1
|
El Miedany Y, El Gaafary M, Toth M, Palmer D, Ali A, Bahlas S, Mahran S, Hassan W, Abu-Zaid MH, Saber S, Elwakil W. Beyond the symptoms: Personalizing giant cell arteritis care through multidimensional patient reported outcome measure. Semin Arthritis Rheum 2023; 63:152285. [PMID: 37944298 DOI: 10.1016/j.semarthrit.2023.152285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Giant Cell Arteritis (GCA) is the commonest form of systemic vasculitis in people over the age of 50. Published research highlighted the lack of a disease-specific patient reported outcomes (PROMs) for GCA. OBJECTIVES To assess the validity, reliability and responsiveness to change of a devised disease specific patient self-reported outcome measures questionnaire for Giant Cell Arteritis (GCA). METHODS The GCA-PROMs was conceptualized based on frameworks outlined in the OMERACT developed core set of Outcome Measures for Large-Vessel Vasculitis and the guiding principles of the FDA guidance. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction was achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. RESULTS A total of 54 GCA patients completed the questionnaire. The GCA-PROMs questionnaire was reliable as demonstrated by a high standardized alpha (0.878-0.983). Content construct assessment of the GCA-PROMs functional disability and QoL revealed significant correlation (p< 0.01) with both HAQ and EQ-5D. Changes in functional disability, QoL showed significant (p< 0.01) variation with diseases activity status in response to therapy. CONCLUSIONS The developed GCA-PROMs questionnaire is a reliable and valid instrument for assessment of GCA patients. A stratified treatment regimen depending on the individual patient's risk factors as well as preferences and associated comorbidities is the best approach to tailored patient management.
Collapse
Affiliation(s)
- Y El Miedany
- Professor Canterbury Christ Church University, England; H. Senior Clinical Lecturer, King's College London, England.
| | - M El Gaafary
- Professor Community and Public Health, Ain Shams University, Cairo, Egypt
| | - M Toth
- H. Senior Clinical Lecturer, King's College London, England; Darent Valley Hospital, Kent, England
| | - D Palmer
- North Middlesex University Hospital, London, England
| | - Ayman Ali
- Darent Valley Hospital, Kent, England
| | - S Bahlas
- Professor of Internal Medicine/Rheumatology, College of Medicine, King Abdulaziz University, Saudi Arabia
| | - S Mahran
- Professor Rheumatology, Physical Medicine and Rehabilitation, Assiut University, Egypt
| | - W Hassan
- Professor Rheumatology and Rehabilitation, Benha University, Benha, Egypt
| | - M H Abu-Zaid
- Assistant Professor Rheumatology and Rehabilitation, Tanta University, Tanta, Egypt
| | - S Saber
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | - W Elwakil
- Lectuer Rheumatology and Rehabilitation, Alexandria University, Alexanrdia, Egypt
| |
Collapse
|
2
|
El Miedany Y, Salah S, Lotfy H, El Gaafary M, Abdulhady H, Salah H, Nasef SI, El-Latif EA, Farag Y, Eissa M, Maher SE, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, Mohamed SS, Tabra SA, Hassan WA, Amer Y, Abu-Zaid MH. Correction: Updated clinical practice treat-to-target guidelines for JIA management: the Egyptian College of Pediatric Rheumatology initiative. Egypt Rheumatol Rehabil 2022. [DOI: 10.1186/s43166-022-00134-0] [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: 11/10/2022] Open
|
3
|
El Miedany Y, Lotfy H, Salah S, Yehia M, Mosa DM, Kaber A, Mortada M, Tabra SA, El Gaafary M, Abdulhady H, Hassan WA, Osman NS, Eissa M, Medhat BM, Mohamed SS, Farag Y, Amer Y, Maher SE, Radwan A, El-Shanawany AT, El Mikkawy D, El Deriny G, Fouad NA, Nasef SI, Elkaraly NE, Abu-Zaid MH. 42 Egyptian evidence-based consensus recommendations for diagnosis and targeted management of juvenile dermatomyositis. An initiative by the Egyptian College of Pediatric Rheumatology. Rheumatology (Oxford) 2022. [PMCID: PMC9538758 DOI: 10.1093/rheumatology/keac496.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2022] Open
Abstract
Background Objective Methods Results Conclusion The implication to policy, practice, research and advocacy
Collapse
Affiliation(s)
- Y El Miedany
- Canterbury Christ Church University, England,Rheumatology and Rehabilitation, Ain Shams University, Egypt
| | - H Lotfy
- Pediatric Rheumatology, Cairo, University, Egypt
| | - S Salah
- Pediatric Rheumatology, Cairo, University, Egypt
| | - M Yehia
- Rheumatology and Rehabilitation, Benha University, Egypt
| | - D. M Mosa
- Rheumatology and Rehabilitation, Mansura University, Egypt
| | - A Kaber
- Rheumatology and Rehabilitation, South Valley University, Egypt
| | - M Mortada
- Rheumatology and Rehabilitation, Zagazig University, Egypt
| | - S. A Tabra
- Rheumatology and Rehabilitation, Tanta University, Egypt
| | - M El Gaafary
- Community medicine and Public Health, Ain Shams University, Egypt
| | - H Abdulhady
- Rheumatology and Rehabilitation, Ain Shams University, Egypt
| | - W. A Hassan
- Rheumatology and Rehabilitation, Benha University, Egypt
| | - N. S Osman
- Pediatric Rheumatology, Assuit University, Egypt
| | - M Eissa
- Rheumatology and Rehabilitation, Cairo University, Egypt
| | - B. M Medhat
- Rheumatology and Rehabilitation, Cairo University, Egypt
| | - S. S Mohamed
- Rheumatology and Rehabilitation, Cairo University, Egypt
| | - Y Farag
- Pediatric Rheumatology, Cairo, University, Egypt
| | - Y Amer
- Rheumatology and Rehabilitation, Zagazig University, Egypt
| | | | - A Radwan
- Rheumatology and Rehabilitation, Sohag University, Egypt
| | | | - D El Mikkawy
- Rheumatology and Rehabilitation, Ain Shams University, Egypt
| | - G El Deriny
- Pediatric Rheumatology, Alexandria University, Egypt
| | - N. A Fouad
- Rheumatology and Rehabilitation, Fayoum University, Egypt
| | - S. I Nasef
- Rheumatology and Rehabilitation, Suez Canal University, Egypt
| | - N. E Elkaraly
- Rheumatology and Rehabilitation, Suez Canal University, Egypt
| | | | | |
Collapse
|
4
|
El Miedany Y, Lotfy H, Salah S, Abu-Zaid MH, Mohamed SS, Esam Maher S, El Gaafary M, Abdulhady H, Hassan WA, Mortada M, Amer Y, Osman NS, Medhat BM, Farag Y, Eissa M, Radwan A, Nasef SI, Elkaraly NE, El-Shanawany AT, El Mikkawy D, Mosa DM, El Deriny G, Fouad NA, Tabra SA. 001 Egyptian consensus-based recommendations for the diagnosis and targeted management of Kawasaki disease. An initiative by the Egyptian College of Pediatric Rheumatology. Rheumatology (Oxford) 2022. [PMCID: PMC9539162 DOI: 10.1093/rheumatology/keac495.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/12/2022] Open
