bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Management of Cardiovascular Risk Factors in Psoriatic Arthritis and Rheumatoid Arthritis: A Population‐Based Study
Authors: Jafri Kashif , Bartels Christie M. , Shin Daniel , Gelfand Joel M. , Ogdie Alexis 
Published: October 2016

ObjectiveTo examine the prevalence and incidence of cardiovascular (CV) risk factors, including hypertension, hyperlipidemia, diabetes mellitus (DM), and obesity among patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) compared to the general population, and to examine the treatment of incident CV risk factors in PsA and RA compared to controls.MethodsA cohort study was conducted within The Health Improvement Network, a medical record database in the UK, using data from 1994 to 2014. Patients ages 18–89 years with PsA or RA were matched to controls on practice and start date. The prevalence and incidence of CV risk factors identified by diagnostic codes were calculated. Cox proportional hazards models were used to examine the relative incidence of these CV risk factors. Finally, pharmacologic therapies for incident CV risk factors were examined.ResultsStudy subjects included patients with PsA (n = 12,548), RA (n = 53,215), and controls (n = 389,269). The prevalence of all CV risk factors was significantly elevated in PsA. Only the prevalence of DM and obesity was increased in RA. Incidence of hypertension, hyperlipidemia, and DM was elevated in PsA and RA. Receipt of therapy within 1 year following incident diagnosis of CV risk factors was not substantially different between the groups; approximately 85%, 65%, and 45% of patients received prescriptions for hypertension, hyperlipidemia, and DM, respectively.ConclusionPatients with PsA have an increased prevalence of CV risk factors, and both patients with PsA and patients with RA have increased incidence of a new diagnosis of CV risk factors. Pharmacologic treatment of CV risk factors in patients with PsA and RA was similar to controls in the UK.
Personalized Physical Therapy Versus Usual Care for Patients With Systemic Sclerosis: A Randomized Controlled Trial
Authors: Rannou François , Boutron Isabelle , Mouthon Luc , Sanchez Katherine , Tiffreau Vincent , Hachulla Eric , Thoumie Philipe , Cabane Jean , Chatelus Emmanuel , Sibilia Jean , Roren Alexandra , Berezne Alice , Baron Gabriel , Porcher Raphael , Guillevin Loic , Ravaud Philippe , Poiraudeau Serge 
Published: October 2016

ObjectiveTo compare a physical therapy program to usual care of systemic sclerosis (SSc) patients on disability.MethodsA 12‐month followup, parallel‐group randomized controlled trial involving a modified Zelen design was conducted in 4 tertiary‐care hospitals. Patients were enrolled if they had a disability rating ≥0.5 on the Health Assessment Questionnaire disability index (HAQ DI) or symptoms of decreased mouth opening or limited range of motion of at least 1 joint. The experimental intervention (n = 112, of which 110 were analyzed) was a 1‐month personalized supervised physical therapy program provided by trained care providers followed by home sessions. The comparator (n = 108, and all 108 were analyzed) was usual care that could include ambulatory physical therapy. The primary outcome was the HAQ DI score.ResultsThere was no statistically significant difference in disability at 12 months (HAQ DI score between‐group difference −0.01 [95% confidence interval (95% CI) −0.15, 0.13]; P = 0.86). Disability was reduced at 1 month for patients in the physical therapy group (HAQ DI between‐group difference −0.14 [95% CI −0.24, −0.03]; P = 0.01); at 6 months the HAQ DI score between‐group difference was −0.12 (95% CI −0.23, 0.01); P = 0.054. There was a statistically significant difference for hand mobility and function, and for pain, at 1 month. Microstomia was lower in the physical therapy group at 1, 6, and 12 months (between‐group difference at 12 months 1.62 [95% CI 0.32, 2.93]; P = 0.01). No differences in adverse effects were observed.ConclusionA personalized physical therapy program did not reduce disability at 12 months but had short‐term benefits for patients with SSc.
Standards of Comparison and Discordance in Rheumatoid Arthritis Global Assessments Between Patients and Clinicians
Authors: Ward Michael M. , Guthrie Lori C. , Alba Maria I. 
Published: October 2016

