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Tristan Manalac, 18 Nov 2020
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Pain, self-reported swollen joints tied to flares in rheumatoid arthritis

22 Sep 2020

Self-reported flares are common and generally managed by analgesics in rheumatoid arthritis (RA), according to a study. In addition, they are substantiated higher activity measures, independently associated with pain and patient-reported swollen joints, and linked to treatment intensification.

The investigators examined consecutive RA patients with 28-joint count Disease Activity Score based on C-reactive protein (DAS28-CRP) <3.2 and no swollen joints at baseline, month 6, and month 12. Their assessments included joint counts, DAS28-CRP, visual analogue scale–evaluator’s global assessment (EGA), and patient-reported outcomes (PROs).

Patients completed the Flare Assessment in Rheumatoid Arthritis and RA Flare Questionnaire and disclosed self-management strategies every 3 months. Finally, the investigators compared flaring and nonflaring patients and explored longitudinal associations between self-reported flare status and disease activity, PRO, and treatment escalation.

Eighty patients with RA (mean age, 63 years; 74 percent females; disease duration, 11 years; baseline DAS28-CRP, 1.9) were included, of whom 64 (80 percent) reported flare at least once during 12 months. More than half (55 percent) of these flares lasted less than 1 week. Analgesics (50 percent) and restricted activities (38 percent) were the common self-management strategies. Patients with flare, compared to those without, had consistently higher disease activity measures and PRO.

Results from a partly adjusted model indicated the association of flares with patient-reported swollen and tender joint counts, disease activity measures, and all flare domains. Moreover, fully adjusted analyses revealed the independent association of present flare with pain (odds ratio [OR], 1.85, 95 percent confidence interval [CI], 1.34–2.60), patient-reported swollen joints (OR, 1.18, 95 percent CI, 1.03–1.36), and higher EGA (OR, 1.15, 95 percent CI, 1.04–1.28). Present flare also correlated with treatment escalation (p≤0.001).

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Most Read Articles
4 days ago
Ivermectin confers benefits in the treatment of COVID-19, with a recent study showing that its use helps reduce the risk of death especially in patients with severe pulmonary involvement.
3 days ago
Mental health comorbidities are common among patients with type 2 diabetes mellitus and may lead to worse outcomes, a recent study has found.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Tristan Manalac, 18 Nov 2020
The substitution of isoleucine to leucine at amino acid 97 (I97L) in the core region of the hepatitis B virus (HBV) seems to reduce its potency, decreasing the efficiency of both infection and the synthesis of the virus’ covalently closed circular (ccc) DNA, reports a new study presented at The Liver Meeting Digital Experience by the American Association for the Study of Liver Diseases (AASLD 2020).