Abstract
Background Objectives Methods Results Conclusion The implication to policy, practice, research and advocacy
Collapse
Affiliation(s)
- Y El Miedany
- Canterbury Christ Church University, England,Rheumatology and Rehabilitation, Ain Shams University, Egypt
| | - H Lotfy
- Pediatric Rheumatology, Cairo, University, Egypt
| | - S Salah
- Pediatric Rheumatology, Cairo, University, Egypt
| | - M. H Abu-Zaid
- Rheumatology and Rehabilitation, Tanta University, Egypt
| | - S. S Mohamed
- Rheumatology and Rehabilitation, Cairo University, Egypt
| | | | - M El Gaafary
- Community medicine and Public Health, Ain Shams University, Egypt
| | - H Abdulhady
- Rheumatology and Rehabilitation, Ain Shams University, Egypt
| | - W. A Hassan
- Rheumatology and Rehabilitation, Benha University, Egypt
| | - M Mortada
- Rheumatology and Rehabilitation, Zagazig University, Egypt
| | - Y Amer
- Rheumatology and Rehabilitation, Zagazig University, Egypt
| | - N. S Osman
- Pediatric Rheumatology, Assuit University, Egypt
| | - B. M Medhat
- Rheumatology and Rehabilitation, Cairo University, Egypt
| | - Y Farag
- Pediatric Rheumatology, Cairo, University, Egypt
| | - M Eissa
- Rheumatology and Rehabilitation, Cairo University, Egypt
| | - A Radwan
- Rheumatology and Rehabilitation, Sohag University, Egypt
| | - S. I Nasef
- Rheumatology and Rehabilitation, Suez Canal University, Egypt
| | - N. E Elkaraly
- Rheumatology and Rehabilitation, Suez Canal University, Egypt
| | | | - D El Mikkawy
- Rheumatology and Rehabilitation, Ain Shams University, Egypt
| | - D. M Mosa
- Rheumatology and Rehabilitation, Mansoura University, Egypt
| | - G El Deriny
- Pediatric Rheumatology, Alexandria University, Egypt
| | - N. A Fouad
- Rheumatology and Rehabilitation, Fayoum University, Egypt
| | - S. A Tabra
- Pediatric Rheumatology, Minia University, Egypt
| |
Collapse
|
5
|
El Miedany Y, Abu-Zaid MH, Elgaafary M, Ali N, Mohasseb D, Zohiery A, Hassan W, Mortada MA, Eissa M, Tabra SAA, Fouad N, Gaballah N, El Noby F, Saber S, Moussa S. POS1288 TREAT TO TARGET MANAGEMENT OF FIBROMYALGIA: EVIDENCE-BASED CONSENSUS ON CLINICAL PRACTICE GUIDELINES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundBecause of the subjective character of symptoms, absence of a diagnostic test, modest response to treatments, and at times, patient reports of important functional disability, fibromyalgia remains a challenge for the treating health care professionals in the standard clinical practice.ObjectivesTo develop an up to date consensus, evidence-based clinical practice guidelines for treat to target management of fibromyalgia.Methods15 key clinical questions were identified by a scientific committee according to the Patient/ Population, Intervention, Comparison, and Outcomes (PICO) approach. A literature review team performed a systematic review to summarize evidence advocating the benefits and harms of available pharmacologic and nonpharmacologic therapies for fibromyalgia. Subsequently, recommendations were formulated. The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A 3-round Delphi process was conducted with 16 experts. All rounds were conducted online. A consensus was achieved on the direction and the strength of the recommendations.ResultsAn online questionnaire were sent to expert panel who participated in the three rounds (response rate 100%). At the end of round 3, a total of fifteen recommendation items, categorized into 10 sections to address the main fibromyalgia categories, were obtained. Agreement with the recommendations (rank 7-9) ranged from 85-100%. Consensus was reached (i.e.≥80%of respondents strongly agreed or agreed) on the wording of all the 15 clinical standards identified by the scientific committee. Algorithm for the management of fibromyalgia have been suggested.ConclusionThese recommendations provide an updated consensus on both the non-pharmacological as well as the pharmacological treatment of fibromyalgia. The provide strategies to reach optimal treat to target outcomes in common clinical scenarios, based on a combination of evidence and expert opinion. Best treatment decisions should be tailored to each individual patient situation.Disclosure of InterestsNone declared
Collapse
|
6
|
El Miedany Y, Abu-Zaid MH, Elgaafary M, Ali N, Mansour M, Fathi N, Hassan W, Mortada MA, Moussa S, Eissa M, Tabra SAA, Fouad N, Ali R, M Medhat B, Jamaleldeen J, Adel Abdelsalam Hussein Y, Ghaleb RM, Nourhan Elameen E, Dessouki E, Saber S. AB0908 Treating to target of psoriasis: An evidence-based consensus on clinical practice recommendations. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe Tight Control of psoriatic arthritis (TICOPA) trial revealed a treat to target (T2T) strategy has led to improved clinical outcomes in psoriatic arthritis (PsA). The heterogeneity of the disease, the feasibility of therapy and the associated comorbidities made the implementation of such strategy in routine care a real challenge. There is a high need for establish real world recommendations for the T2T approach in PsA tailored to the disease activity status, the Psoriasis manifestations as well as the individual patient’s requirements.Objectivesto provide up-to-date, evidence-based and consensus-based recommendations for Treat-to-Target management of psoriatic arthritis (PsA) and its associated clinical manifestations.Methods14 key clinical questions were identified by scientific committee according to the Patient/ Population, Intervention, Comparison, Outcomes and Timing (PICOT) approach. Literature Review team performed a systematic review to summarize evidence advocating the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. Subsequently, recommendations were formulated. The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A 3-round Delphi process was conducted with 19 experts. All rounds were conducted online. A consensus was achieved on the direction and the strength of the recommendations.ResultsAn online questionnaire were sent to expert panel who participated in the three rounds (response rate 100%). At the end of round 3, a total of fifty-one recommendation items, categorized into 6 sections to address the main 6 PsA categories, were obtained. Agreement with the recommendations (rank 7-9) ranged from 89.5-100%. Consensus was reached (i.e.≥75%of respondents strongly agreed or agreed) on the wording of all the 51 clinical standards identified by the scientific committee. Algorithms for the management of PsA have been suggested.ConclusionThese recommendations provide an updated consensus on the pharmacological treatment of PsA and strategies to reach optimal treat to target outcomes in in common clinical scenarios, based on a combination of evidence and expert opinion. Best treatment decisions should be tailored to each individual patient situation.Disclosure of InterestsNone declared
