuropathic pain prevalence is unknown. We aimed to obtain an overall prevalence estimate by systematically reviewing and meta-analysing the prevalence of neuropathic pain in people with hip or knee OA. ⋯ Neuropathic pain prevalence in people with knee or hip OA is considerable at 23%, and may be higher after other potential causes of neuropathic pain are excluded. Concerns regarding the validity of neuropathic pain questionnaires, selection bias, methodological quality and study heterogeneity suggest caution with interpretation of these findings. Prevalence studies using standardised criteria for neuropathic pain are required.