Search

Your search keyword '"Bergstra, Sytske Anne"' showing total 201 results
Start Over Author "Bergstra, Sytske Anne"
201 results on '"Bergstra, Sytske Anne"'

1. Increasing the etanercept dose in a treat-to-target approach in juvenile idiopathic arthritis: does it help to reach the target? A post-hoc analysis of the BeSt for Kids randomised clinical trial

Author

van Dijk, Bastiaan T., Bergstra, Sytske Anne, van den Berg, J. Merlijn, Schonenberg-Meinema, Dieneke, van Suijlekom-Smit, Lisette W.A., van Rossum, Marion A.J., Koopman-Keemink, Yvonne, ten Cate, Rebecca, Allaart, Cornelia F., Brinkman, Daniëlle M.C., and Hissink Muller, Petra C.E.

Published
2024
Full Text
View/download PDF

2. Significant pain decrease in children with non-systemic Juvenile Idiopathic Arthritis treated to target: results over 24 months of follow up

Author

Spekking, Katinka, Anink, Janneke, de Boer, Piroska, Bergstra, Sytske Anne, van den Berg, J. Merlijn, Schonenberg-Meinema, Dieneke, van Suijlekom-Smit, Lisette W. A., van Rossum, Marion A. J., Koopman-Keemink, Yvonne, Cate, Rebecca ten, Allaart, Cornelia F., Brinkman, Daniëlle M. C., and Muller, Petra C. E. Hissink

Published
2023
Full Text
View/download PDF

3. Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies

Author

Lauper, Kim, Mongin, Denis, Bergstra, Sytske Anne, Choquette, Denis, Codreanu, Catalin, Gottenberg, Jacques-Eric, Kubo, Satoshi, Hetland, Merete Lund, Iannone, Florenzo, Kristianslund, Eirik K., Kvien, Tore K., Lukina, Galina, Mariette, Xavier, Nordström, Dan C., Pavelka, Karel, Pombo-Suarez, Manuel, Rotar, Ziga, Santos, Maria J., Tanaka, Yoshiya, Turesson, Carl, Courvoisier, Delphine S., Finckh, Axel, and Gabay, Cem

Published
2024
Full Text
View/download PDF

8. Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept:Results from the international TOCERRA and PANABA observational collaborative studies

Author

Lauper, Kim, Mongin, Denis, Bergstra, Sytske Anne, Choquette, Denis, Codreanu, Catalin, Gottenberg, Jacques Eric, Kubo, Satoshi, Hetland, Merete Lund, Iannone, Florenzo, Kristianslund, Eirik K., Kvien, Tore K., Lukina, Galina, Mariette, Xavier, Nordström, Dan C., Pavelka, Karel, Pombo-Suarez, Manuel, Rotar, Ziga, Santos, Maria J., Tanaka, Yoshiya, Turesson, Carl, Courvoisier, Delphine S., Finckh, Axel, Gabay, Cem, Lauper, Kim, Mongin, Denis, Bergstra, Sytske Anne, Choquette, Denis, Codreanu, Catalin, Gottenberg, Jacques Eric, Kubo, Satoshi, Hetland, Merete Lund, Iannone, Florenzo, Kristianslund, Eirik K., Kvien, Tore K., Lukina, Galina, Mariette, Xavier, Nordström, Dan C., Pavelka, Karel, Pombo-Suarez, Manuel, Rotar, Ziga, Santos, Maria J., Tanaka, Yoshiya, Turesson, Carl, Courvoisier, Delphine S., Finckh, Axel, and Gabay, Cem

Abstract

Objective To evaluate and compare the use of oral glucocorticoids with three classes of bDMARDs in patients with rheumatoid arthritis (RA). Methods We included patients from 13 observational registries treated with a TNF-inhibitor, abatacept or tocilizumab and with available information on the use of oral glucocorticoids. The main outcome was oral glucocorticoid withdrawal. A McNemar test was used to analyse the change in the use of glucocorticoids after 1 year. Kaplan-Meier estimates and Cox regressions, adjusted for patient, treatment, and disease characteristics, were used to evaluate glucocorticoid discontinuation in patients with glucocorticoids at baseline. Because of heterogeneity, analyses were done by registers and pooled using random-effects meta-analysis. Results A total of 12,334 participants treated with TNF-inhibitors, 2100 with tocilizumab and 3229 with abatacept were included. At one-year, oral glucocorticoid use decreased in all treatment groups (odds ratio for stopping vs. starting of 2.19 [95% CI 1.58; 3.04] for TNF-inhibitors, 2.46 [1.39; 4.35] for tocilizumab; 1.73 [1.25; 2.21] for abatacept). Median time to glucocorticoid withdrawal was ≈2 years or more in most countries, with a gradual decrease over time. Compared to TNF-inhibitors, crude hazard ratios of glucocorticoid discontinuation were 0.65[0.48–0.87] for abatacept, and 1.04 [0.76–1.43] for tocilizumab, and adjusted hazard ratios were 1.1 [0.83–1.47] for abatacept, and 1.30 [0.96–1.78] for tocilizumab. Conclusion After initiation of a bDMARD, glucocorticoid use decreased similarly in all treatment groups. However, glucocorticoid withdrawal was much slower than advocated by current international guidelines. More effort should be devoted to glucocorticoid tapering when low disease activity is achieved., Objective: To evaluate and compare the use of oral glucocorticoids with three classes of bDMARDs in patients with rheumatoid arthritis (RA). Methods: We included patients from 13 observational registries treated with a TNF-inhibitor, abatacept or tocilizumab and with available information on the use of oral glucocorticoids. The main outcome was oral glucocorticoid withdrawal. A McNemar test was used to analyse the change in the use of glucocorticoids after 1 year. Kaplan-Meier estimates and Cox regressions, adjusted for patient, treatment, and disease characteristics, were used to evaluate glucocorticoid discontinuation in patients with glucocorticoids at baseline. Because of heterogeneity, analyses were done by registers and pooled using random-effects meta-analysis. Results: A total of 12,334 participants treated with TNF-inhibitors, 2100 with tocilizumab and 3229 with abatacept were included. At one-year, oral glucocorticoid use decreased in all treatment groups (odds ratio for stopping vs. starting of 2.19 [95% CI 1.58; 3.04] for TNF-inhibitors, 2.46 [1.39; 4.35] for tocilizumab; 1.73 [1.25; 2.21] for abatacept). Median time to glucocorticoid withdrawal was ≈2 years or more in most countries, with a gradual decrease over time. Compared to TNF-inhibitors, crude hazard ratios of glucocorticoid discontinuation were 0.65[0.48–0.87] for abatacept, and 1.04 [0.76–1.43] for tocilizumab, and adjusted hazard ratios were 1.1 [0.83–1.47] for abatacept, and 1.30 [0.96–1.78] for tocilizumab. Conclusion: After initiation of a bDMARD, glucocorticoid use decreased similarly in all treatment groups. However, glucocorticoid withdrawal was much slower than advocated by current international guidelines. More effort should be devoted to glucocorticoid tapering when low disease activity is achieved.