Collapse
|
7
|
Hmamouchi I, Paruk F, Tabra SAA, Maatallah K, Bouziane A, Abouqal R, El Miedany Y, EL Maghraoui A, Kalla AA. AB1031 PREVALENCE OF GLUCOCORTICOID INDUCED OSTEOPOROSIS IN AFRICAN ADULT PATIENTS WITH CHRONIC RHEUMATIC DISEASES. A SYSTEMATIC REVIEW AND META-ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundGlucocorticoid (GC) use is well established in the treatment of rheumatics diseases, particularly rheumatoid arthritis (RA). The use of low dose GC has been endorsed by EULAR recommendations for the management of rheumatic and musculoskeletal diseases even if in the context of SARS-CoV-2, but long-term use is generally discouraged.ObjectivesTo estimate the prevalence of glucocorticosteroids induced osteoporosis (GIOP) on bone mineral density (BMD) in African adult patients with inflammatory rheumatic diseases.MethodsFor this systematic review and meta-analysis, PubMed, Google Scholar, Scopus and African index medicus were systematically searched up to December 2020 without language restrictions. We included studies as follows: population-based or hospital-based study, study with sufficient information to estimate the prevalence of GIOP and osteoporotic fractures in African patients with rheumatic disease. Searches were limited to peer-reviewed full text articles. A standardized data extraction form was used to collect information from eligible studies. A random-effects meta-analysis was conducted to obtain the pooled prevalence of GIOP in these studies. The meta-analysis was stratified by geographical region. The study is registered with PROSPERO, number CRD42021256252.ResultsOur search identified 8571 studies, of which 8 studies were included in the systematic review from only four African countries and 7 studies in the meta-analysis. The pooled prevalence of osteoporotic fractures in our study was 47.7% (95% CI 32.9–62.8) with 52.2% (95% CI 36.5-67.6) in North Africa and 15.4% (95% 1.9-45.4%) in South Africa (SA). There was no evidence of publication bias, although heterogeneity was high (p=0.018). There was no data from sub-Saharan Africa apart from the two studies from SA.ConclusionThe overall prevalence of GIOP in African adult patients with inflammatory rheumatic diseases was high at 47.7% (95% CI 32.9–62.8). Meta-analysis calculation revealed patient geographic origin as possible confounding factors of the proportion outcomes and further studies are required.References[1]Landewé RB, Machado PM, Kroon F, et al. EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2Annals of the Rheumatic Diseases 2020;79:851-858.Disclosure of InterestsNone declared
Collapse
|
8
|
El Miedany Y, Abu-Zaid MH, Elgaafary M, Ali N, Mansour M, Hassan W, Mortada MA, Eissa M, Tabra SAA, Fouad N, Ali R, M Medhat B, Adel Abdelsalam Hussein Y, Ghaleb RM, Nourhan Elameen E, Saber S, Moussa S. POS1168 TREAT TO TARGET OF GOUT: AN EVIDENCE-BASED CONSENSUS ON CLINICAL PRACTICE GUIDELINES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundNew therapies, management approaches and evidence regarding the management of gout have become available over the past years. This triggered the need for updated recommendations for the management of gout.Objectivesto develop an up-to-date consensus evidence-based clinical practice guideline for the management of gout including recommendations for management of acute gout flares, optimum usage of urate lowering therapy for chronic gout as well as patient education and lifestyle guidance.MethodsAn extensive systematic literature review was performed, and evidence-based recommendations were extrapolated, based on 16-key questions identified according to population, intervention, comparator, and outcomes (PICO) approach. For each item, the level of evidence was determined using the Oxford Centre for Evidence-based Medicine (CEBM) system. These were evaluated by a panel of 17-experts via online surveys over a 2-round Delphi process.ResultsAt the end of round 2, a total of 30-recommendation items, categorized into 10 domains to were obtained. Agreement with the recommendations (rank 7-9) ranged from 90-100%. Consensus was reached (i.e.≥75%of respondents strongly agreed or agreed) on the wording, the grade of recommendation and level of evidence of all the 30 clinical standards identified by the scientific committee. The guideline emphasized that all gouty patients should be screened for comorbidities. Based on this, an algorithm for treat to target management approach tailored to the individual patient’s needs and associated comorbidities has been outlined.ConclusionThis work provides updated evidence-based recommendations for the prevention and treatment of acute as well as chronic gouty arthritis. It provides an approach for physicians and patients making decisions on the management of gout. It will also facilitate improvement and uniformity of care.Disclosure of InterestsNone declared
Collapse
|
9
|
El Miedany Y, Salah S, Lotfy H, El Gaafary M, Abdulhady H, Salah H, Nasef SI, El-Latif EA, Farag Y, Eissa M, Esam Maher S, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, Mohamed SS, Tabra SA, Hassan WA, Amer Y, Abu-Zaid MH. Updated clinical practice treat-to-target guidelines for JIA management: the Egyptian College of Pediatric Rheumatology initiative. Egypt Rheumatol Rehabil 2022. [DOI: 10.1186/s43166-022-00125-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Abstract
Background
These updated guidelines aimed to provide appropriate and convenient guidelines for the treatment of various types of juvenile idiopathic arthritis (JIA).
