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1. Significant overlap of inflammatory and degenerative features on imaging among patients with degenerative disc disease, diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis: a real-life cohort study

Author

Nelly Ziade, Melanie Udod, Nikolaos Kougkas, Styliani Tsiami, and Xenofon Baraliakos

Subjects
Diffuse idiopathic skeletal hyperostosis, Axial spondyloarthritis, Degenerative disc disease, Imaging, Spine, Radiography, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background Differentiating between degenerative disc disease (DDD), diffuse idiopathic skeletal hyperostosis (DISH), and axial spondyloarthritis (axSpA) represents a diagnostic challenge in patients with low back pain (LBP). We aimed to evaluate the distribution of inflammatory and degenerative imaging features in a real-life cohort of LBP patients referred to a tertiary university rheumatology center. Methods In a retrospective cross-sectional analysis of patients referred for LBP, demographics, symptom information, and available imaging were collected. SpA-like changes were considered in the spine in the presence of one of the following lesions typically related to SpA: erosions, sclerosis, squaring, and syndesmophytes on conventional radiographs (CR) and bone marrow oedema (BMO), erosions, sclerosis, and fat lesions (FL) on MRI. SIJ CR were graded per New York criteria; on MRIs, SIJs were evaluated by quadrant for BMO, erosions, FL, sclerosis and ankylosis, similar to the approach used by the Berlin SIJ MRI scoring system. The final diagnosis made by the rheumatologist was the gold standard. Data were presented descriptively, by patient and by quadrant, and compared among the three diagnosis groups. Results Among 136 referred patients, 71 had DDD, 38 DISH, and 27 axSpA; median age 62 years [IQR55-73], 63% males. On CR, SpA-like changes were significantly higher in axSpA in the lumbar (50%, vs. DDD 23%, DISH 22%), in DISH in the thoracic (28%, vs. DDD 8%, axSpA 12%), and in DDD in the cervical spine (67% vs. DISH 0%, axSpA 33%). On MRI, BMO was significantly higher in DISH in the thoracic (37%, vs. DDD 22%, axSpA 5%) and equally distributed in the lumbar spine (35-42%). FL were significantly more frequently identified in DISH and axSpA in the thoracic (56% and 52%) and DDD and axSpA in the lumbar spine (65% and 74%, respectively). Degenerative changes were frequent in the three groups. Sacroiliitis (NY criteria) was identified in 49% (axSpA 76%, DDD 48%, DISH 29%). Conclusion A significant overlap was found among DDD, DISH, and axSpA for inflammatory and degenerative imaging features. Particularly, SpA-like spine CR features were found in one-fourth of patients with DISH, and MRI BMO was found in one-third of those patients.

Published
2024
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2. P132 Exploring the impact of comorbidity, multimorbidity, and mental health conditions on health related outcomes in systemic lupus erythematous: a global study

Author

John D Pauling, Rohit Aggarwal, James B Lilleker, Ai Lyn Tan, Chris Wincup, Ioannis Parodis, Elena Nikiphorou, Latika Gupta, Marcin Milchert, Jessica Day, Nelly Ziade, Wanruchada Katchamart, Amelia Holloway, Arvind Nune, Sreoshy Saha, Syahrul Sazliyana Shaharir, Gagandeep Sukhija, Eman Elfar, Sook Yan Lee, Naveen R, Mrudula Joshi, Phonpen Akawatcharangura Goo, Lisa S Traboco, Yi Ming Chen, Parikshit Sen, Abraham Edgar Gracia-Ramos, and Carlo Vinicio Caballero-Uribe

Subjects
Immunologic diseases. Allergy, RC581-607
Published
2024
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3. P152 Exploring global discrepancies in systemic lupus erythematosus treatment

Author

John D Pauling, Rohit Aggarwal, James B Lilleker, Ai Lyn Tan, Chris Wincup, Elena Nikiphorou, Latika Gupta, Marcin Milchert, Jessica Day, Nelly Ziade, Wanruchada Katchamart, Amelia Holloway, Arvind Nune, Sreoshy Saha, Syahrul Sazliyana Shaharir, Gagandeep Sukhija, Eman Elfar, Sook Yan Lee, Naveen R, Mrudula Joshi, Phonpen Akawatcharangura Goo, Lisa S Traboco, Yi Ming Chen, Parikshit Sen, Abraham Edgar Gracia-Ramos, Carlo Vinicio Caballero-Uribe, and Ioannis Parodi

Subjects
Immunologic diseases. Allergy, RC581-607
Published
2024
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5. Vaccine hesitancy in patients with autoimmune diseases: Data from the coronavirus disease-2019 vaccination in autoimmune diseases study

Author

Parikshit Sen, James B Lilleker, Vishwesh Agarwal, Sinan Kardes, Marcin Milchert, Tamer Gheita, Babur Salim, Tsvetelina Velikova, Abraham Edgar Gracia-Ramos, Ioannis Parodis, Albert Selva O'Callaghan, Elena Nikiphorou, Ai Lyn Tan, Lorenzo Cavagna, Miguel A Saavedra, Samuel Katsuyuki Shinjo, Nelly Ziade, Johannes Knitza, Masataka Kuwana, Giovanni Cagnotto, Arvind Nune, Oliver Distler, Hector Chinoy, Rohit Aggarwal, and Latika Gupta

Subjects
Diseases of the musculoskeletal system, RC925-935
Published
2022
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6. Social Media Use Among Members of the Assessment of Spondyloarthritis International Society: Results of a Web-Based Survey

Author

Yu Heng Kwan, Jie Kie Phang, Ting Hui Woon, Jean W Liew, Maureen Dubreuil, Fabian Proft, Sofia Ramiro, Anna Molto, Victoria Navarro-Compán, Manouk de Hooge, Bhowmik Meghnathi, Nelly Ziade, Sizheng Steven Zhao, Maria Llop, Xenofon Baraliakos, and Warren Fong

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundThe use of social media in health care may serve as a beneficial tool for education, information dissemination, telemedicine, research, networking, and communications. To better leverage the benefits of social media, it is imperative to understand the patterns of its use and potential barriers to its implementation in health care. A previous study in 2016 that investigated social media use among young clinical rheumatologists (≤45 years) and basic scientists showed that there was substantial social media use among them for social and professional reasons. However, there is a limited inquiry into social media use in different areas of rheumatology, such as spondyloarthritis. ObjectiveWe aimed to explore the motivations, barriers, and patterns of social media use among an international group of experts in spondyloarthritis. MethodsWe distributed a web-based survey via email from March 2021 to June 2021 to 198 members of the Assessment of Spondyloarthritis International Society. It contained 24 questions about demographic characteristics, patterns of current social media use, and perceptions of utility. Univariable and multivariable logistic regression analyses were performed to identify the characteristics associated with use trends. ResultsThe response rate was 78.8% (156/198). Of these, 93.6% (146/156) of participants used at least one social media platform. Apart from internet-based shopping and entertainment, the use of social media for clinical updates (odds ratio [OR] 6.25, 95% CI 2.43-16.03) and research updates (OR 3.45, 95% CI 1.35-8.78) were associated with higher social media consumption. Among the respondents, 66% (103/156) used social media in a work-related manner. The use of social media for new web-based resources (OR 6.55, 95% CI 2.01-21.37), interaction with international colleagues (OR 4.66, 95% CI 1.21-17.90), and establishing a web-based presence (OR 4.05, 95% CI 1.25-13.13) were associated with higher levels of consumption for work-related purposes. Time investment, confidentiality concerns, and security concerns were the top 3 challenges to a wider adoption of social media. ConclusionsMost respondents (103/156, 66%) use social media in a work-related manner. Professional development, establishing a web-based presence, and international collaboration were associated with higher use. Challenges to social media adoption should be addressed to maximize its benefits.

Published
2023
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7. Peripheral spondyloarthritis and psoriatic arthritis sine psoriase: are we dealing with semantics or clinically meaningful differences?

