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1. Current smoking is related to severe damage in systemic lupus erythematosus patients.

Author

Cosatti, MA, Muñoz, SA, Tamborenea, MT, García, M, Curti, A, Cappuccio, A, Rillo, O, Imamura, PM, Schneeberger, E, Dal Pra, F, Ballent, M, Cousseau, ML, Velasco Zamora, J, Saurit, V, Toloza, S, Danielsen, MC, Bellomio, VI, Graf, C, Paira, S, and Cavallasca, J

Subjects
SYSTEMIC lupus erythematosus, MULTIPLE regression analysis, EX-smokers, DISEASE duration, SMOKING
Abstract

Objective: To assess the relationship between smoking exposure and organ damage accrual measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for Systemic Lupus Erythematosus score (SLICC-SDI) in consecutive patients with systemic lupus erythematosus (SLE) from Argentina. Methods: 623 consecutive SLE patients (fulfilling ≥4, 1997 ACR criteria) were included in this cross-sectional study. Sociodemographic and disease related variables including SLICC-SDI score and smoking status were collected. Patients currently smoking were considered "smokers", and "non-smokers" those who never smoked and former smokers. SLICC-SDI was divided into two categories: <3 and ≥3 was defined as severe damage. Results: Six hundred and 23 patients were included in the analysis, 89% women. Eighty-four per cent were non-smokers and 16 % were current smokers 83 percent of patients had SLICC-SDI <3 and 17 % had SLICC-SDI ≥3. Twenty one percent of patients with SLICC-SDI ≥3 and 15% with <3 SLICC-SDI were current smokers (p 0.081). In the multiple regression analysis, current smoking (OR 1.82, CI 95% 1.01-3.31, p 0.046), older age (OR 1.04, CI 95% 1.00-1.05, p 0.034), disease duration (OR 1.03, CI 95% 1.00-1.07, p 0.021) and cyclophosphamide exposure (OR 2.97, CI 95% 1.49-5.88, p 0.002) were related to SLICC-SDI ≥3. Conclusion: In our sample of patients, current smoking, older age, disease duration and cyclophosphamide were related to severe damage (SLICC-SDI ≥3). [ABSTRACT FROM AUTHOR]

Published
2025
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2. Sex Differences in Quality of Life in Patients With Systemic Lupus Erythematosus

Author

Jolly, M, Sequeira, W, Block, J, Toloza, S, Bertoli, A, Blazevic, I, Vila, L, Moldovan, I, Torralba, K, Mazzoni, D, Cicognani, E, Hasni, S, Goker, B, Haznedaroglu, S, Bourre-Tessier, J, Navarra, S, Mok, C, Weisman, M, Clarke, A, Wallace, D, Alarcon, G, Jolly M., Sequeira W., Block J. A., Toloza S., Bertoli A., Blazevic I., Vila L. M., Moldovan I., Torralba K. D., Mazzoni D., Cicognani E., Hasni S., Goker B., Haznedaroglu S., Bourre-Tessier J., Navarra S. V., Mok C. C., Weisman M., Clarke A. E., Wallace D., Alarcon G., Jolly, M, Sequeira, W, Block, J, Toloza, S, Bertoli, A, Blazevic, I, Vila, L, Moldovan, I, Torralba, K, Mazzoni, D, Cicognani, E, Hasni, S, Goker, B, Haznedaroglu, S, Bourre-Tessier, J, Navarra, S, Mok, C, Weisman, M, Clarke, A, Wallace, D, Alarcon, G, Jolly M., Sequeira W., Block J. A., Toloza S., Bertoli A., Blazevic I., Vila L. M., Moldovan I., Torralba K. D., Mazzoni D., Cicognani E., Hasni S., Goker B., Haznedaroglu S., Bourre-Tessier J., Navarra S. V., Mok C. C., Weisman M., Clarke A. E., Wallace D., and Alarcon G.

Abstract

Objective: Systemic lupus erythematosus (SLE) predominantly affects women. Clinical phenotype and outcomes in SLE may vary by sex and are further complicated by unique concerns that are dependent upon sex-defined roles. We aimed to describe sex differences in disease-specific quality of life (QoL) assessment scores using the Lupus Patient-Reported Outcome (LupusPRO) tool in a large international study. Methods: Cross-sectional data from 1,803 patients with SLE on demographics, self-identified sex status, LupusPRO, and disease activity were analyzed. The LupusPRO tool has 2 constructs: health-related QoL (HRQoL) and non-HRQoL. Disease activity and damage were evaluated using the Safety of Estrogens in Lupus Erythematosus National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, respectively. Nonparametric tests were used to compare QoL and disease activity by sex. Results: A total of 122 men and 1,681 women with SLE participated. The mean age was similar by sex, but the damage scores were greater among men. Men fared worse on the non-HRQoL social support domain than women (P = 0.02). When comparing disease and QoL among men and women ages ≤45 years, men were found to have greater damage and worse social support than women. However, women fared significantly worse on lupus symptoms, cognition, and procreation domains with trends for worse functioning on physical health and pain-vitality domains. Conclusion: In the largest study of a diverse group of SLE patients, utilizing a disease-specific QoL tool, sex differences in QoL were observed on both HRQoL and non-HRQoL constructs. Although men performed worse in the social support domain, women (especially those in the reproductive age group) fared worse in other domains. These observations may assist physicians in appropriately addressing QoL issues in a sex-focused manner.

Published
2019

3. Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST–RA database

Author

Sokka, T, Kautiainen, H, Pincus, T, Toloza, S, da Rocha Castelar Pinheiro, G, Lazovskis, J, Hetland, M L, Peets, T, Immonen, K, Maillefert, J F, Drosos, A A, Alten, R, Pohl, C, Rojkovich, B, Bresnihan, B, Minnock, P, Cazzato, M, Bombardieri, S, Rexhepi, S, Rexhepi, M, Andersone, D, Stropuviene, S, Huisman, M, Sierakowski, S, Karateev, D, Skakic, V, Naranjo, A, Baecklund, E, Henrohn, D, Gogus, F, Badsha, H, Mofti, A, Taylor, P, McClinton, C, and Yazici, Y

Published
2009
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8. Update of EULAR recommendations for the treatment of systemic sclerosis

Author

Kowal-Bielecka O., Fransen J., Avouac J., Becker M., Kulak A., Allanore Y., Distler O., Clements P., Cutolo M., Czirjak L., Damjanov N., Del Galdo F., Denton C. P., Distler J. H. W., Foeldvari I., Figelstone K., Frerix M., Furst D. E., Guiducci S., Hunzelmann N., Khanna D., Matucci-Cerinic M., Herrick A. L., Van Den Hoogen F., Van Laar J. M., Riemekasten G., Silver R., Smith V., Sulli A., Tarner I., Tyndall A., Welling J., Wigley F., Valentini G., Walker U. A., Zulian F., Muller-Ladner U., Daikeler T., Lanciano E., Becvar R., Tomcik M., Gindzienska-Sieskiewicz E., Cuomo G., Iudici M., Rednic S., Vlachoyiannopoulos P. G., Caporali R., Carreira P. E., Novak S., Minier T., Kucharz E. J., Gabrielli A., Moroncini G., Airo' P., Hesselstrand R., Martinovic D., Radic M., Marasovic-Krstulovic D., Braun-Moscovici Y., Balbir-Gurman A., Lo Monaco A., Caramaschi P., Morovic-Vergles J., Henes J., Ortiz Santamaria V., Heitmann S., Krasowska D., Seidel M. F., Hasler P., Pereira Da Silva J. A., Salvador M. J., Stamenkovic B., Stankovic A., Tikly M., Ananieva L. P., Beretta L., Szucs G., Szamosi S., de la Puente Bujidos C., Midtvedt O., Hoffmann-Vold A. -M., Launay D., Hachulla E., Riccieri V., Ionescu R., Opris D., Mihai C., Herrgott I., Beyer C., Ingegnoli F., von Muhlen C. A., Alegre-Sancho J. J., Beltran-Catalan E., Aringer M., Fantana J., Leuchten N., Tausche A. -K., De Langhe E., Vanthuyne M., Anic B., Baresic M., Mayer M., Uprus M., Otsa K., Yavuz S., Granel B., Azevedo V. F., Muller C., Jimenez S. A., Popa S., Agachi S., Zenone T., Stebbings S., Dockerty J., Vacca A., Schollum J., Veale D. J., Toloza S., Xu D., Olas J., Rosato E., Foti R., Adler S., Dan D., Wiesik-Szewczyk E., Olesinska M., Kayser C., Fathi N., de la Pena Lefebvre P. G., Imbert B., Kowal-Bielecka, O., Fransen, J., Avouac, J., Becker, M., Kulak, A., Allanore, Y., Distler, O., Clements, P., Cutolo, M., Czirjak, L., Damjanov, N., Del Galdo, F., Denton, C. P., Distler, J. H. W., Foeldvari, I., Figelstone, K., Frerix, M., Furst, D. E., Guiducci, S., Hunzelmann, N., Khanna, D., Matucci-Cerinic, M., Herrick, A. L., Van Den Hoogen, F., Van Laar, J. M., Riemekasten, G., Silver, R., Smith, V., Sulli, A., Tarner, I., Tyndall, A., Welling, J., Wigley, F., Valentini, G., Walker, U. A., Zulian, F., Muller-Ladner, U., Daikeler, T., Lanciano, E., Becvar, R., Tomcik, M., Gindzienska-Sieskiewicz, E., Cuomo, G., Iudici, M., Rednic, S., Vlachoyiannopoulos, P. G., Caporali, R., Carreira, P. E., Novak, S., Minier, T., Kucharz, E. J., Gabrielli, A., Moroncini, G., Airo', P., Hesselstrand, R., Martinovic, D., Radic, M., Marasovic-Krstulovic, D., Braun-Moscovici, Y., Balbir-Gurman, A., Lo Monaco, A., Caramaschi, P., Morovic-Vergles, J., Henes, J., Ortiz Santamaria, V., Heitmann, S., Krasowska, D., Seidel, M. F., Hasler, P., Pereira Da Silva, J. A., Salvador, M. J., Stamenkovic, B., Stankovic, A., Tikly, M., Ananieva, L. P., Beretta, L., Szucs, G., Szamosi, S., de la Puente Bujidos, C., Midtvedt, O., Hoffmann-Vold, A. -M., Launay, D., Hachulla, E., Riccieri, V., Ionescu, R., Opris, D., Mihai, C., Herrgott, I., Beyer, C., Ingegnoli, F., von Muhlen, C. A., Alegre-Sancho, J. J., Beltran-Catalan, E., Aringer, M., Fantana, J., Leuchten, N., Tausche, A. -K., De Langhe, E., Vanthuyne, M., Anic, B., Baresic, M., Mayer, M., Uprus, M., Otsa, K., Yavuz, S., Granel, B., Azevedo, V. F., Muller, C., Jimenez, S. A., Popa, S., Agachi, S., Zenone, T., Stebbings, S., Dockerty, J., Vacca, A., Schollum, J., Veale, D. J., Toloza, S., Xu, D., Olas, J., Rosato, E., Foti, R., Adler, S., Dan, D., Wiesik-Szewczyk, E., Olesinska, M., Kayser, C., Fathi, N., de la Pena Lefebvre, P. G., Imbert, B., UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (MGD) Service de rhumatologie, Kowal Bielecka, Otylia, Fransen, Jaap, Avouac, Jerome, Becker, Mike, Kulak, Agnieszka, Allanore, Yannick, Distler, Oliver, Clements, Philip, Cutolo, Maurizio, Czirjak, Laszlo, Damjanov, Nemanja, del Galdo, Francesco, Denton, Christopher P., Distler, Jörg H. W., Foeldvari, Ivan, Figelstone, Kim, Frerix, Marc, Furst, Daniel E., Guiducci, Serena, Hunzelmann, Nicola, Khanna, Dinesh, Matucci Cerinic, Marco, Herrick, Ariane L., van den Hoogen, Frank, van Laar, Jacob M., Riemekasten, Gabriela, Silver, Richard, Smith, Vanessa, Sulli, Alberto, Tarner, Ingo, Tyndall, Alan, Welling, Joep, Wigley, Frederic, Valentini, Gabriele, Walker, Ulrich A., Zulian, Francesco, Müller Ladner, Ulf, Daikeler, Thoma, Lanciano, Elisabetta, Becvã¡r, Radim, Tomcik, Michal, Gindzienska Sieskiewicz, Ewa, Iudici, Michele, Rednic, Simona, Vlachoyiannopoulos, Panayiotis G., Caporali, Roberto, Carreira, Patricia E., Novak, Srdan, Minier, Tã¼nde, Kucharz, Eugene J., Gabrielli, Armando, Moroncini, Gianluca, Airo, Paolo, Hesselstrand, Roger, Martinovic, Duska, Radic, Mislav, Marasovic Krstulovic, Daniela, Braun Moscovici, Yolanda, Monaco, Andrea Lo, Morovic Vergles, Jadranka, Culo, Melanie I., Henes, Jã¶rg, Santamaria, Vera Ortiz, Heitmann, Stefan, Krasowska, Dorota, Michalska Jakubus, Malgorzata, Seidel, Matthias F., Klinik III, Medizinische, Hasler, Paul, Da Silva, José A. Pereira, Salvador, Maria J., Stamenkovic, Bojana, Stankovic, Aleksandra, Tikly, Mohammed, Ananieva, Lidia P., Beretta, Lorenzo, Szucs, Gabriella, Szamosi, Szilvia, de la Puente Bujidos, Carlo, Midtvedt, Øyvind, Hoffmann Vold, Anna Maria, Launay, David, Hachulla, Eric, Riccieri, Valeria, Ionescu, Ruxandra, Opris, Daniela, Mihai, Carina, Herrgott, Ilka, Beyer, Christian, Ingegnoli, Francesca, von Mühlen, Carlos Alberto, Alegre Sancho, Juan José, Beltran Catalan, Emma, Aringer, Martin, Fantana, Julia, Leuchten, Nicolai, Tausche, Anne Kathrin, Langhe, Ellen De, Vanthuyne, Marie, Anic, Branimir, Bareå¡ic, Marko, Mayer, Miroslav, Ãœprus, Maria, Otsa, Kati, Yavuz, Sule, Granel, Brigitte, Jimenez, Sergio A., Popa, Serghei, Agachi, Svetlana, Zenone, Thierry, Stebbings, Simon, Dockerty, Joanne, Vacca, Alessandra, Schollum, Joanna, Veale, Douglas J., Toloza, Sergio, Xu, Dong, Olas, Jacek, Rosato, Edoardo, Foti, Rosario, Adler, Sabine, Dan, Diana, Wiesik Szewczyk, Ewa, Olesinska, Marzena, Kayser, Cristiane, Fathi, Nihal, de la Peña Lefebvre, Paloma García, Imbert, Bernard, and Cuomo, Giovanna