Using the Delphi technique, this study was conducted to reach expert consensus on a treat-to-target management strategy for JIA. According to the PICO (patient/population, intervention, comparison, and outcomes) approach, the preliminary scientific committee identified a total of 17 key clinical questions. To assemble evidence on the advantages and dangers associated with JIA treatments, an evidence-based, systematic literature review was conducted. Researchers and clinicians with experience in JIA management were identified by the core leadership team. To establish a consensus on the management suggestions for JIA patients, a Delphi approach (2 rounds) was used.
Results
An online survey was applied to the expert panel (n = 27), and 26 of them completed both rounds. At the conclusion of round 2, a total of eighteen (18) recommendation items were gathered, which were divided into four sections to address the four key JIA categories. The percentage of those who agreed with the recommendations (ranks 7–9) ranged from 83.2 to 100% (average 86.8%). The phrasing of all 18 clinical standards identified by the scientific committee was agreed upon (i.e. 75% of respondents strongly agreed or agreed). Algorithms have been proposed for the management of JIA polyarthritis, oligoarthritis, and systemic JIA.
Conclusion
A wide and representative panel of experts initiated a consensus about the management of JIA. The created guidelines give a complete approach to the management of JIA for all healthcare professionals involved in its management, as well as a means of monitoring and evaluating these guidelines on a regular basis.
Collapse
|
10
|
Abu-Zaid MH, Tabra SA, Salah S, Lotfy H, Abdulhady H, Salah H, El Gaafary M, Farag Y, Eissa M, Maher SE, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, Mohamed SS, Hassan WA, Amer Y, Nasef SI, El Miedany Y. P063 Consensus-based recommendations for treat to target management of immunoglobulin A vasculitis. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
IgAvasculitis (IgAV) is the commonest cause of vasculitis in childhood.
It is characterized by small vessel vasculitis of the skin, gastrointestinal tract, kidneys, joints, and, rarely, the lungs and the central nervous system. There is paucity of international guidelines for management of IgA V. the Objective is to develop guidelines specific for Egyptian children with IgA vasculitis.
Method
This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for IgA vasculitis using Delphi technique. The preliminary scientific committee identified a total of 16 key clinical questions according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) approach. Delphi process was implemented (2-rounds) to reach a consensus.
Results
An online questionnaire were sent to expert panel (n = 26) who participated in the two rounds. At the end of round 2, a total of 20 recommendation items, categorized into 2 sections were obtained. Agreement with the recommendations (rank 7–9) ranged from 91.7–100%. Consensus was reached (i.e. ≥75% of respondents strongly agreed or agreed) on the wording of all the 20 clinical standards identified by the scientific committee. Algorithms for the management have been suggested.
Conclusion
This was an expert, consensus recommendations for the diagnosis and treatment of IgA V and IgA V nephritis, based on best available evidence and expert opinion.
Collapse
Affiliation(s)
| | | | - S Salah
- Egyptian Academy of Bone Health
| | - H Lotfy
- Egyptian Academy of Bone Health
| | | | - H Salah
- Egyptian Academy of Bone Health
| | | | - Y Farag
- Egyptian Academy of Bone Health
| | - M Eissa
- Egyptian Academy of Bone Health
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Y Amer
- Egyptian Academy of Bone Health
| | | | | |
Collapse
|
11
|
El Miedany Y, Hassan M, Salah S, Lotfy H, Abdulhady H, Salah H, El Gaafary M, Abd El-Latif E, Farag Y, Eissa M, Esam Maher S, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, SMohamed S, Tabra S, Hassan WA, Amer Y, Nasef SI. P016 Updated Clinical Practice Guidelines for JIA management adopting Treat to Target approach: the Egyptian College of Paediatric Rheumatology initiative. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is an unmet need from paediatric rheumatologists and rheumatologists, managing children with JIA, for a well formulated guidelines aiming at achieving better outcomes of their patients. To establish adequate and easily adopted guidelines in management of different variants of JIA in a relatively low resources country.
Method
This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for Juvenile Idiopathic Arthritis using Delphi technique. The preliminary scientific committee identified a total of 17 key clinical questions according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) approach. An evidence-based, systematic, literature review was conducted to compile evidence for the benefits and harms associated with JIA treatments. The core leadership team identified researchers and clinicians with expertise in JIA management in Egypt upon which Experts were gathered from different governorates and health centres across Egypt. Delphi process was implemented (2-rounds) to reacha consensus on the management recommendations of Egyptian JIA patients. Results: An online questionnaire were sent to expert panel (n = 27), of whom 26 participated in the two rounds. At the end of round 2, a total of eighteen (18) recommendation items, categorized into 4 sections to address the main 4 JIA categories, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.2–100% (average 86.8%). Consensus was reached (i.e. ≥75% of respondents strongly agreed or agreed) on the wording of all the 18 clinical standards identified by the scientific committee. Algorithms for the management of JIA polyarthritis, oligoarthritis and systemic JIA have been suggested.
Conclusion
A wide and representative panel of experts established a consensus regarding the management of JIA in Egypt. The developed guidelines provide a comprehensive approach to the management of JIA for ll Egyptian healthcare professionals who are involved in its management for follow up and frequent evaluation of these guidelines.
Collapse
|
12
|
Salah S, Lotfy H, Hassan M, Abdulhady H, Salah H, El Gaafary M, Abd El-Latif E, Farag Y, Eissa M, Esam Maher S, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, Mohamed SS, Tabra S, Hassan WA, Amer Y, Nasef SI, El Miedany Y. P050 Consensus based practice guidelines for the management and treatment of Juvenile familial Mediterranean fever: the Egyptian College of Paediatric Rheumatology initiative. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Familial Mediterranean fever (FMF) is the most common monogenic auto-inflammatory disease, with the highest prevalence amongst Mediterranean countries including Egypt (where there is high carrier rate of MEFV gene), characterized by recurrent attacks of fever and polyserositis. Mutations in the MEFV gene encoding pyrin has been associated with the disease, which causes exaggeration of the inflammatory response through uncontrolled interleukin production. Issuing updated treatment recommendations are vital for the treating healthcare professionals to get well acquainted with its diagnosis & treatment. To produce consensus-based recommendations to guide the early diagnosis, management and follow-up of patients with FMF.
Methods
The Patient/Population, Intervention, Comparison, and Outcomes (PICO) questions were developed and refined by the core team.
A qualitative synthesis of scientific evidence based on systematic review and clinical experience was conducted to compile evidence for the diagnosis and management of FMF.