Author

Xenofon Baraliakos, Nelly Ziade, and Michel Bou Absi

Subjects
Medicine
Abstract

Diagnosing peripheral spondyloarthritis (pSpA) remains a significant challenge due to the lack of specific disease biomarkers and the overlap with other SpA subtypes, mainly psoriatic arthritis (PsA), which represents a diagnostic challenge particularly in the absence of skin psoriasis (PsA sine psoriase). This narrative review aimed to compare the epidemiology, genetic susceptibility, pathophysiology, classification criteria, disease phenotype and burden, and therapeutic guidelines between patients diagnosed with pSpA and those with PsA sine psoriase, to determine if the two entities should be considered jointly or distinctly. Globally, pSpA appears to be more inclusive compared with PsA sine psoriase. Areas of similarities include age of onset, number of joints involved and prevalence of axial involvement. However, patients with pSpA have a male gender predominance, a higher prevalence of HLA-B27, enthesitis and involvement of large joints of the lower limbs, whereas patients with PsA sine psoriase have a higher prevalence HLA-Cw6, dactylitis and involvement of hand distal interphalangeal joints. Therefore, the difference between pSpA and PsA sine psoriase goes beyond semantics. The few dissimilarities should drive scientific efforts to reach a better characterisation of pSpA as an individual disease. Accordingly, randomised clinical trials should target patients with well-defined pSpA to identify effective therapies in this population.

Published
2022
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8. Treat to Target in Spondyloarthritis: Myth or Reality?

Author

Nelly Ziade and Ihsane Hamamouchi

Subjects
axial spondyloarthritis (axspa), psoriatic arthritis (psa), spondyloarthritis, treat-totarget, treatment strategy, Diseases of the musculoskeletal system, RC925-935
Abstract

A treat-to-target (T2T) strategy is a treatment plan in which the clinician treats the patient aggressively enough to reach and maintain explicitly specified and sequentially measured goals. To apply a T2T strategy, some conditions should be met. First, a proactive, clear endpoint should be used and a threshold should be defined. Second, a choice between several effective therapies must be available. Third, the endpoint should be supported by findings from randomised controlled trials supporting early aggressive treatment. Fourth, the strategy should be cost-effective. Finally, it needs to be acceptable by the stakeholders. The objective of this review was to verify if the conditions for applying the T2T strategy were met in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), using a narrative review. Based on the currently available literature, the conditions for applying the T2T in PsA and axSpA were partially met. First, proactive outcome measures are available; however, there is no clear consensus regarding the optimal one. Second, there is a reasonable choice of approved therapies for both diseases. Third, additional randomised controlled trials demonstrating the effectiveness of a T2T approach are still needed. Fourth, cost-effectiveness studies are needed and should include patients from different healthcare systems. Fifth, the implementation of T2T recommendations in routine care and the adherence to its application in clinical practice should be promoted. In summary, preliminary data suggest that T2T might be beneficial to patients with PsA and axSpA. However, further studies are needed to meet all the criteria before strongly advocating for T2T strategies.

Published
2021

9. Women in Rheumatology in the Arab League of Associations for Rheumatology Countries: A Rising Workforce

Author

Nelly Ziade, Ihsane Hmamouchi, and Lina El Kibbi

Subjects
rheumatology, workforce, leadership, female, women empowerment, social media, Medicine (General), R5-920
Abstract

BackgroundAn increase in women physicians in the medical workforce is witnessed in recent decades, paralleled by an increase in leadership positions and, to a lesser extent, in academic advancement.ObjectivesThis study aims to evaluate the women rheumatologists (WR) workforce and to identify the challenges faced by WR in the Arab League of Associations for Rheumatology (ArLAR) countries.MethodsWe collected data from members of special interest groups from 16 ArLAR countries about the number of rheumatologists in the national societies and boards – including WR –, and the estimated percentage of WR involved in academia. Also, a sample of WR was identified based on their established leadership positions and invited to a structured interview addressing their career path and the gender-related challenges.ResultsThe proportion of WR varied widely across the ArLAR countries, with a mean of 56%. Moreover, WR constituted 47% of the society’s board members and roughly 49% of WR were involved in academia. However, only 37% of the current society presidents were females. Structured interviews indicated that WR place a high value on patient care and teaching, followed by research and publications. The primary reported gender-related challenge was balancing work with family demands. Moreover, some WR reported gender-related discrimination incurred by colleagues, patients, and administrations.ConclusionWR constituted more than half of the current rheumatology workforce in the ArLAR countries, with a lower – but steadily growing – proportion of WR in leadership positions. As they embrace their growing role in the workforce, WR must benefit from all the provided tools, from learning from the experience of current women leaders in the field to using the latest technology such as social media platforms to empower them to reach gender equity.

Published
2022
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10. Predictors of not Achieving Remission or Low Disease Activity in Axial Spondyloarthritis Patients from Middle Eastern Countries: A Prospective, Multicenter, Real-world Study

Author

Jamal Ali Al-Saleh, Majid Abi Saab, Ahmed Negm, Farida Balushi, Rajaie Namas, and Nelly Ziade

Subjects
ankylosing spondyloarthritis, middle east, psoriasis, enthesitis, compliance, hla-b27 antigen, Medicine
Abstract

Objectives: We sought to identify the predictors of not achieving remission or low disease activity (LDA) among axial spondyloarthritis (SpA) patients in four Middle Eastern countries. Methods: In this multicenter prospective real-world study, adult patients with axial SpA diagnosed clinically during January–June 2019, and who met the Assessment of SpondyloArthritis International Society classification criteria for axial SpA, were enrolled from the participating centers of four countries—Lebanon, Oman, Qatar, and the UAE. Patient demographics, disease history, comorbidities, treatment, and compliance data were obtained at baseline. The primary outcome was to determine the percentage of patients who did not achieve the clinical target of remission or LDA as indicated by Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) < 2.1 after a three-month follow-up period. Secondary outcomes were assessing the demographic and clinical characteristics of ‘achievers’ and ‘non-achievers’ and to study the predictors of ASDAS-CRP ≥ 2.1 in different clinical subsets. Results: The participants were 309 patients of both sexes, with a median age of 43 years. Women had a slight majority (53.7%). At the end of the study, 72.2% of patients achieved the clinical target of ASDAS-CRP < 2.1. Non-achievers were significantly more likely to have enthesitis, positive human leukocyte antigen B 27 status, psoriasis, peripheral involvement, fibromyalgia, and a lower score on Compliance Questionnaire for Rheumatology (CQR). Multiple regression analysis showed that low CQR score, enthesitis, psoriasis, and family history of SpA were independent predictors of ASDAS-CRP ≥ 2.1. Conclusions: This real-world study suggests that low compliance, positive human leukocyte antigen B 27 status, peripheral involvement, and presence of enthesitis, psoriasis, and fibromyalgia are predictors of not achieving remission or LDA in axial SpA patients.

Published
2022
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11. Identification of clinical phenotypes of peripheral involvement in patients with spondyloarthritis, including psoriatic arthritis: a cluster analysis in the worldwide ASAS-PerSpA study

Author

Robert Landewé, Désirée van der Heijde, Maxime Dougados, Fernando M Pimentel-Santos, Anna Molto, Joachim Sieper, Clementina López-Medina, Marina Magrey, Sylvie Chevret, Ruben Burgos-Vargas, Floris A van Gaalen, Alessandro Biglia, Mitsumasa Kishimoto, Tuncay Duruöz, Bassel Elzorkany, Najia Hajjaj-Hassouni, José Maldonado-Cocco, Nelly Ziade, Meghna Gavali, Shue-Fen Luo, Kim Tae-Jong, Jieruo Gu, Pál Geher, Wilson Bautista-Molano, Walter Maksymowych, Laura Muntean, and Sebastián E Ibáñez-Vodnizza

Subjects
Medicine
Published
2021
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12. Establishing a sorting protocol for healthcare databases

Author

Elie Ghabi, Wehbeh Farah, Maher Abboud, Elias Chalhoub, Nelly Ziade, Isabella Annesi-Maesano, Laurie Abi-Habib, and Myriam Mrad Nakhle

Subjects
Sorting protocol, data cleaning, database, health record, Public aspects of medicine, RA1-1270
Abstract

Background: Health information records in many countries, especially developing countries, are still paper based. Compared to electronic systems, paper-based systems are disadvantageous in terms of data storage and data extraction. Given the importance of health records for epidemiological studies, guidelines for effective data cleaning and sorting are essential. They are, however, largely absent from the literature. The following paper discusses the process by which an algorithm was developed for the cleaning and sorting of a database generated from emergency department records in Lebanon. Design and methods: Demographic and health related information were extracted from the emergency department records of three hospitals in Beirut. Appropriate categories were selected for data categorization. For health information, disease categories and codes were selected according to the International Classification of Disease 10th Edition. Results: A total of 16,537 entries were collected. Demographic information was categorized into groups for future epidemiological studies. Analysis of the health information led to the creation of a sorting algorithm which was then used to categorize and code the health data. Several counts were then performed to represent and visualize the data numerically and graphically. Conclusions: The article describes the current state of health information records in Lebanon and the associated disadvantages of a paper-based system in terms of storage and data extraction. Furthermore, the article describes the algorithm by which health information was sorted and categorized to allow for future data analysis using paper records.