Subjects
Endothelin Receptor Antagonists, Lung Diseases, Kidney Disease, Delphi Technique, Gastrointestinal Diseases, systemic sclerosis, Scleroderma Renal Crisis, Placebo-controlled study, Angiotensin-Converting Enzyme Inhibitors, Lung Disease, Scleroderma, 0302 clinical medicine, Glucocorticoid, Phosphodiesterase 5 Inhibitor, Immunology and Allergy, skin and connective tissue diseases, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, integumentary system, treatment, genetics and molecular biology (all), Hematopoietic Stem Cell Transplantation, cyclophosphamide, methotrexate, Pulmonary, Orvostudományok, Serotonin Uptake Inhibitor, 3. Good health, Europe, Systematic review, Hypertension, Serotonin Uptake Inhibitors, Cyclophosphamide, Methotrexate, Systemic Sclerosis, Treatment, Fingers, Fluoxetine, Glucocorticoids, Humans, Hypertension, Pulmonary, Kidney Diseases, Phosphodiesterase 5 Inhibitors, Prostaglandins I, Pyrazoles, Pyrimidines, Raynaud Disease, Rheumatology, Scleroderma, Systemic, Ulcer, Immunology, Biochemistry, Genetics and Molecular Biology (all), 030211 gastroenterology & hepatology, Endothelin Receptor Antagonist, Selective Serotonin Reuptake Inhibitors, medicine.drug, Human, medicine.medical_specialty, Gastrointestinal Disease, Klinikai orvostudományok, Riociguat, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, medicine, Finger, biochemistry, Intensive care medicine, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, Systemic Sclerosi, 030203 arthritis & rheumatology, business.industry, Systemic, Angiotensin-Converting Enzyme Inhibitor, medicine.disease, Transplantation, Clinical research, Pyrimidine, immunology and allergy, rheumatology, immunology, Pyrazole, Physical therapy, business, Rheumatism
Abstract

The aim was to update the 2009 European League against Rheumatism (EULAR) recommendations for the treatment of systemic sclerosis (SSc), with attention to new therapeutic questions. Update of the previous treatment recommendations was performed according to EULAR standard operating procedures. The task force consisted of 32 SSc clinical experts from Europe and the USA, 2 patients nominated by the pan-European patient association for SSc (Federation of European Scleroderma Associations (FESCA)), a clinical epidemiologist and 2 research fellows. All centres from the EULAR Scleroderma Trials and Research group were invited to submit and select clinical questions concerning SSc treatment using a Delphi approach. Accordingly, 46 clinical questions addressing 26 different interventions were selected for systematic literature review. The new recommendations were based on the available evidence and developed in a consensus meeting with clinical experts and patients. The procedure resulted in 16 recommendations being developed (instead of 14 in 2009) that address treatment of several SSc-related organ complications: Raynaud's phenomenon (RP), digital ulcers (DUs), pulmonary arterial hypertension (PAH), skin and lung disease, scleroderma renal crisis and gastrointestinal involvement. Compared with the 2009 recommendations, the 2016 recommendations include phosphodiesterase type 5 (PDE-5) inhibitors for the treatment of SSc-related RP and DUs, riociguat, new aspects for endothelin receptor antagonists, prostacyclin analogues and PDE-5 inhibitors for SSc-related PAH. New recommendations regarding the use of fluoxetine for SSc-related RP and haematopoietic stem cell transplantation for selected patients with rapidly progressive SSc were also added. In addition, several comments regarding other treatments addressed in clinical questions and suggestions for the SSc research agenda were formulated. These updated data-derived and consensus-derived recommendations will help rheumatologists to manage patients with SSc in an evidence-based way. These recommendations also give directions for future clinical research in SSc.

Published
2017
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9. Assessment of disease activity in large-vessel vasculitis: Results of an international delphi exercise

Author

Aydin, S. Z., Direskeneli, H., Merkel, P. A., Toloza, S., Blockmans, D., Sato, E. I., De Souza, A. W. S., Cabral, D., Carette, S., Famorca, L., Khalidi, N., Milman, N., Yacyshyn, E., Tesar, V., Baslund, B., Faurschou, M., Guillevin, L., Puechal, X., Aries, P., Hellmich, B., Herlyn, K., Holle, J., Lamprecht, P., Moosig, F., Neumann, T., Zwerina, J., Tomasson, G., Bambery, P., Jois, R., Rajasekhar, L., Sharma, A., Sivakumar, R., Molloy, E., Hashkes, P., Catapano, F., Cimino, L., De Fanti, A., Pipitone, N., Salvarani, C., Vaglio, A., Kobayashi, S., Suzuki, K., Flores-Suarez, L. F., Hinojosa-Azaola, A., Brouwer, E., Rutgers, A., Stegeman, C., Suppiah, R., Hollan, I., Arguis, P., Cid, M. C., Daikeler, T., Alibaz-Oner, F., Hamuryudan, V., Hatemi, G., Hazirolan, T., Inanc, M., Kalayci, M. B., Kamali, S., Kansu, T., Karaaslan, Y., Karadag, O., Keser, G., Onat, A. M., Ozbalkan, Z., Ozen, S., Ozer, H. T. E., Pamuk, O. N., Yilmaz, S. G., Basu, N., Casian, A., Chakravarty, K., D'Cruz, D., Edelsten, C., Harper, L., Jayne, D., Levy, J., Mason, J., Robson, J., Scott, D., Stanford, M., Watts, R., Albert, D., Amudala, N., Beckman, J., Chacko, B., Chung, S., Fessler, B., Giardino, A., Grayson, P., Hunder, G., Langford, C., Lerman, M., Liang, K., Litt, H., Mason, T., Matteson, E., Mikdashi, J., Mohler, E., Monach, P., Rice, B., Sreih, A., Stone, J., Tsapatsaris, N., Villa-Forte, A., Warrington, K., Yazici, Y., Ytterberg, S., Çukurova Üniversitesi, Aydin, S.Z., Direskeneli, H., Merkel, P.A., Toloza, S., Blockmans, D., Sato, E.I., De Souza, A.W.S., and Yeditepe Üniversitesi

Subjects
Vasculitis, medicine.medical_specialty, Delphi Technique, Immunology, Delphi method, Outcomes, Severity of Illness Index, Article, Disease activity, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Large vessel vasculitis, Severity of illness, medicine, Large vessel, Humans, Immunology and Allergy, 030212 general & internal medicine, computer.programming_language, Giant cell arteritis, 030203 arthritis & rheumatology, Takayasu arteritis, business.industry, medicine.disease, Clinical trial, Physical therapy, business, computer, Delphi
Abstract

PubMedID: 28864648 Objective. To arrive at consensus for candidate outcomes for disease activity assessment in largevessel vasculitis (LVV) in clinical trials. Methods.A Delphi survey including 99 items was circulated among international experts for 3 rounds. Results. Fifty-seven items were accepted for both giant cell arteritis and Takayasu arteritis. Sixty-seven percent of experts voted to have a common approach for both diseases with additional disease-specific items such as weight loss, scalp tenderness/necrosis, morning stiffness, dizziness, visual symptoms, and imaging. Conclusion. This study highlights similarities and differences in experts' perspectives for assessing clinical activity in LVV and may guide a consensus-driven core set of validated outcomes. Copyright © 2017. All rights reserved. National Institute of Arthritis and Musculoskeletal and Skin Diseases: U01 AR51874 04, U54 AR057319 National Center for Research Resources: U54 RR019497 Sponsored by the Vasculitis Clinical Research Consortium, which has received support from the US National Institute of Arthritis and Musculoskeletal and Skin Diseases (U54 AR057319 and U01 AR51874 04), the National Center for Research Resources (U54 RR019497), and the Office of Rare Diseases Research. Additional support for the work of the OMERACT Vasculitis Working Group was received through a Patient-Centered Outcomes Research Institute Pilot Project Grant. S.Z. Aydin, MD, Associate Professor, Division of Rheumatology, The Ottawa Hospital Research Institute, University of Ottawa; H. Direskeneli, MD, Professor of Rheumatology, Division of Rheumatology, Marmara University Faculty of Medicine; P.A. Merkel, MD, MPH, Professor of Medicine and Epidemiology, Division of Rheumatology, and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania. Address correspondence to Dr. P.A. Merkel, Section of Rheumatology, University of Pennsylvania, White Building, 5th Floor Penn, 3400 Spruce St., Philadelphia, Pennsylvania 19104, USA. E-mail: pmerkel@upenn.edu Accepted for publication June 3, 2017.

Published
2017

10. Drivers of Satisfaction With Care for Patients With Lupus

Author

Jolly, M, Sethi, B, O'Brien, C, Sequeira, W, Block, J, Toloza, S, Bertoli, A, Blazevic, I, Vilá, L, Moldovan, I, Torralba, K, Cicognani, E, Mazzoni, D, Hasni, S, Goker, B, Haznedaroglu, S, Bourre‐tessier, J, Navarra, S, Mok, C, Clarke, A, Weisman, M, Wallace, D, Jolly, Meenakshi, Sethi, Bhavika, O'Brien, Courtney, Sequeira, Winston, Block, Joel A., Toloza, Sergio, Bertoli, Ana, Blazevic, Ivana, Vilá, Luis M., Moldovan, Ioana, Torralba, Karina D., Cicognani, Elvira, Mazzoni, Davide, Hasni, Sarfaraz, Goker, Berna, Haznedaroglu, Seminur, Bourre‐Tessier, Josiane, Navarra, Sandra V., Mok, Chi Chiu, Clarke, Ann, Weisman, Michael, Wallace, Daniel, Jolly, M, Sethi, B, O'Brien, C, Sequeira, W, Block, J, Toloza, S, Bertoli, A, Blazevic, I, Vilá, L, Moldovan, I, Torralba, K, Cicognani, E, Mazzoni, D, Hasni, S, Goker, B, Haznedaroglu, S, Bourre‐tessier, J, Navarra, S, Mok, C, Clarke, A, Weisman, M, Wallace, D, Jolly, Meenakshi, Sethi, Bhavika, O'Brien, Courtney, Sequeira, Winston, Block, Joel A., Toloza, Sergio, Bertoli, Ana, Blazevic, Ivana, Vilá, Luis M., Moldovan, Ioana, Torralba, Karina D., Cicognani, Elvira, Mazzoni, Davide, Hasni, Sarfaraz, Goker, Berna, Haznedaroglu, Seminur, Bourre‐Tessier, Josiane, Navarra, Sandra V., Mok, Chi Chiu, Clarke, Ann, Weisman, Michael, and Wallace, Daniel

Abstract

Objective: Quality of life (QOL) and quality of care (QOC) in systemic lupus erythematosus (SLE) remains poor. Satisfaction with care (SC), a QOC surrogate, correlates with health behaviors and outcomes. This study aimed to determine correlates of SC in SLE. Methods: A total of 1262 patients with SLE were recruited from various countries. Demographics, disease activity (modified Systemic Lupus Erythematosus Disease Activity Index for the Safety of Estrogens in Lupus Erythematosus: National Assessment trial [SELENA-SLEDAI]), and QOL (LupusPRO version 1.7) were collected. SC was collected using LupusPRO version 1.7. Regression analyses were conducted using demographic, disease (duration, disease activity, damage, and medications), geographic (eg, China vs United States), and QOL factors as independent predictors. Results: The mean (SD) age was 41.7 (13.5) years; 93% of patients were women. On the univariate analysis, age, ethnicity, current steroid use, disease activity, and QOL (social support, coping) were associated with SC. On the multivariate analysis, Asian participants had worse SC, whereas African American and Hispanic patients had better SC. Greater disease activity, better coping, and social support remained independent correlates of better SC. Compared with US patients, patients from China and Canada had worse SC on the univariate analysis. In the multivariate models, Asian ethnicity remained independently associated with worse SC, even after we adjusted for geographic background (China). No associations between African American or Hispanic ethnicity and SC were retained when geographic location (Canada) was added to the multivariate model. Canadian patients had worse SC when compared with US patients. Higher disease activity, better social support, and coping remained associated with better SC. Conclusion: Greater social support, coping, and, paradoxically, SLE disease activity are associated with better SC. Social support and coping are modifiable factors

Published
2019

11. Update of EULAR recommendations for the treatment of systemic sclerosis

Author

Kowal-Bielecka, O. Fransen, J. Avouac, J. Becker, M. Kulak, A. Allanore, Y. Distler, O. Clements, P. Cutolo, M. Czirjak, L. Damjanov, N. Del Galdo, F. Denton, C.P. Distler, J.H.W. Foeldvari, I. Figelstone, K. Frerix, M. Furst, D.E. Guiducci, S. Hunzelmann, N. Khanna, D. Matucci-Cerinic, M. Herrick, A.L. Van Den Hoogen, F. Van Laar, J.M. Riemekasten, G. Silver, R. Smith, V. Sulli, A. Tarner, I. Tyndall, A. Welling, J. Wigley, F. Valentini, G. Walker, U.A. Zulian, F. Müller-Ladner, U. EUSTAR Coauthors Daikeler, T. Lanciano, E. Becvár, R. Tomcik, M. Gińdzieńska-Sieskiewicz, E. Cuomo, G. Iudici, M. Rednic, S. Vlachoyiannopoulos, P.G. Caporali, R. Carreira, P.E. Novak, S. Minier, T. Kucharz, E.J. Gabrielli, A. Moroncini, G. Airo', P. Hesselstrand, R. Martinovic, D. Radic, M. Marasovic-Krstulovic, D. Braun-Moscovici, Y. Balbir-Gurman, A. Lo Monaco, A. Caramaschi, P. Morovic-Vergles, J. Henes, J. Ortiz Santamaria, V. Heitmann, S. Krasowska, D. Seidel, M.F. Hasler, P. Pereira Da Silva, J.A. Salvador, M.J. Stamenkovic, B. Stankovic, A. Tikly, M. Ananieva, L.P. Beretta, L. Szucs, G. Szamosi, S. de la Puente Bujidos, C. Midtvedt, Ø. Hoffmann-Vold, A.-M. Launay, D. Hachulla, E. Riccieri, V. Ionescu, R. Opris, D. Mihai, C. Herrgott, I. Beyer, C. Ingegnoli, F. von Mühlen, C.A. Alegre-Sancho, J.J. Beltrán-Catalán, E. Aringer, M. Fantana, J. Leuchten, N. Tausche, A.-K. De Langhe, E. Vanthuyne, M. Anic, B. Barešic, M. Mayer, M. Üprus, M. Otsa, K. Yavuz, S. Granel, B. Azevedo, V.F. Muller, C. Jimenez, S.A. Popa, S. Agachi, S. Zenone, T. Stebbings, S. Dockerty, J. Vacca, A. Schollum, J. Veale, D.J. Toloza, S. Xu, D. Olas, J. Rosato, E. Foti, R. Adler, S. Dan, D. Wiesik-Szewczyk, E. Olesińska, M. Kayser, C. Fathi, N. de la Peña Lefebvre, P.G. Imbert, B.

