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Kiltz U, Boonen A, van der Heijde D, Bautista-Molano W, Vargas RB, Chiowchanwisawakit P, El-Zorkany B, Gaydukova I, Geher P, Gossec L, Gilio M, Grazio S, Gu J, Khan MA, Kim TJ, Maksymowych WP, Marzo-Ortega H, Navarro-Compán V, Ozgocmen S, Patrikos D, Pimentel-Santos FM, Reveille J, Schirmer M, Stebbings S, Van den Bosch F, Weber U, Braun J. Development of an environmental contextual factor item set relevant to global functioning and health in patients with axial Spondyloarthritis. Rheumatology (Oxford) 2021; 61:2054-2062. [PMID: 34534275 DOI: 10.1093/rheumatology/keab653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/28/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the development of an Environmental contextual factors (EF) Item Set (EFIS) accompanying the disease specific Assessment of SpondyloArthritis international Society Health Index (ASAS HI). METHOD First, a candidate item pool was developed by linking items from existing questionnaires to 13 EF previously selected for the ICF/ASAS Core Set. Second, using data from two international surveys, which contained the EF item pool as well as the items from the ASAS HI, the number of EF-items was reduced based on the correlation between the item and the ASAS HI sum score combined with expert opinion. Third, the final English EFIS was translated into 15 languages and cross-culturally validated. RESULTS The initial item pool contained 53 EF addressing 4 ICF EF-chapters: products and technology (e1), support and relationship (e3), attitudes (e4) and health services (e5). Based on 1754 responses of axial spondyloarthritis patients in an international survey, 44 of 53 initial items were removed based on low correlations to the ASAS HI or redundancy combined with expert opinion. 9 items of the initial item pool (range correlation 0.21-0.49) form the final EFIS. The EFIS was translated into 15 languages and field tested in 24 countries. CONCLUSIONS An EFIS is available complementing the ASAS HI and helps to interpret the ASAS HI results by gaining an understanding of the interaction between a health condition and contextual factors. The EFIS emphasizes the importance of support and relationships, as well as attitudes of the patient and health services in relation to self-reported health.
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Affiliation(s)
- Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne Germany; and.,Ruhr-Universität Bochum, Germany
| | - Annelies Boonen
- Department of Internal MedicineDivision of Rheumatology, Maastricht University Medical Center, the Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands
| | | | - Wilson Bautista-Molano
- University Hospital Fundación Santa Fe de Bogotá, and Universidad El Bosque, Bogotá, Colombia
| | | | | | | | | | - Pal Geher
- Semmelweis University, Budapest, Hungary
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris France.,Pitié-Salpêtrière hospital, AP-HP Sorbonne Université, Rheumatology department, Paris, France
| | - Michele Gilio
- Department of Internal Medicine - "San Carlo" Hospital Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
| | - Simeon Grazio
- Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | | | - Muhammad Asim Khan
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Tae-Jong Kim
- Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | | | - Helena Marzo-Ortega
- NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | | | - Salih Ozgocmen
- Department of RheumatologyIstinye University, Medicalpark Gaziosmanpasa Hospital, Istanbul, Turkey
| | | | | | - John Reveille
- Department of Internal MedicineUniversity of Texas Health Science Center at Houston, USA
| | - Michael Schirmer
- Innsbruck Medical University, Department of Internal Medicine, Clinic IIAustria
| | - Simon Stebbings
- University of Otago, Dunedin School of Medicine, Dunedin, New Zealand
| | - Filip Van den Bosch
- VIB Center for Inflammation Research, Ghent, Belgium.,Department of Rheumatology Ghent University Hospital, Ghent, Belgium
| | - Ulrich Weber
- Practice Buchsbaum, Rheumatology, Schaffhausen, Switzerland
| | - Juergen Braun
- Rheumazentrum Ruhrgebiet, Herne Germany; and.,Ruhr-Universität Bochum, Germany
