Abstract:
INTRODUCTION:Early arthritis clinics (EACs) have been well established since 1980s. Most of the data for their effectiveness comes from rheumatoid arthritis (RA) management and is largely limited to process outcomes. There is little evidence that such clinics improve clinical outcomes particularly for psoriatic arthritis (PsA). We examined whether EACs provide better outcomes irrespective of final arthritis diagnosis. METHODS:A 52-week prospective observational study of all inflammatory arthritis patients presenting to early arthritis service at our secondary care hospital in 2016 was undertaken. A protocolised approach to the early initiation of therapy (within 3 weeks) and 6-weekly review of treatment outcomes was embedded irrespective of the arthritis diagnosis. Statistical analysis was undertaken using Mann-Whitney U test for disease activity scores to ascertain the significance of outcomes. RESULTS:Of 1884 patients referred, 482 (25.5%) were triaged into EACs based on set criteria. 159 (64.3%) had RA, 55 (22%) with PsA and 33 had other inflammatory arthritides. Mean DAS28 for RA at first visit was 4.65 (0.6-8.0). Treating to target achieved DAS28 remission for 84 (53.5%) and low disease activity (LDA) for a further 44 (34%). Median time to achieve remission or LDA was 20 weeks (0-52 weeks). Mean tender (TJ) and swollen joint (SJ) counts for PsA at first visit were 8.2 (1-35) and 3.5 (0-14), respectively [n = 55]. The patient (PtGA) and physician (PhGA) global assessments mean were 3.0 and 2.9 (1-5). Target [TJ and SJ ≤ 2] was achieved for 38 patients (69%) and good PsARC response for a further four (7%). Median time to achieve the target or good response was 22 weeks (0-48 weeks). Final TJ and SJ mean was significantly better at 1.2 (0-4) and 0.3 (0-2) [p < 0.0001] with similar improvement in PtGA [mean 1.8 (1-4)] and PhGA [mean 1.6 (1-3)]. CONCLUSION:Dedicated EACs help achieve good clinical outcomes in majority of patients with RA and PsA. Nearly 80% of our cohort attained the target or good disease response in less than 6 months. This was despite a significant delay in patients presenting to their GPs and moderately high disease activity.
journal_name
Rheumatol Intjournal_title
Rheumatology internationalauthors
Nisar MKdoi
10.1007/s00296-019-04253-4subject
Has Abstractpub_date
2019-04-01 00:00:00pages
657-662issue
4eissn
0172-8172issn
1437-160Xpii
10.1007/s00296-019-04253-4journal_volume
39pub_type
杂志文章abstract::We have prepared antibody/3H-dsDNA immune complexes and have used three independent radioimmunoassays to quantitate their interaction with complement; the solution phase C1q assay, the Raji cell assay, and a complement-based red blood cell adherence assay (RBC-CF). Our results indicate that although there is reasonabl...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/BF00541220
更新日期:1981-01-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-006-0227-z
更新日期:2007-02-01 00:00:00
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journal_title:Rheumatology international
pub_type: 临床试验,杂志文章
doi:10.1007/BF00270248
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abstract::The group of autoimmune cutaneous connective tissue diseases (CCTD) includes systemic sclerosis, dermatomyositis (DM), lupus erythematosus (LE), and subtypes. Most CCTD patients can be assigned to one of these phenotypes or mixed forms, and transitions among the subsets exist. We present the case of a 26-year-old woma...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-003-0354-8
更新日期:2004-03-01 00:00:00
abstract::Osteoarthritis (OA) is the most common form of arthritis, resulting in substantial disability and economic burden worldwide. While its exact pathogenesis remains elusive, both in vitro and human population-based studies have merged to support the hypothesis that TGF-β/BMP-mediated signalling pathways play a role in th...
journal_title:Rheumatology international
pub_type: 杂志文章,评审
doi:10.1007/s00296-015-3251-z
更新日期:2015-08-01 00:00:00
abstract::Hydroxyapatite crystals are often deposited in the vicinity of joints, where they can cause a clinical periarthritis. Clodronate is a first-generation bisphosphonate that has the ability to reduce ectopic calcifications. Two women were affected by disabling calcific periarthritis of the shoulders lasting for years and...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-010-1575-2
更新日期:2011-03-01 00:00:00
abstract::Neopterin levels of serum and fluid were determined in 30 patients with inflammatory synovial fluids and in 30 controls with joint effusions induced by trauma or osteoarthritis. Neopterin was significantly elevated in inflammatory fluids. There was no correlation with the acute phase reactants. Neopterin levels were s...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/BF00541281
更新日期:1986-01-01 00:00:00
abstract::Clinical presentation of fibromyalgia syndrome (FMS) is heterogeneous and often involves psychological comorbidities. Clinical subgrouping of FMS patients has been proposed as a strategy to improve patients' long-term outcomes by helping identify specific treatment needs. Using the 90 Symptom Checklist Revised (SCL-90...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-011-2199-x
更新日期:2012-11-01 00:00:00
abstract::Behçet's disease (BD) is a multi-system inflammatory disorder, in which cytokine balance is polarized to Th1. In this study, the cell surface molecule expression, Th1/Th2, inflammatory cytokine levels in blood, and synovial fluid of CD3(+) T lymphocytes in BD were investigated. The study group consisted of 10 BD, 10 a...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-012-2446-9
更新日期:2013-03-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-004-0447-z
更新日期:2005-06-01 00:00:00
abstract::Knee osteoarthritis is a common disease in the elderly population worldwide. The alleviation of the symptoms associated with this disease can be achieved with physical exercise that induces a cascade of molecular and cellular processes. Of the neurotrophins, brain-derived neurotrophic factor (BDNF) appears to be the m...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-013-2786-0