Subjects
integumentary system, skin and connective tissue diseases
Abstract

The aim was to update the 2009 European League against Rheumatism (EULAR) recommendations for the treatment of systemic sclerosis (SSc), with attention to new therapeutic questions. Update of the previous treatment recommendations was performed according to EULAR standard operating procedures. The task force consisted of 32 SSc clinical experts from Europe and the USA, 2 patients nominated by the pan-European patient association for SSc (Federation of European Scleroderma Associations (FESCA)), a clinical epidemiologist and 2 research fellows. All centres from the EULAR Scleroderma Trials and Research group were invited to submit and select clinical questions concerning SSc treatment using a Delphi approach. Accordingly, 46 clinical questions addressing 26 different interventions were selected for systematic literature review. The new recommendations were based on the available evidence and developed in a consensus meeting with clinical experts and patients. The procedure resulted in 16 recommendations being developed (instead of 14 in 2009) that address treatment of several SSc-related organ complications: Raynaud's phenomenon (RP), digital ulcers (DUs), pulmonary arterial hypertension (PAH), skin and lung disease, scleroderma renal crisis and gastrointestinal involvement. Compared with the 2009 recommendations, the 2016 recommendations include phosphodiesterase type 5 (PDE-5) inhibitors for the treatment of SSc-related RP and DUs, riociguat, new aspects for endothelin receptor antagonists, prostacyclin analogues and PDE-5 inhibitors for SSc-related PAH. New recommendations regarding the use of fluoxetine for SSc-related RP and haematopoietic stem cell transplantation for selected patients with rapidly progressive SSc were also added. In addition, several comments regarding other treatments addressed in clinical questions and suggestions for the SSc research agenda were formulated. These updated data-derived and consensus-derived recommendations will help rheumatologists to manage patients with SSc in an evidence-based way. These recommendations also give directions for future clinical research in SSc. © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Published
2017

13. Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis: results from the EULAR Scleroderma Trial and Research Group (EUSTAR) database

Author

Avouac, Jerome, Walker, Ulrich, Tyndall, Alan, Kahan, André, Matucci Cerinic, Marco, Allanore, Yannick, Miniati, I., Müller, A., Iannone, F., Giacomelli, R., Distler, O., Becvar, R., Sierakowsky, S., Kowal Bielecka, O., Coelho, P., Cabane, J., Cutolo, M., Shoenfeld, Y., Rovensky, J., Riemekasten, G., Nicoara, I., Vlachoyiannopoulos, P., Caporali, R., Jiri, S., Inanc, M., Gorska, I. Zimmermann, Carreira, P., Novak, S., Czirjak, L., Ramos, F. Oliveira, Jendro, M., Chizzolini, C., Kucharz, E. J., Richter, J., Cozzi, F., Rozman, B., Mallia, C. M., Gabrielli, A., Farge, D., Kiener, H. P., Schöffel, D., Sticherling, M., Airo, P., Wollheim, F., Martinovic, D., Trotta, F., Hunzelmann, N., Jablonska, S., Reich, K., Bombardieri, S., Siakka, P., Pellerito, R., Bambara, L. M., Morovic Vergles, J., Denton, C., Hinrichs, R., Van Den Hoogen, F., Damjanov, N., Kötter, I., Ortiz, V., Heitmann, S., Krasowska, D., Seidel, M., Hasler, P., Van Laar, J. M., Kaltwasser, J. P., Foeldvari, I., Juan Mas, A., Bajocchi, G., Wislowska, M., Pereira Da Silva, J. A., Jacobsen, S., Worm, M., Graniger, W., Kuhn, A., Stankovic, A., Cossutta, R., Majdan, M., Rajcevska, L. Damjanovska, Tikly, M., Nasonov, E. L., Steinbrink, K., Herrick, A., Müller Ladner, U., Dinc, A., Scorza, R., Sondergaard, K., Indiveri, F., Nielsen, H., Szekanecz, Z., Silver, R. M., Antivalle, M., Espinosa, I. B., García De La Pena Lefebvre, P., Midtvedt, O., Launay, D., Valesini, F., Tuvik, P., Ionescu, R. M., Del Papa, N., Pinto, S., Wigley, F., Mihai, C., Capranu, M. Sinziana, Sunderkötter, C., Jun, J. B., Derk, C., Alhasani, S., Distler, J. H., Ton, E., Soukup, T., Seibold, J., Zeni, S., Nash, P., Mouthon, L., De Keyser, F., Duruöz, M. T., Cantatore, F. P., Strauss, G., Von Mülhen, C. A., Pozzi, M. R., Eyerich, K., Szechinski, J., Keiserman, M., Houssiau, F. A., Rom Ivorra, J. A., Krummel Lorenz, B., Aringer, M., Westhovens, R., Bellisai, F., Mayer, M., Stoeckl, F., Üprus, M., Volpe, A., Buslau, M., Yavuz, S., Granel, B., Feijó, A. Valderílio, Del Galdo, F., Popa, S., Zenone, T., Machado, X. Ricardo, Pileckyte, M., Stebbings, S., Mathieu, A., Tulli, A., Tourinho, T., Souza, R., Acayaba De Toledo, R., Stamp, L., Solanki, K., Veale, D., Neto, J. Francisco Marques, Bagnato, G. F., Loyo, E., Toloza, S., Li, M., Mohamed, W. Ahmed Abdel Atty, Cobankara, V., Olas, J., Salsano, F., Oksel, F., Tanaseanu, C. M., Foti, R., Ancuta, C., Vonk, M., Caramashi, P., Beretta, L., Balbir, A., Shine, B., Chiàla, A., Simic, K. Pasalic, Ghio, M., Stamenkovic, B., Rednic, S., Host, N., Hachulla, E., Furst, D. E., VALENTINI, Gabriele, Avouac, Jerome, Walker, Ulrich, Tyndall, Alan, Kahan, André, Matucci Cerinic, Marco, Allanore, Yannick, Miniati, I., Müller, A., Iannone, F., Giacomelli, R., Distler, O., Becvar, R., Sierakowsky, S., Kowal Bielecka, O., Coelho, P., Cabane, J., Cutolo, M., Shoenfeld, Y., Valentini, Gabriele, Rovensky, J., Riemekasten, G., Nicoara, I., Vlachoyiannopoulos, P., Caporali, R., Jiri, S., Inanc, M., Gorska, I. Zimmermann, Carreira, P., Novak, S., Czirjak, L., Ramos, F. Oliveira, Jendro, M., Chizzolini, C., Kucharz, E. J., Richter, J., Cozzi, F., Rozman, B., Mallia, C. M., Gabrielli, A., Farge, D., Kiener, H. P., Schöffel, D., Sticherling, M., Airo, P., Wollheim, F., Martinovic, D., Trotta, F., Hunzelmann, N., Jablonska, S., Reich, K., Bombardieri, S., Siakka, P., Pellerito, R., Bambara, L. M., Morovic Vergles, J., Denton, C., Hinrichs, R., Van Den Hoogen, F., Damjanov, N., Kötter, I., Ortiz, V., Heitmann, S., Krasowska, D., Seidel, M., Hasler, P., Van Laar, J. M., Kaltwasser, J. P., Foeldvari, I., Juan Mas, A., Bajocchi, G., Wislowska, M., Pereira Da Silva, J. A., Jacobsen, S., Worm, M., Graniger, W., Kuhn, A., Stankovic, A., Cossutta, R., Majdan, M., Rajcevska, L. Damjanovska, Tikly, M., Nasonov, E. L., Steinbrink, K., Herrick, A., Müller Ladner, U., Dinc, A., Scorza, R., Sondergaard, K., Indiveri, F., Nielsen, H., Szekanecz, Z., Silver, R. M., Antivalle, M., Espinosa, I. B., García De La Pena Lefebvre, P., Midtvedt, O., Launay, D., Valesini, F., Tuvik, P., Ionescu, R. M., Del Papa, N., Pinto, S., Wigley, F., Mihai, C., Capranu, M. Sinziana, Sunderkötter, C., Jun, J. B., Derk, C., Alhasani, S., Distler, J. H., Ton, E., Soukup, T., Seibold, J., Zeni, S., Nash, P., Mouthon, L., De Keyser, F., Duruöz, M. T., Cantatore, F. P., Strauss, G., Von Mülhen, C. A., Pozzi, M. R., Eyerich, K., Szechinski, J., Keiserman, M., Houssiau, F. A., Rom Ivorra, J. A., Krummel Lorenz, B., Aringer, M., Westhovens, R., Bellisai, F., Mayer, M., Stoeckl, F., Üprus, M., Volpe, A., Buslau, M., Yavuz, S., Granel, B., Feijó, A. Valderílio, Del Galdo, F., Popa, S., Zenone, T., Machado, X. Ricardo, Pileckyte, M., Stebbings, S., Mathieu, A., Tulli, A., Tourinho, T., Souza, R., Acayaba De Toledo, R., Stamp, L., Solanki, K., Veale, D., Neto, J. Francisco Marque, Bagnato, G. F., Loyo, E., Toloza, S., Li, M., Mohamed, W. Ahmed Abdel Atty, Cobankara, V., Olas, J., Salsano, F., Oksel, F., Tanaseanu, C. M., Foti, R., Ancuta, C., Vonk, M., Caramashi, P., Beretta, L., Balbir, A., Shine, B., Chiàla, A., Simic, K. Pasalic, Ghio, M., Stamenkovic, B., Rednic, S., Host, N., Hachulla, E., Furst, D. E., Chizzolini, Carlo, and Westhovens, Rene

Subjects
Male, Systemic disease, Databases, Factual, Cross-sectional study, Joint Diseases/etiology/pathology/physiopathology, Systemic inflammation, Joint involvement, Scleroderma, systemic sclrosis, systemic inflemmetion, joint involvement, Tendons, Systemic sclerosi, Scleroderma, Localized, 0302 clinical medicine, data base, Immunopathology, joint radiography, Immunology and Allergy, Joints/pathology, scleroderma, 030212 general & internal medicine, nuclear magnetic resonance imaging, Range of Motion, Articular, skin and connective tissue diseases, rheumatic disease, ddc:616, interstitial lung disease, Joint contracture, Clinical Trials as Topic, Synovitis, Inflammation/etiology/pathology/physiopathology, integumentary system, article, Tendons/pathology, Middle Aged, musculoskeletal system, cohort analysis, Connective tissue disease, priority journal, Joint, Synoviti, Systemic sclerosis, Female, medicine.symptom, Joint Diseases, Human, musculoskeletal diseases, Adult, medicine.medical_specialty, hand radiography, Immunology, Scleroderma, Localized/etiology/*pathology, Auto-immunity, transplantation and immunotherapy [N4i 4], 03 medical and health sciences, SYSTEMIC SCLEROSIS, JOINT INVOLVEMENT, SYNOVITIS, JOINT CONTRACTURE, TENDON FRICTION RUB, Tendon friction rub, Rheumatology, Internal medicine, medicine, Humans, Health care ethics [NCEBP 5], Tendon, Aged, 030203 arthritis & rheumatology, Cross-Sectional Studie, Inflammation, skin disease, Scleroderma, Systemic, business.industry, echography, medicine.disease, major clinical study, tenosynovitis, Synovitis/etiology/pathology, clinical feature, body regions, Cross-Sectional Studies, Evaluation of complex medical interventions [NCEBP 2], Scleroderma, Systemic/complications/pathology/physiopathology, Joints, disease duration, business, Joint Disease, disease activity
Abstract

Objective.To determine the prevalence of and independent factors associated with joint involvement in a large population of patients with systemic sclerosis (SSc).Methods.This study was cross-sectional, based on data collected on patients included in the European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) registry. We queried this database to extract data regarding global evaluation of patients with SSc and the presence of any clinical articular involvement: synovitis (tender and swollen joints), tendon friction rubs (rubbing sensation detected as the tendon was moved), and joint contracture (stiffness of the joints that decreased their range of motion). Overall joint involvement was defined by the occurrence of synovitis and/or joint contracture and/or tendon friction rubs.Results.We recruited 7286 patients with SSc; their mean age was 56 ± 14 years, disease duration 10 ± 9 years, and 4210 (58%) had a limited cutaneous disease subset. Frequencies of synovitis, tendon friction rubs, and joint contractures were 16%, 11%, and 31%, respectively. Synovitis, tendon friction rubs, and joint contracture were more prevalent in patients with the diffuse cutaneous subset and were associated together and with severe vascular, muscular, renal, and interstitial lung involvement. Moreover, synovitis had the highest strength of association with elevated acute-phase reactants taken as the dependent variable.Conclusion.Our results highlight the striking level of articular involvement in SSc, as evaluated by systematic examination in a large cohort of patients with SSc. Our data also show that synovitis, joint contracture, and tendon friction rubs are associated with a more severe disease and with systemic inflammation.