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Tennant A, Kutlay S, McKenna S, Bender T, Braun J, Castillo-Gallego C, Favero M, Geher P, Kiltz U, Martin-Mola E, Ramonda R, Twiss J, Wilburn J, Küçükdeveci A. SAT0569 The Impact of Pain and Physical Function upon Quality of Life in Osteoarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Szentesi M, Nagy Z, Geher P. SAT0197 Biological Therapy and Radiosynoviorthesis in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Szentesi M, Farbaky Z, Geher P. AB0130 Ultrasound monitoring of the synovial thickness after 166-holmium-phytate radiosynoviorthesis seven years results phase III prospectiv study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kiss S, Vig R, Nagy Z, Geher P, Szentesi M. THU0147 Comparison of biological hasards of 166-holmium-phytate and 90-yttrium used for radiosynoviorthesis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dougados M, Braun J, Szanto S, Combe B, Geher P, Leblanc V, Logeart I. Continuous efficacy of etanercept in severe and advanced ankylosing spondylitis: results from a 12-week open-label extension of the SPINE study. Rheumatology (Oxford) 2012; 51:1687-96. [DOI: 10.1093/rheumatology/kes125] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Dougados M, Braun J, Szanto S, Combe B, Geher P, Leblanc V, Logeart I. Nonsteroidal antiinflammatory drug intake according to the Assessment of SpondyloArthritis International Society Score in clinical trials evaluating tumor necrosis factor blockers: example of etanercept in advanced ankylosing spondylitis. Arthritis Care Res (Hoboken) 2012; 64:290-4. [PMID: 22006544 DOI: 10.1002/acr.20671] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To evaluate the interest of the Assessment of SpondyloArthritis international Society (ASAS) nonsteroidal antiinflammatory drug (NSAID) score as a quality indicator and a potential outcome measure in clinical studies. METHODS We used data from patients with active, advanced, axial ankylosing spondylitis refractory to NSAIDs. The study design was a 12-week, randomized, placebo-controlled period followed by a 12-week open-label extension. The ASAS-NSAID score was collected during 3 periods of interest (i.e., the 12 weeks preceding baseline, the 12 weeks of the placebo-controlled trial, and the 12 weeks of the open-label trial). RESULTS For the 82 enrolled patients, the mean ± SD ASAS-NSAID score at baseline was similar between the 2 groups: 93 ± 76 and 74 ± 54 in the etanercept and placebo groups, respectively. There was no significant change in the ASAS-NSAID score during the first part of the trial, as recommended by the protocol. There was a statistically significant decrease in the ASAS-NSAID score during the second part of the trial with a relevant effect size (-0.56) in the placebo to etanercept group. CONCLUSION This study confirms the feasibility and simplicity of the ASAS-NSAID score and suggests that such a score be integrated in all studies in spondylarthritis either to check the quality of the observed data (i.e., intergroup baseline characteristics) or to evaluate the NSAID-sparing effect of other therapies.
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Affiliation(s)
- Maxime Dougados
- Paris-Descartes University, UPRES-EA 4058, AP-HP, Cochin Hospital, Paris 14, France.
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Braun J, van den Berg R, Baraliakos X, Boehm H, Burgos-Vargas R, Collantes-Estevez E, Dagfinrud H, Dijkmans B, Dougados M, Emery P, Geher P, Hammoudeh M, Inman RD, Jongkees M, Khan MA, Kiltz U, Kvien T, Leirisalo-Repo M, Maksymowych WP, Olivieri I, Pavelka K, Sieper J, Stanislawska-Biernat E, Wendling D, Ozgocmen S, van Drogen C, van Royen B, van der Heijde D. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011; 70:896-904. [PMID: 21540199 PMCID: PMC3086052 DOI: 10.1136/ard.2011.151027] [Citation(s) in RCA: 607] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This first update of the ASAS/EULAR recommendations on the management of ankylosing spondylitis (AS) is based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010. Each original bullet point was discussed in detail and reworded if necessary. Decisions on new recommendations were made — if necessary after voting. The strength of the recommendations (SOR) was scored on an 11-point numerical rating scale after the meeting by email. These recommendations apply to patients of all ages that fulfill the modified NY criteria for AS, independent of extra-articular manifestations, and they take into account all drug and non-drug interventions related to AS. Four overarching principles were introduced, implying that one bullet has been moved to this section. There are now 11 bullet points including 2 new ones, one related to extra-articular manifestations and one to changes in the disease course. With a mean score of 9.1 (range 8-10) the SOR was generally very good.
