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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
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Yesterday
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