Published
2010
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14. DISEASE SPECIFIC QUALITY OF LIFE IN PATIENTS WITH LUPUS NEPHRITIS

Author

Kaya, A., Clarke, A., Toloza, S., Blazevic, I., Jolly, M., Bertoli, A., Alarcon, G., Weisman, M., Vila, L., Mok, C. C., Navarra, S., Bourre-Tessier, J., Haznedaroglu, S., Moldovan, I., Tezcan, M., Torralba, K., Wallace, D., and Goker, B.

Published
2014

15. Characteristics of joint involvement and relationship with systemic inflammation in systemic sclerosis: result from the EULAR scleroderma trial and research (EUSTAR) database

Author

Avouac, J, Walker, U, Tyndall, A, Kahan, A, Matucci Cerinic, M, Allanore, Y, Eustar, Miniati, I, Muller, A, Iannone, F, Distler, O, Becvar, R, Sierakowsky, S, Kowal Bielecka, O, Coelho, P, Cabane, J, Cutolo, M, Shoenfeld, Y, Valentini, G, Rovensky, J, Riemekasten, G, Vlachoyiannopoulos, P, Caporali, R, Jiri, S, Inanc, M, Zimmermann Gorska, I, Carreira, P, Novak, S, Czirjak, L, Oliveira Ramos, F, Jendro, M, Chizzolini, C, Kucharz, Ej, Richter, J, Cozzi, F, Rozman, B, Mallia, Cm, Gabrielli, A, Farge, D, Kiener, Hp, Schöffel, D, Airo, P, Wollheim, F, Martinovic, D, Trotta, F, Jablonska, S, Reich, K, Bombardieri, S, Siakka, P, Pellerito, R, Bambara, Lm, Morovic Vergles, J, Denton, C, Hinrichs, R, Van den Hoogen, F, Damjanov, N, Kötter, I, Ortiz, V, Heitmann, S, Krasowska, D, Seidel, M, Hasler, P, Van Laar JM, Kaltwasser, Jp, Foeldvari, I, Juan Mas, A, Bajocchi, G, Wislowska, M, Pereira Da Silva JA, Jacobsen, S, Worm, M, Graniger, W, Kuhn, A, Stankovic, A, Cossutta, R, Majdan, M, Damjanovska Rajcevska, L, Tikly, M, Nasonov, El, Steinbrink, K, Herrick, A, Müller Ladner, U, Dinc, A, Scorza, R, Sondergaard, K, Indiveri, F, Nielsen, H, Szekanecz, Z, Silver, Rm, Antivalle, M, Espinosa, Ib, García de la Pena Lefebvre, P, Midtvedt, O, Launay, D, Valesini, F, Tuvik, P, Ionescu, Rm, Del Papa, N, Pinto, S, Wigley, F, Mihai, C, Sinziana Capranu, M, Sunderkötter, C, Jun, Jb, Alhasani, S, Distler, Jh, Ton, E, Soukup, T, Seibold, J, Zeni, S, Nash, P, Mouthon, L, De Keyser, F, Duruöz, Mt, Cantatore, Fp, Strauss, G, von Mülhen CA, Pozzi, Mr, Eyerich, K, Szechinski, J, Keiserman, M, Houssiau, Fa, Román Ivorra JA, Krummel Lorenz, B, Aringer, M, Westhovens, R, Bellisai, F, Mayer, M, Stoeckl, F, Uprus, M, Volpe, A, Buslau, M, Yavuz, S, Granel, B, Valderílio Feijó, A, Del Galdo, F, Popa, S, Zenone, T, Ricardo Machado, X, Pileckyte, M, Stebbings, S, Mathieu, A, Tulli, A, Tourinho, T, Souza, R, Acayaba de Toledo, R, Stamp, L, Solanki, K, Veale, D, Francisco Marques Neto, J, Bagnato, Gf, Loyo, E, Toloza, S, Li, M, Ahmed Abdel Atty Mohamed, W, Cobankara, V, Olas, J, Salsano, F, Oksel, F, Tanaseanu, Cm, Foti, R, Ancuta, C, Vonk, M, Caramaschi, Paola, Beretta, L, Balbir, A, Chiàla, A, Pasalic Simic, K, Ghio, M, Stamenkovic, B, Rednic, S, Host, N, Hachulla, E, and Furst, D. E.

Subjects
joint involvement, Systemic sclerosis, synovitis
Published
2010

16. Work disability remains a major problem in rheumatoid arthritis in the 2000s: data from 32 countries in the QUEST-RA study

Author

Sokka, T, Kautiainen, H, Pincus, T, Verstappen, Sm, Aggarwal, A, Alten, R, Andersone, D, Badsha, H, Baecklund, E, Belmonte, M, CRAIG MÜLLER, J, DA MOTA LM, Dimic, A, Fathi, Na, Ferraccioli, G, Fukuda, W, Géher, P, Gogus, F, HAJJAJ HASSOUNI, N, Hamoud, H, Haugeberg, G, Henrohn, D, HORSLEV PETERSEN, K, Ionescu, R, Karateew, D, Kuuse, R, Laurindo, Im, Lazovskis, J, Luukkainen, R, Mofti, A, Murphy, E, Nakajima, A, Oyoo, O, Pandya, Sc, Pohl, C, Predeteanu, D, Rexhepi, M, Rexhepi, S, Sharma, B, Shono, E, Sibilia, J, Sierakowski, S, Skopouli, Fn, Stropuviene, S, Toloza, S, Valter, I, Woolf, A, Yamanaka, H, and Bombardieri, Stefano

Published
2010

17. Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis: Results from the EULAR Scleroderma Trial and Research Group (EUSTAR) database

Author

Avouac, J., Walker, U., Tyndall, A., Kahan, A., Matucci-Cerinic, M., Allanore, Y., Miniati, I., Müller, A., Iannone, F., Giacomelli, R., Distler, O., Becvar, R., Sierakowsky, S., Kowal-Bielecka, O., Coelho, P., Cabane, J., Cutolo, M., Shoenfeld, Y., Valentini, G., Rovensky, J., Riemekasten, G., Nicoara, I., Vlachoyiannopoulos, P., Caporali, R., Jiri, S., Inanc, M., Gorska, I.Z., Carreira, P., Novak, S., Czirjak, L., Ramos, F.O., Jendro, M., Chizzolini, C., Kucharz, E.J., Richter, J., Cozzi, F., Rozman, B., Mallia, C.M., Gabrielli, A., Farge, D., Kiener, H.P., Schöffel, D., Sticherling, M., Airo, P., Wollheim, F., Martinovic, D., Trotta, F., Hunzelmann, N., Jablonska, S., Reich, K., Bombardieri, S., Siakka, P., Pellerito, R., Bambara, L.M., Morovic-Vergles, J., Denton, C., Hinrichs, R., Van Den Hoogen, F., Damjanov, N., Kötter, I., Ortiz, V., Heitmann, S., Krasowska, D., Seidel, M., Hasler, P., Van Laar, J.M., Kaltwasser, J.P., Foeldvari, I., Juan Mas, A., Bajocchi, G., Wislowska, M., Pereira Da Silva, J.A., Jacobsen, S., Worm, M., Graniger, W., Kuhn, A., Stankovic, A., Cossutta, R., Majdan, M., Rajcevska, L.D., Tikly, M., Nasonov, E.L., Steinbrink, K., Herrick, A., Müller-Ladner, U., Dinc, A., Scorza, R., Sondergaard, K., Indiveri, F., Nielsen, H., Szekanecz, Z., Silver, R.M., Antivalle, M., Espinosa, I.B., García De La Pena Lefebvre, P., Midtvedt, O., Launay, D., Valesini, F., Tuvik, P., Ionescu, R.M., Del Papa, N., Pinto, S., Wigley, F., Mihai, C., Capranu, M.S., Sunderkötter, C., Jun, J.B., Derk, C., Alhasani, S., Distler, J.H., Ton, E., Soukup, T., Seibold, J., Zeni, S., Nash, P., Mouthon, L., De Keyser, F., Duruöz, M.T., Cantatore, F.P., Strauss, G., Von Mülhen, C.A., Pozzi, M.R., Eyerich, K., Szechinski, J., Keiserman, M., Houssiau, F.A., Rom-Ivorra, J.A., Krummel-Lorenz, B., Aringer, M., Westhovens, R., Bellisai, F., Mayer, M., Stoeckl, F., Üprus, M., Volpe, A., Buslau, M., Yavuz, S., Granel, B., Feijó, A.V., Del Galdo, F., Popa, S., Zenone, T., Machado, X.R., Pileckyte, M., Stebbings, S., Mathieu, A., Tulli, A., Tourinho, T., Souza, R., Acayaba De Toledo, R., Stamp, L., Solanki, K., Veale, D., Neto, J.F.M., Bagnato, G.F., Loyo, E., Toloza, S., Li, M., Mohamed, W.A.A.A., Çobankara, Veli, Olas, J., Salsano, F., Oksel, F., Tanaseanu, C.M., Foti, R., Ancuta, C., Vonk, M., Caramashi, P., Beretta, L., Balbir, A., Shine, B., Chiàla, A., Simic, K.P., Ghio, M., Stamenkovic, B., Rednic, S., Host, N., Hachulla, E., and Furst, D.E.

Subjects
musculoskeletal diseases, Adult, Male, Databases, Factual, systemic sclerosis, joint contracture, hand radiography, Joint involvement, Tendons, Scleroderma, Localized, data base, joint radiography, Humans, scleroderma, human, nuclear magnetic resonance imaging, Range of Motion, Articular, rheumatic disease, Aged, interstitial lung disease, Inflammation, skin disease, Clinical Trials as Topic, Synovitis, Scleroderma, Systemic, integumentary system, article, echography, Middle Aged, musculoskeletal system, cohort analysis, major clinical study, tenosynovitis, clinical feature, body regions, female, Cross-Sectional Studies, priority journal, Tendon friction rub, Joints, disease duration, Joint Diseases, disease activity
Abstract

Objective. To determine the prevalence of and independent factors associated with joint involvement in a large population of patients with systemic sclerosis (SSc). Methods. This study was cross-sectional, based on data collected on patients included in the European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) registry. We queried this database to extract data regarding global evaluation of patients with SSc and the presence of any clinical articular involvement: synovitis (tender and swollen joints), tendon friction rubs (rubbing sensation detected as the tendon was moved), and joint contracture (stiffness of the joints that decreased their range of motion). Overall joint involvement was defined by the occurrence of synovitis and/or joint contracture and/or tendon friction rubs. Results. We recruited 7286 patients with SSc; their mean age was 56 ± 14 years, disease duration 10 ± 9 years, and 4210 (58%) had a limited cutaneous disease subset. Frequencies of synovitis, tendon friction rubs, and joint contractures were 16%, 11%, and 31%, respectively. Synovitis, tendon friction rubs, and joint contracture were more prevalent in patients with the diffuse cutaneous subset and were associated together and with severe vascular, muscular, renal, and interstitial lung involvement. Moreover, synovitis had the highest strength of association with elevated acute-phase reactants taken as the dependent variable. Conclusion. Our results highlight the striking level of articular involvement in SSc, as evaluated by systematic examination in a large cohort of patients with SSc. Our data also show that synovitis, joint contracture, and tendon friction rubs are associated with amore severe disease and with systemic inflammation. The Journal of Rheumatology Copyright © 2010. All rights reserved.

Published
2010

18. Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study

Author

Sokka, T, Häkkinen, A, Kautiainen, H, Maillefert, Jf, Toloza, S, Mørk Hansen, T, Calvo Alen, J, Oding, R, Liveborn, M, Huisman, M, Alten, R, Pohl, C, Cutolo, Maurizio, Immonen, K, Woolf, A, Murphy, E, Sheehy, C, Quirke, E, Celik, S, Yazici, Y, Tlustochowicz, W, Kapolka, D, Skakic, V, Rojkovich, B, Müller, R, Stropuviene, S, Andersone, D, Drosos, Aa, Lazovskis, J, Pincus, T, and QUEST RA Group

Subjects
Questionnaires, Male, medicine.medical_specialty, Internationality, Cross-sectional study, Immunology, Arthritis, Physical exercise, Motor Activity, Arthritis, Rheumatoid/physiopathology, Arthritis, Rheumatoid, Rheumatology, Internal medicine, Immunopathology, Surveys and Questionnaires, medicine, Immunology and Allergy, Humans, Pharmacology (medical), In patient, business.industry, Middle Aged, medicine.disease, Comorbidity, Obesity, Cross-Sectional Studies, Rheumatoid arthritis, Physical therapy, Female, business
Abstract

Objective Regular physical activity is associated with decreased morbidity and mortality. Traditionally, patients with rheumatoid arthritis (RA) have been advised to limit physical exercise. We studied the prevalence of physical activity and associations with demographic and disease-related variables in patients with RA from 21 countries. Methods The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) is a cross-sectional study that includes a self-report questionnaire and clinical assessment of nonselected consecutive outpatients with RA who are receiving usual clinical care. Frequency of physical exercise (≥30 minutes with at least some shortness of breath, sweating) is queried with 4 response options: ≥3 times weekly, 1–2 times weekly, 1–2 times monthly, and no exercise. Results Between January 2005 and April 2007, a total of 5,235 patients from 58 sites in 21 countries were enrolled in QUEST-RA: 79% were women, >90% were white, mean age was 57 years, and mean disease duration was 11.6 years. Only 13.8% of all patients reported physical exercise ≥3 times weekly. The majority of the patients were physically inactive with no regular weekly exercise: >80% in 7 countries, 60–80% in 12 countries, and 45% and 29% in 2 countries, respectively. Physical inactivity was associated with female sex, older age, lower education, obesity, comorbidity, low functional capacity, and higher levels of disease activity, pain, and fatigue. Conclusion In many countries, a low proportion of patients with RA exercise. These data may alert rheumatologists to motivate their patients to increase physical activity levels.