ObjectivePatient‐physician discordance in health status ratings may arise because patients use temporal comparisons (comparing their current status with their previous status), while clinicians use social comparisons (comparing this patient's status to that of other patients, or to the full range of disease severity possible) to guide their assessments. We compared discordance between patients with rheumatoid arthritis (RA) and clinicians, using either the conventional patient global assessment (PGA) or a rating scale with 5 anchors describing different health states. We hypothesized that discordance would be smaller with the rating scale because clinicians likely used similar social comparisons when making global assessments.MethodsWe prospectively studied 206 patients with active RA and assessed the PGA (range 0–100), rating scale (range 0–100), and evaluator global assessment (EGA; range 0–100) on each of 2 visits (total visits = 401). We compared the PGA/EGA discordance and the rating scale/EGA discordance at each visit.ResultsThe mean ± SD PGA/EGA discordance was 8.5 ± 22.4, and the mean ± SD rating scale/EGA discordance was 2.3 ± 24.0. The intraclass correlation, measuring agreement, was higher between the rating scale and EGA than between the PGA and EGA (0.39 versus 0.31). Agreement was larger at low levels of RA activity on both pairs of measures.ConclusionDiscordance between patients’ global assessments and evaluators’ global assessments was smaller when patients used a social standard of comparison than when they marked the PGA, suggesting that differences in standards of comparison contribute to patient‐clinician discordance when the PGA is used.
Relationship Between Attitudes and Beliefs and Physical Activity in Older Adults With Knee Pain: Secondary Analysis of a Randomized Controlled Trial
Authors: Quicke Jonathan G. , Foster Nadine E. , Ogollah Reuben O. , Croft Peter R. , Holden Melanie A. 
Published: October 2016

ObjectiveTo investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA).MethodsWe conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross‐sectional and longitudinal associations between baseline Self‐Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self‐report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6‐month followup) were investigated using multiple linear and logistic regression.ResultsCross‐sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found.ConclusionGreater exercise self‐efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity.
Defining Low Disease Activity in Systemic Lupus Erythematosus
Authors: Polachek Ari , Gladman Dafna D. , Su Jiandong , Urowitz Murray B. 
Published: October 2016

ObjectiveTo define and identify a group of systemic lupus erythematosus patients with low disease activity (LDA) and to examine whether LDA is similar to patients in remission and different from a high disease activity group (HDA) in short‐term outcomes.MethodsThe LDA group was defined as Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI‐2K) <3, including only 1 clinical manifestation of rash, alopecia, mucosal ulcers, pleurisy, pericarditis, fever, thrombocytopenia, or leukopenia. The patients could be taking antimalarials. Remission was defined as no clinical manifestation from taking antimalarials alone, and the HDA group was defined as SLEDAI‐2K >6. The time frame for inclusion in each group was at least 1 year.ResultsOf 620 patients with active disease who were seen between 1970 and 2015, 80 patients (12.9%) fulfilled the criteria for LDA, 191 (30.8%) for remission, and 349 (56.3%) for HDA. The LDA patients with and without positive serology results were similar at baseline and with prior disease characteristics. After 2 years of followup, the LDA and remission groups were similar in their adjusted mean SLEDAI‐2K score, organ involvement, The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) score, mortality, and therapies. After 2 and 4 years of followup, the HDA group had a higher adjusted mean SLEDAI‐2K score, more major organ involvement, a higher SDI score, higher mortality, and more therapy compared to the combined LDA/remission groups.ConclusionLDA and remission groups had similar short‐term outcomes, and both had better outcomes and prognosis than the HDA group. LDA may be used as an outcome measure in therapeutic trials or in treat‐to‐target regimens.
Do Short and Sustained Periods of American College of Rheumatology/European League Against Rheumatism Remission Predict Functional and Radiographic Outcome in Early Rheumatoid Arthritis Patients With Low Overall Damage Progression?
Authors: Konijn Nicole P. C. , van Tuyl Lilian H. D. , Boers Maarten , den Uyl Debby , ter Wee Marieke M. , Kerstens Pit , Voskuyl Alexandre E. , van Schaardenburg Dirkjan , Nurmohamed Michael T. , Lems Willem F. 
Published: October 2016