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Affiliation(s)
- J Braun
- Rheumazentrum Ruhrgebiet, Landgrafenstrasse 15, 44652 Herne, Germany.
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Dougados M, Braun J, Szanto S, Combe B, Elbaz M, Geher P, Thabut G, Leblanc V, Logeart I. Efficacy of etanercept on rheumatic signs and pulmonary function tests in advanced ankylosing spondylitis: results of a randomised double-blind placebo-controlled study (SPINE). Ann Rheum Dis 2011; 70:799-804. [PMID: 21317434 PMCID: PMC3070274 DOI: 10.1136/ard.2010.139261] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2010] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Patients with advanced ankylosing spondylitis (AS) experience disability because of reduced spinal mobility and pulmonary function impairment. This placebo-controlled study evaluated the effect of etanercept (ETN) in patients with advanced AS. METHODS A multicentre randomised double-blind placebo-controlled trial of 12 weeks' duration was performed. Patients had definite (modified New York criteria), active (Bath AS Disease Activity Index (BASDAI) ≥40), severe (radiological intervertebral bridges) AS refractory to non-steroidal anti-inflammatory drugs and were antitumour necrosis factor naive. They were treated with ETN 50 mg once weekly or identical placebo (PBO). RESULTS Of the 95 patients screened, 82 were randomised to receive ETN (n=39) or PBO (n=43). At baseline the disease was active (mean BASDAI 61.0±13.4, C reactive protein (CRP) 20.7±25.5 mg/l) and severe (mean Bath AS Metrology Index (BASMI) 5.7±1.3, mSASSS 36.5±20.5); forced pulmonary vital capacity (FVC) was 3.3±0.7 l. Improvement in BASDAI (normalised net incremental area under the curve between baseline and week 12, primary end point) was significantly greater in the ETN group than in the PBO group (-19.8±16.5 vs -11.0±16.4, p=0.019). Moreover, at week 12, ETN gave better results than PBO for the BASDAI (-26.4±19.7 vs -14.4±19.7; p=0.008), total back pain (-29.2±24.0 vs -14.9±24.0; p=0.010), BASFI (-21.7±17.6 vs -10.1±17.6; p=0.004), BASMI (-0.6±0.6 vs -0.2±0.6; p=0.011), CRP level (-15.7±14.2 vs -1.3±14.2; p<0.001) and FVC (+160±280 ml vs -20±280 ml; p=0.006). CONCLUSIONS ETN has short-term efficacy for patients with advanced AS, as was previously reported for less advanced disease. The efficacy is observed for the main symptoms (pain) and on markers of inflammation (CRP), as well as disease severity in terms of spinal mobility and pulmonary function.
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Affiliation(s)
- M Dougados
- Paris-Descartes University, UPRES-EA 4058, and APHP, Rheumatology B Department, Cochin Hospital, Paris, France.
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Gyorgy B, Tothfalusi L, Nagy G, Pasztoi M, Geher P, Polgar A, Rojkovich B, Ujfalussy I, Misjak P, Koncz A, Pozsonyi E, Fust G, Falus A, Buzas EI. Natural autoantibodies reactive to glycosaminoglycans are disease state markers in rheumatoid arthritis and are associated with HLA. Ann Rheum Dis 2010. [DOI: 10.1136/ard.2010.129577c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nagy G, Clark JM, Buzas E, Gorman CL, Geher P, Perl A, Falus A, Cope AP. Nitric oxide differentially regulates T-cell function in rheumatoid arthritis and systemic lupus erythematosus. Arthritis Res Ther 2007. [PMCID: PMC4061952 DOI: 10.1186/ar2252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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van der Heijde D, Da Silva JC, Dougados M, Geher P, van der Horst-Bruinsma I, Juanola X, Olivieri I, Raeman F, Settas L, Sieper J, Szechinski J, Walker D, Boussuge MP, Wajdula JS, Paolozzi L, Fatenejad S. Etanercept 50 mg once weekly is as effective as 25 mg twice weekly in patients with ankylosing spondylitis. Ann Rheum Dis 2006; 65:1572-7. [PMID: 16968715 PMCID: PMC1798458 DOI: 10.1136/ard.2006.056747] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To compare the efficacy, pharmacokinetics and safety of etanercept 50 mg once weekly with 25 mg twice weekly and placebo in patients with ankylosing spondylitis. METHODS A 12-week, double-blind, placebo-controlled study compared the effects of etanercept 50 mg once weekly, etanercept 25 mg twice weekly and placebo in 356 patients with active