Published
2010

19. Questra [SAT0515] country economy rather than disease activity predicts initiation of a biologic treatment over a 4-5 year follow up in a world-wide cohort of RA

Author

Sokka, T, Pincus, T, Kautiainen, H, Gogus, F, Henrohn, D, Naranjo, A, Karateev, D, Sierakowski, S, Bonte-Mineur, F, Rexhepi, S, Yamanaka, H, Nakajima, A, Ferraccioli, GF, Cutolo, M, Minnock, P, Géher, P, Skopouli, FN, Herborn, G, Wassenberg, S, Gossec, L, Otsa, K, Hørslev-Petersen, Kim, Lazovskis, J, da Rocha Castelar Pinheiro, G, Airton Rocha, P, and Toloza, S

Published
2010

20. Every third patient with new rheumatoid arthritis becomes work disabled in the 2000's:People in poor countries remain working with high levels of disability and disease activity

Author

Sokka, T, Toloza, S, Pinheiro, G. da Rocha Castelar, Lazovskis, J, Hørslev-Petersen, Kim, Peets, T, Luukkainen, R, Gossec, L, Drosos, A.A., Schett, G, Burmeister, G.R., Aggarwal, a., Bresnihan, B, Ferraccioli, G, Rojkovich, B, Ujfalussy, I, Yamanaka, H, Nakajima, A, Rexhepi, S, Rexhepi, M, Andersone, D, Stropuviene, S, Verstappen, S.M.M., Haugeberg, G, Sierakowski, S, Majdan, M, Gogus, F, Skakic, V, Karateev, D, Luchikhina, E, Calvo-Alen, J, Oding, R, Liveborn, M, Badsha, H, Woolf, A, Bergman, M, and Pincus, T

Published
2009

23. Should joint limited motion or deformity be recorded in joint count?

Author

Horslev-Petersen, K., Pincus, T., Majdan, M., Sadkiewicz, S., Yazici, Y., Toloza, S., Gogus, F., Minnock, P., Bresnihan, B., Woolf, A., Sibilia, J., Huisman, M., Cazzato, M., Pohl, C., Alten, R., Belmonte, M., Holmqvist, A. C., Luukkainen, R., Kautiainen, H., and Sokka, T.

Published
2006

24. Joint pain may be missed in physician assessment of tender joint count

Author

Ornbjerg, L., Morelli, A., Kautiainen, H., Calvo-Alen, J., Bresnlhan, B., Yazicl, Y., Skakic, V., Luukkainen, R., Gogus, F., Sokka, T., Pincus, T., Horsley-Petersen, K., Alten, R., Maillefert, J., and Toloza, S.

Abstract

Annual European Congress of Rheumatology (EULAR 2006), Jun 21-24, 2006, Amsterdam, Netherlands

Published
2006

25. Disease-specific quality of life in patients with lupus nephritis.

Author

Jolly, M., Toloza, S., Goker, B., Clarke, A. E., Navarra, S. V., Wallace, D., Weisman, M., and Mok, C. C.

Subjects
*LUPUS nephritis, *SYSTEMIC lupus erythematosus, *QUALITY of life, *DATA, *PATIENTS, *THERAPEUTICS
Abstract

Background: Patient-reported outcomes in lupus nephritis (LN) are not well studied. Studies with disease-targeted PRO tool in LN do not exist. Herein, we describe quality of life (QOL: HRQOL & non-HRQOL) among LN patients using LupusPRO. Methods: International, cross-sectional data from 1259 patients with systemic lupus erythematosus (SLE) and LupusPRO were compared, stratified by (a) presence of LN (ACR classification criteria (ACR-LN)) at any time and, (b) active LN (on SLEDAI) at study visit. Damage was assessed by SLICC/ACR-SDI. Multivariate regression analyses for QOL against ACR-LN (active LN) after adjusting for age, gender, ethnicity and country of recruitment were performed. Results: Mean (SD) age was 41.7 (13.5) yrs, 93% were women. Five hundred and thirty-nine of 1259 SLE patients had ACR-LN. ACR-LN group was younger, were more often on immunosuppressive medications, had worse QOL on lupus medications and procreation than non-ACRLN patients. HRQOL and non-HRQOL scores were similar in both groups. One hundred and twenty-nine of 539 ACR-LN patients had active LN. Active LN group was younger, had greater disease activity and had worse HRQOL and non-HRQOL compared to patients without active LN. Specific domains adversely affected were lupus symptoms, lupus medications, procreation, emotional health, body image and desires-goals domains. Patients with ACR-LN and active LN fared significantly worse in lupus medications and procreation HRQOL domains, even after adjusting for age, ethnicity, gender and country of recruitment. Conclusions: Lupus nephritis patients have poor QOL. Patients with active LN have worse HRQOL and non-HRQOL. Most domains affected are not included in the generic QOL tools used in SLE. LN patients must receive discussion on lupus medications and procreation issues. Patients with active LN need comprehensive assessments and addressal of QOL, along with treatment for active LN. [ABSTRACT FROM AUTHOR]

Published
2018
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26. FRI0398 Disease Specific Quality of Life in Patients with Lupus Nephritis

Author

Jolly, M., primary, Toloza, S., additional, Bertoli, A., additional, Blazevic, I., additional, Vila, L., additional, Moldovan, I., additional, Torralba, K., additional, Kaya, A., additional, Goker, B., additional, Tezcan, M., additional, Haznedaroglu, S., additional, Bourre-Tessier, J., additional, Navarra, S., additional, Wallace, D., additional, Weisman, M., additional, Clarke, A., additional, Alarcon, G., additional, and Mok, C.C., additional

Published
2014
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27. Monoterapia biológica en pacientes con artritis reumatoidea en Argentina

Author

Sommerfleck, F.A., Siri, D., Sole, J., Toloza, S., Velasco, J., Mysler, E., Albarello, A., Arturi, A., Asnal, C., Babini, Alejandra, Borgia, Ariel R., Carrió, J., Casado, G., Catalán Pellet, Antonio, Chemez, J., Eimon, Alicia, Espindola Echazú, M., Lazaro, M., Lima, N., Magri, Sebastián, Mannucci, A., Marcos, A., Messina, O., Montoya, F., Najún Dubos, N., Nasswetter, G., Orden, Alberto Omar, Pereyra, D., Pérez Rincón, J., Quinteros, A., Re, L., Salinas, R., Wiederhold, C., Sommerfleck, F.A., Siri, D., Sole, J., Toloza, S., Velasco, J., Mysler, E., Albarello, A., Arturi, A., Asnal, C., Babini, Alejandra, Borgia, Ariel R., Carrió, J., Casado, G., Catalán Pellet, Antonio, Chemez, J., Eimon, Alicia, Espindola Echazú, M., Lazaro, M., Lima, N., Magri, Sebastián, Mannucci, A., Marcos, A., Messina, O., Montoya, F., Najún Dubos, N., Nasswetter, G., Orden, Alberto Omar, Pereyra, D., Pérez Rincón, J., Quinteros, A., Re, L., Salinas, R., and Wiederhold, C.

Abstract

La utilización de agentes biológicos para el tratamiento de la Artritis Reumatoidea (AR) es habitualmente usada en aquellos pacientes con enfermedad activa que no hayan respondido al tratamiento con drogas modificadoras de la Artritis Reumatoidea convencionales (DMARD, por sus siglas en inglés) o que hayan presentado intolerancia a las mismas. Al estado actual de la evidencia, la terapia combinada de agentes biológicos más un DMARD convencional (principalmente metotrexato) constituye el estándar de tratamiento. Sin embargo existen algunos escenarios como la intolerancia, la falta de adherencia y la aparición de eventos adversos a las DMARDs convencionales donde la monoterapia biológica emerge como una opción terapéutica válida. Según los distintos registros a nivel internacional, la frecuencia de utilización de agentes biológicos en monoterapia oscila entre 12 a 39%. Debido a la ausencia de estos datos a nivel local decidimos realizar este estudio para conocer el porcentaje de pacientes que se encuentran en monoterapia biológica y analizar las causas que llevaron a este tipo de tratamiento. Materiales y métodos: Estudio de tipo corte transversal donde se invitó a participar a diferentes centros reumatológicos distribuidos a lo largo de Argentina. Cada centro revisó las historias clínicas de los últimos 30 a 50 pacientes consecutivos vistos con AR, mayores de 18 años, que habían presentado inadecuada respuesta al tratamiento con DMARDs y que estaban bajo tratamiento biológico. Se completaba una ficha por cada paciente incluido, registrando datos demográficos, de la enfermedad y tratamientos previos. Resultados: Se incluyeron 32 centros y se evaluaron 1148 historias clínicas de pacientes con AR durante el mes de octubre y noviembre del 2012. Un 21,4% (246) de los pacientes al momento del estudio se encontraba bajo tratamiento biológico en monoterapia. Las razones de la selección del tratamiento monoterapia fueron: 45% evento adverso, 35% decisión del médico por buena

Published
2013

28. Smokers and non-smokers with rheumatoid arthritis have similar clinical status : data from the multinational QUEST-RA database

Author

Naranjo, A., Toloza, S., Guimaraes da Silveira, I., Lazovskis, J., Hetland, M. L., Hamoud, H., Peets, T., Makinen, H., Gossec, L., Herborn, G., Skopouli, F. N., Rojkovich, B., Aggarwal, A., Minnock, P., Cazzato, M., Yamanaka, H., Oyoo, O., Rexhepi, S., Andersone, D., Baranauskaite, A., Hajjaj-Hassouni, N., Jacobs, J. W. G., Haugeberg, G., Sierakowski, S., Ionescu, R., Karateew, D., Dimic, A., Henrohn, Dan, Gogus, F., Badsha, H., Choy, E., Bergman, M., Sokka, T., Naranjo, A., Toloza, S., Guimaraes da Silveira, I., Lazovskis, J., Hetland, M. L., Hamoud, H., Peets, T., Makinen, H., Gossec, L., Herborn, G., Skopouli, F. N., Rojkovich, B., Aggarwal, A., Minnock, P., Cazzato, M., Yamanaka, H., Oyoo, O., Rexhepi, S., Andersone, D., Baranauskaite, A., Hajjaj-Hassouni, N., Jacobs, J. W. G., Haugeberg, G., Sierakowski, S., Ionescu, R., Karateew, D., Dimic, A., Henrohn, Dan, Gogus, F., Badsha, H., Choy, E., Bergman, M., and Sokka, T.

Abstract

Objectives To analyse clinical severity/activity of rheumatoid arthritis (RA) according to smoking status. Methods The QUEST-RA multinational database reviews patients for Core Data Set measures including 28 swollen and tender joint count, physician global estimate, erythrocyte sedimentation rate (ESR), HAQ-function, pain, and patient global estimate, as well as DAS28, rheumatoid factor (RE), nodules, erosions and number of DMARDs were recorded. Smoking status was assessed by self-report as "never smoked", "currently smoking" and "former smokers". Patient groups with different smoking status were compared for demographic and RA measures. Results Among the 7,307 patients with smoking data available, status as "never smoked," "current smoker" and "former smoker" were reported by 65%, 15% and 20%. Ever smokers were more likely to be RF-positive (OR 1.32; 1.17-1.48, p<0.001). Rheumatoid nodules were more frequent in ever smokers (OR 1.41; 1.24-1.59, p<0.001). The percentage of patients with erosive arthritis and extra-articular disease was similar in all smoking categories. Mean DAS28 was 4.4 (SD 1.6) in non-smokers vs. 4.0 (SD 1.6) in those who had ever smoked. However, when adjusted by age, sex, disease duration, and country gross domestic product, only ESR remained significantly different among Core Data Set measures (mean 31.7mm in non-smokers vs. 26.8mm in ever smoked category). Conclusion RA patients who had ever smoked were more likely to have RF and nodules, hut values for other clinical status measures were similar in all smoking categories (never smoked, current smokers and former smokers).

Published
2010

29. Smokers and non smokers with rheumatoid arthritis have similar clinical status: data from the multinational QUEST-RA database

Author

Naranjo, A, Toloza, S, Guimaraes da Silveira, I, Lazovskis, J, Hetland, M L, Hamoud, H, Peets, T, Mäkinen, H, Gossec, L, Herborn, G, Skopouli, F N, Rojkovich, B, Aggarwal, A, Minnock, P, Cazzato, M, Yamanaka, H, Oyoo, O, Rexhepi, S, Andersone, D, Baranauskaite, A, Hajjaj-Hassouni, N, Jacobs, J W G, Haugeberg, G, Sierakowski, S, Ionescu, R, Karateew, D, Dimic, A, Henrohn, D, Gogus, F, Badsha, H, Choy, E, Bergman, Ingrid-Maria, Sokka, T, Naranjo, A, Toloza, S, Guimaraes da Silveira, I, Lazovskis, J, Hetland, M L, Hamoud, H, Peets, T, Mäkinen, H, Gossec, L, Herborn, G, Skopouli, F N, Rojkovich, B, Aggarwal, A, Minnock, P, Cazzato, M, Yamanaka, H, Oyoo, O, Rexhepi, S, Andersone, D, Baranauskaite, A, Hajjaj-Hassouni, N, Jacobs, J W G, Haugeberg, G, Sierakowski, S, Ionescu, R, Karateew, D, Dimic, A, Henrohn, D, Gogus, F, Badsha, H, Choy, E, Bergman, Ingrid-Maria, and Sokka, T

Abstract

To analyse clinical severity/activity of rheumatoid arthritis (RA) according to smoking status.

