August 2023 to November 2023
Authors: Dalifer Freites Nuñez and Alejandro Gómez Gómez
Arthritis Care and Research
ACR 2022 guidelines for prevention and treatment of glucocorticoid-induced osteoporosis
Humphrey et al (doi.org/10.1002/acr.25240) presented the 2022 ACR guidelines for prevention and treatment of glucocorticoid-induced osteoporosis, for patients with rheumatic or non-rheumatic conditions receiving >3 months of treatment with glucocorticoids (GCs) ≥2.5 mg daily. The guidelines strongly recommend conducting an initial assessment of fracture risk, including clinical fracture assessment, bone mineral density measurement with vertebral fracture assessment or spinal x-ray, and the use of the Fracture Risk Assessment Tool if ≥40 years old as soon as possible after the initiation of GCs. For adults at medium, high, or very high fracture risk, they strongly recommend pharmacological treatment. Choice of treatment should be made by shared decision-making. Anabolic agents are conditionally recommended as initial therapy for those with high and very high fracture risk.
Factors associated with AxSpA diagnostic delay
McDermott et al (doi.org/10.1002/acr.25264) investigated factors associated with axial spondyloarthritis diagnostic delay. Among 554 patients with a median diagnostic delay of 3.8 (IQR 1.1 to 10) years, peripheral arthritis (OR: 0.65, 95% CI: 0.45 to 0.93) and older age at symptom onset (OR: 0.83, 95% CI: 0.78 to 0.88 per 5 years) were associated with shorter delay. Ankylosing spondylitis at diagnosis (OR: 1.85, 95% CI: 1.30 to 2.63), a history of uveitis prior to diagnosis (OR: 2.77, 95% CI: 1.73 to 4.52), and higher social vulnerability (OR: 1.99, 95% CI: 1.06 to 3.84) were associated with longer diagnostic delay.
Systematic review of anxiety in adult patients with RA
Meade et al (doi.org/10.1002/acr.25245) performed a systematic review in adults with RA to determine the overall prevalence, severity, and commonly used measures of anxiety. In studies conducted across 23 countries, anxiety prevalence ranged from 2.4% to 77%, predominantly determined with standardized self-reporting measures; only 8 studies used a clinical diagnostic interview to confirm a specific anxiety diagnosis. Notable associations with anxiety in RA were physical disability, pain, disease activity, depression, and quality of life.
Delivery of an eHealth physical activity programme in patients with osteoarthritis
Mesa-Castrillon et al (doi.org/10.1002/acr.25272) evaluated the effectiveness of a 3-month physiotherapist-delivered eHealth physical activity program compared with usual care to improve function in 156 adults with low back pain or knee osteoarthritis in rural Australia. Participants receiving the eHealth intervention (n=78) reported significantly greater and clinically worthwhile improvements in function (mean between-group difference 3.6; 95% CI: 1.3 to 5.9) compared to participants receiving usual care (n=78). Improvements in disability (7.2/100; 95% CI: 2.1 to 12.3), and quality of life (4.5/100; 95% CI: 0.0 to 9.0) also favoured the eHealth group. No differences between groups were found for the secondary outcomes of pain, coping skills, and physical activity levels.
Extra-articular RA manifestations: incidence and mortality risk
Kimbrough et al (doi.org/10.1002/acr.25231) assessed the changes in the cumulative incidence of extra-articular manifestations of RA (ExRAs) and associated mortality risk. The 10-year cumulative incidence of any ExRA decreased significantly between the earlier and later cohorts (45.1% vs 31.6%, p< 0.001). Mortality was increased in patients with either non-severe (HR: 1.83, 95% CI: 1.18 to 2.85) or severe ExRAs (HR: 3.05, 95% CI 1.44 to 6.49).
Dálifer Freites Núñez
Dálifer is a rheumatologist at Hospital Clínico San Carlos, Madrid, Spain, and a PhD candidate at Complutense University of Madrid. Dálifer is a member of the EMEUNET Social Media committee, with a genuine interest and enthusiasm in research on immune-mediated inflammatory diseases and their treatments.
Alejandro Gómez
Alejandro is a consultant rheumatologist at Hospital Universitari Vall d’Hebron, in Barcelona, and a PhD candidate at Complutense University of Madrid. His main clinical and research interests are Sjögren’s syndrome, uveitis and crystal-induced arthritis. Alejandro is a member of Social Media Sub-Committee.