Published
2024

9. Evaluation of discontinuation for adverse events of JAK inhibitors and bDMARDs in an international collaboration of rheumatoid arthritis registers (the ‘JAK-pot’ study)

Author

Aymon, Romain, primary, Mongin, Denis, additional, Bergstra, Sytske Anne, additional, Choquette, Denis, additional, Codreanu, Catalin, additional, De Cock, Diederik, additional, Dreyer, Lene, additional, Elkayam, Ori, additional, Huschek, Doreen, additional, Hyrich, Kimme L, additional, Iannone, Florenzo, additional, Inanc, Nevsun, additional, Kearsley-Fleet, Lianne, additional, KOCA, Suleyman Serdar, additional, Kvien, Tore K, additional, Leeb, Burkhard F, additional, Lukina, Galina, additional, Nordström, Dan C, additional, Pavelka, Karel, additional, Pombo-Suarez, Manuel, additional, Rodrigues, Ana, additional, Rotar, Ziga, additional, Strangfeld, Anja, additional, Verschueren, Patrick, additional, Westermann, Rasmus, additional, Zavada, Jakub, additional, Courvoisier, Delphine Sophie, additional, Finckh, Axel, additional, and Lauper, Kim, additional

Published
2023
Full Text
View/download PDF

12. Evaluation of discontinuation for adverse events of JAK inhibitors and bDMARDs in an international collaboration of rheumatoid arthritis registers (the 'JAK-pot' study).

Author

Aymon, Romain, Mongin, Denis, Bergstra, Sytske Anne, Choquette, Denis, Codreanu, Catalin, De Cock, Diederik, Dreyer, Lene, Elkayam, Ori, Huschek, Doreen, Hyrich, Kimme L., Iannone, Florenzo, Inanc, Nevsun, Kearsley-Fleet, Lianne, KOCA, Suleyman Serdar, Kvien, Tore K., Leeb, Burkhard F., Lukina, Galina, Nordström, Dan C., Pavelka, Karel, and Pombo-Suarez, Manuel

Published
2024
Full Text
View/download PDF

14. Initial glucocorticoid bridging in rheumatoid arthritis: does it affect glucocorticoid use over time?

Author

van Ouwerkerk, Lotte, primary, Verschueren, Patrick, additional, Boers, Maarten, additional, Emery, Paul, additional, de Jong, Pascal Hendrik Pieter, additional, Landewé, Robert BM, additional, Lems, Willem, additional, Smolen, Josef S, additional, Huizinga, Tom WJ, additional, Allaart, Cornelia F, additional, and Bergstra, Sytske Anne, additional

Published
2023
Full Text
View/download PDF

18. Patterns of clinical joint inflammation in juvenile idiopathic arthritis

Author

Heckert, Sascha L, primary, Hissink-Muller, Petra C E, additional, van den Berg, J Merlijn, additional, Schonenberg-Meinema, Dieneke, additional, van Suijlekom-Smit, Lisette W A, additional, van Rossum, Marion A J, additional, Koopman, Yvonne, additional, ten Cate, Rebecca, additional, Brinkman, Danielle M C, additional, Huizinga, Tom W J, additional, Allaart, Cornelia F, additional, and Bergstra, Sytske Anne, additional

Published
2023
Full Text
View/download PDF

19. Patterns of clinical joint inflammation in juvenile idiopathic arthritis

Author

Heckert, Sascha L., Hissink-Muller, Petra C.E., van den Berg, J. Merlijn, Schonenberg-Meinema, Dieneke, van Suijlekom-Smit, Lisette W.A., van Rossum, Marion A.J., Koopman, Yvonne, Ten Cate, Rebecca, Brinkman, Danielle M.C., Huizinga, Tom W.J., Allaart, Cornelia F., Bergstra, Sytske Anne, Heckert, Sascha L., Hissink-Muller, Petra C.E., van den Berg, J. Merlijn, Schonenberg-Meinema, Dieneke, van Suijlekom-Smit, Lisette W.A., van Rossum, Marion A.J., Koopman, Yvonne, Ten Cate, Rebecca, Brinkman, Danielle M.C., Huizinga, Tom W.J., Allaart, Cornelia F., and Bergstra, Sytske Anne

Abstract

OBJECTIVES: We studied patterns of joint inflammation in juvenile idiopathic arthritis (JIA) to assess whether joint activity recurs locally in the same joints. METHODS: Joints of 91 patients of the BeSt for Kids study, a treat-to-target trial for children with recent-onset oligoarticular, rheumatoid factor-negative polyarticular and psoriatic JIA, were clinically assessed during 2 years (10 study visits). The association between joint inflammation at baseline and later inflammation in the same joint was assessed using a multilevel mixed-effects logistic regression model at joint level. With a Poisson model, the association between baseline joint inflammation and the number of study visits at which the same joint was recurrently inflamed was tested. RESULTS: Of the 6097 joints studied, 15% (897) was clinically inflamed at baseline. In 42% (377/897) of those joints, inflammation recurred during follow-up. Joint inflammation at baseline was statistically significantly associated with joint inflammation during follow-up in the same joint (OR 3.9, 95% CI 3.5 to 4.4) and specifically with the number of episodes of recurrent joint inflammation (IRR 1.6, 95% CI 1.2 to 2.1). CONCLUSION: In JIA, joint inflammation has the tendency to recur multiple times in joints that are clinically inflamed at disease onset. This indicates that local factors might play a role in the processes contributing to the occurrence of JIA flares.