Published
2010

30. Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST-RA database

Author

Sokka, T., Kautiainen, H., Pincus, T., Toloza, S., Castelar Pinheiro, G. da Rocha, Lazovskis, J., Hetland, M. L., Peets, T., Immonen, K., Maillefert, J. F., Drosos, A. A., Alten, R., Pohl, C., Rojkovich, B., Bresnihan, B., Minnock, P., Cazzato, M., Bombardieri, S., Rexhepi, S., Rexhepi, M., Andersone, D., Stropuviene, S., Huisman, M., Sierakowski, S., Karateev, D., Skakic, V., Naranjo, A., Baecklund, Eva, Henrohn, Dan, Gogus, F., Badsha, H., Mofti, A., Taylor, P., McClinton, C., Yazici, Y., Sokka, T., Kautiainen, H., Pincus, T., Toloza, S., Castelar Pinheiro, G. da Rocha, Lazovskis, J., Hetland, M. L., Peets, T., Immonen, K., Maillefert, J. F., Drosos, A. A., Alten, R., Pohl, C., Rojkovich, B., Bresnihan, B., Minnock, P., Cazzato, M., Bombardieri, S., Rexhepi, S., Rexhepi, M., Andersone, D., Stropuviene, S., Huisman, M., Sierakowski, S., Karateev, D., Skakic, V., Naranjo, A., Baecklund, Eva, Henrohn, Dan, Gogus, F., Badsha, H., Mofti, A., Taylor, P., McClinton, C., and Yazici, Y.

Abstract

Objective: To analyse associations between the clinical status of patients with rheumatoid arthritis ( RA) and the gross domestic product (GDP) of their resident country. Methods: The Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) cohort includes clinical and questionnaire data from 6004 patients who were seen in usual care at 70 rheumatology clinics in 25 countries as of April 2008, including 18 European countries. Demographic variables, clinical characteristics, RA disease activity measures, including the disease activity score in 28 joints (DAS28), and treatment-related variables were analysed according to GDP per capita, including 14 "high GDP'' countries with GDP per capita greater than US$ 24 000 and 11 "low GDP'' countries with GDP per capita less than US$ 11 000. Results: Disease activity DAS28 ranged between 3.1 and 6.0 among the 25 countries and was significantly associated with GDP (r = -0.78, 95% CI -0.56 to -0.90, r(2) = 61%). Disease activity levels differed substantially between "high GDP'' and "low GDP'' countries at much greater levels than according to whether patients were currently taking or not taking methotrexate, prednisone and/or biological agents. Conclusions: The clinical status of patients with RA was correlated significantly with GDP among 25 mostly European countries according to all disease measures, associated only modestly with the current use of antirheumatic medications. The burden of arthritis appears substantially greater in "low GDP'' than in "high GDP'' countries. These findings may alert healthcare professionals and designers of health policy towards improving the clinical status of patients with RA in all countries.

Published
2009
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31. Physical inactivity in patients with rheumatoid arthritis: Data from twenty-one countries in a cross-sectional, international study

Author

Sokka, T., Hakkinen, A., Kautiainen, H., Maillefert, J.F., Toloza, S., Hansen, Troels Mørk, Calvo-Alen, J., Oding, R., Liveborn, M., Huisman, M., Alten, R., Pohl, C., Cutolo, M., Immonen, K., Woolf, A., Murphy, E., Sheehy, C., Quirke, E., Celik, S., Yazici, Y., Tlustochowicz, W., Kapolka, D., Skakic, V., Roikovich, B., Muller, R., Stropuviene, S., Andersone, D., Drosos, A.A., Lazovskis, J., Pincus, T., Sokka, T., Hakkinen, A., Kautiainen, H., Maillefert, J.F., Toloza, S., Hansen, Troels Mørk, Calvo-Alen, J., Oding, R., Liveborn, M., Huisman, M., Alten, R., Pohl, C., Cutolo, M., Immonen, K., Woolf, A., Murphy, E., Sheehy, C., Quirke, E., Celik, S., Yazici, Y., Tlustochowicz, W., Kapolka, D., Skakic, V., Roikovich, B., Muller, R., Stropuviene, S., Andersone, D., Drosos, A.A., Lazovskis, J., and Pincus, T.

Abstract

Objective. Regular physical activity is associated with decreased morbidity and mortality. Traditionally, patients with rheumatoid arthritis (RA) have been advised to limit physical exercise. We studied the prevalence of physical activity and associations with demographic and disease-related variables in patients with RA from 21 countries. Methods. The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) is a crosssectional study that includes a self-report questionnaire and clinical assessment of nonselected consecutive outpatients with RA who are receiving usual clinical care. Frequency of physical exercise (>= 30 minutes with at least some shortness of breath, sweating) is queried with 4 response options: >= 3 times weekly, 1-2 times weekly, 1-2 times monthly, and no exercise. Results. Between January 2005 and April 2007, a total of 5,235 patients from 58 sites in 21 countries were enrolled in QUEST-RA: 79% were women, >90% were white, mean age was 57 years, and mean disease duration was 11.6 years. Only 13.8% of all patients reported physical exercise >= 3 times weekly. The majority of the patients were physically inactive with no regular weekly exercise: >80% in 7 countries, 60-80% in 12 countries, and 45% and 29% in 2 countries, respectively. Physical inactivity was associated with female sex, older age, lower education, obesity, comorbidity, low functional capacity, and higher levels of disease activity, pain, and fatigue. Conclusion. In many countries, a low proportion of patients with RA exercise. These data may alert rheumatologists to motivate their patients to increase physical activity levels Udgivelsesdato: 2008/1/15

Published
2008

32. Monoterapia biológica en pacientes con artritis reumatoidea en Argentina

Author

Sommerfleck, F., primary, Siri, D., additional, Sole, J., additional, Toloza, S., additional, Velasco, J., additional, Mysler, E., additional, Albarello, A., additional, Arturi, A., additional, Asnal, C., additional, Babini, A., additional, Borgia, A., additional, Carrió, J., additional, Casado, G., additional, Catalan Pallet, A., additional, Chemez, J., additional, Eimon, A., additional, Espindola Echazú, M., additional, Lazaro, M., additional, Lima, N., additional, Magri, S., additional, Mannucci, A., additional, Marcos, A., additional, Messina, O., additional, Montoya, F., additional, Najún Dubos, N., additional, Nasswetter, G., additional, Orden, A., additional, Pereyra, D., additional, Pérez Rincón, J., additional, Quinteros, A., additional, Re, L., additional, Salinas, R., additional, and Wiederhold, C., additional

Published
2013
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33. Spanish LupusPRO: cross-cultural validation study for lupus

Author

Jolly, M, primary, Toloza, S, additional, Block, J, additional, Mikolaitis, R, additional, Kosinski, M, additional, Wallace, D, additional, Durran-Barragan, S, additional, Bertoli, A, additional, Blazevic, I, additional, Vilá, L, additional, Cooray, D, additional, Moldovan, I, additional, Katsaros, E, additional, Weisman, M, additional, Torralba, KM, additional, and Alarcón, G, additional

Published
2013
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34. Joint pain may be missed in physician assessment of tender joint count

Author

Sokka, T., Kautiainen, H., Toloza, S., Luukkainen, R., Horsley-Petersen, K., Ornbjerg, L., Morelli, A., Calvo-Alen, J., Bresnlhan, B., Maillefert, J., Gogus, F., Skakic, V., Alten, R., Yazicl, Y., Pincus, T., Sokka, T., Kautiainen, H., Toloza, S., Luukkainen, R., Horsley-Petersen, K., Ornbjerg, L., Morelli, A., Calvo-Alen, J., Bresnlhan, B., Maillefert, J., Gogus, F., Skakic, V., Alten, R., Yazicl, Y., and Pincus, T.

Published
2006

35. Familial aggregation of psoriatic arthritis

Author

Chandran, V, primary, Schentag, C T, additional, Brockbank, J E, additional, Pellett, F J, additional, Shanmugarajah, S, additional, Toloza, S M A, additional, Rahman, P, additional, and Gladman, D D, additional

Published
2008
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36. Vitamin D insufficiency in a large female SLE cohort.

Author

Toloza, S. M. A., Cole, D. E. C., Gladman, D. D., Ibañez, D., and Urowitz, M. B.

Subjects
*SYSTEMIC lupus erythematosus, *VITAMIN D, *DISEASES in women, *OSTEOPOROSIS, *GLUCOCORTICOIDS, *CREATININE, *MULTIVARIATE analysis
Abstract

The objective of this study was to determine the vitamin D status and its relationship with disease and therapy features and with bone mineral density in women with systemic lupus erythematosus. Non-pregnant systemic lupus erythematosus women with dual-energy X-ray absorptiometry and vitamin D measurements performed between May 1 2005 and August 31 2006 were studied. In each patient, the lowest T-score of the first dual-energy X-ray absorptiometry scan during the study period was used. In postmenopausal women, a T-score ≥1.0 standard deviation was considered normal, between -1.0 and -2.5 standard deviations osteopenia and ≤2.5 standard deviations osteoporosis; in premenopausal women a T-score ≥2.5 standard deviations was normal and ≤2.5 standard deviations defined as reduced bone density. 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were determined at the time of dual-energy X-ray absorptiometry. A 25-hydroxyvitamin D level of <80 nmol/L was defined as sub-optimal and a level <40 nmol/L as deficient. Demographic and clinical variables were investigated for association with vitamin D levels by univariate and multivariate analyses. One-hundred and twenty-four systemic lupus erythematosus women had dual-energy X-ray absorptiometry scans and vitamin D assays performed during the study period. Sub-optimal 25-hydroxyvitamin D levels were found in 82 (66.7%) and deficient 25-hydroxyvitamin D levels in 22 (17.9%) patients. The disease-related features examined at the time of vitamin D assays or bone mineral density showed no correlation with vitamin D levels by univariate analyses. Neither 25-hydroxyvitamin D nor 1,25-dihydroxyvitamin D was associated with bone mineral density status among these patients. A multivariate logistic regression model identified season, cumulative glucocorticoid exposure, and serum creatinine as being associated with 25-hydroxyvitamin D levels, whereas ethnicity, glucocorticoid exposure, and serum creatinine were associated with 1,25-dihydroxyvitamin D levels. In conclusion, sub-optimal vitamin D status is common in women with systemic lupus erythematosus and is related to season, cumulative glucocorticoid dose, and serum creatinine. [ABSTRACT FROM AUTHOR]

Published
2010
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37. Association of killer cell immunoglobulin-like receptor genotypes with vascular arterial events and anticardiolipin antibodies in patients with lupus.

Author

Toloza, S. M. A., Pellett, F. J., Chandran, V., Ibanez, D., Urowitz, M. B., and Gladman, D. D.

Subjects
*KILLER cells, *THERAPEUTIC use of immunoglobulins, *SYSTEMIC lupus erythematosus, *VASCULITIS, *REGRESSION analysis, *MEDICAL research, *PATIENTS
Abstract

To determine whether killer cell immunologlobulin-like receptor (KIR) genotypes are associated with vasculitis, vascular arterial events or anticardiolipin (aCL) antibodies in patients with lupus. A total of 304 patients followed prospectively at the University of Toronto Lupus Clinic were assessed for the occurrence of vasculitis and vascular arterial events. Molecular H LA-C and KIR (presence or absence of KIR2DLI, 2DL2, 2DL3, 2DSI and 2DS2) genotyping were performed. Chi-square and logistic regression were used to analyse association between KIR genes and vascular arterial events and aCL antibodies. In patients with vascular arterial events, there was a significant increase in KIR2DS2 (60% vs 45%, P = 0.02) and in KIR2DL2 (62% vs 47%, P = 0.01) compared with patients without events. There was no increase in activating KIR genotypes in patients with vasculitis. In patients with aCL antibodies, significant increases were seen in KIR2DS2 (54% vs 41%, P = 0.03) and KIR2DL2 (58% vs 41%, P = 0.003), but KIR2DL3 was decreased (87% vs 95%, P = 0.03). Logistic regression confirmed independent association of KIR2DS2 with vascular arterial events. We found an increase in KIR2DS2 in lupus patients with vascular arterial events, but not in patients with vasculitis. [ABSTRACT FROM AUTHOR]

Published
2008
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39. Systemic lupus erythematosus in a multiethnic US Cohort (LUMINA). XXX: association between C-reactive protein (<it>CRP</it>) gene polymorphisms and vascular events

Author

Szalai, A. J., Alarcón, G. S., Calvo-Alén, J., Toloza, S. M. A., McCrory, M. A., Edberg, J. C., McGwin, G., Bastian, H. M., Fessler, B. J., Vilá, L. M., Kimberly, R. P., and Reveille, J. D.

Abstract

Objectives. To determine if a polymorphic GTn repeat in the intron of the C-reactive protein (CRP) gene associates with occurrence of vascular arterial events in systemic lupus erythematosus (SLE).Methods. We performed a nested case–control study on the LUMINA cohort of 546 Hispanic, African-American and Caucasian SLE patients. Twenty-five patients who developed vascular arterial events (i.e. myocardial infarction, angina, coronary artery bypass graft surgery, stroke, claudication, gangrene or significant tissue loss and/or arterial peripheral thrombosis) after enrolment were selected as cases and 32 ethnically matched patients with no previous vascular arterial events served as controls. Their CRP gene GTn polymorphism and plasma CRP was determined.Results. Patients with vascular events had more severe SLE and were more likely to have plasma CRP in the highest quintile of measured values. The overall distribution of GTn alleles for patients with vascular events had a greater number of the GT20 variant compared with controls [26.0% of alleles (13/50) vs 15.6% (10/64)]. This greater number of GT20 in patients with vascular events was observed for African-Americans [29.2% (7/24) vs 21.0% (8/38)] and Hispanics [33.0% (4/12) vs 0% (0/16)] but not for Caucasians [14.3% (2/14) vs 20.0% (2/10)]. For African-Americans and Hispanics combined (45 patients), the frequency of GT20 in those with vascular events (30.6%, 11/36) was significantly higher than in those without them (14.8%, 8/54) (P<0.05, one-tailed test for difference in proportions). When patients were categorized according to the number of GT20 alleles they carried (thus GT20/GT20, GT20/GTx or GTx/GTx, where x is any allele other than GT20), for both African-Americans and Hispanics the likelihood of vascular arterial events increased in proportion with the GT20 dose, and all GT20-homozygous patients developed vascular arterial events.Conclusions. The CRP GT20 variant is more likely to occur in African-American and Hispanic SLE patients than in Caucasian ones, and SLE patients carrying the GT20 allele are more likely to develop vascular arterial events.

