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1. Recommendations for the treatment of rheumatoid arthritis in Saudi Arabia: adolopment of the 2021 American College of Rheumatology guidelines

Author

Mohammed A. Omair, Hanan Al Rayes, Joanne Khabsa, Sally Yaacoub, Sultana Abdulaziz, Ghada A. Al Janobi, Abdulaziz Al Khalaf, Bader Al Mehmadi, Mahasin Al Nassar, Faisal AlBalawi, Abdullah S. AlFurayj, Ahmed Hamdan Al-Jedai, Haya Mohammed Almalag, Hajer Yousef Almudaiheem, Ali AlRehaily, Mohammed A. Attar, Lina El Kibbi, Hussein Halabi, Manal Hasan, Jasvinder A. Singh, Liana Fraenkel, and Elie A. Akl

Subjects
Adaptation, Adolopment, Contextualization, Rheumatoid arthritis, American College of Rheumatology, Kingdom of Saudi Arabia, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background The 2021 American College of Rheumatology (ACR) rheumatoid arthritis (RA) guideline considers the specific context of the United States which differs from that of Saudi Arabia in many aspects that may impact recommendations. The objective of this project was to adapt a set of prioritized recommendations from the 2021 ACR guideline for the treatment of rheumatoid arthritis RA for the context of Saudi Arabia, by the Saudi Society for Rheumatology (SSR). Methods The process followed the GRADE-ADOLOPMENT methodology, and the reporting adhered to the RIGHT-Ad@pt checklist. Working groups included a coordination group and a 19-member panel representing different stakeholder groups. The Evidence to Decision (EtD) tables included evidence on health effects from the source guideline and contextual information from the Saudi setting. Results The panel prioritized and adapted five recommendations from the source guideline. The process led to modifying two out of the five prioritized recommendations, all listed here. In naive patients with low disease activity, methotrexate (MTX) is conditionally recommended over sulfasalazine (SSZ) (modified direction); hydroxychloroquine (HCQ) is conditionally recommended over SSZ (unmodified). Initiation of csDMARDs with short-term glucocorticoids is conditionally recommended over csDMARDs alone in naive patients with moderate to high disease activity (modified direction). Switch to subcutaneous MTX is conditionally recommended over addition/switch to alternative DMARD(s) in patients taking oral MTX who are not at target (unmodified). Discontinuation of MTX is conditionally recommended over gradual discontinuation of the bDMARD or tsDMARD for patients taking MTX plus a bDMARD or tsDMARD who wish to discontinue a DMARD (unmodified). Conclusion Rheumatologists practicing in Saudi Arabia can use the adoloped recommendations generated by this project while adopting the rest of the recommendations from the 2021 ACR guidelines.

Published
2022
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2. Prolonged COVID-19 symptom duration in people with systemic autoimmune rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Author

Francis Berenbaum, Jasvinder A Singh, Ali Duarte-García, Jinoos Yazdany, Pedro M Machado, Namrata Singh, Deshire Alpizar-Rodriguez, Zachary S Wallace, Eimear Duff, Rebecca Grainger, Tamer A Gheita, Elizabeth R Graef, Jean W Liew, Michael S Putman, Julia F Simard, Emily Sirotich, Carly Harrison, Philip C Robinson, Sebastian E Sattui, Jeffrey A Sparks, Gary Foster, Suleman Bhana, Wendy Costello, Jonathan S Hausmann, Paul Sufka, Richard Conway, Akpabio Akpabio, Michal Nudel, Manuel F Ugarte-Gil, Michael DiIorio, Mitchell Levine, Evelyn Hsieh, Richard A Howard, John Wallace, Inita Bulina, Kevin Kennedy, Tarin T Moni, Aman Dev Singh, Lina El Kibbi, Chieh Lo, David FL Liew, Monique Gore-Massy, Maggie J Larché, More A Kodhek, Nadine Lalonde, Laura-Ann Tomasella, Richard P Beesley, and Eugenia Yupei Chock