Published
2023

20. Individual patient data meta-analysis on continued use of glucocorticoids after their initiation as bridging therapy in patients with rheumatoid arthritis

Author

Van Ouwerkerk, Lotte, Boers, Maarten, Emery, Paul, De Jong, Pascal H.P., Landewé, Robert B.M., Lems, Willem, Smolen, Josef S., Verschueren, Patrick, Huizinga, Tom W.J., Allaart, Cornelia F., Bergstra, Sytske Anne, Van Ouwerkerk, Lotte, Boers, Maarten, Emery, Paul, De Jong, Pascal H.P., Landewé, Robert B.M., Lems, Willem, Smolen, Josef S., Verschueren, Patrick, Huizinga, Tom W.J., Allaart, Cornelia F., and Bergstra, Sytske Anne

Abstract

Objectives: To investigate whether patients with rheumatoid arthritis (RA) can discontinue glucocorticoids (GC) after GC bridging' in the initial treatment step and to identify factors that may affect this. Methods: Data from 7 clinical trial arms (with 1653 patients) that included a GC bridging schedule, previously identified in a systematic literature search, were combined in an individual patient data meta-analysis. Outcomes were GC use (yes/no) at predefined time points (1/3/6/12/18 months after bridging had ended), cumulative GC dose and continuous (≥3 months) GC use after bridging had ended. Age, sex, ACPA status, initial GC dose, duration of bridging schedule, oral versus parenteral GC administration and initial co-treatment were univariably tested with each outcome. Results: The probability of using GC 1 month after bridging therapy had ended was 0.18, decreasing to 0.07 from 6 until 18 months after bridging had ended. The probability of continuous GC use after bridging had ended was 0.18 at 1 year and 0.30 at 2 years of follow-up. In oral GC bridging studies only, the probabilities of later and continuous GC use and the cumulative GC doses were higher compared to the combined analyses with also parenteral GC bridging studies included. A higher initial dose and a longer GC bridging schedule were associated with higher cumulative GC doses and more patients on GC at 18 months after bridging had ended. Conclusions: Based on these RA clinical trial arms with an initial GC bridging schedule, the probability of subsequent ongoing GC use following bridging is low.

Published
2023

21. Mouth opening in systemic sclerosis:its course over time, determinants and impact on mouth handicap

Author

Khidir, Sarah J.H., Boonstra, Maaike, Bergstra, Sytske Anne, Boerrigter, Gerry W.M., Voogt-van der Harst, Elles M., Ninaber, Maarten K., Ajmone Marsan, Nina, Huizinga, Tom W.J., van der Helm-van Mil, Annette H.M., de Vries-Bouwstra, Jeska K., Khidir, Sarah J.H., Boonstra, Maaike, Bergstra, Sytske Anne, Boerrigter, Gerry W.M., Voogt-van der Harst, Elles M., Ninaber, Maarten K., Ajmone Marsan, Nina, Huizinga, Tom W.J., van der Helm-van Mil, Annette H.M., and de Vries-Bouwstra, Jeska K.

Abstract

Objective: Decreased maximal mouth opening is a common and disabling manifestation in systemic sclerosis patients. We aimed to study the course of maximal mouth opening, determinants of smaller maximal mouth opening over time and the burden of smaller maximal mouth opening on mouth handicap. Methods: Consecutive systemic sclerosis patients participating in the prospective Leiden Combined Care in systemic sclerosis cohort were included. Annual clinical assessment included maximal mouth opening measurement and mouth handicap evaluation (Mouth Handicap in Systemic Sclerosis scale). Presence of microstomia (maximal mouth opening < 30 mm) was studied. Maximal mouth opening over time was assessed on group level and for all patients individually. Baseline characteristics were analysed for their association with smaller maximal mouth opening over time (linear mixed-effects models). Furthermore, cross-sectional association between maximal mouth opening with Mouth Handicap in Systemic Sclerosis scale was assessed (linear regression analysis). Results: A total of 382 systemic sclerosis patients were studied with median follow-up time of 2.0 years (interquartile range = 0.0–3.0). At baseline, mean maximal mouth opening was 42.2 ± 8.0 mm and 7% suffered from microstomia. Annual decrease of > 5.0 mm in maximal mouth opening during follow-up occurred in 63 patients and was accompanied by increase in disease severity. Disease characteristics at baseline independently predictive for smaller maximal mouth opening over time were: more extended skin subtype; peripheral vasculopathy; pulmonary, renal and gastrointestinal involvement. Smaller maximal mouth opening was significantly associated with more reported mouth handicap. Conclusion: The course of maximal mouth opening is stable in a majority of systemic sclerosis patients. Still, maximal mouth opening over time was smaller in patients with more severe organ involvement. Although microstomia was infrequent, a smaller maxima

Published
2023

23. Frequency of joint inflammation is associated with local joint damage progression in rheumatoid arthritis despite long-term targeted treatment

Author

Heckert, Sascha L, primary, Bergstra, Sytske Anne, additional, Goekoop-Ruiterman, Yvonne P M, additional, Güler-Yüksel, Melek, additional, Lems, Willem F, additional, Matthijssen, Xanthe M E, additional, van Oosterhout, Maikel, additional, Huizinga, Tom W J, additional, and Allaart, Cornelia F, additional

Published
2023
Full Text
View/download PDF

24. Individual patient data meta-analysis on continued use of glucocorticoids after their initiation as bridging therapy in patients with rheumatoid arthritis

Author

van Ouwerkerk, Lotte, primary, Boers, Maarten, additional, Emery, Paul, additional, de Jong, Pascal HP, additional, Landewé, Robert BM, additional, Lems, Willem, additional, Smolen, Josef S, additional, Verschueren, Patrick, additional, Huizinga, Tom WJ, additional, Allaart, Cornelia F, additional, and Bergstra, Sytske Anne, additional

Published
2022
Full Text
View/download PDF

25. Mouth opening in systemic sclerosis: Its course over time, determinants and impact on mouth handicap

Author

Khidir, Sarah JH, primary, Boonstra, Maaike, additional, Bergstra, Sytske Anne, additional, Boerrigter, Gerry WM, additional, Voogt-van der Harst, Elles M, additional, Ninaber, Maarten K, additional, Ajmone Marsan, Nina, additional, Huizinga, Tom WJ, additional, van der Helm-van Mil, Annette HM, additional, and de Vries-Bouwstra, Jeska K, additional

Published
2022
Full Text
View/download PDF

26. Efficacy, duration of use and safety of glucocorticoids: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis

Author

Bergstra, Sytske Anne, primary, Sepriano, Alexandre, additional, Kerschbaumer, Andreas, additional, van der Heijde, Désirée, additional, Caporali, Roberto, additional, Edwards, Christopher John, additional, Verschueren, Patrick, additional, de Souza, Savia, additional, Pope, Janet E, additional, Takeuchi, Tsutomu, additional, Hyrich, Kimme L, additional, Winthrop, Kevin L, additional, Aletaha, Daniel, additional, Stamm, Tanja A, additional, Schoones, Jan W, additional, Smolen, Josef S, additional, and Landewé, Robert B M, additional