Published
2021
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13. Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

Author

Robert Landewé, Désirée van der Heijde, Maxime Dougados, Anna Molto, Joachim Sieper, Pedro M Machado, Clementina López-Medina, Uta Kiltz, Sebastián E Ibáñez Vodnizza, Sara Monti, Marina Magrey, Ruben Burgos-Vargas, Victoria Navarro-Compán, Floris A van Gaalen, Mitsumasa Kishimoto, Tuncay Duruöz, Bassel Elzorkany, Najia Hajjaj-Hassouni, José Maldonado-Cocco, Nelly Ziade, Meghna Gavali, Shue-Fen Luo, Kim Tae-Jong, F M Pimentel-Santos, Jieruo Gu, Ruxandra Schiotis, Pál Geher, Wilson Bautista-Molano, and Walter Maksymowych

Subjects
Medicine
Abstract

Objectives To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.Methods Cross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.Results A total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).Conclusion These results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.

Published
2021
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14. Adaptation of the 2015 American College of Rheumatology treatment guideline for rheumatoid arthritis for the Eastern Mediterranean Region: an exemplar of the GRADE Adolopment

Author

Andrea Darzi, Manale Harfouche, Thurayya Arayssi, Samar Alemadi, Khalid A. Alnaqbi, Humeira Badsha, Farida Al Balushi, Bassel Elzorkany, Hussein Halabi, Mohammed Hamoudeh, Wissam Hazer, Basel Masri, Mohammed A. Omair, Imad Uthman, Nelly Ziade, Jasvinder A. Singh, Robin Christiansen, Peter Tugwell, Holger J. Schünemann, and Elie A. Akl

Subjects
Practice guideline, Adaptation, GRADE, Evidence-based medicine, Eastern Mediterranean Region, Rheumatoid arthritis, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract Background It has been hypothesized that adaptation of health practice guidelines to the local setting is expected to improve their uptake and implementation while cutting on required resources. We recently adapted the published American College of Rheumatology (ACR) Rheumatoid Arthritis (RA) treatment guideline to the Eastern Mediterranean Region (EMR). The objective of this paper is to describe the process used for the adaptation of the 2015 ACR guideline on the treatment of RA for the EMR. Methods We used the GRADE-Adolopment methodology for the guideline adaptation process. We describe in detail how adolopment enhanced the efficiency of the following steps of the guideline adaptation process: (1) groups and roles, (2) selecting guideline topics, (3) identifying and training guideline panelists, (4) prioritizing questions and outcomes, (5) identifying, updating or conducting systematic reviews, (6) preparing GRADE evidence tables and EtD frameworks, (7) formulating and grading strength of recommendations, (8) using the GRADEpro-GDT software. Results The adolopment process took 6 months from January to June 2016 with a project coordinator dedicating 40% of her time, and the two co-chairs dedicating 5% and 10% of their times respectively. In addition, a research assistant worked 60% of her time over the last 3 months of the project. We held our face-to-face panel meeting in Qatar. Our literature update included five newly published trials. The certainty of the evidence of three of the eight recommendations changed: one from moderate to very low and two from low to very low. The factors that justified a very low certainty of the evidence in the three recommendations were: serious risk of bias and very serious imprecision. The strength of five of the recommendations changed from strong to conditional. The factors that justified the conditional strength of these 5 recommendations were: cost (n = 5 [100%]), impact on health equities (n = 4 [80%]), the balance of benefits and harms (n = 1 [20%]) and acceptability (n = 1 [20%]). Conclusion This project confirmed the feasibility of GRADE-Adolopment. It also highlighted the value of collaboration with the organization that had originally developed the treatment guideline. We discuss the implications for both guideline adaptation and future research to advance the field.

Published
2017
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15. Correction to: Adaptation of the 2015 American College of Rheumatology treatment guideline for rheumatoid arthritis for the Eastern Mediterranean Region: an exemplar of the GRADE Adolopment

Author

Andrea Darzi, Manale Harfouche, Thurayya Arayssi, Samar Alemadi, Khalid A. Alnaqbi, Humeira Badsha, Farida Al Balushi, Bassel Elzorkany, Hussein Halabi, Mohammed Hamoudeh, Wissam Hazer, Basel Masri, Mohammed A. Omair, Imad Uthman, Nelly Ziade, Jasvinder A. Singh, Robin Christiansen, Peter Tugwell, Holger J. Schünemann, and Elie A. Akl

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Published
2017
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16. An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists

Author

Agnete Overgaard Donskov, Sarah Louise Mackie, Ellen Margrethe Hauge, Carlos Enrique Toro-Gutiérrez, Ib Tønder Hansen, Andrea Katharina Hemmig, Aatke Van der Maas, Tamer Gheita, Berit Dalsgaard Nielsen, Karen M J Douglas, Richard Conway, Elena Rezus, Bhaskar Dasgupta, Sara Monti, Eric L Matteson, Sebastian E Sattui, Mark Matza, Vanessa Ocampo, Margarita Gromova, Rebecca Grainger, Andrea Bran, Simone Appenzeller, Annelise Goecke, Nelly Colman, Helen I Keen, Masataka Kuwana, Latika Gupta, Babur Salim, Ghita Harifi, Mariam Erraoui, Nelly Ziade, Nizar Abdulateef Al-Ani, Adeola Ajibade, Johannes Knitza, Line Frølund, Max Yates, Victor R Pimentel-Quiroz, Andre Marun Lyrio, Maria Sandovici, Kornelis S M Van der Geest, Toby Helliwell, Elisabeth Brouwer, Christian Dejaco, and Kresten Krarup Keller

Subjects
Rheumatology, Pharmacology (medical)
Abstract

Objectives To explore current management practices for PMR by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment. Methods An English language questionnaire was constructed by a working group of rheumatologists and GPs from six countries. The questionnaire focused on: 1: Respondent characteristics; 2: Referral practices; 3: Treatment with glucocorticoids; 4: Diagnostics; 5: Comorbidities; and 6: Barriers to research. The questionnaire was distributed to rheumatologists and GPs worldwide via members of the International PMR/Giant Cell Arteritis Study Group. Results In total, 394 GPs and 937 rheumatologists responded to the survey. GPs referred a median of 25% of their suspected PMR patients for diagnosis and 50% of these were returned to their GP for management. In general, 39% of rheumatologists evaluated patients with suspected PMR >2 weeks after referral, and a median of 50% of patients had started prednisolone before rheumatologist evaluation. Direct comparison of initial treatment showed that the percentage prescribing >25 mg prednisolone daily for patients was 30% for GPs and 12% for rheumatologists. Diagnostic imaging was rarely used. More than half (56%) of rheumatologists experienced difficulties recruiting people with PMR to clinical trials. Conclusion This large international survey indicates that a large proportion of people with PMR are not referred for diagnosis, and that the proportion of treatment-naive patients declined with increasing time from referral to assessment. Strategies are needed to change referral and management of people with PMR, to improve clinical practice and facilitate recruitment to clinical trials.

Published
2023
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17. Social media use among members of the assessment of spondyloarthritis international society

Author

Yu Heng Kwan, Jie Kie Phang, Ting Hui Woon, Jean W Liew, Maureen Dubreuil, Fabian Proft, Sofia Ramiro, Anna Molto, Victoria Navarro-Compán, Manouk de Hooge, Bhowmik Meghnathi, Nelly Ziade, Sizheng Steven Zhao, Maria Llop, Xenofon Baraliakos, and Warren Fong

Subjects
social media, Health Informatics, spondyloarthritis, cross-sectional survey
Abstract

Background The use of social media in health care may serve as a beneficial tool for education, information dissemination, telemedicine, research, networking, and communications. To better leverage the benefits of social media, it is imperative to understand the patterns of its use and potential barriers to its implementation in health care. A previous study in 2016 that investigated social media use among young clinical rheumatologists (≤45 years) and basic scientists showed that there was substantial social media use among them for social and professional reasons. However, there is a limited inquiry into social media use in different areas of rheumatology, such as spondyloarthritis. Objective We aimed to explore the motivations, barriers, and patterns of social media use among an international group of experts in spondyloarthritis. Methods We distributed a web-based survey via email from March 2021 to June 2021 to 198 members of the Assessment of Spondyloarthritis International Society. It contained 24 questions about demographic characteristics, patterns of current social media use, and perceptions of utility. Univariable and multivariable logistic regression analyses were performed to identify the characteristics associated with use trends. Results The response rate was 78.8% (156/198). Of these, 93.6% (146/156) of participants used at least one social media platform. Apart from internet-based shopping and entertainment, the use of social media for clinical updates (odds ratio [OR] 6.25, 95% CI 2.43-16.03) and research updates (OR 3.45, 95% CI 1.35-8.78) were associated with higher social media consumption. Among the respondents, 66% (103/156) used social media in a work-related manner. The use of social media for new web-based resources (OR 6.55, 95% CI 2.01-21.37), interaction with international colleagues (OR 4.66, 95% CI 1.21-17.90), and establishing a web-based presence (OR 4.05, 95% CI 1.25-13.13) were associated with higher levels of consumption for work-related purposes. Time investment, confidentiality concerns, and security concerns were the top 3 challenges to a wider adoption of social media. Conclusions Most respondents (103/156, 66%) use social media in a work-related manner. Professional development, establishing a web-based presence, and international collaboration were associated with higher use. Challenges to social media adoption should be addressed to maximize its benefits.