ObjectiveTo investigate whether remission at single and consecutive visits predicts good outcome in early rheumatoid arthritis (RA).MethodsThe presence of remission according to American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) and other criteria (Boolean clinical, Clinical Disease Activity Index, Disease Activity Score [DAS], DAS in 28 joints, and Routine Assessment of Patient Index Data 3) was assessed in early RA patients during the first year of the Combination Therapy for Rheumatoid Arthritis light trial. Likelihood ratios were used to assess whether meeting the remission criteria at single visits (13, 26, 39, or 52 weeks) and consecutive visits (13 and 26, 26 and 39, or 39 and 52 weeks) predicted good outcome in the second year (52–104 weeks). Good outcome was defined for function (Health Assessment Questionnaire score consistently ≤0.5 and no deterioration), radiographic damage progression (no deterioration in Sharp/van der Heijde scores), and both (“overall good outcome”).ResultsOf the original 164 trial patients, 144 had evaluable data. In the second year, good functional outcome was observed in 35%, good radiographic outcome in 79%, and both in 28% of the patients. Almost all criteria predicted good functional and good overall outcome, at both single and consecutive visits; only single DAS remission did not significantly predict good overall outcome (P = 0.07). Sustained remission periods resulted in higher likelihood ratios than remission at single visits. None of the criteria predicted good radiographic outcome.ConclusionEarly RA patients who reached remission according to ACR/EULAR and other criteria during short or sustained periods were likely to retain good physical function in the subsequent months. Sustained remission periods were a stronger predictor than remission at single visits. However, in the setting of low overall damage progression, (sustained) remission was not predictive of good radiographic outcome.
Incidence and impact of subclinical epileptiform activity in Alzheimer's disease
Authors: Vossel Keith A. , Ranasinghe Kamalini G. , Beagle Alexander J. , Mizuiri Danielle , Honma Susanne M. , Dowling Anne F. , Darwish Sonja M. , Van Berlo Victoria , Barnes Deborah E. , Mantle Mary , Karydas Anna M. , Coppola Giovanni , Roberson Erik D. , Miller Bruce L. , Garcia Paul A. , Kirsch Heidi E. , Mucke Lennart , Nagarajan Srikantan S. 
Published: October 2016

ObjectiveSeizures are more frequent in patients with Alzheimer's disease (AD) and can hasten cognitive decline. However, the incidence of subclinical epileptiform activity in AD and its consequences are unknown. Motivated by results from animal studies, we hypothesized higher than expected rates of subclinical epileptiform activity in AD with deleterious effects on cognition.MethodsWe prospectively enrolled 33 patients (mean age, 62 years) who met criteria for AD, but had no history of seizures, and 19 age‐matched, cognitively normal controls. Subclinical epileptiform activity was assessed, blinded to diagnosis, by overnight long‐term video‐electroencephalography (EEG) and a 1‐hour resting magnetoencephalography exam with simultaneous EEG. Patients also had comprehensive clinical and cognitive evaluations, assessed longitudinally over an average period of 3.3 years.ResultsSubclinical epileptiform activity was detected in 42.4% of AD patients and 10.5% of controls (p = 0.02). At the time of monitoring, AD patients with epileptiform activity did not differ clinically from those without such activity. However, patients with subclinical epileptiform activity showed faster declines in global cognition, determined by the Mini–Mental State Examination (3.9 points/year in patients with epileptiform activity vs 1.6 points/year in patients without; p = 0.006), and in executive function (p = 0.01).InterpretationExtended monitoring detects subclinical epileptiform activity in a substantial proportion of patients with AD. Patients with this indicator of network hyperexcitability are at risk for accelerated cognitive decline and might benefit from antiepileptic therapies. These data call for more sensitive and comprehensive neurophysiological assessments in AD patient evaluations and impending clinical trials. Ann Neurol 2016;80:858–870
Cam Deformity and Acetabular Dysplasia as Risk Factors for Hip Osteoarthritis
Authors: Saberi Hosnijeh Fatemeh , Zuiderwijk Maria E. , Versteeg Mathijs , Smeele Hieronymus T. W. , Hofman Albert , Uitterlinden André G. , Agricola Rintje , Oei Edwin H. G. , Waarsing Jan H. , Bierma‐Zeinstra Sita M. , van Meurs Joyce B. J. 
Published: October 2016