Published
2022
Full Text
View/download PDF

27. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis

Author

Sepriano, Alexandre, primary, Kerschbaumer, Andreas, additional, Bergstra, Sytske Anne, additional, Smolen, Josef S, additional, van der Heijde, Désirée, additional, Caporali, Roberto, additional, Edwards, Christopher J, additional, Verschueren, Patrick, additional, de Souza, Savia, additional, Pope, Janet, additional, Takeuchi, Tsutomu, additional, Hyrich, Kimme, additional, Winthrop, Kevin L, additional, Aletaha, Daniel, additional, Stamm, Tanja, additional, Schoones, Jan W, additional, and Landewé, Robert B M, additional

Published
2022
Full Text
View/download PDF

28. Efficacy of synthetic and biological DMARDs: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis

Author

Kerschbaumer, Andreas, primary, Sepriano, Alexandre, additional, Bergstra, Sytske Anne, additional, Smolen, Josef S, additional, van der Heijde, Désirée, additional, Caporali, Roberto, additional, Edwards, Christopher John, additional, Verschueren, Patrick, additional, de Souza, Savia, additional, Pope, Janet E, additional, Takeuchi, Tsutomu, additional, Hyrich, Kimme L, additional, Winthrop, Kevin L, additional, Aletaha, Daniel, additional, Stamm, Tanja A, additional, Schoones, Jan W, additional, and Landewé, Robert B M, additional

Published
2022
Full Text
View/download PDF

29. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update

Author

Smolen, Josef S, primary, Landewé, Robert B M, additional, Bergstra, Sytske Anne, additional, Kerschbaumer, Andreas, additional, Sepriano, Alexandre, additional, Aletaha, Daniel, additional, Caporali, Roberto, additional, Edwards, Christopher John, additional, Hyrich, Kimme L, additional, Pope, Janet E, additional, de Souza, Savia, additional, Stamm, Tanja A, additional, Takeuchi, Tsutomu, additional, Verschueren, Patrick, additional, Winthrop, Kevin L, additional, Balsa, Alejandro, additional, Bathon, Joan M, additional, Buch, Maya H, additional, Burmester, Gerd R, additional, Buttgereit, Frank, additional, Cardiel, Mario Humberto, additional, Chatzidionysiou, Katerina, additional, Codreanu, Catalin, additional, Cutolo, Maurizio, additional, den Broeder, Alfons A, additional, El Aoufy, Khadija, additional, Finckh, Axel, additional, Fonseca, João Eurico, additional, Gottenberg, Jacques-Eric, additional, Haavardsholm, Espen A, additional, Iagnocco, Annamaria, additional, Lauper, Kim, additional, Li, Zhanguo, additional, McInnes, Iain B, additional, Mysler, Eduardo F, additional, Nash, Peter, additional, Poor, Gyula, additional, Ristic, Gorica G, additional, Rivellese, Felice, additional, Rubbert-Roth, Andrea, additional, Schulze-Koops, Hendrik, additional, Stoilov, Nikolay, additional, Strangfeld, Anja, additional, van der Helm-van Mil, Annette, additional, van Duuren, Elsa, additional, Vliet Vlieland, Theodora P M, additional, Westhovens, René, additional, and van der Heijde, Désirée, additional

Published
2022
Full Text
View/download PDF

30. sj-pdf-1-jso-10.1177_23971983231181719 – Supplemental material for The long-term course of the Health Assessment Questionnaire in patients with systemic sclerosis

Author

Liem, Sophie IE, Bergstra, Sytske Anne, Ciaffi, Jacopo, van der Meulen, Coen, Ueckert, David A, Schriemer, Marisca R, Huizinga, Tom WJ, Vliet Vlieland, Theodora PM, and de Vries-Bouwstra, Jeska K

Subjects
110322 Rheumatology and Arthritis, FOS: Clinical medicine
Abstract

Supplemental material, sj-pdf-1-jso-10.1177_23971983231181719 for The long-term course of the Health Assessment Questionnaire in patients with systemic sclerosis by Sophie IE Liem, Sytske Anne Bergstra, Jacopo Ciaffi, Coen van der Meulen, David A Ueckert, Marisca R Schriemer, Tom WJ Huizinga, Theodora PM Vliet Vlieland and Jeska K de Vries-Bouwstra in Journal of Scleroderma and Related Disorders

Published
2023
Full Text
View/download PDF

31. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update

Author

Smolen, Josef S., Landewé, Robert B. M., Bergstra, Sytske Anne, Kerschbaumer, Andreas, Sepriano, Alexandre, Aletaha, Daniel, Caporali, Roberto, Edwards, Christopher John, Hyrich, Kimme L., Pope, Janet E., de Souza, Savia, Stamm, Tanja A., Takeuchi, Tsutomu, Verschueren, Patrick, Winthrop, Kevin L., Balsa, Alejandro, Bathon, Joan M., Buch, Maya H., Burmester, Gerd R., Buttgereit, Frank, Cardiel, Mario Humberto, Chatzidionysiou, Katerina, Codreanu, Catalin, Cutolo, Maurizio, den Broeder, Alfons A., el Aoufy, Khadija, Finckh, Axel, Fonseca, João Eurico, Gottenberg, Jacques-Eric, Haavardsholm, Espen A., Iagnocco, Annamaria, Lauper, Kim, Li, Zhanguo, McInnes, Iain B., Mysler, Eduardo F., Nash, Peter, Poor, Gyula, Ristic, Gorica G., Rivellese, Felice, Rubbert-Roth, Andrea, Schulze-Koops, Hendrik, Stoilov, Nikolay, Strangfeld, Anja, van der Helm-van Mil, Annette, van Duuren, Elsa, Vliet Vlieland, Theodora P. M., Westhovens, René, van der Heijde, D. sirée, Clinical Immunology and Rheumatology, and AII - Inflammatory diseases

Subjects
Arthritis, Rheumatoid, Biological Therapy, All institutes and research themes of the Radboud University Medical Center, Rheumatology, Arthritis, Rheumatoid, Antirheumatic Agents, Immunology, Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5], Immunology and Allergy, General Biochemistry, Genetics and Molecular Biology
Abstract