Subjects
Medicine
Abstract

Objective We investigated prolonged COVID-19 symptom duration, defined as lasting 28 days or longer, among people with systemic autoimmune rheumatic diseases (SARDs).Methods We analysed data from the COVID-19 Global Rheumatology Alliance Vaccine Survey (2 April 2021–15 October 2021) to identify people with SARDs reporting test-confirmed COVID-19. Participants reported COVID-19 severity and symptom duration, sociodemographics and clinical characteristics. We reported the proportion experiencing prolonged symptom duration and investigated associations with baseline characteristics using logistic regression.Results We identified 441 respondents with SARDs and COVID-19 (mean age 48.2 years, 83.7% female, 39.5% rheumatoid arthritis). The median COVID-19 symptom duration was 15 days (IQR 7, 25). Overall, 107 (24.2%) respondents had prolonged symptom duration (≥28 days); 42/429 (9.8%) reported symptoms lasting ≥90 days. Factors associated with higher odds of prolonged symptom duration included: hospitalisation for COVID-19 vs not hospitalised and mild acute symptoms (age-adjusted OR (aOR) 6.49, 95% CI 3.03 to 14.1), comorbidity count (aOR 1.11 per comorbidity, 95% CI 1.02 to 1.21) and osteoarthritis (aOR 2.11, 95% CI 1.01 to 4.27). COVID-19 onset in 2021 vs June 2020 or earlier was associated with lower odds of prolonged symptom duration (aOR 0.42, 95% CI 0.21 to 0.81).Conclusion Most people with SARDs had complete symptom resolution by day 15 after COVID-19 onset. However, about 1 in 4 experienced COVID-19 symptom duration 28 days or longer; 1 in 10 experienced symptoms 90 days or longer. Future studies are needed to investigate the possible relationships between immunomodulating medications, SARD type/flare, vaccine doses and novel viral variants with prolonged COVID-19 symptoms and other postacute sequelae of COVID-19 among people with SARDs.

Published
2022
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3. 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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4. Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Author

Jasvinder A Singh, Jinoos Yazdany, Namrata Singh, Zachary S Wallace, Bruce Miller, Maggie Larche, Lisa G Rider, Eimear Duff, Rebecca Grainger, Tamer A Gheita, Jean W Liew, Emily Sirotich, Carly Harrison, Philip C Robinson, Kristen J Young, Jeffrey A Sparks, Gary Foster, Suleman Bhana, Wendy Costello, Jonathan S Hausmann, Paul Sufka, Alfred Hyoungju Kim, Akpabio Akpabio, Michal Nudel, Catherine L Hill, Serena Mingolla, Karen L Durrant, Mitchell Levine, Evelyn Hsieh, Richard A Howard, John Wallace, Inita Bulina, Adam Kilian, Sebastian Eduardo Sattui, Kevin Kennedy, Michael Putman, Tarin T Moni, Aman Dev Singh, Lina El Kibbi, David F L Liew, Chieh Lo, and Candace A Palmerlee

Subjects
Medicine
Published
2021
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5. Mixed Cryoglobulinemia in a Patient with Juvenile Idiopathic Arthritis

Author

Fahad Bnatig, Leen Raddaoui, Talal Hijji, and Lina El Kibbi

Subjects
Diseases of the musculoskeletal system, RC925-935
Abstract

Cryoglobulinemia is a rare illness of cryoglobulin accumulation in the blood which can typically present with arthralgia, purpura, skin ulcers, glomerulonephritis, and peripheral neuropathy. It is classified as mixed cryoglobulinemia when cryoglobulins contain more than one immune component such as IgM rheumatoid factor and polyclonal IgG. Typically, it presents in the setting of clonal hematologic disease, viral infection, or certain connective tissue diseases. Herein, we report the case of a 24-year-old man diagnosed and treated as mixed cryoglobulinemia in the setting of juvenile idiopathic arthritis (JIA). Investigations for viral etiologies, including HBV, HCV, and HIV, and all serologic tests were negative. Additionally serum protein and urine protein electrophoresis did not reveal monoclonal gammopathy; however, testing for plasma cryoglobulins was positive, and qualitative analysis revealed a faint polyclonal pattern. Thus, he was diagnosed with cryoglobulinemia in the setting of JIA, which has not been reported in the literature before. He dramatically improved upon initiation of rituximab and methotrexate.

Published
2019
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6. How to optimize recruitment strategies of patients with rheumatic and musculoskeletal diseases for online surveys: experience from an international study

Author

Ihsane Hmamouchi, Antonella Abi Najm, Lina El Kibbi, Mona Metawee, Hussein Halabi, Nizar Abdulateef, Mervat Eissa, Manal El Rakawi, Basel Masri, Fatma Boutaiban, Wafa Hamdi, Asal Adnan, Renaud Felten, Laurent Arnaud, and Nelly Ziadé

