Publications

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213 Publications visible to you, out of a total of 213
Primary and secondary patient data in contrast: the use of observational studies like RABBIT

Abstract (Expand)

The study of secondary patient data, particularly represented by claims data, has increased in recent years. The strength of this approach involves easy access to data that have been generated for … administrative purposes. By contrast, collection of primary data for research is time-consuming and may therefore appear outdated. Both administrative data and data collected prospectively in clinical care can address similar research questions concerning effectiveness and safety of treatments. Therefore, why should we invest the precious time of rheumatologists to generate primary patient data? This article will outline some features of primary patient data collection illustrated by the German biologics register RABBIT (Rheumatoid arthritis: observation of biologic therapy). RABBIT is a long-term observational cohort study that was initiated more than 15 years ago. We will discuss as quality indicators: (i) study design, (ii) type of documentation, standardisation of (iii) clinical and (iv) safety data, (v) monitoring of the longitudinal follow-up, (vi) losses to follow-up as well as (vii) the possibilities to link the data base. The impact of these features on interpretation and validity of results is illustrated using recent publications. We conclude that high quality and completeness of data prospectively-collected offers many advantages over large quantities of non-standardised data collected in an unsupervised manner. We expect the enthusiasm about the use of secondary patient data to decline with more awareness of their methodological limitations while studies with primary patient data like RABBIT will maintain and broaden their impact on daily clinical practice.

Authors: A. Richter, Y. Meissner, A. Strangfeld, A. Zink

Date Published: 2016

Publication Type: Journal

[Medication treatment of rheumatoid arthritis with a history of malignancy. Epidemiological data]

Abstract (Expand)

INTRODUCTION: Only insufficient data are available regarding the question whether treatment with immunosuppressants or biologicals is feasible and safe in patients with a history of malignancy. METHOD: … Literature search via PubMed, EULAR abstracts and ACR abstracts from 2013 to 2015. RESULTS: The Societe Francaise de Rhumatologie, the Canadian Rheumatology Association and the American College of Rheumatology have tried to make recommendations on this topic. Direct evidence mainly originates from data in three national registries which suggest that treatment with tumor necrosis factor (TNF) inhibitors and rituximab appears to be safe for carefully selected patients, at least if there is a longer interval between treatment with biologicals and oncological treatment. Furthermore, despite partly conflicting data all routine drugs for treating rheumatoid arthritis do not seem to show a consistently increased risk of de novo malignancies. The currently available data are presented for each drug of interest. CONCLUSION: Taking the current literature into account an attempt is made to formulate an algorithm for the medicinal treatment of patients with rheumatoid arthritis and a history of malignancy.

Authors: M. Schmalzing, A. Strangfeld, H. P. Tony

Date Published: 2016

Publication Type: Journal

[Influence of therapy on risk of cancer in rheumatoid arthritis. Pathophysiological principles]

Abstract (Expand)

The increased incidence of certain tumor entities in chronic inflammation and infections as well as the increased tumor risk under immunosuppression, illustrate the multiple and complex influences of … the immune system on tumor pathogenesis. It is therefore conceivable that immunomodulatory therapy for rheumatoid arthritis (RA) could also influence the risk of malignancies, apart from treating the underlying disease. Basic scientific research studies have identified various signal transduction pathways that are relevant for tumorigenesis and tumor defense mechanisms. This review presents the current knowledge on the effects of the immune system on the occurrence of cancer and tries, where possible, to relate it to specific treatment options.

Authors: M. J. Waldner, A. Strangfeld, M. Aringer

Date Published: 2016

Publication Type: Journal

Prevalence of overweight in children and adolescents with juvenile idiopathic arthritis

Abstract

Not specified

Authors: S Schenck, M Niewerth, C Sengler, R Trauzeddel, A Thon, K Minden, J Klotsche

Date Published: 1st Mar 2015

Publication Type: Journal

Is primary Sjogren’s syndrome an orphan disease? A critical appraisal of prevalence studies in Europe

Abstract

Not specified

Authors: D. Cornec, L. Chiche

Date Published: 2015

Publication Type: Journal

The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review

Abstract (Expand)

Primary Sjogren’s syndrome (pSS) is a frequent autoimmune systemic disease, clinically characterized by eyes and mouth dryness in all patients, salivary gland swelling or extraglandular systemic … manifestations in half of the patients, and development of lymphoma in 5 to 10 % of the patients. However, patients presenting with sicca symptoms or salivary gland swelling may have a variety of conditions that may require very different investigations, treatments, or follow-up. Eye and/or mouth dryness is a frequent complaint in clinical setting, and its frequency increases with age. When evaluating a patient with suspected pSS, the first step is to rule out its differential diagnoses, before looking for positive arguments for the disease. Knowledge of normal and abnormal lachrymal and salivary gland physiology allows the clinician to prescribe the most adapted procedures for evaluating their function and structure. New tests have been developed in recent years for evaluating these patients, notably new ocular surface staining scores or salivary gland ultrasonography. We describe the different diagnoses performed in our monocentric cohort of 240 patients with suspected pSS. The most frequent diagnoses are pSS, other systemic autoimmune diseases, idiopathic sicca syndrome and drug-induced sicca syndrome. However, other diseases are important to rule out due to their specific management, such as sarcoidosis, granulomatosis with polyangeitis, IgG4-related disease, chronic hepatitis C virus or human immunodeficiency virus infections, graft-versus-host disease, and head and neck radiation therapy. At the light of these data, we propose a core of minimal investigations to be performed when evaluating a patient with suspected pSS.

Authors: D. Cornec, A. Saraux, S. Jousse-Joulin, J. O. Pers, S. Boisrame-Gastrin, Y. Renaudineau, Y. Gauvin, A. M. Roguedas-Contios, S. Genestet, M. Chastaing, B. Cochener, V. Devauchelle-Pensec

Date Published: 2015

Publication Type: Journal

Evolution of cost structures in rheumatoid arthritis over the past decade

Abstract (Expand)

OBJECTIVE: To estimate the changes in direct and indirect costs induced by patients with rheumatoid arthritis (RA) in German rheumatology, between 2002 and 2011. To examine the impact of functional … status on various cost domains. To compare the direct costs incurred by patients at working age (18-64 years) to patients at an age of retirement (>/=65 years). METHODS: We analysed data from the National Database of the German Collaborative Arthritis Centres with about 3400 patients each year. Costs were calculated using fixed prices as well as annually updated cost factors. Indirect costs were calculated using the human capital as well as the friction cost approaches. RESULTS: There was a considerable increase in direct costs: from euro4914 to euro8206 in patients aged 18-64, and from euro4100 to euro6221 in those aged >/=65, attributable to increasing prescription of biologic agents (18-64 years from 5.6% to 31.2%, >/=65 years from 2.8% to 19.2%). This was accompanied by decreasing inpatient treatment expenses and indirect costs due to sick leave and work disability. The total growth of cost, on average, was euro2437-2981 for patients at working age, and euro2121 for patients at retirement age. CONCLUSIONS: The increase in treatment costs for RA over the last decade was associated with lower hospitalisation rates, better functional status and a lower incidence of work disability, offsetting a large proportion of risen drug costs. Since the rise in drug costs has manifested a plateau from 2009 onwards, no relevant further increase in total costs for patients with RA treated in German rheumatology is expected.

Authors: D. Huscher, T. Mittendorf, U. von Hinuber, I. Kotter, G. Hoese, A. Pfafflin, S. Bischoff, A. Zink, Centres German Collaborative Arthritis

Date Published: 2015

Publication Type: Journal

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