ObjectivesTo provide an update of the EULAR rheumatoid arthritis (RA) management recommendations addressing the most recent developments in the field.MethodsAn international task force was formed and solicited three systematic literature research activities on safety and efficacy of disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs). The new evidence was discussed in light of the last update from 2019. A predefined voting process was applied to each overarching principle and recommendation. Levels of evidence and strengths of recommendation were assigned to and participants finally voted on the level of agreement with each item.ResultsThe task force agreed on 5 overarching principles and 11 recommendations concerning use of conventional synthetic (cs) DMARDs (methotrexate (MTX), leflunomide, sulfasalazine); GCs; biological (b) DMARDs (tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab including biosimilars), abatacept, rituximab, tocilizumab, sarilumab and targeted synthetic (ts) DMARDs, namely the Janus kinase inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib. Guidance on monotherapy, combination therapy, treatment strategies (treat-to-target) and tapering in sustained clinical remission is provided. Safety aspects, including risk of major cardiovascular events (MACEs) and malignancies, costs and sequencing of b/tsDMARDs were all considered. Initially, MTX plus GCs is recommended and on insufficient response to this therapy within 3–6 months, treatment should be based on stratification according to risk factors; With poor prognostic factors (presence of autoantibodies, high disease activity, early erosions or failure of two csDMARDs), any bDMARD should be added to the csDMARD; after careful consideration of risks of MACEs, malignancies and/or thromboembolic events tsDMARDs may also be considered in this phase. If the first bDMARD (or tsDMARD) fails, any other bDMARD (from another or the same class) or tsDMARD (considering risks) is recommended. With sustained remission, DMARDs may be tapered but should not be stopped. Levels of evidence and levels of agreement were high for most recommendations.ConclusionsThese updated EULAR recommendations provide consensus on RA management including safety, effectiveness and cost.

Published
2023

32. 2022 update

Author

Smolen, Josef S., Landewé, Robert B.M., Bergstra, Sytske Anne, Kerschbaumer, Andreas, Sepriano, Alexandre, Aletaha, Daniel, Caporali, Roberto, Edwards, Christopher John, Hyrich, Kimme L., Pope, Janet E., De Souza, Savia, Stamm, Tanja A., Takeuchi, Tsutomu, Verschueren, Patrick, Winthrop, Kevin L., Balsa, Alejandro, Bathon, Joan M., Buch, Maya H., Burmester, Gerd R., Buttgereit, Frank, Cardiel, Mario Humberto, Chatzidionysiou, Katerina, Codreanu, Catalin, Cutolo, Maurizio, Den Broeder, Alfons A., El Aoufy, Khadija, Finckh, Axel, Fonseca, João Eurico, Gottenberg, Jacques Eric, Haavardsholm, Espen A., Iagnocco, Annamaria, Lauper, Kim, Li, Zhanguo, McInnes, Iain B., Mysler, Eduardo F., Nash, Peter, Poor, Gyula, Ristic, Gorica G., Rivellese, Felice, Rubbert-Roth, Andrea, Schulze-Koops, Hendrik, Stoilov, Nikolay, Strangfeld, Anja, Van Der Helm-Van Mil, Annette, Van Duuren, Elsa, Vliet Vlieland, Theodora P.M., Westhovens, René, Van Der Heijde, Désirée, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Comprehensive Health Research Centre (CHRC) - pólo NMS

Subjects
Arthritis, Rheumatoid, Biological Therapy, Rheumatology, Biochemistry, Genetics and Molecular Biology(all), Antirheumatic Agents, Immunology, Immunology and Allergy
Abstract

Funding Information: This study was funded by European League Against Rheumatism. Publisher Copyright: © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. Objectives: To provide an update of the EULAR rheumatoid arthritis (RA) management recommendations addressing the most recent developments in the field. Methods: An international task force was formed and solicited three systematic literature research activities on safety and efficacy of disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs). The new evidence was discussed in light of the last update from 2019. A predefined voting process was applied to each overarching principle and recommendation. Levels of evidence and strengths of recommendation were assigned to and participants finally voted on the level of agreement with each item. Results: The task force agreed on 5 overarching principles and 11 recommendations concerning use of conventional synthetic (cs) DMARDs (methotrexate (MTX), leflunomide, sulfasalazine); GCs; biological (b) DMARDs (tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab including biosimilars), abatacept, rituximab, tocilizumab, sarilumab and targeted synthetic (ts) DMARDs, namely the Janus kinase inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib. Guidance on monotherapy, combination therapy, treatment strategies (treat-to-target) and tapering in sustained clinical remission is provided. Safety aspects, including risk of major cardiovascular events (MACEs) and malignancies, costs and sequencing of b/tsDMARDs were all considered. Initially, MTX plus GCs is recommended and on insufficient response to this therapy within 3-6 months, treatment should be based on stratification according to risk factors; With poor prognostic factors (presence of autoantibodies, high disease activity, early erosions or failure of two csDMARDs), any bDMARD should be added to the csDMARD; after careful consideration of risks of MACEs, malignancies and/or thromboembolic events tsDMARDs may also be considered in this phase. If the first bDMARD (or tsDMARD) fails, any other bDMARD (from another or the same class) or tsDMARD (considering risks) is recommended. With sustained remission, DMARDs may be tapered but should not be stopped. Levels of evidence and levels of agreement were high for most recommendations. Conclusions: These updated EULAR recommendations provide consensus on RA management including safety, effectiveness and cost. publishersversion published

Published
2022

33. After JAK inhibitor failure: to cycle or to switch, that is the question – data from the JAK-pot collaboration of registries

Author

Pombo-Suarez, Manuel, primary, Sanchez-Piedra, Carlos, additional, Gómez-Reino, Juan, additional, Lauper, Kim, additional, Mongin, Denis, additional, Iannone, Florenzo, additional, Pavelka, Karel, additional, Nordström, Dan C, additional, Inanc, Nevsun, additional, Codreanu, Catalin, additional, Hyrich, Kimme L, additional, Choquette, Denis, additional, Strangfeld, Anja, additional, Leeb, Burkhard F, additional, Rotar, Ziga, additional, Rodrigues, Ana, additional, Kristianslund, Eirik Klami, additional, Kvien, Tore K, additional, Elkayam, Ori, additional, Lukina, Galina, additional, Bergstra, Sytske Anne, additional, Finckh, Axel, additional, and Courvoisier, Delphine Sophie, additional

Published
2022
Full Text
View/download PDF

37. Effectiveness of TNF-inhibitors, abatacept, IL6-inhibitors and JAK-inhibitors in 31 846 patients with rheumatoid arthritis in 19 registers from the ‘JAK-pot’ collaboration

Author

Lauper, Kim, primary, Iudici, Michele, additional, Mongin, Denis, additional, Bergstra, Sytske Anne, additional, Choquette, Denis, additional, Codreanu, Catalin, additional, Cordtz, René, additional, De Cock, Diederik, additional, Dreyer, Lene, additional, Elkayam, Ori, additional, Hauge, Ellen-Margrethe, additional, Huschek, Doreen, additional, Hyrich, Kimme L, additional, Iannone, Florenzo, additional, Inanc, Nevsun, additional, Kearsley-Fleet, Lianne, additional, Kristianslund, Eirik Klami, additional, Kvien, Tore K, additional, Leeb, Burkhard F, additional, Lukina, Galina, additional, Nordström, Dan C, additional, Pavelka, Karel, additional, Pombo-Suarez, Manuel, additional, Rotar, Ziga, additional, Santos, Maria Jose, additional, Strangfeld, Anja, additional, Verschueren, Patrick, additional, Courvoisier, Delphine Sophie, additional, and Finckh, Axel, additional

Published
2022
Full Text
View/download PDF

39. The effect of silver fibre gloves on Raynaud's phenomenon in patients with systemic sclerosis: a double-blind randomized crossover trial.