Published
2005
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41. Smokers and non-smokers with rheumatoid arthritis have similar clinical status: data from the multinational QUEST-RA database

Author

Naranjo A, Toloza S, Guimaraes da Silveira I, Lazovskis J, Ml, Hetland, Hesham hamoud, Peets T, Mäkinen H, Gossec L, Herborn G, Fn, Skopouli, Rojkovich B, Aggarwal A, Minnock P, Cazzato M, Yamanaka H, Oyoo O, Rexhepi S, Andersone D, Baranauskaite A, Hajjaj-Hassouni N, Jw, Jacobs, Haugeberg G, Sierakowski S, Ionescu R, Karateew D, Dimic A, Henrohn D, Gogus F, Badsha H, Choy E, Bergman M, and Sokka T

Subjects
Arthritis, Rheumatoid, Male, Disability Evaluation, Cross-Sectional Studies, genetic structures, Databases as Topic, International Cooperation, Multivariate Analysis, Smoking, Humans, Female, Middle Aged, Severity of Illness Index
Abstract

To analyse clinical severity/activity of rheumatoid arthritis (RA) according to smoking status.The QUEST-RA multinational database reviews patients for Core Data Set measures including 28 swollen and tender joint count, physician global estimate, erythrocyte sedimentation rate (ESR), HAQ-function, pain, and patient global estimate, as well as DAS28, rheumatoid factor (RF), nodules, erosions and number of DMARDs were recorded. Smoking status was assessed by self-report as 'never smoked', 'currently smoking' and 'former smokers'. Patient groups with different smoking status were compared for demographic and RA measures.Among the 7,307 patients with smoking data available, status as 'never smoked,' 'current smoker' and 'former smoker' were reported by 65%, 15% and 20%. Ever smokers were more likely to be RF-positive (OR 1.32;1.17-1.48, p0.001). Rheumatoid nodules were more frequent in ever smokers (OR 1.41;1.24-1.59, p0.001). The percentage of patients with erosive arthritis and extra-articular disease was similar in all smoking categories. Mean DAS28 was 4.4 (SD 1.6) in non-smokers vs. 4.0 (SD 1.6) in those who had ever smoked. However, when adjusted by age, sex, disease duration, and country gross domestic product, only ESR remained significantly different among Core Data Set measures (mean 31.7mm in non-smokers vs. 26.8mm in ever smoked category).RA patients who had ever smoked were more likely to have RF and nodules, but values for other clinical status measures were similar in all smoking categories (never smoked, current smokers and former smokers).

44. Gender, body mass index and rheumatoid arthritis disease activity: Results from the QUEST-RA study

Author

Jawaheer, D., Olsen, J., Lahiff, M., Forsberg, S., Lähteenmäki, J., Da Silveira, I. G., Rocha, F. A., Laurindo, I. M. M., Da Mota, L. M. H., Drosos, A. A., Murphy, E., Sheehy, C., Quirke, E., Cutolo, M., Rexhepi, S., Dadoniene, J., Verstappen, S. M. M., Sokka, T., Toloza, S., Aguero, S., Barrera, S. O., Retamozo, S., Alba, P., Lascano, C., Babini, A., Albiero, E., Pinheiro, G. R. C., Lazovskis, J., Hetland, M. L., Ørnbjerg, L., Hørslev-Petersen, K., Hansen, T. M., Knudsen, L. S., Hamoud, H., Sobhy, M., Fahmy, A., Magdy, M., Aly, H., Saeid, H., Nagm, A., Fathi, N. A., Abda, E., Ebraheam, Z., Müller, R., Kuuse, R., Tammaru, M., Kallikorm, R., Peets, T., Otsa, K., Laas, K., Valter, I., Mäkinen, H., Immonen, K., Luukkainen, R., Gossec, L., Dougados, M., Maillefert, J. F., Combe, B., Sibilia, J., Exarchou, S., Moutsopoulos, H. M., Tsirogianni, A., Skopouli, F. N., Mavrommati, M., Herborn, G., Rau, R., Alten, R., Pohl, C., Burmester, G. R., Marsmann, B., Géher, P., Rojkovich, B., Bresnihan, B., Minnock, P., Devlin, J., Alraqi, S., Aggarwal, A., Pandya, S., Sharma, B., Cazzato, M., Bombardieri, S., Ferraccioli, G., Morelli, A., Salaffi, F., Stancati, A., Yamanaka, H., Nakajima, A., Fukuda, W., Shono, E., Oyoo, O., Rexhepi, M., Andersone, D., Stropuviene, S., Baranauskaite, A., Najia Hajjaj-Hassouni, Benbouazza, K., Allali, F., Bahiri, R., Amine, B., Jacobs, J. W. G., Huisman, M., Hoekstra, M., Haugeberg, G., Gjelberg, H., Sierakowski, S., Majdan, M., Romanowski, W., Tlustochowicz, W., Kapolka, D., Sadkiewicz, S., Zarowny-Wierzbinska, D., Ionescu, R., Predeteanu, D., Karateev, D., Luchikhina, E., Chichasova, N., Badokin, V., Skakic, V., Dimic, A., Nedovic, J., Stankovic, A., Naranjo, A., Rodríguez-Lozano, C., Calvo-Alen, J., Belmonte, M., Baecklund, E., Henrohn, D., Oding, R., Liveborn, M., Holmqvist, A. -C, Gogus, F., Tunc, R., Celic, S., Badsha, H., Mofti, A., Taylor, P., Mcclinton, C., Woolf, A., Chorghade, G., Choy, E., Kelly, S., Pincus, T., Yazici, Y., Bergman, M., Craig-Muller, J., Kautiainen, H., Swearingen, C., University of California Los Angeles, University of California Berkeley, North Karelia Central Hospital, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Universidade Federal do Ceará, Universidade Estadual Paulista (UNESP), Hospital Universitário de Brasília, University of Ioannina Ioannina, Waterford Regional Hospital, Connolly Hospital, University of Genova, Rheumatology Department, Vilnius University, University Medical Centre Utrecht, Jyväskylä Central Hospital, Medcare Oy, Hospital Oakland Research Institute, Hospital San Juan Bautista, Hospital of Cordoba, Universidade do Estado do Rio de Janeiro (UERJ), Riverside Professional Centre, Copenhagen University Hospital at Hvidovre, King Christian the Xth Hospital, Copenhagen University Hospital at Herlev, Al-Azhar University, Assiut University Hospital, Abo Sohage University Hospital, Tartu University Hospital, East-Tallinn Central Hospital, Centre for Clinical and Basic Research, Satakunta Central Hospital, Hôpital Cochin, INSERM U887, Hôpital Lapeyronie, Hôpital Hautepierre, National University of Athens, Euroclinic Hospital, Evangelisches Fachkrankenhaus, Schlosspark-Klinik, University Medicine Berlin, Semmelweis University of Medical Sciences, Polyclinic of the Hospitaller Brothers of St. John of God in Budapest, St. Vincent University Hospital, Our Lady's Hospice, Vedanta Institiute of Medical Sciences, Jaipur Hospital, Santa Chiara Hospital, Catholic University of Sacred Heart, University of Ancona, Tokyo Women's Medical University, Kyoto First Red Cross Hospital, Shono Rheumatism Clinic, Kenyatta Hospital, Pauls Stradina Clinical University Hospital, Kaunas University Hospital, El Ayachi Hospital Mohamed Vth Souissi University, Sint Franciscus Gasthuis Hospital, Medisch Spectrum Twente, Sørlandet Hospital, Medical University in Bialystok, Medical University of Lublin, Poznan Rheumatology Centre in Srem, Military Institute of Medicine, Silesian Hospital for Rheumatology and Rehabilitation in Ustron Slaski, Szpital Wojewodzki im. Jana Biziela, Wojewodzki Zespol Reumatologiczny im. dr Jadwigi Titz-Kosko, Spitalul Clinic Sf Maria, Institute of Rheumatology of Russian Academy of Medical Sciences, Moscow Medical Academy, Russian Medical Academy of Postgraduate Education, Rheumatology Institut, Hospital de Gran Canaria Dr. Negrin, Hospital Sierrallana Ganzo, Hospital General de Castellón, Uppsala University Hospital, Centrallasarettet, Hudiksvall Medical Clinic, Gazi University Medical Faculty, Meram Medical Faculty, Cerrahpasa Medic Faculty, Dubai Bone and Joint Centre, American Hospital Dubai, Charing Cross Hospital, Royal Cornwall Hospital, Kings College Hospital, Vanderbilt University, NYU Hospital for Joint Diseases, Taylor Hospital, Centra Care Clinic, University of Arkansas for Medical Sciences, and New York University Hospital for Joint Diseases

Subjects
Bmi, Gender, Disease activity, Rheumatoid arthritis
Abstract

Made available in DSpace on 2022-04-28T18:56:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-12-01 Objective: To investigate whether body mass index (BMI), as a proxy for body fat, influences rheumatoid arthritis (RA) disease activity in a gender-specific manner. Methods: Consecutive patients with RA were enrolled from 25 countries into the QUEST-RA program between 2005 and 2008. Clinical and demographic data were collected by treating rheumatologists and by patient self-report. Distributions of Disease Activity Scores (DAS28), BMI, age, and disease duration were assessed for each country and for the entire dataset; mean values between genders were compared using Student's t-tests. An association between BMI and DAS28 was investigated using linear regression, adjusting for age, disease duration and country. Results: A total of 5,161 RA patients (4,082 women and 1,079 men) were included in the analyses. Overall, women were younger, had longer disease duration, and higher DAS28 scores than men, but BMI was similar between genders. The mean DAS28 scores increased with increasing BMI from normal to overweight and obese, among women, whereas the opposite trend was observed among men. Regression results showed BMI (continuous or categorical) to be associated with DAS28. Compared to the normal BMI range, being obese was associated with a larger difference in mean DAS28 (0.23, 95% CI: 0.11, 0.34) than being overweight (0.12, 95% CI: 0.03, 0.21); being underweight was not associated with disease activity. These associations were more pronounced among women, and were not explained by any single component of the DAS28. Conclusion: BMI appears to be associated with RA disease activity in women, but not in men. © Copyright Clinical and Experimental Rheumatology 2010. University of California Los Angeles, Los Angeles, CA University of California Berkeley, Berkeley, CA North Karelia Central Hospital, Joensuu Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre Universidade Federal do Ceará, Fortaleza Universidade Estadual de São Paulo, São Paulo Hospital Universitário de Brasília, Brasilia University of Ioannina Ioannina Waterford Regional Hospital, Waterford Connolly Hospital, Dublin University of Genova, Genova Rheumatology Department, Pristine Institute of Experimental and Clinical Medicine Vilnius University, Vilnius University Medical Centre Utrecht, Utrecht Jyväskylä Central Hospital, Jyväskylä Medcare Oy, Äänekoski Hospital Oakland Research Institute, Oakland, CA Hospital San Juan Bautista, Catamarca Hospital of Cordoba, Cordoba Universidade do Estado do Rio de Janeiro, Rio de Janeiro Riverside Professional Centre, Sydney, NS Copenhagen University Hospital at Hvidovre, Hvidovre King Christian the Xth Hospital, Gråsten Copenhagen University Hospital at Herlev, Herlev Al-Azhar University, Cairo Assiut University Hospital, Assiut Abo Sohage University Hospital, Sohage Tartu University Hospital, Tartu East-Tallinn Central Hospital, Tallinn Centre for Clinical and Basic Research, Tallinn Satakunta Central Hospital, Rauma University René Descartes Hôpital Cochin, Paris Dijon University Hospital University of Burgundy INSERM U887, Dijon Hôpital Lapeyronie, Montpellier Hôpital Hautepierre, Strasbourg School of Medicine National University of Athens, Athens Euroclinic Hospital, Athens Evangelisches Fachkrankenhaus, Ratingen Schlosspark-Klinik, Berlin University Medicine Berlin, Berlin Semmelweis University of Medical Sciences, Budapest Ilona Újfalussy Polyclinic of the Hospitaller Brothers of St. John of God in Budapest, Budapest St. Vincent University Hospital, Dublin Our Lady's Hospice, Dublin Department of Immunology, Lucknow Vedanta Institiute of Medical Sciences, Ahmedabad Department of Immunology Jaipur Hospital Santa Chiara Hospital, Pisa Catholic University of Sacred Heart, Rome University of Ancona, Ancona Institute of Rheumatology Tokyo Women's Medical University, Tokyo Department of Rheumatology Kyoto First Red Cross Hospital, Kyoto Shono Rheumatism Clinic, Fukuoka Kenyatta Hospital, Nairobi Pauls Stradina Clinical University Hospital, Riga Kaunas University Hospital, Kaunas El Ayachi Hospital Mohamed Vth Souissi University, Rabat Sint Franciscus Gasthuis Hospital, Rotterdam Medisch Spectrum Twente, Enschede Sørlandet Hospital, Kristiansand Medical University in Bialystok, Bialystok Medical University of Lublin, Lublin Poznan Rheumatology Centre in Srem, Srem Military Institute of Medicine, Warsaw Silesian Hospital for Rheumatology and Rehabilitation in Ustron Slaski, Ustroñ Slaski Szpital Wojewodzki im. Jana Biziela, Bydgoszcz Wojewodzki Zespol Reumatologiczny im. dr Jadwigi Titz-Kosko, Sopot Spitalul Clinic Sf Maria, Bucharest Institute of Rheumatology of Russian Academy of Medical Sciences, Moscow Moscow Medical Academy, Moscow Russian Medical Academy of Postgraduate Education, Moscow Rheumatology Institut, Niska Banja Hospital de Gran Canaria Dr. Negrin, Las Palmas Hospital Sierrallana Ganzo, Torrelavega Hospital General de Castellón, Castellón Uppsala University Hospital, Uppsala Centrallasarettet, Västerås Hudiksvall Medical Clinic, Hudiksvall Gazi University Medical Faculty, Ankara Meram Medical Faculty, Konya Cerrahpasa Medic Faculty, Istanbul Dubai Bone and Joint Centre, Dubai American Hospital Dubai, Dubai Charing Cross Hospital, London Royal Cornwall Hospital, Truro Kings College Hospital, London Vanderbilt University, Nashville, TN NYU Hospital for Joint Diseases, New York, NY Taylor Hospital, Ridley Park, PA Centra Care Clinic, St. Cloud, MN University of Arkansas for Medical Sciences, Little Rock, AR New York University Hospital for Joint Diseases, New York, NY Universidade Estadual de São Paulo, São Paulo

45. Sex Differences in Quality of Life in Patients With Systemic Lupus Erythematosus

Author

Daniel J. Wallace, Winston Sequeira, Ivanna Blazevic, Elvira Cicognani, Ana M. Bertoli, Sarfaraz Hasni, Luis M. Vilá, Sandra V. Navarra, Berna Goker, Meenakshi Jolly, Joel A. Block, Josiane Bourré-Tessier, Graciela S. Alarcón, Davide Mazzoni, Karina D. Torralba, Seminur Haznedaroglu, Ioana Moldovan, Sergio Toloza, Chi Chiu Mok, Michael H. Weisman, Ann E. Clarke, Jolly, M, Sequeira, W, Block, J, Toloza, S, Bertoli, A, Blazevic, I, Vila, L, Moldovan, I, Torralba, K, Mazzoni, D, Cicognani, E, Hasni, S, Goker, B, Haznedaroglu, S, Bourre-Tessier, J, Navarra, S, Mok, C, Weisman, M, Clarke, A, Wallace, D, Alarcon, G, and Jolly M, Sequeira W., Block J.A., Toloza S., Bertoli A., Blazevic I., Vila L.M., Moldovan I., Torralba K.D., Mazzoni D., Cicognani E., Hasni S., Goker B., Haznedaroglu S., Bourre-Tessier J., Navarra S.V., Mok C.C., Weisman M., Clarke A.E., Wallace D., Alarcón G.

