Clinical rheumatology
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Clinical rheumatology · Nov 2018
Multicenter StudyValidity of the central sensitization inventory with measures of sensitization in people with knee osteoarthritis.
Our purpose was to determine the validity of the Central Sensitization Inventory (CSI) with psychophysical tests, psychological and physical factors in patients with Knee Osteoarthritis (KOA). Patients with KOA were recruited from three Montreal hospitals. Psychophysical tests (pressure pain threshold, conditioned pain modulation, temporal summation) were conducted and questionnaires administered to determine the presence of neuropathic pain, somatization, anxiodepressive symptoms, pain catastrophizing (PC), and widespread pain (WSP). ⋯ After adjustment for covariates, a multivariable linear regression determined WSP (unstandardized ß 4.161(0.067, 8.255) p = 0.046), somatization (unstandardized ß 1.828 (1.368, 2.288) p < 0.005), and anxiodepressive symptoms (unstandardized ß 0.419 (0.107, 0.730) p = 0.009) significantly predicted CSI scores. The CSI is more strongly associated with psychological factors than psychophysical test results in a KOA population. Its moderate sensitivity and specificity suggest it should be used as part of a more comprehensive evaluative toolkit.
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Clinical rheumatology · May 2017
Multicenter Study Observational StudySwitching profiles in a population-based cohort of rheumatoid arthritis receiving biologic therapy: results from the KOBIO registry.
Despite improved quality of care for rheumatoid arthritis (RA) patients, many still experience treatment failure with a biologic agent and eventually switch to another biologic agent. We investigated patterns of biologic treatment and reasons for switching biologics in patients with RA. Patients with RA who had started on a biologic agent or had switched to another biologic agent were identified from the prospective observational Korean nationwide Biologics (KOBIO) registry. ⋯ The most common reason for switching biologics was inefficacy, followed by adverse events, including infusion reactions, infections, and skin eruptions. Furthermore, the proportion of inefficacy, as a reason for switching, was significantly higher with respect to switching between biologics with different mechanisms of action than between biologics with similar mechanisms. In this registry, we showed diverse prescribing patterns and differing baseline profiles based on the chronological order of biologic agents.
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Clinical rheumatology · May 2017
Multicenter Study Observational StudyKnee symptoms among adults at risk for accelerated knee osteoarthritis: data from the Osteoarthritis Initiative.
The purpose of this study was to examine if adults who develop accelerated knee osteoarthritis (KOA) have greater knee symptoms with certain activities than those with or without incident common KOA. We conducted a case-control study using data from baseline and the first four annual visits of the Osteoarthritis Initiative. Participants had no radiographic KOA at baseline (Kellgren-Lawrence (KL) <2). ⋯ Individuals who developed accelerated KOA were more likely to report greater difficulty with lying down (OR = 2.10, 95% CI = 1.04 to 4.25), pain with straightening the knee fully (OR = 2.04, 95% CI = 1.08, 3.85), and pain walking (OR = 2.49, 95% CI = 1.38, 4.84) than adults who developed common KOA. Individuals who develop accelerated KOA report greater symptoms with certain activities than those with common KOA. Our results may help identify individuals at risk for accelerated KOA or with early-stage accelerated KOA.
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Clinical rheumatology · Mar 2017
Randomized Controlled Trial Multicenter Study Comparative StudyAutologous whole blood versus corticosteroid local injection in treatment of plantar fasciitis: A randomized, controlled multicenter clinical trial.
Plantar fasciitis is the most common cause of heel pain. Local injection modalities are among treatment options in patients with resistant pain. The aim of the present study was to evaluate the effect of local autologous whole blood compared with corticosteroid local injection in treatment of plantar fasciitis. ⋯ The corticosteroid group showed an early sharp and then more gradual improvement in pain scores, but autologous blood group had a steady gradual drop in pain. Autologous whole blood and corticosteroid local injection can both be considered as effective methods in the treatment of chronic plantar fasciitis. These treatments decrease pain and significantly improve function compared to no treatment.
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Clinical rheumatology · Feb 2017
Multicenter Study Observational StudyTreatment with ustekinumab in a Spanish cohort of patients with psoriasis and psoriatic arthritis in daily clinical practice.
After approval of the use of ustekinumab for treatment of moderate to severe psoriasis, patients with psoriatic arthritis have treated with this drug in daily clinical practice. The aims of this study were to describe baseline characteristics and evolution of a cohort of patients with psoriasis and psoriatic arthritis treated with ustekinumab and to compare differences between patients who discontinued treatment and those who maintained. A retrospective multicenter observational study including patients who had received ustekinumab for a minimum of 3 months from 2009 to 2015 was performed. ⋯ The main indication was dermatological (72.4% of cases), and treatment with ustekinumab was maintained in most patients (62.1% of cases) with low discontinuation by side effects and rheumatological lack of efficacy. Discontinuation of ustekinumab was correlated with more number of obese patients, less presence of plaque psoriasis and more number of previous biological therapies. Ustekinumab demonstrated efficacy and safety in the management of patients with psoriasis and psoriatic arthritis in daily clinical practice in our cohort of patients.