Author

Liem, Sophie I E, Hoekstra, Eva M, Bonte-Mineur, Femke, Checa, César Magro, Schouffoer, Anne, Allaart, Cornelia F, Huizinga, Tom W J, Bergstra, Sytske Anne, and Vries-Bouwstra, Jeska K de

Subjects
THERMOTHERAPY, RAYNAUD'S disease, RESEARCH, CONFIDENCE intervals, SYSTEMIC scleroderma, TREATMENT effectiveness, RANDOMIZED controlled trials, COMPARATIVE studies, GLOVES, BLIND experiment, QUESTIONNAIRES, DESCRIPTIVE statistics, RESEARCH funding, CROSSOVER trials, ODDS ratio, SILVER, WORLD Wide Web, EVALUATION
Abstract

Objectives Silver fibre gloves transport heat from the palm to the fingers, possibly reducing the burden of RP in SSc patients. We aim to evaluate the clinical efficiency of this intervention. Methods A multicentre, double-blind, randomized trial was performed, accounting for interindividual differences and external factors using a crossover design. Patients were randomized in two groups: group 1 wore 8% silver fibre gloves in period 1 and normal gloves in period 2 and group 2 vice versa. Each period lasted 6 weeks. The primary outcome was the Raynaud Condition Score (RCS) over time (minimal clinical important difference 1.4), assessed three times per week using an online questionnaire. Secondary outcomes included vascular complications and Scleroderma-Health Assessment Questionnaire (SHAQ). Outcomes were evaluated before unblinding using linear mixed models. Results A total of 85 SSc patients were included, with 76 completing the study. The mean RCS during 2 weeks before the study (i.e. without gloves) was 6.4 (s. d. 1.6). Both with silver fibre gloves and normal gloves the mean RCS decreased to 3.9 (s. d. 2.3) with a similar course over time. There was no difference in mean RCS over time between the type of gloves [β = 0.067 (95% CI −0.006, 0.19)]. Of secondary outcomes, total SHAQ [β = 0.036 (95% CI 0.026, 0.046)] was slightly higher with silver fibre gloves, which is clinically irrelevant. Three patients developed new digital ulcers with normal gloves vs one patient with silver fibre gloves [odds ratio 3.2 (95% CI 0.32, 31.1)]. Conclusions Wearing gloves in SSc patients clearly decreases the RP burden. Our results do not support the hypothesis that increased heat transport of 8% silver fibre gloves is associated with less disease burden as measured in this study by the RCS compared with normal gloves. Clinical trial registration number Netherlands Trial register (https://www.trialregister.nl/) NL7904 [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

40. Systematic literature review of observational cohorts and clinical trials into the success rate of glucocorticoid discontinuation after their use as bridging therapy in patients with rheumatoid arthritis

Author

van Ouwerkerk, Lotte, primary, Palmowski, Andriko, additional, Nevins, Isabell S, additional, Buttgereit, Frank, additional, Verschueren, Patrick, additional, Smolen, Josef S, additional, Landewé, Robert BM, additional, Bijlsma, Johannes JW, additional, Kerschbaumer, Andreas, additional, Westhovens, René, additional, Huizinga, Tom WJ, additional, Allaart, Cornelia F, additional, and Bergstra, Sytske Anne, additional

Published
2022
Full Text
View/download PDF

42. EULAR points to consider when analysing and reporting comparative effectiveness research using observational data in rheumatology

Author

Courvoisier, Delphine Sophie, Lauper, Kim, Kedra, Joanna, de Wit, Maarten, Fautrel, Bruno, Frisell, Thomas, Hyrich, Kimme, Iannone, Florenzo, Machado, Pedro, Ørnbjerg, Lykke Midtbøll, Rotar, Ziga, Santos, Maria Jose, Stamm, Tanja, Stones, Simon, Strangfeld, Anja, Bergstra, Sytske Anne, Landewé, Robert, Finckh, Axel, Courvoisier, Delphine, Ørnbjerg, Lykke, Santos, Maria, Bergstra, Sytske, Clinical Immunology and Rheumatology, AII - Inflammatory diseases, Université de Genève = University of Geneva (UNIGE), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), VU University Medical Center [Amsterdam], Service de Rhumatologie [CHU Pitié Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Karolinska Institutet [Stockholm], University of Manchester [Manchester], Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Department of Genetics [Cambridge], University of Cambridge [UK] (CAM), Center for Healthy Aging [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), University of Ljubljana, Hospital Garcia de Orta (EPE), Medizinische Universität Wien = Medical University of Vienna, University of Leeds, Deutsches Rheuma-ForschungsZentrum (DRFZ), Deutsches Rheuma-ForschungsZentrum, Leiden University Medical Center (LUMC), Dpt of Clinical Immunology & Rheumatology [Amsterdam], Amsterdam and Atrium Medical Center, and Gestionnaire, HAL Sorbonne Université 5

Subjects
ddc:616, Comparative Effectiveness Research, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, endocrine system diseases, Epidemiology, Advisory Committees, Immunology, Health care, Reproducibility of Results, Patient reported outcome measures, health care, General Biochemistry, Genetics and Molecular Biology, Outcome assessment, Bias, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatology, patient reported outcome measures, Humans, Immunology and Allergy, epidemiology, outcome assessment
Abstract

BackgroundComparing treatment effectiveness over time in observational settings is hampered by several major threats, among them confounding and attrition bias.ObjectivesTo develop European Alliance of Associations for Rheumatology (EULAR) points to consider (PtC) when analysing and reporting comparative effectiveness research using observational data in rheumatology.MethodsThe PtC were developed using a three-step process according to the EULAR Standard Operating Procedures. Based on a systematic review of methods currently used in comparative effectiveness studies, the PtC were formulated through two in-person meetings of a multidisciplinary task force and a two-round online Delphi, using expert opinion and a simulation study. Finally, feedback from a larger audience was used to refine the PtC. Mean levels of agreement among the task force were calculated.ResultsThree overarching principles and 10 PtC were formulated, addressing, in particular, potential biases relating to attrition or confounding by indication. Building on Strengthening the Reporting of Observational Studies in Epidemiology guidelines, these PtC insist on the definition of the baseline for analysis and treatment effectiveness. They also focus on the reasons for stopping treatment as an important consideration when assessing effectiveness. Finally, the PtC recommend providing key information on missingness patterns.ConclusionTo improve the reliability of an increasing number of real-world comparative effectiveness studies in rheumatology, special attention is required to reduce potential biases. Adherence to clear recommendations for the analysis and reporting of observational comparative effectiveness studies will improve the trustworthiness of their results.

