December 2023 to March 2024
Author: Halbert Hernández-Negrin
Arthritis Care and Research
Gait alterations in knee osteoarthritis
Bacon et al (doi: 10.1002/acr.25327) analyzed gait alterations associated with worsening knee pain and physical function in osteoarthritis patients using machine learning approaches applied to wearable-sensor derived data. Through the Multicenter Osteoarthritis Study cohort with 2324 participants, 29% and 24% had worsening knee pain and function over 2-years, respectively. They found that greater gait asymmetry, longer average step length, and lower dominant frequency were associated with worsening pain, and lower cadence was associated with worsening function. These alterations could be assessed with wearable sensors in clinical settings.
Estimation of mortality in systemic-sclerosis-associated pulmonary hypertension
Brown et al. (doi: 10.1002/acr.25328) evaluated the 2022 European Society of Cardiology (ESC) risk score in predicting mortality among systemic sclerosis-associated pulmonary arterial hypertension patients. The ESC updated and simplified its risk stratification tool, based on three variables: WHO functional class (FC), serum N-terminal pro-brain type natriuretic peptide (NT-proBNP) and six-minute walk distance (6MWD). This study demonstrated that the 2022 ESC score accurately predicts all-causes mortality risk, with a higher score correlating with increased significant risk at baseline and follow-up, suggesting its utility in clinical assessments for these patients.
Palliative care needs in systemic sclerosis
Ross et al.’s work (doi: 10.1002/acr.25329) assessed the need for specialist palliative care in systemic sclerosis. Using data from 875 patients enrolled in the Australian Scleroderma Cohort Study, they defined need for palliative care as a high symptom burden at ≥2 consecutive study visits, ≥50% of overall study visits or at the study visit immediately prior to death. Their results indicate that 72% of the patients had unmet palliative care needs, particularly in managing severe pain, breathlessness, constipation, fatigue and mobility issues. This underscores the importance of integrated care models for this complex patient group.
Methylprednisolone pulses in systemic lupus erythematosus to induce prolonged remission
Ruiz-Irastorza et al. (doi: 10.1002/acr.25334) focused on the impact of methylprednisolone pulses in achieving prolonged remission in SLE. Their findings showed that patients receiving methylprednisolone pulses within the first year had a significantly higher rate of prolonged remission (57% vs. 34%, p=0.042) and required lower average doses of maintenance prednisone (6.6 mg/day vs. 10.2 mg/day, p=0.017 for moderate activity; 14 mg/day vs. 28 mg/day, p=0.015 for severe activity). This study supports the use of methylprednisolone pulses to induce prolonged remission in patients with SLE, particularly in those with moderate and severe disease activity.
Sex differences in the initiation of NSAIDs and bDMARDs in axial spondyloarthritis
Shridharmurthy et al. (doi: 10.1002/acr.25332) investigated sex differences in the initiation of NSAIDs or bDMARDs among axial spondyloarthritis patients, identifying that NSAIDs were initiated earlier in females than males (NSAID initiators: Females (32.9%), Males (29.3%); aHR: 1.14, 95% CI: 1.11-1.16).). Time to bDMARDs initiation was longer for females than males (aHR:0.61, 95% CI:0.52-0.72), but bDMARDs were initiated sooner among those with NSAIDs use in the baseline period. This highlighting the need for gender-equitable treatment strategies.
Halbert Hernández-Negrin
Halbert is an internist, Master in Autoimmune Diseases by the University of Barcelona and is a researcher at the Systemic Autoimmune Diseases Unit of the Internal Medicine Service of the Regional University Hospital of Malaga and Biomedical Research Institute of Malaga (IBIMA-BIONAND Platform) and PhD student at the University of Malaga. His research interests focus on epidemiological and translational research in systemic autoimmune diseases, specifically in systemic lupus erythematosus.