A consensus process was conducted among the expert panel to generate the final recommendations and grade their strength.
3 rounds of Delphi process were carried out.
Results
Following 3 Delphi rounds, recommendations were developed for: early diagnosis, who to treat, treatment targets, genetic testing and its interpretation in association with clinical presentation, treatment of FMF and dealing with acute attacks, monitoring of management, identify treatment response, systemic affection, persistent attacks or inflammation, resistant cases, protracted symptoms, as well as remission status.
Algorithm for patients’ diagnosis and management is provided.
The final document comprises 12 recommendations, each presented with its degree of agreement (0–10), Level of agreement, grade of recommendation and rationale. The degree of agreement was >7/10 in all instances.
Conclusion
This guideline provides comprehensive approach to the accurate diagnosis and effective management/monitoring of FMF. It also represents a model for the incorporation of medical genetics practice into the more traditional domains of general medicine.
Collapse
|
13
|
El Miedany Y, El Gaafary M, Toth M, Hegazi MO, El Aroussy N, Hassan W, Almedany S, Nasr A, Bahlas S. OP0313 THERAPEUTIC APPROACHES TO OSTEOSARCOPENIA: DENOSUMAB EFFECT ON FALLS RISK, PHYSICAL PERFORMANCE AND WALKING SPEED. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:There is a strong association between osteoporosis and skeletal muscle dysfunction. Heparan-sulfate proteoglycans are abundant in skeletal muscles and may represent a target for RANKL inhibitor. It was noted that patients who completed their planned denosumab therapy course (5-years) started to sustain falls.Objectives:To assess the effect of Denosumab on falls risk, physical performance, grip strength and gait speed and whether there is a relation with bone mineral density.Methods:127 osteoporotic patients treated with denosumab were assessed prior to starting denosumab therapy for: baseline BMD using DXA scan, blood test for osteoporosis bone profile, self-reported falls risk using (FRAS score [1]), fracture risk using FRAX, handgrip strength using a calibrated dynamometer (the best of three trials of the dynamometer testing was recorded), the patient’s physical performance assessed by testing for: Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), and the 4 Meter Walk Gait Speed. Same measures were assessed again after completing 5-years of denosumab therapy. Comparison groups included 112 patients diagnosed to have osteoporosis and treated with zoledronate (Zol), once yearly IV injection, for 3-years; and 134 patients treated with once weekly oral alendronate (Aln) 70mg for 5-years. The patients were assessed for the same parameters as in the denosumab therapy. All the measures were reassessed 1-year after stopping the osteoporosis therapy.Results:No differences were seen on comparing the baseline parameters of the 3 groups. In comparison to the baseline, there was significant increase in the BMD in the 3 groups, Denosumab /Zol/Aln at both spine and hip (P = 0.02) at 5-, 3- and 5-years of treatment respectively. In the denosumab group, at 5-years of therapy, there was significant decrease in falls risk score (-1.4, 95% CI = −2.8 to −0.7; P = .01), significant improvements in the grip strength (+4.2Kg, P = 0.01), SPPB score (1.2 points; 95% CI = −0.07 to 2.2; P = .02), TUG (1.7 seconds; 95% CI = −2.2 to 0.1; P = .031) and gait speed (0.1 m/s; 95% CI = 0.03-0.2; P = .01). Zol and Aln improved significantly SPPB score (0.9 and 0.8 points; P = .04), TUG (1.4 and 1.3 seconds; P = .05) and gait speed (0.2 and 0.3 m/s; P = .02) respectively, however, there was no significant change in the falls risk (p = 0.06 and 0.07 respectively). 1-year after stopping Denosumab, there was significant worsening of the falls risk score, grip strength, SPPB score, TUG and gait speed (P = 0.1). There was no difference in all the measures 1-year after stopping Zol and Aln. There was no relation to the increase in BMD gained.Conclusion:Denosumab displayed positive impact and significant improvements in physical performance, grip strength and gait speed. Also, Denosumab, enhanced multidirectional agility as depicted by TUG. Collectively, this would explain the reduction of falls risk which got worse on stopping the medication.Osteoporosis and sarcopenia share similar risk factors, highlighting muscle-bone interactions, which may result in debilitating consequences, such as falls and fractures. RANK/RANKL/OPG pathway, a key regulator of bone homeostasis, may contribute also to the regulation of skeletal muscle integrity and function.References:[1]El Miedany et al. Falls Risk Assessment Score (FRAS). J Clin Gerontology and Geriatrics 2011; 21-26.Acknowledgments:Ali El Miedany for his help in data entryDisclosure of Interests:None declared
Collapse
|
14
|
El Miedany Y, El Gaafary M, El Aroussy N, Bahlas S, Hegazi M, Palmer D, Youssef S. Toward electronic health recording: evaluation of electronic patient reported outcome measures (e-PROMs) system for remote monitoring of early systemic lupus patients. Clin Rheumatol 2017; 36:2461-2469. [PMID: 28567555 DOI: 10.1007/s10067-017-3675-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 04/27/2017] [Accepted: 05/08/2017] [Indexed: 01/06/2023]
Abstract
The study aimed to assess the value of evaluation of electronic patient reported outcome measures (e-PROMs) in the assessment and management of SLE disease activity flares, its association with adherence to therapy as well as organ damage. A randomized, controlled crossover study was carried out over a 24-month duration. One hundred forty-seven SLE patients meeting the revised American College of Rheumatology (ACR) criteria were enrolled. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was used to assess disease activity, whereas organ damage was scored using the Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index. In the first 12 months, the patients were assessed every 3 months. At 12 months, the patients were randomized into a cohort of 73 patients who continued their care in the same style and 74 patients who completed an online e-PROMs questionnaire on monthly basis for another 12-month period. The data captured were then retrospectively analyzed at the end of the 24-month study period. At the end of the first year of the study, the mean SLEDAI and SDI scores were 8.72 (6.1) and 1.9 (2.2). At the end of the second year, the mean SLEDAI and SDI scores in the e-PROMs cohort were 3.1 (2.6) and 1.2 (1.3), whereas in the control group, the scores were 7.63 (6.7) and 1.8 (2.3), respectively (p < 0.01). Adjusting for possible confounding variables, the number of flares, regardless of their severity, was associated with damage accrual (OR 2.03, 95% CI 1.34 to 2.83, p < 0.001). Adherence to therapy was significantly (p < 0.1) higher in the e-PROMs group. e-PROMs was equivalent to PROMs paper format and has a potential disease-modifying effect as it facilitated close monitoring of disease activity with an option of management escalation whenever indicated.