Published
2022

43. sj-pdf-1-jso-10.1177_23971983221138177 – Supplemental material for Mouth opening in systemic sclerosis: its course over time, determinants and impact on mouth handicap

Author

Khidir, Sarah JH, Boonstra, Maaike, Bergstra, Sytske Anne, Boerrigter, Gerry WM, Voogt-van der Harst, Elles M, Ninaber, Maarten K, Ajmone Marsan, Nina, Huizinga, Tom WJ, van der Helm-van Mil, Annette HM, and de Vries-Bouwstra, Jeska K

Subjects
110322 Rheumatology and Arthritis, FOS: Clinical medicine
Abstract

Supplemental material, sj-pdf-1-jso-10.1177_23971983221138177 for Mouth opening in systemic sclerosis: its course over time, determinants and impact on mouth handicap by Sarah JH Khidir, Maaike Boonstra, Sytske Anne Bergstra, Gerry WM Boerrigter, Elles M Voogt-van der Harst, Maarten K Ninaber, Nina Ajmone Marsan, Tom WJ Huizinga, Annette HM van der Helm-van Mil and Jeska K de Vries-Bouwstra in Journal of Scleroderma and Related Disorders

Published
2022
Full Text
View/download PDF

44. Analysing and reporting of observational data: a systematic review informing the EULAR points to consider when analysing and reporting comparative effectiveness research with observational data in rheumatology

Author

Lauper, Kim, primary, Kedra, Joanna, additional, de Wit, Maarten, additional, Fautrel, Bruno, additional, Frisell, Thomas, additional, Hyrich, Kimme L, additional, Iannone, Florenzo, additional, Machado, Pedro M, additional, Ørnbjerg, Lykke M, additional, Rotar, Ziga, additional, Santos, Maria Jose, additional, Stamm, Tanja A, additional, Stones, Simon R, additional, Strangfeld, Anja, additional, Landewé, Robert BM, additional, Finckh, Axel, additional, Bergstra, Sytske Anne, additional, and Courvoisier, Delphine S, additional

Published
2021
Full Text
View/download PDF

45. Efficacy of synthetic and biological DMARDs: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis.

Author

Kerschbaumer, Andreas, Sepriano, Alexandre, Bergstra, Sytske Anne, Smolen, Josef S., van der Heijde, Désirée, Caporali, Roberto, Edwards, Christopher John, Verschueren, Patrick, de Souza, Savia, Pope, Janet E., Takeuchi, Tsutomu, Hyrich, Kimme L., Winthrop, Kevin L., Aletaha, Daniel, Stamm, Tanja A., Schoones, Jan W., and Landewé, Robert B. M.

Abstract

Objectives: To update the evidence on efficacy of DMARDs (disease-modifying antirheumatic drugs) and inform the taskforce of the 2022 update of the European Alliance of Associations for Rheumatology (EULAR) recommendations for management of rheumatoid arthritis (RA).Methods: This systematic literature review (SLR) investigated the efficacy of conventional synthetic (cs), biological (b), biosimilar and targeted synthetic (ts)DMARDs in patients with RA. Medline, EMBASE, Cochrane CENTRAL and Web of Science were used to identify all relevant articles published since the previous update in 2019 to 14 January 2022.Results: Of 8969 search results, 169 articles were selected for detailed review and 47 were finally included. Trials investigated the efficacy of csDMARDs, bDMARDs and tsDMARDs, DMARD switching, tapering and trials investigating different treatment strategies. The compounds investigated were csDMARDs (methotrexate (MTX), leflunomide, sulfasalazine, hydroxychloroquine), bDMARDs (abatacept, adalimumab, certolizumab-pegol, denosumab, etanercept, infliximab, levilimab, olokizumab, opineracept, rituximab, sarilumab, tocilizumab) and tsDMARDs (baricitinib, filgotinib, tofacitinib, upadacitinib). The efficacy of csDMARDs+ short-term glucocorticoids in early RA was confirmed and similar to bDMARD+MTX combination therapy. Interleukin-6 pathway inhibition was effective in trials on olokizumab and levilimab. Janus kinase inhibitor (JAKi) was efficacious in different patient populations. After insufficient response to JAKi, patients could respond to TNFi treatment. Tapering of DMARDs was feasible for a proportion of patients, who were able to taper therapy while remaining in low disease activity or remission.Conclusion: The results of this SLR, together with one SLR on safety of DMARD and one on glucocorticoids, informed the taskforce of the 2022 update of the EULAR recommendations for pharmacological management of RA. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

46. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis.

Author

Sepriano, Alexandre, Kerschbaumer, Andreas, Bergstra, Sytske Anne, Smolen, Josef S., van der Heijde, Désirée, Caporali, Roberto, Edwards, Christopher J., Verschueren, Patrick, de Souza, Savia, Pope, Janet, Takeuchi, Tsutomu, Hyrich, Kimme, Winthrop, Kevin L., Aletaha, Daniel, Stamm, Tanja, Schoones, Jan W., and Landewé, Robert B. M.