更新日期:2014-06-01 00:00:00
abstract::Healthy human sexuality is integral to a well-lived life. Recent studies reported that sexual problems were common in patients with ankylosing spondylitis (AS) in relation to the consequences of the illness such as pain, stiffness of the spine and depression. Twenty-three female patients with AS and 27 healthy female ...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-011-2340-x
更新日期:2013-01-01 00:00:00
abstract::This study was performed to investigate the frequency of human leukocyte antigen (HLA)-B27 in Chinese patients with suspected of ankylosing spondylitis (AS) and to assess the clinical significance of HLA-B27 typing. A total of 1,016 patients suspected of AS were classified into six groups based on one major AS-related...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-009-1148-4
更新日期:2010-08-01 00:00:00
abstract::A 42-year-old woman presented with a 3-week history of left knee pain and swelling. She had suffered dermatitis herpetiformis for 12 years, proved by skin biopsy. She had never been on gluten-free diet. Knee pain increased with motion and her gait was antalgic. On admission, she was mainly dependent on wheelchair due ...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-010-1670-4
更新日期:2011-05-01 00:00:00
abstract::Noninvasive assessment of endothelial dysfunction (ED) and diagnosing the early vascular development of atherosclerosis in active mucocutaneous Behçet's disease. Twenty-nine active BD patients (study group) without any obstructive vascular involvement were compared with twenty-nine healthy controls (control group) in ...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-007-0491-6
更新日期:2008-05-01 00:00:00
abstract::To investigate the clinical manifestations and outcomes of musculoskeletal (MSK) nontuberculous mycobacterium (NTM) infections. This study was a retrospective cohort study using the Siriraj Hospital database from 2005 to 2017. Enrolled were all patients aged 15 or older who had an MSK infection with NTM identified in ...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-019-04392-8
更新日期:2019-10-01 00:00:00
abstract::Rheumatology has its roots in ancient Greece. Hippocrates and other prominent Greek (Hellenes) physicians in ancient times, Hellenistic, Roman, and Byzantine period were acute observers of disease course and of patients and were able to define many disorders. They wrote books on various aspects of medicine and these w...
journal_title:Rheumatology international
pub_type: 历史文章,杂志文章,评审
doi:10.1007/s00296-019-04261-4
更新日期:2019-06-01 00:00:00
abstract::The distribution of tumour necrosis factor alpha (TNF alpha) in rheumatoid synovium has been investigated. Ten rheumatoid synovia were compared with seven normal synovia and a range of other tissues, using one polyclonal and six monoclonal antibodies. A common staining pattern was obtained with five reagents. Absence ...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/BF00290246
更新日期:1991-01-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-016-3606-0
更新日期:2017-02-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章,评审
doi:10.1007/s00296-017-3677-6
更新日期:2017-07-01 00:00:00
abstract::The results from previous studies on association of IL-6 -174 G/C and -572 G/C polymorphisms with the risk of systemic lupus erythematosus (SLE) remained inconsistent. Therefore, a meta-analysis was performed to assess the association between these two polymorphisms and SLE susceptibility. A literature-based search wa...
journal_title:Rheumatology international
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-02-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-011-2056-y
更新日期:2012-09-01 00:00:00
abstract::We present the case of a patient with long-standing rheumatoid arthritis and an acute onset of total dysfunction of the posterior tibial tendon. On MRI, a rupture of the tendon was apparent. Intraoperatively, however, massive tenosynovitis with stricture of the tendon was identified as the cause of posterior tibial te...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-002-0183-1
更新日期:2002-05-01 00:00:00
abstract::A 51-year-old man shepherd presented with mild pain and swelling of the right posterior aspect of his right elbow. In ultrasonography, the affected bursal space had swelling and effusion. Moreover, the aspiration of the affected bursa revealed an inflammatory profile. Brucella melitensis was detected in aspirated flui...
journal_title:Rheumatology international
pub_type: 杂志文章,评审
doi:10.1007/s00296-019-04414-5
更新日期:2019-12-01 00:00:00
abstract::Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting up to 1% of the worldwide population. RA is associated with multiple extra-articular manifestations (EAMs). Middle ear, cochlea and the auditory nerve are suspected sites of RA activity and hearing loss is a possible novel EAM of RA. Objective was to...
journal_title:Rheumatology international
pub_type: 杂志文章,评审
doi:10.1007/s00296-020-04609-1
更新日期:2020-11-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-004-0477-6
更新日期:2005-10-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-018-3994-4
更新日期:2018-05-01 00:00:00
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journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/BF00270349
更新日期:1986-01-01 00:00:00
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journal_title:Rheumatology international
pub_type: 临床试验,杂志文章
doi:10.1007/s00296-002-0246-3
更新日期:2002-11-01 00:00:00
abstract::Behçet's disease (BD) commonly presents with articular manifestations and thrombotic vasculopathy. Arthritis of BD characteristically demonstrates a recurrent and nondestructive course. The pathobiological basis of the thrombotic vasculopathy and protective factors against cartilage destruction in arthritis of BD have...
journal_title:Rheumatology international
pub_type: 杂志文章
doi:10.1007/s00296-003-0324-1
更新日期:2004-03-01 00:00:00