Collapse
Affiliation(s)
- Y El Miedany
- Rheumatology, Darent Valley Hospital, Darenth Wood Road, Dartford, England, DA2 8DA, UK.
- Rheumatology & Rehab, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt.
| | - M El Gaafary
- Community and Public Health, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt
| | - Nadia El Aroussy
- Rheumatology & Rehab, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt
| | - S Bahlas
- Rheumatology Department, King Abdulaziz University, Jeddah, 21441, Saudi Arabia
| | - M Hegazi
- Medicine Department, Al Adan Hospital, KW52853, Hadeya, Kuwait
| | - D Palmer
- Rheumatology, North Middlesex University Hospitals, Sterling Way, London, N18 1QX, UK
| | - S Youssef
- Rheumatology & Rehab, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt
| |
Collapse
|
15
|
El Miedany Y, El Gaafary M, Youssef S, El Aroussy N. Meaningful patient engagement in inflammatory arthritis: development of the Patient Motivation Questionnaire. Clin Rheumatol 2017:10.1007/s10067-017-3605-x. [PMID: 28382403 DOI: 10.1007/s10067-017-3605-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 03/07/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Abstract
The objective of this study is to develop a questionnaire for evaluating the patient's "motivation" and assess the psychometric properties of that measure in patients with chronic inflammatory arthritis. Using Rasch analysis and questions item pool, content analysis, and semi-structured group discussion, the questionnaire was developed including 10-item scale (0-10 on VAS scale). Construct validity was assessed by correlating the questionnaire score to parameters of disease activity (DAS-28, ASDAS, and DAPSA scores), functional disability, quality of life, patient self-helplessness measure, as well as the patients' compliance to therapy. Reliability and comprehensibility and sensitivity to change were also assessed. The questionnaire was assessed in 432 RA, 415 psoriatic arthritis patients, and 232 ankylosing spondylitis patients. Dimensionality analysis revealed a 1-factor solution, explaining 98% of the total variance. It showed acceptable validity as it correlated significantly with disease activity measures: DAS-28: r = -0.85, ASDAS: r = -0.86, and DAPSA: r = -0.89. It also correlated significantly with functional disability score: r = -0.91, QoL: r = -0.90, as well as patient self-helplessness: r = -0.88. The questionnaire was reliable (Cronbach's alpha 0.958) and had no misfitting items. In addition, it was comprehensible (9.4) and sensitive to change (p < 0.01). The patient motivation score showed significant (p < 0.01) variation with the medication compliance. The measure is a patient-reported tool that is valid, reliable, comprehensible, and unidimensional scale that reflects the patients' motivation and engagement. The measure has good psychometric properties indicating that it can be used at the individual patient level to tailor management and monitor changes.
Collapse
Affiliation(s)
- Y El Miedany
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt.
- Darent Valley Hospital, Dartford, Kent, England, DA2 8DA, UK.
| | - Maha El Gaafary
- Public Health and Community Department, Ain Shams University, Cairo, Egypt
| | - Sally Youssef
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | - Nadia El Aroussy
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| |
Collapse
|
16
|
El Miedany Y, El Gaafary M, Youssef S, Ahmed I, Bahlas S, Hegazi M, Nasr A. Optimizing therapy in inflammatory arthritis: prediction of relapse after tapering or stopping treatment for rheumatoid arthritis patients achieving clinical and radiological remission. Clin Rheumatol 2016; 35:2915-2923. [DOI: 10.1007/s10067-016-3413-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 09/10/2016] [Accepted: 09/10/2016] [Indexed: 12/22/2022]
|
17
|
El Miedany Y, Maha El Gaafary M, Youssef S, Palmer D. FRI0114 Development of The Patient Motivation Questionnaire: Conceptualizing and Measuring Motivation in Patients with Inflammatory Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2425] [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]
|
18
|
El Miedany Y, El Gaafary M, Youssef S, Bahlas S, Ahmed I, Hegazi M. OP0091 Psoriatic Arthritis Comorbidity Index: Development and Validation of A New Specific Tool for Classifying Prognostic Comorbidity in Psoriatic Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4598] [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]
|
19
|
El Miedany Y, El Gaafary M, Youssef S, Bahlas S, Ahmed I, Hegazi M. OP0255 Rheumatoid Arthritis Comorbidity Index: Development and Validation of A New Specific Tool for Classifying Prognostic Comorbidity in Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1557] [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]
|
20
|
El Miedany Y, Maha El Gaafary M, Youssef S, Palmer D, Nasr A. OP0258 Optimizing Therapy in Inflammatory Arthritis: Prediction of Relapse after Tapering or Stopping Dmards/ Biologic Agents by Ultrasonographic Assessment in Rheumatoid Arthritis Patients Who Achieved Clinical Remission. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4909] [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]
|
21
|
El Miedany Y, Nestorova R, Petranova T, El Gaafary M. AB1129-HPR Cross-Cultural Adaptation and Validation of The Patient Reported Outcome Measures Questionnaire for Inflammatory Arthritis for Bulgarian-Speaking Individuals. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2470] [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]
|
22
|
El Miedany Y, Palmer D, El Gaafary M, Youssef S. SAT0175 Towards a “Tipping Point” in Rheumatology Practice: Implementing an Integrative Model of Electronic Shared Decision Making in the Standard Rheumatology Outpatient Setting. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1405] [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]
|
23
|
|
24
|
El Miedany Y, El Gaafary M, Youssef S, Palmer D. AB0325 Biomarkers and Patient Tailored Approach in Rheumatoid Arthritis: Can Proms be the Missing Biomarker? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
25
|
El Miedany Y, El Gaafary M, Youssef S, Palmer D. OP0005 Electronic Patient Reported Outcome Measures (E-PROMS) for Early Arthritis in Standard Clinical Practice: A Pilot Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1409] [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]
|
26
|
El Miedany Y, El Gaafary M, Youssef S, El Aroussy N. OP0312 Simulated Teaching in Rheumatology: Assessment of an Interactive E-Learning Postgraduate Rheumatology Teaching Module. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1408] [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]
|
27
|
Affiliation(s)
- Deborah Palmer
- Clinical Nurse Specialist, Rheumatology Department, North Middlesex University Hospital
| | - Y El Miedany
- Consultant Rheumatologist, Darent Valley Hospital, Kent
| |
Collapse
|
28
|
El Miedany Y. Adopting patient-centered care in standard practice: PROMs moving toward disease-specific era. Clin Exp Rheumatol 2014; 32:S-40-6. [PMID: 25365088] [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] [Received: 08/01/2014] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
Past discussions about the challenges of using patient-reported outcome measures (PROMs) in clinical practice included clinicians' skepticism, time and resources for the implementation, validity of the PROMs, unfamiliarity with the interpretation of PROMs, and costs of implementation. However, these concerns are diminishing now as PROMs has confirmed its place in the management of patients with inflammatory arthritic conditions where there is no surrogate outcome measure available to capture the patient's well-being and response to treatment. Therefore, PROMs has been endorsed as a primary outcome in clinical trials. PROMs directly measure treatment benefit beyond survival, disease, and physiologic markers, and are often the outcomes of greatest importance to patients. Recently, PROMs has progressed from the generic phase into a 'disease-specific' era. This article will discuss the evolving role of PROMs in the assessment and management of patients suffering from inflammatory arthritic conditions and how it can help in transforming patient-centered care concept into reality.