Published
2023

18. High fatigue scores in patients with idiopathic inflammatory myopathies: a multigroup comparative study from the COVAD e-survey

Author

Silvia, Grignaschi, Minchul, Kim, Giovanni, Zanframundo, Naveen, Ravichandran, Lilleker, James B., Parikshit, Sen, Mrudula, Joshi, Vishwesh, Agarwal, Sinan, Kardes, Jessica, Day, Ashima, Makol, Marcin, Milchert, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Elena, Nikiphorou, Tulika, Chatterjee, Ai Lyn Tan, Saavedra, Miguel A., Samuel Katsuyuki Shinjo, Nelly, Ziade, Johannes, Knitza, Masataka, Kuwana, Arvind, Nune, Oliver, Distler, Hector, Chinoy, Lorenzo, Cavagna, Vikas, Agarwal, Rohit, Aggarwal, Latika, Gupta, Bhupen, Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, Rakesh Kumar Pilania, Aman, Sharma, M Manesh Manoj, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Arunkumar, R Pande, Kunal, Chandwar, Döndü Üsküdar Cansu, John, D Pauling, Chris, Wincup, Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Lisa, S Traboco, Suryo Anggoro Kusumo Wibowo, Jorge Rojas Serrano, Ignacio García-De La Torre, Erick Adrian Zamora Tehozol, Jesús, Loarce-Martos, Sergio, Prieto-González, Raquel Aranega Gonzalez, Akira, Yoshida, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Stylianos, Tomaras, Margarita Aleksandrovna Gromova, Aharonov, Or, Ihsane, Hmamouchi, Leonardo Santos Hoff, Margherita, Giannini, François, Maurier, Julien, Campagne, Alain, Meyer, Melinda, Nagy-Vincze, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Océane, Landon-Cardinal, Syahrul Sazliyana Shaharir, Wilmer Gerardo Rojas Zuleta, José António Pereira Silva, and João Eurico Fonseca

Subjects
Myositis, Surveys and questionnaires, Autoimmune diseases, COVID-19, Fatigue
Published
2023

19. COVAD survey 2 long-term outcomes: unmet need and protocol

Author

Zoha Zahid Fazal, Parikshit, Sen, Mrudula, Joshi, Naveen, Ravichandran, Lilleker, James B., Vishwesh, Agarwal, Sinan, Kardes, Minchul, Kim, Jessica, Day, Ashima, Makol, Marcin, Milchert, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Elena, Nikiphorou, Ai Lyn Tan, Tulika, Chatterjee, Lorenzo, Cavagna, Saavedra, Miguel A., Samuel Katsuyuki Shinjo, Nelly, Ziade, Albert, Selva-O’Callaghan, Arvind, Nune, Johannes, Knitza, Masataka, Kuwana, Carlos-Enrique Toro Gutiérrez, Carlo Vinicio Caballero-Uribe, Dzifa, Dey, Oliver, Distler, Hector, Chinoy, Vikas, Agarwal, Rohit, Aggarwal, Latika Gupta, COVAD Study Group: Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, Rakesh Kumar Pilania, Aman, Sharma, Manesh Manoj, M, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Arun Kumar, R Pandey, Prithvi Sanjeevkumar Gaur, Mahabaleshwar, Mamadapur, Akanksha, Ghodke, Kunal, Chandwar, Kshitij, Jagtap, Döndü Üsküdar Cansu, Reşit, Yıldırım, Aarat, Patel, John, D Pauling, Chris, Wincup, Margherita, Giannini, François, Maurier, Julien, Campagne, Alain, Meyer, Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Silvia, Grignaschi, Alessandro, Giollo, Lisa, S Traboco, Syahrul Sazliyana Shaharir, Suryo Anggoro Kusumo Wibowo, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Colunga‑pedraza, Iris J., Javier, Merayo-Chalico, Jesús, Loarce-Martos, Sergio, Prieto-González, Albert, Gil-Vila, Raquel, Aranega, Leonardo Santos Hoff, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Stylianos, Tomaras, Fabian Nikolai Proft, Marie-Therese, Holzer, Margarita Aleksandrovna Gromova, Aharonov, Or, Melinda, Nagy-Vincze, Zoltán, Griger, Ihsane, Hmamouchi, Pr Imane El bouchti, Zineb, Baba, Uyi, Ima-Edomwonyi, Ibukunoluwa, Dedeke, Emorinken, Airenakho, Nwankwo Henry Madu, Abubakar, Yerima, Hakeem, Olaosebikan, Okwara Celestine Chibuzo, Becky, A, Ouma Devi Koussougbo, Elisa, Palalane, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Océane, Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, Álvaro, Arbeláez, Javier, Cajas, José António Pereira Silva, João Eurico Fonseca, Olena, Zimba, Doskaliuk, Bohdana, Ho, So, Manuel Francisco Ugarte-Gil, Lyn, Chinchay, José Proaño Bernaola, Victorio, Pimentel, Tanveer Hasan, A. T. M., Sreoshy, Saha, Binit, Vaidya, Hanan Mohamed Fathi, Reem Hamdy, A Mohammed, Yi-Ming, Chen, Ghita, Harifi, Lina El Kibbi, Hussein Mohammed Halabi, Akawatcharangura, P, Wanruchada, Katchamart, Yurilís, Fuentes-Silva, Karoll, Cabriza, Jonathan, Losanto, Nelly, Colaman, Antonio, Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Raúl Agustín González, Lilith Stange Nunez, Cristian Vergara, M, Jossiell Then Báez, Hugo, Alonzo, Carlos Benito Santiago Pastelin, Rodrigo García Salinas, Alejandro Quiñónez Obiols, Nilmo, Chávez, Andrea Bran Ordóñez, Sandra, Argueta, Daniel, Quijivix, Gil Alberto Reyes Llerena, Radames, Sierra-Zorita, Dina, Arrieta, Eduardo Romero Hidalgo, Ricardo, Saenz, Idania Escalante, M., Roberto, Morales, Wendy, Calapaqui, Ivonne, Quezada, Gabriela, Arredondo, Institut Català de la Salut, [Fazal ZZ] Medical College, Aga Khan University Hospital, National Stadium Road, Sindh, Pakistan. [Sen P] Maulana Azad Medical College, 2-Bahadurshah Zafar Marg, New Delhi, India. [Joshi M] Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India. [Ravichandran N] Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. [Lilleker JB] Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Neurology, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, UK. [Agarwal V] Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India. [Selva-O'Callaghan A] Unitat d’Inflamació i Autoimmunitat, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Autoimmune diseases, COVID-19, Long-term adverse effects, Registries, Vaccination, COVID-19 Vaccines, COVID-19/prevention & control, Immunology, Complex Mixtures::Biological Products::Vaccines::Viral Vaccines [CHEMICALS AND DRUGS], Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores], Enquestes, Antiviral Agents, Rheumatology, Other subheadings::Other subheadings::/adverse effects [Other subheadings], virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Immunology and Allergy, Humans, Pandemics/prevention & control, Vacunes - Efectes secundaris, Pandemics, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], mezclas complejas::productos biológicos::vacunas::vacunas víricas [COMPUESTOS QUÍMICOS Y DROGAS], Long term adverse effects, Covid-19, COVID-19 (Malaltia) - Vacunació, COVID-19 Vaccines/adverse effects
Abstract