Subjects
Rheumatology, Immunology, Immunology and Allergy
Abstract

The use of online surveys as a recruitment tool for clinical research has recently expanded; nevertheless, optimal recruitment strategies remain poorly identified. Objectives. The study aimed to identify the most effective recruitment strategies for online research studies and to determine the optimal survey channels for obtaining patients' responses. This is a post-hoc analysis of the ARCOVAX (ArLAR COVID Vaccination) study. Multiple recruitment strategies were disseminated in Arabic, English, and French. The proportion of enrolled patients was correlated with each strategy. Channels used by patients to complete the survey were divided into three categories (social media (SoMe), doctor, and patients' associations). These channels were correlated with the patients' characteristics and the country's Gross Domestic Product (GDP). A total of 1595 patients from 19 Arab countries completed the survey. Patients' mean age was 39 years, 73.2% (1159) were females, 17.8% (284) had a university education level and 93.1% (1468) answered the survey in Arabic. The most effective recruitment strategies were personalized WhatsApp reminders to recruiters (30% of enrolled patients), technical support in response to access issues (27%) and sharing recruitment status by country on a WhatsApp group (24%). The channels used to complete the survey were: SoMe in 45% (711), doctor in 40% (647), and patients' associations in 8.5% (233), and correlated with age and GDP. To optimize recruitment, it is recommended to combine multiple strategies and channels, use the native language and be active (mobilize teams), reactive (provide prompt technical support), and proactive (share regular updates and reminders).

Published
2022

8. COVID-19 vaccine perceptions and uptake: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Author

Michael Putman, Kevin Kennedy, Emily Sirotich, Jean W Liew, Sebastian E Sattui, Tarin T Moni, Akpabio A Akpabio, Deshire Alpizar-Rodriguez, Saskya Angevare, Richard P Beesley, Francis Berenbaum, Inita Bulina, Yu Pei Eugenia Chock, Richard Conway, Ali Duarte-García, Aman Dev Singh, Eimear Duff, Karen L Durrant, Tamer A Gheita, Catherine L Hill, Richard Howard, Bimba F Hoyer, Evelyn Hsieh, Lina el Kibbi, Adam Kilian, Alfred H J Kim, David F L Liew, Chieh Lo, Elsa F Mateus, Bruce Miller, Serena Mingolla, Michal Nudel, Jasvinder A Singh, Namrata Singh, Manuel F Ugarte-Gil, John Wallace, Kristen J Young, Erick Adrian Zamora-Tehozol, Suleman Bhana, Wendy Costello, Rebecca Grainger, Pedro M Machado, Philip C Robinson, Paul Sufka, Zachary S Wallace, Jinoos Yazdany, Carly Harrison, Maggie J Larché, Mitchell Levine, Gary Foster, Lehana Thabane, Jonathan S Hausmann, Jeffrey A Sparks, and Julia F Simard