Abstract

Objectives: To perform a systematic literature review (SLR) concerning the safety of synthetic(s) and biological (b) disease-modifying antirheumatic drugs (DMARDs) to inform the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis (RA).Methods: SLR of observational studies comparing safety outcomes of any DMARD with another intervention in RA. A comparator group was required for inclusion. For treatments yet without, or limited, registry data, randomised controlled trials (RCTs) were used.Results: Fifty-nine observational studies addressed the safety of DMARDs. Two studies (unclear risk of bias (RoB)) showed an increased risk of serious infections with bDMARDs compared with conventional synthetic (cs)DMARDs. Herpes zoster infections occurred more with JAKi than csDMARDs (adjusted HR (aHR): 3.66) and bDMARDs (aHR: 1.9-2.3) (four studies, two low RoB). The risk of malignancies was similar across bDMARDs (five studies) and with tofacitinib compared with bDMARDs (one study, low RoB). The risk of major adverse cardiovascular events (MACE) was similar with bDMARDs and tofacitinib (two studies, one low RoB). Thirty studies reported safety from RCTs, with one, designed to evaluate safety, showing that malignancies (HR (95% CI): 1.48 (1.04 to 2.09)) and MACE (HR (95% CI): 1.33 (0.91 to 1.94)) occurred numerically more frequently with tofacitinib (5 mg and 10 mg doses combined) than with TNFi in patients with cardiovascular risk factors. In this study, the risk of venous thromboembolism (VTE) was higher with tofacitinib 10 mg than with TNFi.Conclusion: The safety profile of bDMARDs was further demonstrated. Whether the difference in incidence of malignancies, MACE and VTE between tofacitinib and TNFi applies to other JAKi needs further evaluation. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

48. Mouth opening in systemic sclerosis: Its course over time, determinants and impact on mouth handicap

Author

Khidir, Sarah JH, Boonstra, Maaike, Bergstra, Sytske Anne, Boerrigter, Gerry WM, Voogt-van der Harst, Elles M, Ninaber, Maarten K, Ajmone Marsan, Nina, Huizinga, Tom WJ, van der Helm-van Mil, Annette HM, and de Vries-Bouwstra, Jeska K

Abstract

Objective: Decreased maximal mouth opening is a common and disabling manifestation in systemic sclerosis patients. We aimed to study the course of maximal mouth opening, determinants of smaller maximal mouth opening over time and the burden of smaller maximal mouth opening on mouth handicap.Methods: Consecutive systemic sclerosis patients participating in the prospective Leiden Combined Care in systemic sclerosis cohort were included. Annual clinical assessment included maximal mouth opening measurement and mouth handicap evaluation (Mouth Handicap in Systemic Sclerosis scale). Presence of microstomia (maximal mouth opening < 30 mm) was studied. Maximal mouth opening over time was assessed on group level and for all patients individually. Baseline characteristics were analysed for their association with smaller maximal mouth opening over time (linear mixed-effects models). Furthermore, cross-sectional association between maximal mouth opening with Mouth Handicap in Systemic Sclerosis scale was assessed (linear regression analysis).Results: A total of 382 systemic sclerosis patients were studied with median follow-up time of 2.0 years (interquartile range = 0.0–3.0). At baseline, mean maximal mouth opening was 42.2 ± 8.0 mm and 7% suffered from microstomia. Annual decrease of > 5.0 mm in maximal mouth opening during follow-up occurred in 63 patients and was accompanied by increase in disease severity. Disease characteristics at baseline independently predictive for smaller maximal mouth opening over time were: more extended skin subtype; peripheral vasculopathy; pulmonary, renal and gastrointestinal involvement. Smaller maximal mouth opening was significantly associated with more reported mouth handicap.Conclusion: The course of maximal mouth opening is stable in a majority of systemic sclerosis patients. Still, maximal mouth opening over time was smaller in patients with more severe organ involvement. Although microstomia was infrequent, a smaller maximal mouth opening was significantly associated with more mouth handicap, indicating the importance to address maximal mouth opening in routine care of systemic sclerosis patients.

Published
2023
Full Text
View/download PDF

50. The impact of seropositivity on the effectiveness of biologic anti-rheumatic agents:results from a collaboration of 16 registries

Author

Courvoisier, Delphine S., Chatzidionysiou, Katarina, Mongin, Denis, Lauper, Kim, Mariette, Xavier, Morel, Jacques, Gottenberg, Jacques Eric, Bergstra, Sytske Anne, Suarez, Manuel Pombo, Codreanu, Catalin, Kvien, Tore K., Santos, Maria Jose, Pavelka, Karel, Hetland, Merete L., Askling, Johan, Turesson, Carl, Kubo, Satoshi, Tanaka, Yoshiya, Iannone, Florenzo, Choquette, Denis, Nordström, Dan C., Rotar, Ziga, Lukina, Galina, Gabay, Cem, Van Vollenhoven, Ronald, Finckh, Axel, Courvoisier, Delphine S., Chatzidionysiou, Katarina, Mongin, Denis, Lauper, Kim, Mariette, Xavier, Morel, Jacques, Gottenberg, Jacques Eric, Bergstra, Sytske Anne, Suarez, Manuel Pombo, Codreanu, Catalin, Kvien, Tore K., Santos, Maria Jose, Pavelka, Karel, Hetland, Merete L., Askling, Johan, Turesson, Carl, Kubo, Satoshi, Tanaka, Yoshiya, Iannone, Florenzo, Choquette, Denis, Nordström, Dan C., Rotar, Ziga, Lukina, Galina, Gabay, Cem, Van Vollenhoven, Ronald, and Finckh, Axel

Abstract

OBJECTIVES: RF and ACPA are used as diagnostic tools and their presence has been associated with clinical response to some biologic DMARDs (bDMARDs) in RA. This study compared the impact of seropositivity on drug discontinuation and effectiveness of bDMARDs in patients with RA, using head-to-head comparisons in a real-world setting. METHODS: We conducted a pooled analysis of 16 observational RA registries. Inclusion criteria were a diagnosis of RA, initiation of treatment with rituximab (RTX), abatacept (ABA), tocilizumab (TCZ) or TNF inhibitors (TNFis) and available information on RF and/or ACPA status. Drug discontinuation was analysed using Cox regression, including drug, seropositivity, their interaction, adjusting for concomitant and past treatments and patient and disease characteristics and accounting for country and calendar year of bDMARD initiation. Effectiveness was analysed using the Clinical Disease Activity Index evolution over time. RESULTS: Among the 27 583 eligible patients, the association of seropositivity with drug discontinuation differed across bDMARDs (P for interaction <0.001). The adjusted hazard ratios for seropositive compared with seronegative patients were 1.01 (95% CI 0.95, 1.07) for TNFis, 0.89 (0.78, 1.02)] for TCZ, 0.80 (0.72, 0.88) for ABA and 0.70 (0.59, 0.84) for RTX. Adjusted differences in remission and low disease activity rates between seropositive and seronegative patients followed the same pattern, with no difference in TNFis, a small difference in TCZ, a larger difference in ABA and the largest difference in RTX (Lundex remission difference +5.9%, low disease activity difference +11.6%). CONCLUSION: Seropositivity was associated with increased effectiveness of non-TNFi bDMARDs, especially RTX and ABA, but not TNFis.

Published
2021

Catalog

Books, media, physical & digital resources
See catalog results