ankylosing spondylitis (3:3:1 randomisation, respectively). The primary end point was the proportion of patients achieving a response at week 12 based on the Assessment in Ankylosing Spondylitis Working Group criteria (ASAS 20). The pharmacokinetics of etanercept 50 mg once weekly and 25 mg twice weekly were analysed. RESULTS Baseline characteristics and disease activity were similar among the three groups: etanercept 50 mg once weekly, etanercept 25 mg twice weekly and placebo. The percentage of patients discontinuing therapy was 9.0%, 9.3% and 13.7% for the three respective groups. ASAS 20 response at 12 weeks was achieved by 74.2% of patients with etanercept 50 mg once weekly and 71.3% of those with etanercept 25 mg twice weekly, both significantly higher than the percentage of patients taking placebo (37.3%, p<0.001). Percentages of patients with ASAS 5/6 response (70.3%, 72.0% and 27.5%, respectively; p<0.001) and those with ASAS 40 response (58.1%, 53.3% and 21.6%, respectively; p<0.001) followed a similar pattern. Significant improvement (p<0.05) was seen in measures of disease activity, back pain, morning stiffness and C reactive protein levels as early as 2 weeks. Serum etanercept exposure was similar between the etanercept groups. Incidence of treatment-emergent adverse events, including infections, was similar among all three groups, and no unexpected safety issues were identified. CONCLUSIONS Patients with ankylosing spondylitis can expect a comparable significant improvement in clinical outcomes with similar safety when treated with etanercept 50 mg once weekly or with 25 mg twice weekly.
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Palkonyai E, Larsen A, Geher P, Kolarz G, Bogye G, Temesvari P, Kaposi P, Szilagyi M, Ratko I. A short Larsen score is effective when evaluating radiographs in early rheumatoid arthritis. Acta Radiol 2006; 47:484-7. [PMID: 16796311 DOI: 10.1080/02841850600647132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the efficacy of the short Larsen score (LS 12) based on analysis of 12 areas with the original Larsen score (LS 40), which includes 40 areas for assessing radiographic changes in rheumatoid arthritis. MATERIAL AND METHODS The radiographs of the hands, wrists, and feet of 122 patients with early rheumatoid arthritis were evaluated by two radiologists using both the LS 40 and LS 12 methods. Cross-sectional analysis of radiographs of 122 patients and longitudinal analysis in 68 patients were performed. RESULTS There was no significant difference between the mean LS 40 and mean LS 12 in the cross-sectional study. LS 12 correlated strongly (r=0.93, P<0.01) with LS 40 at the baseline, and the rate of progression was similar in both methods (r=0.89, P<0.01) in the longitudinal study. CONCLUSION The short Larsen score was as efficient as the original method.
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Affiliation(s)
- E Palkonyai
- National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.
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Nagyhegyi G, Nadas I, Banyai F, Luzsa G, Geher P, Molnar J, Velics V, Gomor B, Weisz M, Antaloczy Z. Cardiac and cardiopulmonary disorders in patients with ankylosing spondylitis and rheumatoid arthritis. Clin Exp Rheumatol 1988; 6:17-26. [PMID: 3396245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
One hundred patients suffering from ankylosing spondylitis (AS) and one hundred patients suffering from rheumatoid arthritis (RA) were examined by clinical, non-invasive cardiological, radiological and laboratory methods to determine the prevalence of their cardiac and cardiopulmonary disorders. Fourteen patients with AS and 24 patients with RA had several valvular abnormalities. Among the patients not having any valvular abnormality, systolic dysfunction of the myocardium was detectable in 15 and 11 cases respectively, and cor pulmonale was diagnosed in 16 and 7 cases respectively. Conduction disturbances were demonstrated in 17 patients suffering from AS and in 14 patients suffering from RA.
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Affiliation(s)
- G Nagyhegyi
- National Institute of Rheumatology and Physiotherapy, Budapest Postgraduate Medical University, Hungary
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