ObjectiveCam deformity and acetabular dysplasia have been recognized as relevant risk factors for hip osteoarthritis (OA) in a few prospective studies with limited sample sizes. To date, however, no evidence is available from prospective studies regarding whether the magnitude of these associations differs according to sex, body mass index (BMI), and age.MethodsParticipants in the Rotterdam Study cohort including men and women ages 55 years or older without OA at baseline (n = 4,438) and a mean follow‐up of 9.2 years were included in the study. Incident radiographic OA was defined as a Kellgren/Lawrence grade of ≥2 or a total hip replacement at follow‐up. Alpha and center‐edge angles were measured to determine the presence of cam deformity and acetabular dysplasia/pincer deformity, respectively. Odds ratios (ORs) were calculated to assess the associations between both deformities and the development of OA.ResultsSubjects with cam deformity (OR 2.11, 95% confidence interval [95% CI] 1.55–2.87) and those with acetabular dysplasia (OR 2.19, 95% CI 1.50–3.21) had a 2‐fold increased risk of developing OA compared with subjects without deformity, while pincer deformity did not increase the risk of OA. Stratification analyses showed that the associations of cam deformity and acetabular dysplasia with OA were driven by younger individuals, whereas BMI did not influence the associations. Female sex appears to modify the risk of hip OA related to acetabular dysplasia.ConclusionIndividuals with cam deformity and those with acetabular dysplasia are predisposed to OA; these associations were independent of other well‐known risk factors. Interestingly, both deformities predisposed to OA only in relatively young individuals. Therefore, early identification of these conditions is important.
Anti–Interleukin‐6 Receptor Tocilizumab for Severe Juvenile Idiopathic Arthritis–Associated Uveitis Refractory to Anti–Tumor Necrosis Factor Therapy: A Multicenter Study of Twenty‐Five Patients
Authors: Calvo‐Río Vanesa , Santos‐Gómez Montserrat , Calvo Inmaculada , González‐Fernández M. Isabel , López‐Montesinos Berta , Mesquida Marina , Adán Alfredo , Hernández María Victoria , Maíz Olga , Atanes Antonio , Bravo Beatriz , Modesto Consuelo , Díaz‐Cordovés Gisela , Palmou‐Fontana Natalia , Loricera Javier , González‐Vela M. C. , Demetrio‐Pablo Rosalía , Hernández J. L. , González‐Gay Miguel A. , Blanco Ricardo 
Published: October 2016

ObjectiveTo assess the efficacy of tocilizumab (TCZ) for the treatment of juvenile idiopathic arthritis (JIA)–associated uveitis.MethodsWe conducted a multicenter study of patients with JIA‐associated uveitis that was refractory to conventional immunosuppressive drugs and anti–tumor necrosis factor (anti‐TNF) agents.ResultsWe assessed 25 patients (21 female; 47 affected eyes) with a mean ± SD age of 18.5 ± 8.3 years. Uveitis was bilateral in 22 patients. Cystoid macular edema was present in 9 patients. Ocular sequelae found at initiation of TCZ included cataracts (n = 13), glaucoma (n = 7), synechiae (n = 10), band keratopathy (n = 12), maculopathy (n = 9), and amblyopia (n = 5). Before TCZ, patients had received corticosteroids, conventional immunosuppressive drugs, and biologic agents (median 2 [range 1–5]), including adalimumab (n = 24), etanercept (n = 8), infliximab (n = 7), abatacept (n = 6), rituximab (n = 2), anakinra (n = 1), and golimumab (n = 1). Patients received 8 mg/kg TCZ intravenously every 4 weeks in most cases. TCZ yielded rapid and maintained improvement in all ocular parameters. After 6 months of therapy, 79.2% of patients showed improvement in anterior chamber cell numbers, and 88.2% showed improvement after 1 year. Central macular thickness measured by optical coherence tomography in patients with cystoid macular edema decreased from a mean ± SD of 401.7 ± 86.8 μm to 259.1 ± 39.5 μm after 6 months of TCZ (P = 0.012). The best‐corrected visual acuity increased from 0.56 ± 0.35 to 0.64 ± 0.32 (P < 0.01). After a median follow‐up of 12 months, visual improvement persisted, and complete remission of uveitis was observed in 19 of 25 patients. Significant reduction in the prednisone dosage was also achieved. The main adverse effects were severe autoimmune thrombocytopenia in 1 patient, pneumonia and then autoimmune anemia and thrombocytopenia in 1 patient, and viral conjunctivitis and bullous impetigo in 1 patient.ConclusionTCZ appears to be a useful therapy for severe refractory JIA‐associated uveitis.
Little Evidence for Usefulness of Biomarkers for Predicting Successful Dose Reduction or Discontinuation of a Biologic Agent in Rheumatoid Arthritis: A Systematic Review
Authors: Tweehuysen Lieke , van den Ende Cornelia H. , Beeren Fenna M. M. , Been Evelien M. J. , van den Hoogen Frank H. J. , den Broeder Alfons A. 
Published: October 2016