Collapse
Affiliation(s)
- Y El Miedany
- Rheumatology, Darent Valley Hospital, Dartford, Kent, UK and Department of Rheumatology, Ain Shams University, Cairo, Egypt.
| |
Collapse
|
29
|
El Miedany Y, El Gaafary M, Sayed S, Nasr A, Palmer D. SAT0072 Functional Disability: A Parameter Fit to BE A Biomarker for Inflammatory Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1470] [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]
|
30
|
El Miedany Y, El Gaafary M, Sayed S, Ahmed I. THU0037 Validation of A Disease-Specific Patient-Reported Outcome Measure for Arabic Patients with Systemic Lupus Erythematosus. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3758] [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]
|
31
|
El Miedany Y, El Gaafary M, Sayed S, Ahmed I, Palmer D. FRI0156 The Combined Spondylo-Arthritis Questionnaire for Assessment of Functional Disability and Quality of Life: Assessment of the Minimal Clinically Important Difference and REAL Clinically Important Difference in Patients with Spondyloarthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1407] [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]
|
32
|
El Miedany Y, El Gaafary M, Youssef S, Nasr A. THU0358 Gray Scale and Power Doppler Ultrasound Assessment of the Median Nerve: A Biomarker That Can Help in Setting A Treat to Target Approach Tailored for Carpal Tunnel Syndrome Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
El Miedany Y, El Gaafary M, Sayed S, Ahmed I. THU0330 Towards Tailored Patient's Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1405] [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]
|
34
|
El Miedany Y, El Gaafary M, Youssef S, Palmer D. SAT0073 Physician VS Patient Global Assessment in Early Rheumatoid Arthritis: Putting the CART before the Horse. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1408] [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]
|
35
|
Abstract
Early diagnosis and initiation of therapy has become a primary objective in clinical rheumatology. As psoriatic arthritis causes deformities and joint damage leading to impaired quality of life and function as well as increased mortality risk, there was an urgent call for action aiming at inducing remission of the active inflammatory process. Until the year 2000 there were no treatments that led to a reduction in progression of joint damage. However, with the advent of anti-tumour necrosis factor agents, it is now possible to arrest the progression of damage in these patients. Therefore, the concept of window of opportunity, that is early assessment and management in specialist clinics, has been extended to psoriatic arthritis with successful outcomes among psoriatic arthritis patients similar to those with rheumatoid arthritis. Although all this sounds plausible, early psoriatic arthritis assessment remains limited to research as setting up this type of service in standard clinical practice faces several challenges that would need tackling. The objective of this article is to provide an overview of these challenges and suggest a paradigm for use in standard clinical practice to identify early psoriatic arthritis patients.
Collapse
Affiliation(s)
- Deborah Palmer
- Clinical Nurse Specialist at Rheumatology Department, North Middlesex University Hospital, London
| | | |
Collapse
|
36
|
El Miedany Y, El Gaafary M, Ahmed I, Hegazi M, Palmer D. AB0197 The arthritic patients’ perspective of measuring treatment efficacy: patient reported experience measures (prems) as a quality tool. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.2520] [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]
|
37
|
El Miedany Y, El Gaafary M, Youssef S, El Aroussy N, Ahmed I, Palmer D. SAT0401 Towards a Multidimensional Patient Reported Outcome Measures Assessment: Development and Validation of a Questionnaire for Patients with Fibromyalgia. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2125] [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]
|
38
|
El Miedany Y, El Gaafary M, Youssef S, El Aroussy N, Ahmed I, Palmer D. AB0345 A step forward to close the loop: Applying “joint-fitness” and patient reported outcome measures to tailor a patient-specific education program. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.345] [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]
|
39
|
El Miedany Y, El Gaafary M, Youssef S, Palmer D. AB0346 The combined inflammatory arthritis questionnaire for assessment of functional disability and quality of life: Assessment of the minimal clinically important difference and real clinically important difference in patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.346] [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]
|
40
|
El Miedany Y, El Gaafary M, El Aroussy N, Ahmed I, Youssef S. AB0920 Validity, reliability and responsiveness of the arabic patient reported outcome measures questionnaire for patients with spondyloarthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.920] [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]
|
41
|
El Miedany Y, El Gaafary M, El Arousy N, Youssef S, Palmer D. FRI0139 The correlation of self-reported behavioral co-morbidities and disease activity in early inflammatory arthritis patients: A prospective study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2596] [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]
|
42
|
El Miedany Y, El Gaafary M, El Aroussy N, Ahmed I, Youssef S. AB0344 Patient reported outcomes in inflammatory arthritis: Validity, reliability and sensitivity to change of the arabic combined questionnaire for functional impairment and quality of life assessment. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.344] [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]