Subjects
Rheumatology, Immunology, Immunology and Allergy
Published
2022

11. 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

12. COVID-19 vaccine safety during the antenatal period in women with idiopathic inflammatory myopathies

Author

Andreoli, Laura, Parikshit, Sen, Lini, Daniele, Melinda Nagy Vincze, Karen, Schreiber, COVAD Study Group, Vikas, Agarwal, Rohit, Aggarwal, Latika Gupta The COVAD study group includes: Naveen, R, Mrudula, Joshi, Sreoshy, Saha, Kshitij, Jagtap, Lilleker, James B., Vishwesh, Agarwal, Sinan, Kardes, Jessica, Day, Marcin, Milchert, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Elena, Nikiphorou, Tulika, Chatterjee, Ai Lyn Tan, Lorenzo, Cavagna, Saavedra, Miguel A., Samuel Katsuyuki Shinjo, Nelly, Ziade, Johannes, Knitza, Masataka, Kuwana, Arvind, Nune, Oliver, Distler, Hector, Chinoy, Ashima, Makol, Dzifa, Dey, Carlos Enrique Toro Gutie´rrez, Carlo Vinicio Caballero-Uribe, Bhupen, Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Pandya, Sapan C., Rakesh Kumar Pilania, Aman, Sharma, Manesh, Manoj, Vikas, Gupta, Kavadichanda, Chengappa G., 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, Pande, Arunkumar R., Kunal, Chandwar, Akanksha, Ghodke, Zoha Zahid Fazal, Do¨ndu¨ U¨ sku¨ dar Cansu, Res¸it, Yıldırım, Aarat, Patel, Pauling, John D., Chris, Wincup, Armen Yuri Gasparyan, 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, Alessia, Alluno, Florenzo, Ioannone, Marco, Fornaro, Lisa, S Traboco, Syahrul Sazliyana Shaharir, Suryo Anggoro Kusumo Wibowo, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio Garc ıa-De La Torre, Colunga-Pedrazza, Iris J., Javier Merayo Chalico, Jesu´, s Loarce-Martos, Sergio Prieto-Gonza´ lez, Raquel Aranega Gonzalez, Leonardo Santos Hoff, Akira, Yoshida, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Takahisa, Gono, Stylianos, Tomaras, Fabian Nikolai Proft, Marie-Therese, Holzer, Russka, Shumnalieva, Margarita Aleksandrovna Gromova, Aharonov, Or, Zolta´n, Griger, Ihsane, Hmamouchi, Imane El bouchti, Zineb, Baba, Margherita, Giannini, Franc¸ois, Maurier, Julien, Campagne, Alain, Meyer, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Oce´ane, Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, ´ lvaro Arbela´ez, A, Javier, Cajas, Jose´ Anto´nio Pereira Silva, Jo~ao Eurico Fonseca, Olena, Zimba, Doskaliuk, Bohdana, Uyi, Ima-Edomwonyi, Ibukunoluwa, Dedeke, Emorinken, Airenakho, Nwankwo Henry Madu, Abubakar, Yerima, Hakeem, Olaosebikan, Okwara Celestine Chibuzo, Becky, Adugna, Oruma Devi Koussougbo, Elisa, Palalane, Ho, So, Manuel Francisco Ugarte-Gil, Lyn, Chinchay, Jose´ Proa~no Bernaola, Victorio, Pimentel, Tanveer Hasan, A. T. M., Binit, Vaidya, Hanan Mohammed Fathi, Mohammed, Reem Hamdy A., Yi-Ming, Chen, Ghita, Harifi, Lina El Kibbi, Hussein Mohammed Halabi, Akawatcharangura, P., Wanruchada, Katchamart, Yuril ıs Fuentes-Silva, Karoll, Cabriza, Jonathan, Losanto, Nelly, Colaman, Antonio, Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Rau´, l Gonza´ lez, Lilith Stange Nunez, Cristian Vergara, M, Jossiell Then Ba´ez, Hugo, Alonzo, Carlos Benito Santiago Pastelin, Rodrigo Garc ıa Salinas, Alejandro Qui~no´nez Obiols, Nilmo, Cha´vez, Andrea Bran Ordo´ ~nez, 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
Rheumatology, Pharmacology (medical)
Published
2022

13. Impact of the COVID‐19 pandemic on patients with chronic rheumatic diseases: A study in 15 Arab countries

Author

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

Subjects
Adult, Male, medicine.medical_specialty, Telemedicine, Coronavirus disease 2019 (COVID-19), Isolation (health care), Middle East, 03 medical and health sciences, 0302 clinical medicine, Africa, Northern, Rheumatology, Rheumatic Diseases, Surveys and Questionnaires, Internal medicine, Pandemic, medicine, Humans, 030212 general & internal medicine, Pandemics, 030203 arthritis & rheumatology, Internet, business.industry, COVID-19, Hydroxychloroquine, Continuity of Patient Care, Middle Aged, Mental health, Arabs, Cross-Sectional Studies, Mental Health, Family medicine, Medication Persistence, Female, Rheumatologists, business, Delivery of Health Care, medicine.drug
Abstract

Aim To evaluate the impact of the coronavirus disease 2019 pandemic (COVID-19) on the access to rheumatology care for patients with chronic rheumatic diseases (CRD) in the Arab countries. Method A web-based cross-sectional survey was designed by the Arab Adult Arthritis Awareness group (AAAA) consisting of 16 rheumatologists representing countries from the Arab League of Associations for Rheumatology (ArLAR) and was validated by the ArLAR scientific committee. The survey was disseminated online through social media and patients' association channels between May 8 and May 22, 2020. The steering committee developed recommendations to improve the care of patients with CRD during the COVID-19 pandemic. Results A total of 2163 patients were included in the analysis; 72% were female; mean age was 40 years (SD 11.9). The Levant, the Gulf, and North Africa contributed almost equally to the sample. The pandemic had a significant negative impact on rheumatology visits in 82% of cases, access to hydroxychloroquine (47%), and chronic medication persistency (28%). The negative impact on rheumatology visits was associated with female gender, country, medication non-persistency, isolation due to COVID-19, and impact on mental health. Sixty-one patients (2.8%) stated that they had COVID-19, 5% said that a close contact was infected, and 47% were in isolation because of COVID-19. Conclusion The current study highlights the deleterious consequences of the COVID-19 pandemic on the continuity of rheumatology care. Therefore, an action plan, including establishing a telemedicine platform, securing drug availability, and promoting medication persistence through the appropriate communication channels, is strongly recommended.

