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As the clinical course of systemic sclerosis (SSc) varies widely, prognostic indicators have been sought to predict the outcomes of individual patients. Racial differences in SSc render it necessary to validate prognostic indicators in different patient cohorts. In this study, we aimed to assess clinical and laboratory parameters in Japanese patients with early‐stage SSc with diffuse cutaneous involvement and/or interstitial lung disease, and identify predictive factors for disease progression. We performed multivariate analyses of baseline clinical information to estimate symptoms 4 years later in Japanese patients with diffuse cutaneous SSc and/or SSc with interstitial lung disease. Patients were enrolled in the study within 5 years of disease onset at 10 Japanese SSc centers. Over 12 years, 115 patients followed up for 4 years were included in this study. The modified Rodnan skin score (mRSS) at 4 years correlated with the baseline mRSS and finger‐to‐palm distance, defined as the average length from the distal tip of the fourth finger to the distal palmar crease. The percentage predicted vital capacity (%VC) in year 4 positively and negatively correlated with initial %VC and the presence of anti‐topoisomerase I antibodies, respectively. The Health Assessment Questionnaire Disability Index (HAQ‐DI) at 4 years was positively and negatively associated with baseline HAQ‐DI and %VC, respectively. The occurrence of digital ulcers within 4 years was associated with the initial presence of digital ulcers, finger‐to‐palm distance, and the presence of digital pitting scars and anti‐topoisomerase I antibodies. This study identified several factors that may predict the progression of early‐stage SSc in Japanese patients. Finger‐to‐palm distance may be a useful tool for predicting the progression of skin thickening and the development of digital ulcers in the early stages of severe SSc, but larger, long‐term prospective studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the impact of Complementary and Alternative Medicine (CAM) use on functional status and pain relief in patients with Chronic Rheumatic Diseases (CRDs) using the Visual Analogue Pain Scale (VAS) and Health Assessment Questionnaire (HAQ). This cross-sectional multicentre study involved patients from rheumatology outpatient clinics who met the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) criteria for rheumatic disease diagnosis. The exclusion criteria included acute flares or comorbid conditions that could interfere with the outcomes. Data collection included demographic and clinical data, pharmacotherapy, CAM usage, and its impact on the VAS and HAQ scales. The study included 126 patients. A significant proportion (57%) reported CAM use, with a preference for one (67%) or multiple (33%) modalities. CAM users exhibited significantly lower VAS scores, indicating reduced pain perception, and lower HAQ scores, suggesting better functional status than non-users. Correlation analyses highlighted strong positive associations between patient age, disease duration, and CAM use preference, as well as between educational level and specific CAM therapies. CAM use among patients with CRDs is associated with significant improvements in pain perception and functional capacity, as evidenced by lower VAS and HAQ scores. These findings suggest the potential of CAM to complement conventional rheumatology treatments, highlighting its value in patient-centered care and indicating its role in improving patient outcomes. However, the study's cross-sectional design and reliance on self-reported data necessitate further research for causal inferences and robust establishment of CAM efficacy. [ABSTRACT FROM AUTHOR]

Objective. We sought to evaluate the quality and timeliness of patient-reported outcome (PRO) measure reporting, which have not been previously studied. Methods. Clinical trials that informed new US Food and Drug Administration (FDA) approvals for the first rheumatological indication between 1995 and 2021 were identified. Data were recorded to determine whether collected PROs were published, met minimum clinically important difference (MCID) or statistical significance (P < 0.05) thresholds, and were consistent with Consolidated Standards of Reporting Trials (CONSORT)-PRO standards. Hazard ratios and Kaplan-Meier estimate were used to assess the time from FDA approval to PRO publication. Results. Thirty-one FDA approvals corresponded with 110 