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216 Publications visible to you, out of a total of 216
[Is the prevalence of rheumatoid arthritis truly on the rise?]

Abstract (Expand)

A growing number of health insurance data analyses show an increase in the prevalence of rheumatoid arthritis (RA) in Germany. The studies refer to the claims diagnosis of RA, which is more frequent … in recent years compared to earlier periods. Depending on the case definition, the numbers vary between 0.6% and 1.4% of the adult population. In this paper, the different studies are reviewed with regard to their data sources, the case definitions of RA and the frequency of the diagnosis. Due to the lack of clinical validation, the prevalence cannot be precisely determined from claims data.

Authors: K. Albrecht, J. Callhoff, A. Strangfeld

Date Published: 2022

Publication Type: Journal

EULAR points to consider when analysing and reporting comparative effectiveness research using observational data in rheumatology

Abstract (Expand)

BACKGROUND: Comparing treatment effectiveness over time in observational settings is hampered by several major threats, among them confounding and attrition bias. OBJECTIVES: To develop European Alliance … of Associations for Rheumatology (EULAR) points to consider (PtC) when analysing and reporting comparative effectiveness research using observational data in rheumatology. METHODS: The PtC were developed using a three-step process according to the EULAR Standard Operating Procedures. Based on a systematic review of methods currently used in comparative effectiveness studies, the PtC were formulated through two in-person meetings of a multidisciplinary task force and a two-round online Delphi, using expert opinion and a simulation study. Finally, feedback from a larger audience was used to refine the PtC. Mean levels of agreement among the task force were calculated. RESULTS: Three overarching principles and 10 PtC were formulated, addressing, in particular, potential biases relating to attrition or confounding by indication. Building on Strengthening the Reporting of Observational Studies in Epidemiology guidelines, these PtC insist on the definition of the baseline for analysis and treatment effectiveness. They also focus on the reasons for stopping treatment as an important consideration when assessing effectiveness. Finally, the PtC recommend providing key information on missingness patterns. CONCLUSION: To improve the reliability of an increasing number of real-world comparative effectiveness studies in rheumatology, special attention is required to reduce potential biases. Adherence to clear recommendations for the analysis and reporting of observational comparative effectiveness studies will improve the trustworthiness of their results.

Authors: D. S. Courvoisier, K. Lauper, J. Kedra, M. de Wit, B. Fautrel, T. Frisell, K. L. Hyrich, F. Iannone, P. M. Machado, L. M. Ornbjerg, Z. Rotar, M. J. Santos, T. A. Stamm, S. R. Stones, A. Strangfeld, S. A. Bergstra, R. B. M. Landewe, A. Finckh

Date Published: 2022

Publication Type: Journal

Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study

Abstract (Expand)

BACKGROUND: Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate … the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally. METHODS: In this observational study, we derived individual-level data on adults (aged 18-99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death. FINDINGS: 14 044 patients from 23 countries were included in the analyses. 10 178 (72.5%) individuals were female and 3866 (27.5%) were male, with a mean age of 54.4 years (SD 15.6). Air pollution (odds ratio 1.10 per 10 mug/m(3) [95% CI 1.01-1.17]; p=0.0105), proportion of the population aged 65 years or older (1.19 per 1% increase [1.10-1.30]; p<0.0001), and population mobility (1.03 per 1% increase in number of visits to grocery and pharmacy stores [1.02-1.05]; p<0.0001 and 1.02 per 1% increase in number of visits to workplaces [1.00-1.03]; p=0.032) were independently associated with higher odds of mortality. Number of hospital beds (0.94 per 1-unit increase per 1000 people [0.88-1.00]; p=0.046), human development index (0.65 per 0.1-unit increase [0.44-0.96]; p=0.032), government response stringency (0.83 per 10-unit increase in containment index [0.74-0.93]; p=0.0018), as well as follow-up time (0.78 per month [0.69-0.88]; p<0.0001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1.2% [0.1-9.5]; p=0.14). INTERPRETATION: Our findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities. FUNDING: American College of Rheumatology and European Alliance of Associations for Rheumatology.

