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Background: Exercise therapy has proven effective for people with rheumatic and musculoskeletal diseases (RMDs), including those with inflammatory arthritis such as rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA) [1-2]. Exercise therapy is generally considered safe for people with RMDs, although the evidence is scarce. A few reviews reported on the nature and risk of harms of exercise therapy in RMDs, but none of them specifically addressed the quality of reporting of harms of exercise therapy in studies including people with inflammatory arthritis. Objectives: This study aimed to describe the quality of reporting of harms in clinical studies on the effectiveness of exercise therapy in people with RA or axSpA. Methods: RCTs with at least one treatment arm consisting of supervised exercise therapy in people with RA or axSpA were included. Eight electronic databases were searched up to November 2021. Two researchers independently selected studies for inclusion and extracted data and in case of disagreement a third researcher was consulted. Data extraction included study characteristics and fulfillment of a set of quality aspects derived from the Consolidated Standards of Reporting Trials (CONSORT) Extension for Reporting Harms Outcomes [3], predefined on the basis of consensus among authors (Table 1). Harms outcomes were defined as adverse events reported on individual level irrespective of causality or negative effects on group level (only if explicitly designated as measurement of potential harm). We considered the reporting on harms outcomes of sufficient quality if the authors reported at least 1) the methodology for active surveillance of harms outcomes (item 2a); and 2) the observed number and the nature of harms (items 3b and 3c). Results: The search yielded 5921 records, of which 64 studies (n= 41 RA, n=23 axSpA; described in 83 papers) were included. Of those studies in RA and axSpA, 34 (83%) and 15 (65%) included any information on harms, with 1

RIVM rapport:Het is niet duidelijk hoe gezond de mond van de inwoners van Nederland is. Om goede beleidskeuzes over mondzorg te kunnen maken, heeft de minister van VWS besloten een monitor Mondgezondheid op te zetten. Het RIVM heeft nu een plan van aanpak gemaakt om de monitor op te zetten. Welke informatie de monitor moet gaan opleveren, de zogeheten indicatoren, is al eerder onderzocht. Voorbeelden zijn het aantal gaatjes dat niet is behandeld, of mensen naar een mondzorgverlener, zoals de tandarts, gaan en of ze tandpijn hebben. Het RIVM beschrijft in het plan van aanpak welke informatie beschikbaar is voor de indicatoren. Hiervoor zijn 25 gesprekken gevoerd met partijen die mogelijk informatie kunnen aanleveren. Ook is gekeken welke informatie nog ontbreekt. Voor een deel van de indicatoren blijkt er alleen informatie te zijn die een keer is verzameld. Een monitor wil juist de ontwikkelingen door de jaren heen laten zien, waardoor er informatie over meerdere jaren nodig is. Het RIVM heeft verder onderscheid gemaakt tussen informatie die beschikbaar is voor de eerste monitor in 2023 en informatie die in de jaren daarna beschikbaar kan worden gemaakt. Ook hebben de geinterviewde partijen benoemd onder welke voorwaarden de informatie kan worden gebruikt. Voor een aantal indicatoren kan een vragenlijstonderzoek waarin mensen zelf hun ervaringen aangeven, informatie leveren. Bijvoorbeeld hoeveel mensen een kunstgebit hebben. Verder kunnen anonieme declaratiegegevens van behandelingen onder andere informatie geven over wie wel en niet naar een mondzorgverlener gaat. Voor bepaalde informatie, bijvoorbeeld over onbehandelde gaatjes en tandvleesontsteking, is mondonderzoek nodig. Dit kan bijvoorbeeld door mensen in een speciale onderzoeksbus te onderzoeken. Naast de invulling van de indicatoren adviseert het RIVM regelmatig een onderwerp verder uit te diepen. Bijvoorbeeld de mondgezondheid van ouderen of van mensen met een lage sociaaleconomische positie., Currently there is little information about the oral health status of people living in the Netherlands. To make sound policy decisions about oral healthcare, the Minister of Health, Welfare and Sport has decided to organise an Oral Health monitor. RIVM has now developed an action plan for this monitor. Research has already been done regarding the information that the monitor should provide, known as the ‘indicators’. Examples include the number of untreated caries cases, whether people visit an oral healthcare provider, like the dentist, and whether they experience toothache. In this action plan, RIVM describes which information is available for the indicators. To this end, it conducted 25 interviews with parties that might be able to provide information. RIVM also investigated which information is still lacking. For some of the indicators, it appears that information was collected once only. Because a monitor is intended to show developments over time, information from several years is needed. In addition, RIVM made a distinction between information that is already available for the first monitor in 2023 and information that can be made available in subsequent years. The interviewed parties also stated the conditions under which the information can be used. For a number of indicators a survey where people report their experiences can provide information. For example how many people have dentures. Furthermore, anonymous data from insurance companies regarding treatments may yield information about who does and does not visit an oral healthcare provider. For certain types of information, such as untreated caries and gingivitis cases, oral examinations are required. These could be obtained by examining people in a special mobile unit. In addition to collecting data for the indicators, RIVM recommends investigating a single topic in greater depth regularly, such as the oral health of the elderly or people with a low socio-economic status.

BACKGROUND: Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. Functional impairment of hands is common. The Scleroderma Patient-centered Intervention Network (SPIN)-HAND trial compared effects of offering access to an online self-guided hand exercise program to usual care on hand function (primary) and functional health outcomes (secondary) in people with SSc with at least mild hand function limitations. METHODS: The pragmatic, two-arm, parallel-group cohort multiple randomized controlled trial was embedded in the SPIN Cohort. Cohort participants with Cochin Hand Function Scale (CHFS) scores ≥ 3 and who indicated interest in using the SPIN-HAND Program were randomized (3:2 ratio) to an offer of program access or to usual care (targeted N = 586). The SPIN-HAND program consists of 4 modules that address (1) thumb flexibility and strength; (2) finger bending; (3) finger extension; and (4) wrist flexibility and strength. The primary outcome analysis compared CHFS scores 3 months post-randomization between participants offered versus not offered the program. Secondary outcomes were CHFS scores 6 months post-randomization and functional health outcomes (Patient-Reported Outcomes Measurement Information System profile version 2.0 domain scores) 3 and 6 months post-randomization. RESULTS: In total, 466 participants were randomized to intervention offer (N = 280) or usual care (N = 186). Of 280 participants offered the intervention, 170 (61%) consented to access the program. Of these, 117 (69%) viewed at least one hand exercise instruction video and 77 (45%) logged into the program website at least 3 times. In intent-to-treat analyses, CHFS scores were 1.2 points lower (95% CI - 2.8 to 0.3) for intervention compared to usual care 3 months post-randomization and 0.1 points lower (95% CI - 1.8 to 1.6 points) 6 months post-randomization. There were no statistically significant differences in other outcomes. CONCLUSION: The offer to use the SP