COVID-19; Registries; Vaccination COVID-19; Registros; Vacunación COVID-19; Registres; Vacunació Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently approved vaccines are live-attenuated, several reports of disease flares, waning protection, and acute-onset syndromes have emerged as short-term adverse events after vaccination. Hence, scientific literature falls short when discussing potential long-term effects in vulnerable cohorts. The COVAD-2 survey follows on from the baseline COVAD-1 survey with the aim to collect patient-reported data on the long-term safety and tolerability of COVID-19 vaccines in immune modulation. The e-survey has been extensively pilot-tested and validated with translations into multiple languages. Anticipated results will help improve vaccination efforts and reduce the imminent risks of COVID-19 infection, especially in understudied vulnerable groups. HC is supported by the National Institution for Health Research Manchester Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Published
2022
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20. Development of an Educational Video for Self-Assessment of Patients with RA: Steps, Challenges, and Responses

Author

S. Saad, Bhavna Khan, Amani Daher, Jeanine Menassa, Ghita Harifi, Imad Uthman, Bassel Elzorkany, Kamel Mroue, Mira Merashli, Manal Al Mashaleh, Nelly Ziade, Georges Merheb, Thurayya Arayssi, Hussein Halabi, Mohammad Abu Jbara, Samar Al Emadi, Humeira Badsha, Abdel Fattah Masri, Elie Alam, Basel Masri, Ghada Abi Karam, Lina Kibbi, Nelly Salloum, Jamil Messaykeh, and Alla Aiko

Subjects
Self-assessment, musculoskeletal diseases, Medical education, education.field_of_study, Original Paper, treat-to-target, Patient Empowerment, Social distance, Population, Diseases of the musculoskeletal system, self-assessment, patient empowerment, patient education, composite measures, educational video, Rheumatology, RC925-935, Structured interview, Pandemic, In patient, Rheumatoid arthritis, education, Psychology, DAS-28, Patient education
Abstract

Objectives: The primary objective was to develop an educational video to teach patients with rheumatoid arthritis (RA) self-assessment of their disease activity. Secondary objectives were to validate the video, identify the challenges in producing it, and the responses to these challenges. Methods: Rheumatologists from 7 Middle Eastern Arab countries (MEAC) discussed unmet needs in the education of patients with RA. They reviewed pre-existing educational audiovisual material and drafted the script for a new video in Arabic. The video was produced in collaboration with a technical team, then validated by patients using a standardized interview. At each step of production, challenges were identified. Results: Twenty-three rheumatologists from MEAC identified unmet needs in patients’ education. A video was produced, explaining the concepts of treat-to-target and showing a patient performing self-assessment using DAS-28. Sixty-two patients were interviewed for validation and found the video to be useful and easy to understand, albeit not replacing the physician’s visit. Most common challenges encountered included acceptance of patient empowerment, agreement on DAS-28 as composite measure, production of a comprehensible written Arabic text, and addressing the population cultural mix. Conclusion: Despite challenges, the video was well accepted among patients and can be used for clinical and research purposes. It is particularly useful in pandemic periods where social distancing is recommended.

Published
2021

21. Higher risk of short term COVID-19 vaccine adverse events in myositis patients with autoimmune comorbidities: results from the COVAD study

Author

Mrinalini, Dey, Naveen, R, Elena, Nikiphorou, Parikshit, Sen, Sreoshy, Saha, James, B Lilleker, Vishwesh, Agarwal, Sinan, Kardes, Jessica, Day, Marcin, Milchert, Mrudula, Joshi, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Albert Selva O'Callaghan, Minchul, Kim, Tulika, Chatterjee, Ai Lyn Tan, Ashima, Makol, Arvind, Nune, Lorenzo, Cavagna, Miguel, A Saavedra, Samuel Katsuyuki Shinjo, Nelly, Ziade, Johannes, Knitza, Masataka, Kuwana, Oliver, Distler, Bhupen, Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, Rakesh Kumar Pilania, Aman, Sharma, Manesh, Manoj, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Arunkumar, R Pande, Kunal, Chandwar, John, D Pauling, Chris, Wincup, Döndü Üsküdar Cansu, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Nicoletta Del Papa, Gianluca, Sambataro, Fabiola, Atzeni, Marcello, Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Lisa, S Traboco, Leonardo Santos Hoff, Suryo Anggoro Kusumo Wibowo, Stylianos, Tomaras, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Akira, Yoshida, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Jesús, Loarce-Martos, Sergio, Prieto-González, Albert, Gil-Vila, Raquel Arànega Gonzalez, Hector, Chinoy, Vikas, Agarwal, Rohit, Aggarwal, Latika, Gupta, and COVAD Study Group

Published
2022

22. Establishing a sorting protocol for healthcare databases

Author

Laurie E. AbiHabib, Myriam Mrad Nakhle, Maher Abboud, Isabella Annesi-Maesano, Wehbeh Farah, Nelly Ziade, Elias Chalhoub, Elie Ghabi, Hibade, Monique, University of Balamand [Liban] (UOB), Université Saint-Joseph de Beyrouth (USJ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Desbrest de santé publique (IDESP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
Sorting algorithm, Computer science, State of health, Process (engineering), [SDV]Life Sciences [q-bio], 010501 environmental sciences, computer.software_genre, 01 natural sciences, Article, 03 medical and health sciences, health record, 0302 clinical medicine, Health care, data cleaning, database, 0105 earth and related environmental sciences, Protocol (science), Database, business.industry, lcsh:Public aspects of medicine, Sorting, lcsh:RA1-1270, [SDV] Life Sciences [q-bio], Sorting protocol, 030228 respiratory system, Categorization, Data extraction, business, computer
Abstract

Background: Health information records in many countries, especially developing countries, are still paper based. Compared to electronic systems, paper-based systems are disadvantageous in terms of data storage and data extraction. Given the importance of health records for epidemiological studies, guidelines for effective data cleaning and sorting are essential. They are, however, largely absent from the literature. The following paper discusses the process by which an algorithm was developed for the cleaning and sorting of a database generated from emergency department records in Lebanon. Design and methods: Demographic and health related information were extracted from the emergency department records of three hospitals in Beirut. Appropriate categories were selected for data categorization. For health information, disease categories and codes were selected according to the International Classification of Disease 10th Edition. Results: A total of 16,537 entries were collected. Demographic information was categorized into groups for future epidemiological studies. Analysis of the health information led to the creation of a sorting algorithm which was then used to categorize and code the health data. Several counts were then performed to represent and visualize the data numerically and graphically. Conclusions: The article describes the current state of health information records in Lebanon and the associated disadvantages of a paper-based system in terms of storage and data extraction. Furthermore, the article describes the algorithm by which health information was sorted and categorized to allow for future data analysis using paper records. Significance for public health In our protocol, we explain the process by which health information collected from paper-based records were analyzed to develop an algorithm to allocate appropriate ICD 10 disease codes and categories to each entry. The algorithm allows for the sequential analysis of the information present and serves to overcome the issue of incomplete records. This is especially relevant in developing countries where paper-based records are highly relied upon, noting that our protocol has already been applied to a study in the Ivory Coast. The protocol allows for a health information database to be cleaned and sorted for research in environmental, social and occupational health. Furthermore, since data cleaning and sorting protocols are sparse, it is crucial to establish a standardized tool to enhance the quality of the conducted research.

Published
2021
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23. Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

Author

Ruben Burgos-Vargas, Walter P. Maksymowych, Mitsumasa Kishimoto, Najia Hajjaj-Hassouni, Sara Monti, Tuncay Duruöz, Pedro Machado, Anna Molto, Robert Landewé, Joachim Sieper, Victoria Navarro-Compán, Désirée van der Heijde, Sebastian E. Ibáñez Vodnizza, Meghna Gavali, Wilson Bautista-Molano, Pál Géher, Ruxandra Elena Schiotis, Kim Tae-Jong, Jieruo Gu, Fernando Pimentel-Santos, Uta Kiltz, Maxime Dougados, Bassel Elzorkany, Shue Fen Luo, Marina Magrey, José A. Maldonado-Cocco, Nelly Ziade, Clementina López-Medina, Floris A. van Gaalen, López Medina, Clementina [0000-0002-2309-5837], Molto, Anna [0000-0003-2246-1986], Sieper, Joachim [0000-0003-0285-9890], Kiltz, Uta [0000-0001-5668-4497], Hajjaj Hassouni, Najia [0000-0003-0722-6822], Ziade, Nelly [0000-0002-4479-7678], Monti, Sara [0000-0002-1800-6772], van Gaalen, Floris A [0000-0001-8448-7407], Ibáñez Vodnizza, Sebastián E [0000-0002-9577-3078], Bautista Molano, Wilson [0000-0003-0684-9542], Machado, Pedro M [0000-0002-8411-7972], van der Heijde, Desirée [0000-0002-5781-158X], Lopez-Medina, Clementina, Molto, Anna, Sieper, Joachim, Duruoz, Tuncay, Kiltz, Uta, Elzorkany, Bassel, Hajjaj-Hassouni, Najia, Burgos-Vargas, Ruben, Maldonado-Cocco, Jose, Ziade, Nelly, Gavali, Meghna, Navarro-Compan, Victoria, Luo, Shue-Fen, Monti, Sara, Tae-Jong, Kim, Kishimoto, Mitsumasa, Pimentel-Santos, F. M., Gu, Jieruo, Schiotis, Ruxandra, van Gaalen, Floris A., Geher, Pal, Magrey, Marina, Ibanez Vodnizza, Sebastian E., Bautista-Molano, Wilson, Maksymowych, Walter, Machado, Pedro M., Landew, Robert, van der Heijde, Desiree, Dougados, Maxime, Clinical Immunology and Rheumatology, and AII - Inflammatory diseases