Authors: Z. Izadi, M. A. Gianfrancesco, G. Schmajuk, L. Jacobsohn, P. Katz, S. Rush, C. Ja, T. Taylor, K. Shidara, M. I. Danila, K. D. Wysham, A. Strangfeld, E. F. Mateus, K. L. Hyrich, L. Gossec, L. Carmona, S. Lawson-Tovey, L. Kearsley-Fleet, M. Schaefer, S. Al-Emadi, J. A. Sparks, T. Y. Hsu, N. J. Patel, L. Wise, E. Gilbert, A. Duarte-Garcia, M. O. Valenzuela-Almada, M. F. Ugarte-Gil, L. Ljung, C. A. Scire, G. Carrara, E. Hachulla, C. Richez, P. Cacoub, T. Thomas, M. J. Santos, M. Bernardes, R. Hasseli, A. Regierer, H. Schulze-Koops, U. Muller-Ladner, G. Pons-Estel, R. Tanten, R. E. Nieto, C. N. Pisoni, Y. S. Tissera, R. Xavier, C. D. Lopes Marques, G. C. S. Pileggi, P. C. Robinson, P. M. Machado, E. Sirotich, J. W. Liew, J. S. Hausmann, P. Sufka, R. Grainger, S. Bhana, M. Gore-Massy, Z. S. Wallace, J. Yazdany, Covid- Global Rheumatology Alliance Registry

Date Published: 2022

Publication Type: Journal

Outcomes of SARS-CoV-2 infection among children and young people with pre-existing rheumatic and musculoskeletal diseases

Abstract (Expand)

OBJECTIVES: Some adults with rheumatic and musculoskeletal diseases (RMDs) are at increased risk of COVID-19-related death. Excluding post-COVID-19 multisystem inflammatory syndrome of children, children … and young people (CYP) are overall less prone to severe COVID-19 and most experience a mild or asymptomatic course. However, it is unknown if CYP with RMDs are more likely to have more severe COVID-19. This analysis aims to describe outcomes among CYP with underlying RMDs with COVID-19. METHODS: Using the European Alliance of Associations for Rheumatology COVID-19 Registry, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry, and the CARRA-sponsored COVID-19 Global Paediatric Rheumatology Database, we obtained data on CYP with RMDs who reported SARS-CoV-2 infection (presumptive or confirmed). Patient characteristics and illness severity were described, and factors associated with COVID-19 hospitalisation were investigated. RESULTS: 607 CYP with RMDs <19 years old from 25 different countries with SARS-CoV-2 infection were included, the majority with juvenile idiopathic arthritis (JIA; n=378; 62%). Forty-three (7%) patients were hospitalised; three of these patients died. Compared with JIA, diagnosis of systemic lupus erythematosus, mixed connective tissue disease, vasculitis, or other RMD (OR 4.3; 95% CI 1.7 to 11) or autoinflammatory syndrome (OR 3.0; 95% CI 1.1 to 8.6) was associated with hospitalisation, as was obesity (OR 4.0; 95% CI 1.3 to 12). CONCLUSIONS: This is the most significant investigation to date of COVID-19 in CYP with RMDs. It is important to note that the majority of CYP were not hospitalised, although those with severe systemic RMDs and obesity were more likely to be hospitalised.

Authors: L. Kearsley-Fleet, M. L. Chang, S. Lawson-Tovey, R. Costello, S. Fingerhutova, N. Svestkova, A. Belot, F. A. Aeschlimann, I. Melki, I. Kone-Paut, S. Eulert, T. Kallinich, Y. Berkun, Y. Uziel, B. Raffeiner, F. Oliveira Ramos, D. Clemente, C. Dackhammar, N. M. Wulffraat, H. Waite, A. Strangfeld, E. F. Mateus, P. M. Machado, Carra Registry Investigators, Covid- Global Pediatric Rheumatology Database Investigators, M. Natter, K. L. Hyrich

Date Published: 2022

Publication Type: Journal

Effectiveness of TNF-inhibitors, abatacept, IL6-inhibitors and JAK-inhibitors in 31 846 patients with rheumatoid arthritis in 19 registers from the ’JAK-pot’ collaboration

Abstract (Expand)