ObjectiveTo systematically review studies addressing prediction of successful dose reduction or discontinuation of a biologic agent in rheumatoid arthritis (RA).MethodsPubMed, Embase, and Cochrane Library databases were searched for studies that examined the predictive value of biomarkers for successful dose reduction or discontinuation of a biologic agent in RA. Two reviewers independently selected studies, and extracted data and assessed the risk of bias. A biomarker was classified as a “potential predictor” if the univariate association was either strong (odds ratio or hazard ratio >2.0 or <0.5) or statistically significant. For biomarkers that were studied multiple times, qualitative best‐evidence synthesis was performed separately for the prediction of successful dose reduction and discontinuation. Biomarkers that were defined in ≥75% of the studies as potential predictors were regarded as “predictor” for the purposes of our study.ResultsOf 3,029 nonduplicate articles initially searched, 16 articles regarding 15 cohorts were included in the present study. Overall, 17 biomarkers were studied multiple times for the prediction of successful dose reduction, and 33 for the prediction of successful discontinuation of a biologic agent. Three predictors were identified: higher adalimumab trough level for successful dose reduction and lower Sharp/van der Heijde erosion score and shorter symptom duration at the start of a biologic agent for successful discontinuation.ConclusionThe predictive value of a wide variety of biomarkers for successful dose reduction or discontinuation of biologic treatment in RA has been investigated. We identified only 3 biomarkers as predictors, in just 2 studies. The strength of the evidence is limited by the low quality of the included studies and the likelihood of reporting bias and multiple testing.
Increased Activity of the Chondrocyte Translational Apparatus Accompanies Osteoarthritic Changes in Human and Rodent Knee Cartilage
Authors: Katsara Olga , Attur Mukundan , Ruoff Rachel , Abramson Steven B. , Kolupaeva Victoria 
Published: October 2016

ObjectiveDegeneration of articular cartilage is central to the pathology of osteoarthritis (OA). However, the molecular mechanisms leading to these irreversible changes are still poorly understood. This study was undertaken to investigate how changes in the chondrocyte translational apparatus may contribute to the development and progression of knee OA.MethodsArticular cartilage from the knees of normal healthy subjects and patients with OA was used to analyze the activity of different components of the translational machinery. Chondrocytes isolated from lesional and nonlesional areas of the human OA cartilage were used to estimate the relative rate of protein synthesis by metabolic labeling. Experimental OA was induced by transection of the anterior cruciate ligament of rats to investigate changes in the translational apparatus associated with OA. The role of interleukin‐1β (IL‐1β) signaling was assessed in vitro using rat articular chondrocytes. In human or rodent knee cartilage, messenger RNA expression was analyzed by quantitative polymerase chain reaction, and protein levels were determined by immunohistochemistry and Western blotting.ResultsSeveral novel traits of OA chondrocytes were identified, including up‐regulation of the serine/threonine kinases Akt‐2 and Akt‐3 at the posttranscriptional level and an increased rate of total protein synthesis, likely attributable to inactivation of eukaryotic initiation factor 4E binding protein 1 (4E‐BP1), a known repressor of cap‐dependent translation. Inactivation of 4E‐BP1 was dependent on the activity of mechanistic target of rapamycin and was crucial for the up‐regulation of protein synthesis in general and expression of matrix metalloproteinase 13 and ADAMTS‐5 in particular. In addition, treatment of articular chondrocytes with IL‐1β led to inactivation of 4E‐BP1 and up‐regulation of protein synthesis.ConclusionPrecise control of protein synthesis is vital for cartilage homeostasis, and its dysregulation contributes to the molecular pathology of OA. The results of this study therefore identify a novel set of potential therapeutic targets to ameliorate the effects of knee OA.