Subjects
Male, Arthritis, DISEASE, RECOMMENDATIONS, Dactylitis, 0302 clinical medicine, Prevalence, Immunology and Allergy, CLASSIFICATION CRITERIA, 030212 general & internal medicine, INDEX, ANKYLOSING-SPONDYLITIS, spondylitis, LATIN-AMERICA, medicine.anatomical_structure, ankylosing, arthritis, Medicine, Upper limb, Female, medicine.symptom, musculoskeletal diseases, Adult, medicine.medical_specialty, HIP INVOLVEMENT, Immunology, 03 medical and health sciences, Psoriatic arthritis, Rheumatology, Internal medicine, Spondyloarthritis, Spondylarthritis, medicine, Humans, Reactive arthritis, Spondylitis, Ankylosing, Spondylitis, ENTHESITIS, 030203 arthritis & rheumatology, business.industry, Arthritis, Psoriatic, Enthesitis, medicine.disease, juvenile, Cross-Sectional Studies, RISK-FACTORS, psoriatic, business
Abstract

ObjectivesTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.MethodsCross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.ResultsA total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).ConclusionThese results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.

Published
2021

24. COVID-19 vaccination in autoimmune disease (COVAD) survey protocol

Author

Parikshit, Sen, Latika, Gupta, James, B Lilleker, Vishwesh, Aggarwal, Sinan, Kardes, Marcin, Milchert, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Albert Selva O'Callaghan, Elena, Nikiphorou, Ai Lyn Tan, Lorenzo, Cavagna, Miguel, A Saavedra, Samuel Katsuyuki Shinjo, Nelly, Ziade, Johannes, Knitza, Masataka, Kuwana, Giovanni, Cagnotto, Arvind, Nune, Oliver, Distler, Hector, Chinoy, Vikas, Aggarwal, Rohit, Aggarwal, COVAD Study Group COVAD Study Group: Bhupen Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, N Malaviya, A, Rakesh Kumar Pilania, Aman, Sharma, M Manesh Manoj, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Naveen, R, Döndü Üsküdar Cansu, John, D Pauling, Chris, Wincup, Tulika, Chatterjee, Minchul, Kim, Margherita, Giannini, Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Luca, Quartuccio, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Lisa, S Traboco, Suryo Anggoro Kusumo Wibowo, Jorge Rojas Serrano, Ignacio García-De La Torre, Erick Adrian Zamora Tehozol, Jesús, Loarce-Martos, Sergio, Prieto-González, Albert, Gil-Vila, Raquel, Aranega, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Stylianos, Tomaras, Margarita Aleksandrovna Gromova, and Aharonov, Or

Subjects
medicine.medical_specialty, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Autoimmune diseases, Immunology, Disease, Observational Research, Rheumatology, Internal medicine, Pandemic, Humans, Immunology and Allergy, Medicine, Intensive care medicine, Adverse effect, Survey, Autoimmune disease, business.industry, Vaccination, COVAD, COVID-19, medicine.disease, Increased risk, Health Care Surveys, Autoimmune Diseases, Vaccination Hesitancy, business
Abstract

The coronavirus disease-2019 (COVID-19) pandemic continues to be a cause of unprecedented global morbidity and mortality. Whilst COVID-19 vaccination has emerged as the only tangible solution to reducing poor clinical outcomes, vaccine hesitancy continues to be an obstacle to achieving high levels of vaccine uptake. This represents particular risk to patients with autoimmune diseases, a group already at increased risk of hospitalization and poor clinical outcomes related to COVID-19 infection. Whilst there is a paucity of long-term safety and efficacy data of COVID-19 vaccination in patients with autoimmune diseases, the current evidence strongly suggests that the benefits of vaccination outweigh the risks of adverse effects and disease flares. Herein, we report the protocol of the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study, an ongoing international collaborative study involving 29 countries and over 110 investigators. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-021-05046-4.

Published
2021

25. The impact of COVID-19 pandemic on rheumatology practice: a cross-sectional multinational study

Author

Basel Masri, Mervat Eissa, Nizar Abdulateef, F. Abutiban, Ihsane Hmamouchi, Hussein Halabi, Wafa Hamdi, Lina El Kibbi, Nelly Ziade, and Manal El Rakawi

Subjects
Adult, Male, medicine.medical_specialty, Telemedicine, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Access to care, Logistic regression, Reimbursement Mechanisms, Betacoronavirus, Ambulatory care, Rheumatology, Internal medicine, Surveys and Questionnaires, Pandemic, Ambulatory Care, Medicine, Outpatient clinic, Humans, Practice Patterns, Physicians', Pandemics, Aged, business.industry, SARS-CoV-2, Arab World, COVID-19, General Medicine, Middle Aged, Private sector, Rheumatology practice, Telephone, Hospitalization, Family medicine, Antirheumatic Agents, Income, Female, Original Article, business, Coronavirus Infections, Delivery of Health Care, Rheumatologist, Hydroxychloroquine
Abstract

Objective To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on rheumatology practice. Method A cross-sectional web survey was designed by the members of the Arab League of Associations for Rheumatology (ArLAR), validated by its scientific committee and disseminated through e-mail and social media. It included close-ended questions about the impact of the pandemic on the rheumatology activities, including outpatient visits and hospitalizations (in percentage, 100% corresponds to complete suspension) and open-ended questions about unmet needs. Univariate and multivariable logistic regression analyses were used to evaluate the predictors of impact. Suggestions were developed to improve the practice. Results A total of 858 rheumatologists were included in the analysis (27.3% of registered in ArLAR), 37% were 35–44 years old, 60% were females, and 48% worked in the private sector. The impact of COVID-19 was a decrease of 69% in hospitalizations, 65% in outpatient clinic, 56% in infusion centers, and 43% in income. It was associated with the region (highest in the Gulf), use of telemedicine, impact on income and practice sector (lowest in private). There was a hydroxychloroquine shortage in 47%. Telemedicine was mostly based on traditional telephone contacts and e-mails and reimbursed in 12%. Fifteen rheumatologists (1.8%) were infected and 156 cases of COVID-19 were reported among patients. The top-cited unmet needs in rheumatology practice were access to drugs and a telemedicine platform. Conclusions The negative impact of the COVID-19 pandemic on rheumatology practice may compromise rheumatic diseases control. Better access to drugs and providing telemedicine platforms are recommended to improve the practice.Key Points• The COVID-19 pandemic had a significant negative impact on the rheumatology practice, including access to outpatient clinic, hospitalization, and to anchor drugs.• The compromised access to rheumatology care may jeopardize the control of chronic rheumatic diseases and the long-term prognosis.• Better access to drugs and providing telemedicine platforms are strongly recommended. Electronic supplementary material The online version of this article (10.1007/s10067-020-05428-2) contains supplementary material, which is available to authorized users.