Published
2020

14. Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Author

Alfred H.J. Kim, Tamer A. Gheita, Lina El Kibbi, Akpabio Akanimo Akpabio, S. Mingolla, Philip Robinson, Gary Foster, Chieh Lo, Manuel F. Ugarte-Gil, Jean W. Liew, Jinoos Yazdany, Suleman Bhana, Michal Nudel, Christopher Hill, Lehana Thabane, Carly Harrison, Jonathan S. Hausmann, Jasvinder A. Singh, Kristen J. Young, Emily Sirotich, Richard A Howard, Adam Kilian, Tarin Moni, Paul Sufka, Julia F. Simard, Candace A Palmerlee, Bimba F. Hoyer, Pedro Machado, Jeffrey A. Sparks, Bruce Miller, Maggie Larché, Namrata Singh, Aman Dev Singh, Deshire Alpizar-Rodriguez, Eimear Duff, Mitchell Levine, Richard Conway, Evelyn Hsieh, Zachary S. Wallace, Sebastian E. Sattui, Lisa G. Rider, Kevin Kennedy, David F L Liew, Rebecca Grainger, Wendy Costello, Inita Bulina, K. Durrant, Michael S. Putman, John Wallace, Francis Berenbaum, and Medicine

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Aging, COVID-19 Vaccines, Immunology, Population, Clinical Sciences, Infections, Autoimmune Disease, Vaccine Related, Rheumatology, Internal medicine, Rheumatic Diseases, Surveys and Questionnaires, medicine, Immunology and Allergy, Humans, autoimmune diseases, Adverse effect, education, education.field_of_study, business.industry, SARS-CoV-2, Arthritis, Prevention, Inflammatory and immune system, Vaccination, COVID-19, Middle Aged, Vaccine efficacy, medicine.disease, 3.4 Vaccines, Rheumatoid arthritis, 6.1 Pharmaceuticals, Medicine, Chills, Female, Immunization, medicine.symptom, business, Somnolence
Abstract

BackgroundWe describe the early experiences of adults with systemic rheumatic disease who received the COVID-19 vaccine.MethodsFrom 2 April to 30 April 2021, we conducted an online, international survey of adults with systemic rheumatic disease who received COVID-19 vaccination. We collected patient-reported data on clinician communication, beliefs and intent about discontinuing disease-modifying antirheumatic drugs (DMARDs) around the time of vaccination, and patient-reported adverse events after vaccination.ResultsWe analysed 2860 adults with systemic rheumatic diseases who received COVID-19 vaccination (mean age 55.3 years, 86.7% female, 86.3% white). Types of COVID-19 vaccines were Pfizer-BioNTech (53.2%), Oxford/AstraZeneca (22.6%), Moderna (21.3%), Janssen/Johnson & Johnson (1.7%) and others (1.2%). The most common rheumatic disease was rheumatoid arthritis (42.3%), and 81.2% of respondents were on a DMARD. The majority (81.9%) reported communicating with clinicians about vaccination. Most (66.9%) were willing to temporarily discontinue DMARDs to improve vaccine efficacy, although many (44.3%) were concerned about rheumatic disease flares. After vaccination, the most reported patient-reported adverse events were fatigue/somnolence (33.4%), headache (27.7%), muscle/joint pains (22.8%) and fever/chills (19.9%). Rheumatic disease flares that required medication changes occurred in 4.6%.ConclusionAmong adults with systemic rheumatic disease who received COVID-19 vaccination, patient-reported adverse events were typical of those reported in the general population. Most patients were willing to temporarily discontinue DMARDs to improve vaccine efficacy. The relatively low frequency of rheumatic disease flare requiring medications was reassuring.

