Assessing Single Joints in Arthritis Clinical Trials

The need to develop validated outcome measures to assess response to therapies in single joints has been recognized. In 2004, a task force was established to assess established and novel outcome measures in accordance with the OMERACT filter (truth, discrimination, and feasibility) for single joint assessment. This report describes the proceedings of the single joint assessment special interest group (SIG) at OMERACT 9, including an updated literature review of imaging of the knee joints, with a focus on the extent to which these modalities fulfill the OMERACT filter. A series of studies are reported that examine patient reported, clinical examination, and imaging outcomes in therapeutic st…

Anti-Tumour Necrosis Factor-?? Therapy for Rheumatoid and Other Inflammatory Arthropathies

Anti-tumour necrosis factor (TNF)-alpha represents a major advance in the treatment of rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis. It is usually well tolerated, but a potential increase in the incidence of some infections in patients taking anti-TNFalpha agents has been reported. Compared with younger people, elderly patients have more co-morbidities and are likely to be taking more medications. Moreover, the aging process induces an increase in the rate of infections. Nevertheless, in recent studies analysing the databases of etanercept trials, the normalised incidence of adverse events, serious adverse events, medically important infections and deaths was no…

Infections sévères à pyogènes chez les patients traités par infliximab. Étude d’une cohorte régionale

Resume Objectif. – Apprecier la prevalence des infections severes a pyogenes chez les patients traites par infliximab en pratique courante, et essayer de degager des facteurs favorisants. Methodes. – Etude portant sur une cohorte de patients traites dans un reseau regional par infliximab pour polyarthrite rhumatoide ou spondylarthrite ankylosante, et suivis de facon prospective a l’aide d’une feuille de recueil des donnees standardisee. Les observations des patients ayant presente une infection grave a pyogene ont ete analysees, et comparees a celles des autres patients. Resultats. – La cohorte comportait 83 patients (55 femmes et 28 hommes), dont cinq (6 %) ont presente une infection sever…

Validation of a Dutch diagnostic rule for gout without joint fluid analysis in patients hospitalized for acute monoarthritis

Comment on: Tocilizumab induces corticosteroid sparing in rheumatoid arthritis patients in clinical practice: reply

Type de document : lettre à l'éditeur; International audience

Responsiveness to change and reliability of measurement of radiographic joint space width in osteoarthritis of the knee: a systematic review

Import JabRef | WosArea Orthopedics; Rheumatology; International audience; Objective: The goal of this systematic review was to report the responsiveness to change and reliability of conventional radiographic joint space width (JSW) measurement. Method: We searched the PubMed and Embase databases using the following search criteria: [osteoarthritis (OA) (MeSH)] AND (knee) AND (X-ray OR radiography OR diagnostic imaging OR radiology OR disease progression) AND (joint space OR JSW or disease progression). We assessed responsiveness by calculating the standardized response mean (SRM). We assessed reliability using intra- and inter-reader intra-class correlation (ICC) and coefficient of variati…

Th1 and Th17 lymphocytes expressing CD161 are implicated in giant cell arteritis and polymyalgia rheumatica pathogenesis.

International audience; OBJECTIVE: Giant cell arteritis (GCA) is the most frequently occurring vasculitis in elderly individuals, and its pathogenesis is not fully understood. The objective of this study was to decipher the role of the major CD4+ T cell subsets in GCA and its rheumatologic form, polymyalgia rheumatica (PMR). METHODS: A prospective study of the phenotype and the function of major CD4+ T cell subsets (Th1, Th17, and Treg cells) was performed in 34 untreated patients with GCA or PMR, in comparison with 31 healthy control subjects and with the 27 treated patients who remained after the 7 others withdrew. RESULTS: Compared with control subjects, patients with GCA and patients wi…

Tocilizumab induces corticosteroid sparing in rheumatoid arthritis patients in clinical practice

International audience; Objective. The aim of this study was to evaluate the impact of introducing tocilizumab (TCZ) as co-therapy with CS in patients with RA.Methods. This study was an open, observational, retrospective multicentre study. RA patients treated with oral CS for >3 months who started treatment with TCZ between December 2009 and June 2011 in five centres were included. Variables included demographic data, disease history, co-treatments, disease activity and dose of CS at inclusion and at weeks 4, 8, 12 and 24. The evolution of disease activity and of the dose of CS (analysis of variance with repeated measures) were analysed, searching for factors correlated with changes in the …

OARSI/OMERACT Initiative to Define States of Severity and Indication for Joint Replacement in Hip and Knee Osteoarthritis. An OMERACT 10 Special Interest Group

Objective.To define pain and physical function cutpoints that would, coupled with structural severity, define a surrogate measure of “need for joint replacement surgery,” for use as an outcome measure for potential structure-modifying interventions for osteoarthritis (OA).Methods.New scores were developed for pain and physical function in knee and hip OA. A cross-sectional international study in 1909 patients was conducted to define data-driven cutpoints corresponding to the orthopedic surgeons’ indication for joint replacement. A post hoc analysis of 8 randomized clinical trials (1379 patients) evaluated the prevalence and validity of cutpoints, among patients with symptomatic hip/knee OA.…