BACKGROUND: JAK-inhibitors (JAKi), recently approved in rheumatoid arthritis (RA), have changed the landscape of treatment choices. We aimed to compare the effectiveness of four current second-line … therapies of RA with different modes of action, since JAKi approval, in an international collaboration of 19 registers. METHODS: In this observational cohort study, patients initiating tumour necrosis factor inhibitors (TNFi), interleukin-6 inhibitors (IL-6i), abatacept (ABA) or JAKi were included. We compared the effectiveness of these treatments in terms of drug discontinuation and Clinical Disease Activity Index (CDAI) response rates at 1 year. Analyses were adjusted for patient, disease and treatment characteristics, including lines of therapy and accounted for competing risk. RESULTS: We included 31 846 treatment courses: 17 522 TNFi, 2775 ABA, 3863 IL-6i and 7686 JAKi. Adjusted analyses of overall discontinuation were similar across all treatments. The main single reason of stopping treatment was ineffectiveness. Compared with TNFi, JAKi were less often discontinued for ineffectiveness (adjusted HR (aHR) 0.75, 95% CI 0.67 to 0.83), as was IL-6i (aHR 0.76, 95% CI 0.67 to 0.85) and more often for adverse events (aHR 1.16, 95% CI 1.03 to 1.33). Adjusted CDAI response rates at 1 year were similar between TNFi, JAKi and IL-6i and slightly lower for ABA. CONCLUSION: The adjusted overall drug discontinuation and 1 year response rates of JAKi and IL-6i were similar to those observed with TNFi. Compared with TNFi, JAKi were more often discontinued for adverse events and less for ineffectiveness, as were IL-6i.

Authors: K. Lauper, M. Iudici, D. Mongin, S. A. Bergstra, D. Choquette, C. Codreanu, R. Cordtz, D. De Cock, L. Dreyer, O. Elkayam, E. M. Hauge, D. Huschek, K. L. Hyrich, F. Iannone, N. Inanc, L. Kearsley-Fleet, E. K. Kristianslund, T. K. Kvien, B. F. Leeb, G. Lukina, D. C. Nordstrom, K. Pavelka, M. Pombo-Suarez, Z. Rotar, M. J. Santos, A. Strangfeld, P. Verschueren, D. S. Courvoisier, A. Finckh

Date Published: 2022

Publication Type: Journal

SARS-CoV-2 infection after vaccination in patients with inflammatory rheumatic and musculoskeletal diseases

Abstract

Not specified

Authors: S. Lawson-Tovey, K. L. Hyrich, L. Gossec, A. Strangfeld, L. Carmona, B. Raffeiner, G. K. Yardimci, L. Trefond, N. Roux, A. Rodrigues, C. Papagoras, E. F. Mateus, X. Mariette, P. M. Machado

Date Published: 2022

Publication Type: Journal

SARS-CoV-2 vaccine safety in adolescents with inflammatory rheumatic and musculoskeletal diseases and adults with juvenile idiopathic arthritis: data from the EULAR COVAX physician-reported registry

Abstract (Expand)

BACKGROUND: There is a lack of data on SARS-CoV-2 vaccination safety in children and young people (CYP) with rheumatic and musculoskeletal diseases (RMDs). Current vaccination guidance is based on data … from adults with RMDs or CYP without RMDs. OBJECTIVES: To describe the safety of SARS-COV-2 vaccination in adolescents with inflammatory RMDs and adults with juvenile idiopathic arthritis (JIA). METHODS: We described patient characteristics, flares and adverse events (AEs) in adolescent cases under 18 with inflammatory RMDs and adult cases aged 18 or above with JIA submitted to the European Alliance of Associations for Rheumatology COVAX registry. RESULTS: A total of 110 cases were reported to the registry. Thirty-six adolescent cases were reported from four countries, most with JIA (42%). Over half (56%) reported early reactogenic-like AEs. One mild polyarthralgia flare and one serious AE of special interest (malaise) were reported. No CYP reported SARS-CoV-2 infection postvaccination.Seventy-four adult JIA cases were reported from 11 countries. Almost two-thirds (62%) reported early reactogenic-like AEs and two flares were reported (mild polyarthralgia and moderate uveitis). No serious AEs of special interest were reported among adults with JIA. Three female patients aged 20-30 years were diagnosed with SARS-CoV-2 postvaccination; all fully recovered. CONCLUSIONS: This is an important contribution to research on SARS-CoV-2 vaccine safety in adolescents with RMDs and adults with JIA. It is important to note the low frequency of disease flares, serious AEs and SARS-CoV-2 reinfection seen in both populations, although the dataset is limited by its size.

Authors: S. Lawson-Tovey, P. M. Machado, A. Strangfeld, E. Mateus, L. Gossec, L. Carmona, B. Raffeiner, I. Bulina, D. Clemente, J. Zepa, A. M. Rodrigues, X. Mariette, K. L. Hyrich, Covax Eular

Date Published: 2022

Publication Type: Journal

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