Published
2021

15. Prolonged COVID-19 symptom duration in people with systemic autoimmune rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Author

Michael DiIorio, Kevin Kennedy, Jean W Liew, Michael S Putman, Emily Sirotich, Sebastian E Sattui, Gary Foster, Carly Harrison, Maggie J Larché, Mitchell Levine, Tarin T Moni, Lehana Thabane, Suleman Bhana, Wendy Costello, Rebecca Grainger, Pedro M Machado, Philip C Robinson, Paul Sufka, Zachary S Wallace, Jinoos Yazdany, Monique Gore-Massy, Richard A Howard, More A Kodhek, Nadine Lalonde, Laura-Ann Tomasella, John Wallace, Akpabio Akpabio, Deshiré Alpízar-Rodríguez, Richard P Beesley, Francis Berenbaum, Inita Bulina, Eugenia Yupei Chock, Richard Conway, Alí Duarte-García, Eimear Duff, Tamer A Gheita, Elizabeth R Graef, Evelyn Hsieh, Lina El Kibbi, David FL Liew, Chieh Lo, Michal Nudel, Aman Dev Singh, Jasvinder A Singh, Namrata Singh, Manuel F Ugarte-Gil, Jonathan S Hausmann, Julia F Simard, and Jeffrey A Sparks

Subjects
Arthritis, Rheumatoid, Male, COVID-19 Vaccines, Rheumatology, Surveys and Questionnaires, Immunology, COVID-19, Humans, Immunology and Allergy, Female, Middle Aged
Abstract

ObjectiveWe investigated prolonged COVID-19 symptom duration, defined as lasting 28 days or longer, among people with systemic autoimmune rheumatic diseases (SARDs).MethodsWe analysed data from the COVID-19 Global Rheumatology Alliance Vaccine Survey (2 April 2021–15 October 2021) to identify people with SARDs reporting test-confirmed COVID-19. Participants reported COVID-19 severity and symptom duration, sociodemographics and clinical characteristics. We reported the proportion experiencing prolonged symptom duration and investigated associations with baseline characteristics using logistic regression.ResultsWe identified 441 respondents with SARDs and COVID-19 (mean age 48.2 years, 83.7% female, 39.5% rheumatoid arthritis). The median COVID-19 symptom duration was 15 days (IQR 7, 25). Overall, 107 (24.2%) respondents had prolonged symptom duration (≥28 days); 42/429 (9.8%) reported symptoms lasting ≥90 days. Factors associated with higher odds of prolonged symptom duration included: hospitalisation for COVID-19 vs not hospitalised and mild acute symptoms (age-adjusted OR (aOR) 6.49, 95% CI 3.03 to 14.1), comorbidity count (aOR 1.11 per comorbidity, 95% CI 1.02 to 1.21) and osteoarthritis (aOR 2.11, 95% CI 1.01 to 4.27). COVID-19 onset in 2021 vs June 2020 or earlier was associated with lower odds of prolonged symptom duration (aOR 0.42, 95% CI 0.21 to 0.81).ConclusionMost people with SARDs had complete symptom resolution by day 15 after COVID-19 onset. However, about 1 in 4 experienced COVID-19 symptom duration 28 days or longer; 1 in 10 experienced symptoms 90 days or longer. Future studies are needed to investigate the possible relationships between immunomodulating medications, SARD type/flare, vaccine doses and novel viral variants with prolonged COVID-19 symptoms and other postacute sequelae of COVID-19 among people with SARDs.

Published
2022

16. 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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17. The impact of the COVID-19 Pandemic on Patients with Chronic Rheumatic Diseases: A Study in 15 Arab Countries

Author

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

Abstract

Aim. To evaluate the impact of the Coronavirus Disease 2019 pandemic (COVID-19) on the access to rheumatology care for patients with chronic rheumatic diseases (CRD) in the Arab countries.Method. A web-based cross-sectional survey was designed by the Arab Adult Arthritis Awareness group (AAAA) consisting of 16 rheumatologists representing countries from the Arab League of Associations for Rheumatology (ArLAR), and was validated by the ArLAR scientific committee. The survey was disseminated through social media and patients' associations' channels between May 8 and May 22, 2020. The steering committee developed recommendations to improve the care of patients with CRD during the COVID-19 pandemic.Results. A total of 2163 patients were included in the analysis; 72% were females; mean age was 40 years (SD 11.9). The Levant, the Gulf, and North Africa contributed almost equally to the sample. The pandemic had a significant negative impact on rheumatology visits in 82% of cases, on access to hydroxychloroquine (47%), and on chronic medication persistency (28%). The negative impact on rheumatology visits was associated with female gender, country, medication non-persistency, isolation due to COVID-19, and impact on mental health. Sixty-one patients (2.8%) stated that they had COVID-19, 5% said that a close contact was infected, and 47% were in isolation because of COVID-19.Conclusion. The current study highlights the deleterious consequences of the COVID-19 pandemic on the continuity of rheumatology care. Therefore, an action plan, including establishing a telemedicine platform, securing drug availability, and promoting medication persistence through the appropriate communication channels, is strongly recommended.

Published
2020

18. 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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