|
43
|
El Miedany Y, El Gaafary M, El Yassaki A, Ahmed I, Youssef S, Hegazi MO, Palmer D. FRI0326 Incorporating patient reported outcome measures in clinical practice: development and validation of a proms questionnaire for sle. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1453] [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]
|
44
|
El Miedany Y, El Gaafary M, Youssef S, Palmer D. OP0253-PC Training for general practitioners: Does an education program and a diagnostic algorithm improve referral reliability? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1936] [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]
|
45
|
El Miedany Y, El Gaafary M, Nasr A, El Aroussy N, Youssef S. SAT0339 Patterns of us changes in degenerative arthritis: Early vs late osteoarthritis of the knee joint. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3285] [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]
|
46
|
El Miedany Y, El Gaafary M, Youssef S, Ahmed I, Nasr A, Palmer D. SAT0307 Treat to Target of Psoriatic Arthritis: Core Set Criteria of Minimal Disease Activity. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2032] [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]
|
47
|
El Miedany Y, El Gaafary M, Youssef S, Palmer D. SAT0314 The role of musculoskeletal us as an outcome measure in the diagnosis and management of early psoriatic arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3261] [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]
|
48
|
El Miedany Y. Osteoarthritis: Is there a Window of Opportunity. Curr Rheumatol Rev 2012. [DOI: 10.2174/157339710803140210193905] [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: 11/22/2022]
|
49
|
Ickinger C, Musenge E, Tikly M, Barnes J, Donnison C, Scott M, Bartholomew P, Rynne M, Hamilton J, Saravanan V, Heycock C, Kelly C, de la Torre I, Moura RA, Leandro M, Edwards J, Cambridge G, de la Torre I, Leandro M, Edwards J, Cambridge G, Daniels LE, Gullick NJ, Rees JD, Kirkham BW, Daniels LE, Gullick NJ, Kirkham BW, Rees J, Scott IC, Johnson D, Scott DL, Kingsley G, Ma MH, Cope AP, Scott DL, Kirkham BW, Brode S, Nisar MK, Ostor AJ, Gullick NJ, Oakley SP, Rees JD, Jones T, Mistlin A, Panayi GS, Kirkham BW, El Miedany Y, Palmer D, Porkodi R, Rajendran P, Waller R, Williamson L, Collins D, Price E, Juarez MJ, El Miedany Y, El Gaafary M, Youssef S, Palmer D, El Miedany Y, El Gaafary M, Palmer D, El Miedany Y, El Gaafary M, Palmer D, El Miedany Y, Palmer D, Cramp F, Hewlett S, Almeida C, Kirwan J, Choy E, Chalder T, Pollock J, Christensen R, Mirjafari H, Verstappen S, Bunn D, Edlin H, Charlton-Menys V, Pemberton P, Marshall T, Wilson P, Lunt M, Symmons D, Bruce IN, Bell C, Rowe IF, Jayakumar K, Norton SJ, Dixey J, Williams P, Young A, Kurunadalingam H, Parwaiz I, Kumar K, Howlett K, Hands B, Raza K, Pitzalis C, Buckley C, Kelly S, Filer A, Wheater G, Hogan VE, Onno Teng Y, Tekstra J, Tuck SP, Lafeber FP, Huizinga TW, Bijlsma JW, Francis RM, Datta HK, van Laar J, Pratt AG, Charles PJ, Choudhury M, Wilson G, Venables PJ, Isaacs J, Raza K, Kumar K, Stack R, Kwiatkowska B, Rantapaa-Dahlqvist S, Saxne T, Sidiropoulos P, Kteniadaki E, Misirlaki C, Mann H, Vencovsky J, Ciurea A, Tamborrini G, Kyburz D, Bastian H, Burmester GR, Detert J, Buckley CD, Sheehy C, Shipman A, Stech I, Mukhtyar C, Atzeni F, Sitia S, Tomasoni L, Gianturco L, Ricci C, Sarzi-Puttini P, De Gennaro Colonna V, Turiel M, Galloway J, Low A, Mercer LK, Dixon W, Ustianowski A, Watson K, Lunt M, Fisher B, Plant D, Lundberg K, Charles PJ, Barton A, Venables P, Pratt AG, Lorenzi AR, Wilson G, Platt PN, Isaacs J. Rheumatoid arthritis - clinical aspects: 134. Predictors of Joint Damage in South Africans with Rheumatoid Arthritis. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker029] [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: 11/12/2022] Open
|
50
|
Castillo-Gallego C, de Miguel Mendieta E, Garcia-Arias M, Plasencia-Rodriguez C, Lojo-Oliveira L, Martin-Mola E, Tillett W, Cavill C, Korendowych E, McHugh N, Coates L, Bhalla AK, Creamer P, Packham J, Hailwood S, Taylor G, Hamilton L, Brooksby A, Leeder J, Gaffney K, Malipeddi AS, Neame R, Francis J, Hassan W, Mease P, Olds M, Kary S, Kupper H, Bell C, Peffers G, Rees F, Lanyon P, Obrenovic K, Sandhu R, Packham J, Erb N, Coates LC, Conaghan P, Emery P, Green M, Ibrahim G, MakIver H, Helliwell P, Giles JL, McHugh K, DiGleria K, Shaw J, Kollnberger S, Maenaka K, Marroquin O, Renner C, Bowness P, Landewe R, Ritchlin C, Olds M, Guerette B, Lavie F, Kavanaugh A, McInnes I, Krueger GG, Gladman D, Zrubek J, Goldstein N, Xu S, Mudivarthy S, Mack M, Prevosto C, McDonald S, De Riva A, Goodman R, Key T, Hill Gaston JS, Deery MJ, Busch R, Fischer R, Wright C, Kessler B, Bowness P, Sheehy C, Jois RN, Leeder J, Kerrigan N, Mills KS, Somerville M, Scott DG, Gaffney K, Kavanaugh A, van der Heijde D, Chattopadhyay C, Gladman D, Mease P, McInnes I, Krueger GG, Xu W, Rahman MU, Zrubek J, Baratelle A, Beutler A, Stober CB, Benham HJ, Goodall JC, Hill Gaston JS, Sanyal K, Walker-Bone K, Coates LC, Conaghan P, Emery P, Green M, Ibrahim G, MakIver H, Helliwell PS, Vastesaeger N, Wang Y, Inman R, Deodhar A, Hsu B, Rahman MU, Dijkmans B, Braun J, Geusens P, Sieper J, van der Heijde D, El Miedany Y, Palmer D, McHugh K, Giles JL, Shaw J, Kollnberger S, Payeli S, Utriainen L, Milling S, Renner C, Bowness P. Spondylarthropathies (including psoriatic arthritis): 244. Validity of Colour Doppler and Spectral Doppler Ultrasound of Sacroilicac Joints Againts Physical Examination as Gold Standard. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker034] [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: 11/14/2022] Open
|