Published
2020
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26. Recommendations for the management of rheumatoid arthritis in the Eastern Mediterranean region:an adolopment of the 2015 American College of Rheumatology guidelines

Author

Andrea Darzi, Elie A. Akl, Basel Masri, Hussein Halabi, Manale Harfouche, Timothy E. McAlindon, Farida Al Balushi, Imad Uthman, Thurayya Arayssi, Jasvinder A. Singh, Raveendhara R. Bannuru, Bassel Elzorkany, Sumeja Zahirovic, Samar Al Emadi, Mira Merashli, Mohamed Nomier, Mohammed Hammoudeh, Humeira Badsha, Robin Christensen, Nelly Ziade, Mohammed A. Omair, Carole Dib, Peter Tugwell, Khalid A. Alnaqbi, Holger J. Schünemann, Nelly Salloum, and Wissam Hazer

Subjects
medicine.medical_specialty, MEDLINE, Antirheumatic Agents/therapeutic use, Guidelines, Recommendations, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, medicine, Humans, Guideline development, 030212 general & internal medicine, Medical prescription, Rheumatoid arthritis, Societies, Medical, 030203 arthritis & rheumatology, Evidence-Based Medicine, business.industry, Mediterranean Region, Evidence-Based Medicine/standards, General Medicine, medicine.disease, Checklist, United States, Management, Eastern mediterranean, Arthritis, Rheumatoid/drug therapy, Antirheumatic Agents, Family medicine, Adoloped, Practice Guidelines as Topic, business, Evidence synthesis
Abstract

Clinical practice guidelines can assist rheumatologists in the proper prescription of newer treatment for rheumatoid arthritis (RA). The objective of this paper is to report on the recommendations for the management of patients with RA in the Eastern Mediterranean region. We adapted the 2015 American College of Rheumatology guidelines in two separate waves. We used the adolopment methodology, and followed the 18 steps of the “Guidelines 2.0” comprehensive checklist for guideline development. For each question, we updated the original guidelines’ evidence synthesis, and we developed an Evidence Profile (EP) and an Evidence to Decision (EtD) table. In the first wave, we adoloped eight out of the 15 original questions on early RA. The strength changed for five of these recommendations from strong to conditional, due to one or more of the following factors: cost, impact on health equities, the balance of benefits, and harms and acceptability. In the second wave, we adoloped eight out of the original 44 questions on established RA. The strength changed for two of these recommendations from strong to conditional, in both cases due to cost, impact on health equities, balance of benefits and harms, and acceptability. The panel also developed a good practice recommendation. We successfully adoloped 16 recommendations for the management of early and established RA in the Eastern Mediterranean region. The process proved feasible and sensitive to contextual factors.

Published
2018
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27. Short-term relationships between emergency hospital admissions for respiratory and cardiovascular diseases and fine particulate air pollution in Beirut, Lebanon

Author

Dominique Salameh, Maher Abboud, Nelly Ziade, Isabella Annesi-Maesano, Wehbeh Farah, Myriam Mrad Nakhlé, Biology Department, Université Saint-Joseph de Beyrouth (USJ), Arcenciel, Environment Program, Beirut, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physics Department, Rheumatology Department, Chemistry Department, and Administateur, HAL Sorbonne Université

Subjects
Adult, Male, Fine particulate, Respiratory Tract Diseases, Air pollution, Management, Monitoring, Policy and Law, medicine.disease_cause, complex mixtures, symbols.namesake, Environmental health, Air Pollution, 11. Sustainability, Medicine, Humans, Poisson regression, Respiratory system, Lebanon, Child, General Environmental Science, Aged, Pollutant, Air Pollutants, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Confounding, Environmental engineering, General Medicine, Environmental Exposure, Models, Theoretical, Pollution, Confidence interval, 3. Good health, Hospitalization, 13. Climate action, Cardiovascular Diseases, Relative risk, symbols, Female, Particulate Matter, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Environmental Monitoring
Abstract

International audience; High levels of major outdoor air pollutants have been documented in Lebanon, but their health effects remain unknown. The Beirut Air Pollution and Health Effects study aimed to determine the relationship between short-term variations in ambient concentrations of particulate matter (PM10 and PM2.5) and emergency hospital admissions in the city of Beirut, and whether susceptible groups are more greatly affected. An autoregressive Poisson model was used to evaluate the association between daily concentrations of particulate matter and respiratory and cardiovascular emergency hospital admissions after controlling for confounders. All variables were measured during 1 year from January 2012 to December 2012. Relative risks of admissions for respiratory and cardiovascular diseases were calculated for an increase in 10 μg.m−3 of pollutant concentrations. Total respiratory admissions were significantly associated with the levels of PM10 (1.012 [95 % CI 1.004–1.02]) per 10 μg.m−3 rise in daily mean pollutant concentration for PM10 and 1.016 [95 % CI 1.000–1.032] for PM2.5 on the same day. With regard to susceptible groups, total respiratory admissions were associated with PM2.5 and PM10 within the same day in children (relative risk (RR), 1.013 and 1.014; 95 % confidence interval, 0.985–1.042 and 1.000–1.029 for PM2.5 and PM10, respectively). Moreover, a nearly significant association was found between particles and total circulatory admissions for adults and elderly groups in the same day. These results are similar to other international studies. Therefore, air pollution control is expected to reduce the number of admissions of these diseases in Lebanon.

Published
2015
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28. Axial Spondyloarthritis: An Evolving Concept

Author

Nelly Ziadé

Subjects
Ankylosing spondylitis (AS), axial spondyloarthritis (AxSpA), classification, concept, non-radiographic axial spondyloarthritis, Pathophysiology, therapeutic strategies, Diseases of the musculoskeletal system, RC925-935
Abstract

Axial spondyloarthritis (AxSpA) is the prototype of a family of inter-related yet heterogeneous diseases sharing common clinical and genetic manifestations: the spondyloarthritides (SpAs). The condition mainly affects the sacroiliac joints and axial skeleton, and has a clear classification scheme, wider epidemiological data, and distinct therapeutic guidelines when compared with other SpAs. However, the concept of AxSpA has not been immutable over time and has evolved tremendously on many levels over the past decades. This review identifies the evolution of the AxSpA concept at two levels. First, at the level of classification, the old classifications and rationales leading to the current Assessment of SpondyloArthritis international Society (ASAS) classification are reviewed, and the advantages and drawbacks are discussed. Second, at the therapeutic level, current and future treatments are described and treatment strategies are discussed.

Published
2015

29. Enhancing the care of women with rheumatic diseases during pregnancy: challenges and unmet needs in the Middle East

Author

Nelly Ziade, B. Khan, H. Al-Osaimi, S. Al-Emadi, F. Abutiban, Aqeel Ghanem, H. Al Rayes, Adeeba Al-Herz, B. El Zorkany, J. Al Saleh, M. Al-Maini, and M. Østensen

Subjects
Counseling, medicine.medical_specialty, Pediatrics, Complications of pregnancy, Alternative medicine, Review Article, Disease, Women’s health, Middle East, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Pregnancy, Rheumatic Diseases, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Disease management (health), 030203 arthritis & rheumatology, Health Services Needs and Demand, Interdisciplinary management, business.industry, Disease Management, Autoimmune rheumatic diseases, General Medicine, Systemic lupus, medicine.disease, Pregnancy Complications, Family planning, Family medicine, Women's Health, Female, Interdisciplinary Communication, Counselling, business
Abstract

Pregnancy in women with rheumatic disorders is known to be associated with risks for both the mother and fetus; however, these risks can be minimized with proper planning and careful management of the disease. In the Middle East, there are specific cultural challenges that may have a negative impact on the care that women with rheumatic disorders receive. There is a need for cross-collaboration between specialist physicians, improved awareness of rheumatic disorders among the general public and more open discussion with patients about the potential complications of pregnancy. Women in the region are often unwilling to discuss their disease with their partner and are even less likely to seek advice regarding family planning from their physician. The objective of this review is to highlight the specific challenges of pregnancy management and to discuss why establishing specialist pregnancy clinics for women with rheumatic disorders could be an effective solution. Such clinics can provide high quality care before, during and after pregnancy as shown in several European and US centers. Additionally, such clinics could be useful for the collection of pregnancy outcomes data from the Middle East, which may currently be lacking in the region, in order to highlight where further improvements can be made. With specialist care and analysis of pregnancy outcomes, the standard of care for women with rheumatic disorders in this area could be significantly improved.

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30. Osteoporosis-Related Mortality: Time-Trends and Predictive Factors

Author

Nelly Ziadé

Subjects
Bone mineral density, fracture, Mortality, mortality indicators, osteoporosis, population, predictive model, Diseases of the musculoskeletal system, RC925-935
Abstract

Osteoporosis is one of the leading causes of handicap worldwide and a major contributor to the global burden of diseases. In particular, osteoporosis is associated with excess mortality. We reviewed the impact of osteoporosis on mortality in a population by defining three categories: mortality following hip fractures, mortality following other sites of fractures, and mortality associated with low bone mineral density (BMD). Hip fractures, as well as other fractures at major sites are all associated with excess mortality, except at the forearm site. This excess mortality is higher during the first 3-6 months after the fracture and then declines over time, but remains higher than the mortality of the normal population up to 22 years after the fracture. Low BMD is also associated with high mortality, with hazard ratios of around 1.3 for every decrease in 1 standard deviation of bone density at 5 years, independently of fractures, reflecting a more fragile population. Finally predictors of mortality were identified and categorised in demographic known factors (age and male gender) and in factors reflecting a poor general health status such as the number of comorbidities, low mental status, or level of social dependence. Our results indicate that the management of a patient with osteoporosis should include a multivariate approach that could be based on predictive models in the future.