pivotal trials and 262 reported PROs. Of the 90 included studies, 1 (1.1%) met all 5 recommended items, 10 (11.1%) met 4 items, 17 (18.9%) met 3 items, 21 (23.3%) met 2 items, 26 (28.9%) met 1 item, and 15 (16.7%) met none of the reporting standards. Most PROs met MCID thresholds (149/262; 56.9%) and were statistically significant (223/262; 85.1%). Of our subset analysis, one-third of PROs were not published upfront (70/212; 33%) and 1 of 9 (22/212; 10.4%) remained unpublished = 4 years after initial trial reporting. Publication rates were highest for the Health Assessment Questionnaire-Disability Index (97.4%) and lowest for the 36-item Short Form Health Survey (81.8%). Less than half of these published PROs met MCID and statistical significance thresholds (94/212; 44.3%). Conclusion. One in 9 PROs remained unpublished for = 4 years after initial trial reporting, and compliance with CONSORT-PRO reporting guidelines was poor. Efforts should be made to ensure PROs are adequately reported and expeditiously published. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the impact of Complementary and Alternative Medicine (CAM) use on functional status and pain relief in patients with Chronic Rheumatic Diseases (CRDs) using the Visual Analogue Pain Scale (VAS) and Health Assessment Questionnaire (HAQ). This cross-sectional multicentre study involved patients from rheumatology outpatient clinics who met the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) criteria for rheumatic disease diagnosis. The exclusion criteria included acute flares or comorbid conditions that could interfere with the outcomes. Data collection included demographic and clinical data, pharmacotherapy, CAM usage, and its impact on the VAS and HAQ scales. The study included 126 patients. A significant proportion (57%) reported CAM use, with a preference for one (67%) or multiple (33%) modalities. CAM users exhibited significantly lower VAS scores, indicating reduced pain perception, and lower HAQ scores, suggesting better functional status than non-users. Correlation analyses highlighted strong positive associations between patient age, disease duration, and CAM use preference, as well as between educational level and specific CAM therapies. CAM use among patients with CRDs is associated with significant improvements in pain perception and functional capacity, as evidenced by lower VAS and HAQ scores. These findings suggest the potential of CAM to complement conventional rheumatology treatments, highlighting its value in patient-centered care and indicating its role in improving patient outcomes. However, the study's cross-sectional design and reliance on self-reported data necessitate further research for causal inferences and robust establishment of CAM efficacy. [Med-Science 2024; 13(3.000): 557-63]

Objectives: At our hospital, orthopedic surgeons and physical and occupational therapists have developed bodyweight exercises for the lower and upper extremities (BELU) for rheumatoid arthritis (RA) patients, including walking [Timed Up-and-Go (TUG) test and figure-of-eight walking) and weight exercises. We aimed to clarify the effect of bodyweight exercise and the Health Assessment Questionnaire (HAQ) cut-off value for a TUG test result of 12 s (or longer) as a risk factor for a fall., Methods: All patients underwent BELU twice weekly at home for 6 weeks. We assessed the HAQ score, TUG time, and the strengths of quadriceps femoris, biceps brachii, handgrip, side pinch, and pulp pinch before and after the intervention., Results: We analyzed the data of 42 participants. The mean age was 67.0 ± 12.1 years. The mean Disease Activity Score-28 for rheumatoid arthritis with erythrocyte sedimentation rate was 2.91 ± 0.91. The mean HAQ score was 0.69 ± 0.62. The dominant quadriceps femoris, biceps brachii, pulp pinch, and side pinch strengths were significantly strengthened. TUG time was improved from 9.0 ± 3.0 s to 8.6 ± 3.2 s (P=0.009). The receiver operating characteristic analysis revealed the cut-off value of HAQ for a TUG time of 12 s (or longer) was 1.0 (AUC 0.903, 95% confidence interval 0.792-1.0)., Conclusions: Bodyweight exercises strengthened the muscles in female patients with RA, resulting in improved TUG test results. An indicative HAQ cut-off value of 1.0 (or greater) was identified for a TUG test result of 12 s or longer., Competing Interests: CONFLICTS OF INTEREST: The authors declare no conflict of interest., (2024 The Japanese Association of Rehabilitation Medicine.)