Subjects
Adult, Male, Quality of life, Canada, medicine.medical_specialty, Asia, Psychometrics, Cross-sectional study, Health Status, sex difference, SLE, Disease, Systemic lupus erythematosus (SLE), Health-related quality of life (QoL), gender, Severity of Illness Index, Article, 03 medical and health sciences, Social support, Sex Factors, 0302 clinical medicine, Rheumatology, Internal medicine, Severity of illness, medicine, Humans, Lupus Erythematosus, Systemic, Patient Reported Outcome Measures, 030212 general & internal medicine, Sex Distribution, skin and connective tissue diseases, 030203 arthritis & rheumatology, Lupus erythematosus, Systemic lupus erythematosus, business.industry, Middle Aged, medicine.disease, United States, humanities, Europe, Cross-Sectional Studies, Female, LupusPRO, Morbidity, business
Abstract

Objective Systemic lupus erythematosus (SLE) predominantly affects women. Clinical phenotype and outcomes in SLE may vary by sex and are further complicated by unique concerns that are dependent upon sex-defined roles. We aimed to describe sex differences in disease-specific quality of life (QoL) assessment scores using the Lupus Patient-Reported Outcome (LupusPRO) tool in a large international study. Methods Cross-sectional data from 1,803 patients with SLE on demographics, self-identified sex status, LupusPRO, and disease activity were analyzed. The LupusPRO tool has 2 constructs: health-related QoL (HRQoL) and non-HRQoL. Disease activity and damage were evaluated using the Safety of Estrogens in Lupus Erythematosus National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, respectively. Nonparametric tests were used to compare QoL and disease activity by sex. Results A total of 122 men and 1,681 women with SLE participated. The mean age was similar by sex, but the damage scores were greater among men. Men fared worse on the non-HRQoL social support domain than women (P = 0.02). When comparing disease and QoL among men and women ages ≤45 years, men were found to have greater damage and worse social support than women. However, women fared significantly worse on lupus symptoms, cognition, and procreation domains with trends for worse functioning on physical health and pain-vitality domains. Conclusion In the largest study of a diverse group of SLE patients, utilizing a disease-specific QoL tool, sex differences in QoL were observed on both HRQoL and non-HRQoL constructs. Although men performed worse in the social support domain, women (especially those in the reproductive age group) fared worse in other domains. These observations may assist physicians in appropriately addressing QoL issues in a sex-focused manner.

Published
2019

46. Drivers of Satisfaction With Care for Patients With Lupus

Author

Sarfaraz Hasni, Sandra V. Navarra, Luis M. Vilá, Berna Goker, Meenakshi Jolly, Ana M. Bertoli, Ivana Blazevic, Karina D. Torralba, Daniel J. Wallace, Joel A. Block, Josiane Bourré-Tessier, Davide Mazzoni, Courtney O'Brien, Seminur Haznedaroglu, Michael H. Weisman, Ioana Moldovan, Sergio Toloza, Bhavika Sethi, Chi Chiu Mok, Ann E. Clarke, Winston Sequeira, Elvira Cicognani, Jolly, M, Sethi, B, O'Brien, C, Sequeira, W, Block, J, Toloza, S, Bertoli, A, Blazevic, I, Vilá, L, Moldovan, I, Torralba, K, Cicognani, E, Mazzoni, D, Hasni, S, Goker, B, Haznedaroglu, S, Bourre‐tessier, J, Navarra, S, Mok, C, Clarke, A, Weisman, M, Wallace, D, and Meenakshi Jolly,Bhavika Sethi, Courtney O'Brien, Winston Sequeira,Joel A. Block, Sergio Toloza, Ana Bertoli, Ivana Blazevic, Luis M. Vilá, Ioana Moldovan, Karina D. Torralba, Elvira Cicognani, Davide Mazzoni, Sarfaraz Hasni, Berna Goker, Seminur Haznedaroglu, Josiane Bourre-Tessier, Sandra V. Navarra, Chi Chiu Mok, Ann Clarke, Michael Weisman, Daniel Wallace

Subjects
Biopsychosocial model, Quality of life, Coping (psychology), Univariate analysis, Lupu, lcsh:Diseases of the musculoskeletal system, Lupus erythematosus, Multivariate analysis, Systemic lupus erythematosus, business.industry, satisfaction with care, Original Articles, General Medicine, Disease, social support, medicine.disease, Quality of life, quality of care, systemic lupus erythematosus (SLE), coping, Social support, medicine, Original Article, lcsh:RC925-935, business, Demography
Abstract

Objective Quality of life (QOL) and quality of care (QOC) in systemic lupus erythematosus (SLE) remains poor. Satisfaction with care (SC), a QOC surrogate, correlates with health behaviors and outcomes. This study aimed to determine correlates of SC in SLE. Methods A total of 1262 patients with SLE were recruited from various countries. Demographics, disease activity (modified Systemic Lupus Erythematosus Disease Activity Index for the Safety of Estrogens in Lupus Erythematosus: National Assessment trial [SELENA-SLEDAI]), and QOL (LupusPRO version 1.7) were collected. SC was collected using LupusPRO version 1.7. Regression analyses were conducted using demographic, disease (duration, disease activity, damage, and medications), geographic (eg, China vs United States), and QOL factors as independent predictors. Results The mean (SD) age was 41.7 (13.5) years; 93% of patients were women. On the univariate analysis, age, ethnicity, current steroid use, disease activity, and QOL (social support, coping) were associated with SC. On the multivariate analysis, Asian participants had worse SC, whereas African American and Hispanic patients had better SC. Greater disease activity, better coping, and social support remained independent correlates of better SC. Compared with US patients, patients from China and Canada had worse SC on the univariate analysis. In the multivariate models, Asian ethnicity remained independently associated with worse SC, even after we adjusted for geographic background (China). No associations between African American or Hispanic ethnicity and SC were retained when geographic location (Canada) was added to the multivariate model. Canadian patients had worse SC when compared with US patients. Higher disease activity, better social support, and coping remained associated with better SC. Conclusion Greater social support, coping, and, paradoxically, SLE disease activity are associated with better SC. Social support and coping are modifiable factors that should be addressed by the provider, especially in the Asian population. Therefore, evaluation of a patient's external and internal resources using a biopsychosocial model is recommended. Higher disease activity correlated with better SC, suggesting that the latter may not be a good surrogate for QOC or health outcomes.

Published
2019

47. Pelvic floor training to prevent stress urinary incontinence: A systematic review.

Author

Mantilla Toloza SC, Villareal Cogollo AF, and Peña García KM

Subjects
Humans, Female, Pregnancy, Randomized Controlled Trials as Topic, Pregnancy Complications prevention & control, Urinary Incontinence, Stress prevention & control, Pelvic Floor, Exercise Therapy methods
Abstract

Introduction: Stress urinary incontinence (SUI) is a common disorder in women that has a negative impact on quality of life. Pregnancy and childbirth are considered important risk factors that directly affect the pelvic floor during pregnancy and labour, increasing the risk of pelvic floor dysfunction, with prevalence rates of SUI in the postpartum period ranging from 30 to 47% during the first 12 months., Objective: To determine the effectiveness of pelvic floor muscle training (PFMT) in the prevention of SUI in women during the antenatal and postnatal period by reviewing and evaluating the available scientific literature., Methods: This is a systematic review, using only randomised controlled trials. We searched the databases Pubmed, Scopus, Cochrane and PEDro. We reviewed 7 prospective studies in English and Portuguese, which included 1,401 pregnant women of legal age who underwent PFMT to prevent SUI., Results: The results allowed us to establish that PFMT is used for pelvic floor muscles and that this intervention, applied with the appropriate methodology, can prevent or cure SUI., Conclusions: The application of PFMT in an early stage of pregnancy has positive effects on the continence capacity after delivery., (Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.)

Published
2024
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48. The Syzygy, Reformulation and New Perspectives: Dreams, Anima-Animus and Gender.

Author

Saiz M, Abalos MP, Grez C, Bartfeld M, Benchin F, Toloza S, Porre M, and Falcone J

Subjects
Humans, Male, Female, Psychotherapy, Jungian Theory
Abstract

The main objective of this qualitative and quantitative research paper is to explore the occurrences and relations of the anima, animus and androgynous in dreams, with particular emphasis on the consideration of the androgynous in the human psyche. The sample consists of 9 series of dreams (141 dreams in total), from 9 dreamers, 7 women (female sex/gender) and 2 men (male sex/gender), aged 25-57, heterosexual, undergoing Jungian psychotherapy, and presenting couple-related themes. Statistical results and qualitative analysis offer new input for the re-vision of the classical anima-animus model, and the addition of in-depth explorations into the androgynous, paving the way for a new model of psychopathology and psychotherapeutic clinical work, in transition., (© 2023 The Society of Analytical Psychology.)

Published
2023
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49. Addressing health disparities as a function of ethnicity in systemic lupus erythematosus patients.

Author

González LA, Ugarte-Gil MF, Pons-Estel GJ, Durán-Barragán S, Toloza S, Burgos PI, Bertoli A, Borgia RE, and Alarcón GS

Subjects
Humans, United States epidemiology, Female, Ethnicity, Lupus Erythematosus, Systemic
Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disorder with significant health disparities, as it disproportionately and more severely affects vulnerable and disadvantaged population groups in the United States and around the world, that is, women, ethnic minorities, individuals living in poverty, less educated, and lacking medical insurance. Both, genetic and non-genetic factors, contribute to these disparities. To overcome these health disparities and reduce poor outcomes among disadvantaged SLE populations, interventions on non-genetic amendable factors, especially on social health determinants, are necessary.

Published
2022
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50. Does hydroxychloroquine improve patient reported outcomes in patients with lupus?

Author

Jolly M, Sehgal V, Arora S, Azizoddin D, Pinto B, Sharma A, Devilliers H, Inoue M, Toloza S, Bertoli A, Blazevic I, Vilá LM, Moldovan I, Torralba KD, Mazzoni D, Cicognani E, Hasni S, Goker B, Haznedaroglu S, Bourre-Tessier J, Navarra SV, Clarke A, Weisman M, Wallace D, and Mok CC

Subjects
Adult, Cross-Sectional Studies, Databases, Factual, Female, Humans, Male, Middle Aged, Quality of Life, Antirheumatic Agents therapeutic use, Hydroxychloroquine therapeutic use, Lupus Erythematosus, Systemic drug therapy, Patient Reported Outcome Measures
Abstract

Background: Hydroxychloroquine (HCQ) use is associated with less disease activity, flares, damage and improved survival in Systemic Lupus Erythematosus (SLE). However, its effect on patient reported health outcomes (PROs) such as quality of life (QOL) is not known., Methods: International data from Study on Outcomes of Lupus (SOUL) from 2,161 SLE patients were compared by HCQ use. Disease activity and damage were assessed using SELENA-SLEDAI and SLICC-ACR/SDI. QOL was evaluated using LupusPRO and Lupus Impact Tracker (LIT). Linear regression analyses were performed with LupusPRO summary scores health related HRQOL, non-health related NHRQOL and LIT as dependent and HCQ use as independent variable. Analyses were undertaken to test mediation of effects of HCQ use on QOL through disease activity., Results: Mean age was 40.5 ± 12.8 years, 93% were women. Sixty-three (1363/2161) percent were on HCQ. On univariate analysis, HCQ use was associated with (a) better QOL (LupusPRO-HRQOL: β 6.19, 95% CI 4.15, 8.24, P ≤ 0.001, LupusPRO NHRQOL: β 5.83, 95% CI 4.02, 7.64, P ≤ 0.001) and less impact on daily life (LIT: β -9.37, 95% CI -12.24, -6.50, P ≤ 0.001). On multivariate and mediational analyses, the effects of HCQ on QOL were indirectly and completely mediated through disease activity., Conclusions: HCQ use in SLE is associated with better patient reported health outcomes (LupusPRO-HRQOL and NHRQOL and impact on daily life), and the effects are mediated through disease activity. This information can facilitate patients and physician's communication with decision-making regarding the use of HCQ for SLE management.

Published
2021
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