Published
2014

31. Global disparities in the treatment of idiopathic inflammatory myopathies: results from an international online survey study

Author

Nelly, Ziade, Marc, Aoude, Ihsane, Hmamouchi, Naveen, R, James, B Lilleker, Parikshit, Sen, Mrudula, Joshi, Vishwesh, Agarwal, Sinan, Kardes, Jessica, Day, Ashima, Makol, Marcin, Milchert, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Elena, Nikiphorou, Tulika, Chatterjee, Ai Lyn Tan, Miguel, A Saavedra, Samuel Katsuyuki Shinjo, Johannes, Knitza, Masataka, Kuwana, Arvind, Nune, Lorenzo, Cavagna, Oliver, Distler, Hector, Chinoy, Vikas, Agarwal, Rohit, Aggarwal, Latika, Gupta, and the COVAD Study Group Authors: Bhupen Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, Rakesh Kumar Pilania, Aman, Sharma, Manesh Manoj, M, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Arunkumar, R Pande, Kunal, Chandwar, Döndü Üsküdar Cansu, John, D Pauling, Chris Wincup Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Lisa, S Traboco, Suryo Anggoro Kusumo Wibowo, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Jesús, Loarce-Martos, Sergio, Prieto-González, Raquel Aranega Gonzalez, Akira, Yoshida, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Stylianos, Tomaras, Margarita Aleksandrovna Gromova, Aharonov, Or, Leonardo Santos Hoff, Margherita, Giannini, François, Maurier, Julien, Campagne, Alain, Meyer, Melinda, Nagy-Vincze, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Océane, Landon-Cardinal, Syahrul Sazliyana Shaharir, Wilmer Gerardo Rojas Zuleta, José António Pereira Silva, João Eurico Fonseca, and Olena, Zimba.

Subjects
equity, inflammatory myopathies, Keywords: Equity, myositis, rheumatic disease, survey, treatment

32. Beirut Air Pollution and Health Effects - BAPHE study protocol and objectives

Author

Marie-Louise Coussa-Koniski, Maher Abboud, Myriam Mrad Nakhlé, Nelly Ziade, Wehbeh Farah, Isabella Annesi-Maesano, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Saint-Joseph de Beyrouth (USJ), Arcenciel, Environment Program, Beirut, Rizk Hospital, and Administateur, HAL Sorbonne Université

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Time series, International studies, Air pollution, 010501 environmental sciences, 030204 cardiovascular system & hematology, medicine.disease_cause, 01 natural sciences, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Health data, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Epidemiology, 11. Sustainability, medicine, 030212 general & internal medicine, Original Research Article, Air quality index, 0105 earth and related environmental sciences, Protocol (science), Public health, business.industry, Suspended particulate matter, 3. Good health, Work (electrical), 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 13. Climate action, Air quality, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Background: Recent studies investigating the health effects of air pollution have proven an existing impact aroundand below international air quality guidelines and standards. These studies were based on accessible data from official registers managed by public authorities. The protocol followed in BAPHE project is described; its benefits and disadvantages are presented and discussed in this paper. Methods: Based on the review of several international studies we developed a custom made approach in BAPHE (Beirut Air Pollution and Health Effects) project in order to analyze the short term health effects of air pollution taking into consideration the lack of data availability from official sources. Results: PM2.5 and PM10 concentrations were measured in Beirut for the period starting from the 1st of January 2012 to the 31st of December 2012. The annual average concentrations of PM10 and PM2.5 exceeded WHO’s annual average limits by 150 % and 200 %, respectively. Health data for 11,567 individuals were collected over 12 months. A variation of hospital admission causes was observed by age categories and gender. Conclusions: This article presents a simple protocol and the descriptive results of its application in the frame of an eco-epidemiological study in Lebanon. We believe that this work is not only important on a local scale, but it could be helpful for environmental epidemiological studies in other countries.

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33. Vaccine hesitancy decreases, long term concerns remain in myositis, rheumatic disease patients: A comparative analysis of the COVAD surveys

Author

Parikshit, Sen, Naveen, R, Nazanin, Houshmand, Siamak Moghadam Kia, Mrudula, Joshi, Sreoshy, Saha, Kshitij, Jagtap, Vishwesh, Agarwal, Arvind, Nune, Elena, Nikiphorou, Ai Lyn Tan, Samuel Katsuyuki Shinjo, Nelly, Ziade, Tsvetelina, Velikova, Marcin, Milchert, Ioannis, Parodis, Abraham Edgar Gracia-Ramos, Lorenzo, Cavagna, Masataka, Kuwana, Johannes, Knitza, Ashima, Makol, Aarat, Patel, John, D Pauling, Chris, Wincup, Bhupen, Barman, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Iris, J Colunga-Pedraza, Javier, Merayo-Chalico, Okwara Celestine Chibuzo, Wanruchada, Katchamart, Phonpen Akawatcharangura Goo, Russka, Shumnalieva, Yi-Ming, Chen, Leonardo Santos Hoff, Lina El Kibbi, Hussein, Halabi, Binit, Vaidya, Syahrul Sazliyana Shaharir, A T, M Tanveer Hasan, Dzifa, Dey, Carlos Enrique Toro Gutiérrez, Carlo Vinicio Caballero-Uribe, James, B Lilleker, Babur, Salim, Tamer, Gheita, Tulika, Chatterjee, Oliver, Distler, Miguel, A Saavedra, Jessica, Day, Hector, Chinoy, COVAD study group, Vikas, Agarwal, Rohit, Aggarwal, Latika Gupta COVAD Study Group Authors: Sinan Kardes, Andreoli, Laura, Lini, Daniele, Karen, Screiber, Melinda, Nagy, Vince, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, Rakesh Kumar Pilania, Aman, Sharma, Manesh Manoj, M, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Arunkumar, R Pande, Kunal, Chandwar, Akanksha, Ghodke, Hiya, Boro, Zoha Zahid Fazal, Döndü Üsküdar Cansu, Reşit, Yıldırım, Armen Yuri Gasparyan, Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, 4 Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Silvia, Grignaschi, Alessandro, Giollo, Alessia, Alluno, Florenzo, Ioannone, Marco, Fornaro, Lisa, S Traboco, Suryo Anggoro Kusumo Wibowo, Jesús, Loarce-Martos, Sergio, Prieto-González, Raquel Aranega Gonzalez, Akira, Yoshida, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Takahisa, Gono, Stylianos, Tomaras, Fabian Nikolai Proft, Marie-Therese, Holzer, Margarita Aleksandrovna Gromova, Aharonov, Or, Zoltán, Griger, Ihsane 11 Hmamouchi, Imane El bouchti, Zineb, Baba, Margherita, Giannini, François, Maurier, Julien, Campagne, Alain, Meyer, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Océane, Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, Álvaro, Arbeláez, Javier, Cajas, José, António, Pereira, Silva, João Eurico Fonseca, Olena, Zimba, Doskaliuk, Bohdana, Uyi, Ima-Edomwonyi, Ibukunoluwa, Dedeke, Emorinken, Airenakho, Nwankwo Henry Madu, Abubakar, Yerima, Hakeem, Olaosebikan, Becky, A., Oruma Devi Koussougbo, Elisa, Palalane, Ho, So, Manuel Francisco Ugarte-Gil, Lyn, Chinchay, José Proaño Bernaola, Victorio, Pimentel, Hanan Mohammed Fathi, Reem, Hamdy, Mohammed, A, Ghita, Harifi, Yurilís, Fuentes-Silva, Karoll, Cabriza, Jonathan, Losanto, Nelly, Colaman, Antonio, Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Raúl, González, Lilith Stange Nunez, Cristian Vergara, M, Jossiell Then Báez, Hugo, Alonzo, Carlos Benito Santiago Pastelin, Rodrigo García Salinas, Alejandro Quiñónez Obiols, Nilmo, Chávez, Andrea Bran Ordóñez, Sandra, Argueta, Gil Alberto Reyes Llerena, Radames, Sierra-Zorita, Dina, Arrieta, Eduardo Romero Hidalgo, Ricardo, Saenz, Idania Escalante, M, Roberto, Morales, Wendy, Calapaqui, Ivonne, Quezada, and Gabriela, Arredondo

Subjects
COVID-19 vaccines, registries, vaccine hesitancy, autoimmune disease, Idiopathic Inflammatory Myopathies

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