Education for people with inflammatory arthritis

INTRODUCTION
Patient education is a planned interactive learning process designed to support and enable people with inflammatory arthritis to manage their life and optimise their health. Patient education activities include giving help and advice on healthy living and how to stay well. Receiving patient education helps people to manage their own illness and to have better health and well-being. EULAR recommendations give advice to doctors and patients about the best way to treat and manage diseases. EULAR has published in 2015 recommendations on patient education for people with inflammatory arthritis. Inflammatory arthritis is a group of conditions where the joints become stiff and painful due to the immune system attacking the body’s own tissues and causing inflammation. The main conditions include rheumatoid arthritis, spondyloarthritis/ankylosing spondylitis and psoriatic arthritis. Doctors, nurses, health professionals and patients worked together to develop these recommendations. Including patients in the team ensured that the patient point of view was integrated in the recommendations. The authors looked especially at the evidence on what type of patient education is provided, who provides it and how it is provided. They also looked at the evidence on how well patient education works. Continue reading Education for people with inflammatory arthritis

Managing the use of glucocorticoid therapy in rheumatic disease

This is the patient version of the EULAR recommendations for the management of glucocorticoid medicines in people with rheumatic diseases. The original publication can be downloaded from the EULAR website: www.eular.org.

INTRODUCTION
Glucocorticoids (prednisone or prednisolone) are medicines to reduce inflammation. They are used in rheumatic diseases such as rheumatoid arthritis, polymyalgia, lupus and vasculitis for a long time. Documents called recommendations give advice to doctors and patients about the best way to treat and manage diseases. EULAR has written recommendations on glucocorticoids for people with rheumatic diseases before. Those recommendations focused on low (small) doses (less than 7.5 mg every day) rather than the medium or high (large) doses that some people need to take – sometimes as much as 100 mg every day. These new recommendations will make sure that higher doses are used safely. The recommendations were written by doctors and patients. The authors looked at the evidence on the use of medium and high doses of glucocorticoids. They looked especially at the adverse events (side effects) that the medicine can cause.
Continue reading Managing the use of glucocorticoid therapy in rheumatic disease

Newly updated advice on the treatment of patients with AAV

INTRODUCTION
A central focus of newly updated recommendations on treating ANCA-associated vasculitis (AAV) is shared decision-making between patients and doctors. The updated recommendations, produced by a collaboration between the European League Against Rheumatism (EULAR) and European Renal Association – European Dialysis and Transplant Association (ERA-EDTA), taking account of recent research on the benefits and safety treatments for AAV.
Continue reading Newly updated advice on the treatment of patients with AAV

A step closer to defining ‘flare’ in people with axial spondyloarthritis

Flares may be used as outcomes in trials and studies, but to date there is no agreed consensus on how to define them in people with axial spondyloarthritis.

INTRODUCTION
Spondyloarthritis is an umbrella term for several conditions that share many of the same features and symptoms, including ankylosing spondylitis, psoriatic arthritis and reactive arthritis. Patients can also be classified as having axial or non-axial (peripheral) disease, according to which joints in their body are affected. Axial disease affects the sacroiliac joint (in the back part of the pelvis) causing back pain and stiffness. People with axial spondyloarthritis may suffer from flares of their disease, when the symptoms get much worse. These flares tend to alternate with periods of low disease activity or remission, when a person may feel well.
Continue reading A step closer to defining ‘flare’ in people with axial spondyloarthritis

Can adding a musculoskeletal ultrasound assessment to an intensive early treatment strategy improve outcomes for people with rheumatoid arthritis?

Regular use of ultrasound may lead to more intensive treatment, but does not significantly affect short-term outcomes.

INTRODUCTION
Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints and sometimes their internal organs. Many studies have suggested that treatment and interventions should target disease in the early stages to help prevent disability and long-term damage. Current treatment recommendations suggest that disease-modifying antirheumatic drugs (DMARDs) should be used early as part of a ‘treat-to-target’ strategy to achieve low disease activity or remission. Imaging techniques allow doctors to see inside the joints to assess any damage and to monitor disease activity and progression (worsening). Common imaging techniques include X-ray, magnetic resonance imaging (MRI) and ultrasound. Musculoskeletal ultrasound is useful for assessing disease activity in rheumatoid arthritis because it is easy and convenient to use, it avoids the use of radiation, and it allows multiple joints and areas to be examined during a single appointment. This allows clinical flares and the progression or worsening of joint damage to be predicted.
Continue reading Can adding a musculoskeletal ultrasound assessment to an intensive early treatment strategy improve outcomes for people with rheumatoid arthritis?

Textile dust is a risk factor for the development of rheumatoid arthritis

Exposure to textile dust is associated with an increased risk of developing rheumatoid arthritis. In addition, a gene–environment interaction is also seen.

INTRODUCTION
Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints and sometimes their internal organs. Rheumatoid arthritis may develop for a number of reasons, and there may be a link between environmental and genetic factors. Cigarette smoking and inhaling certain chemicals such as silica have both been shown to increase a person’s risk of developing rheumatoid arthritis. It is thought that the chemicals and irritants in smoke and dust particles might cause changes in the lungs. These changes trigger an autoimmune response – leading to inflammation and the development of rheumatoid arthritis.

Continue reading Textile dust is a risk factor for the development of rheumatoid arthritis

New cut-offs for the DAPSA may aid disease activity scoring

The DAPSA is a disease-specific, validated and feasible tool for the assessment of psoriatic arthritis.

INTRODUCTION
Psoriatic arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. The disease often causes swelling of the fingers and toes. It gets its name from the link between this type of arthritis and a skin condition called psoriasis, which causes redness and scaling. Being able to measure disease activity in psoriatic arthritis allows doctors to see how well medicines are working. There are many different disease activity scores available that look at different parameters. The Disease Activity Index for Psoriatic Arthritis (also known as DAPSA) is one of these and has been developed to include a series of key disease elements. High disease activity generally means that a person’s disease is not well controlled, and may be causing joint damage and pain. Being in low disease activity or remission (no signs of symptoms) is the goal of treatment for psoriatic arthritis. Continue reading New cut-offs for the DAPSA may aid disease activity scoring

Negative life events may cause chronic pain

Negative life events are a risk factor for the onset of chronic pain, suggesting that psychosocial factors play a role in triggering the development of this condition.

INTRODUCTION
Some people experience chronic, long-term pain with no obvious medical reason. It is thought that this could be caused by stressful events in a person’s life that cause areas of the brain and nervous system to become extra sensitive. Stress is a normal biological response to a threat. The biological stress system is a complicated interaction between the body’s stress hormones, the immune system and the nervous system. Some parts of this are sometimes called the ‘fight or flight’ response. Continue reading Negative life events may cause chronic pain

Inflammation in rheumatoid arthritis results in shortened lifespan

Much of the increase in mortality in people with rheumatoid arthritis who are also diagnosed with cancer may be due to the inflammatory effects of the arthritis or its treatment, and not the cancer.

INTRODUCTION
Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can affect both men and women of all ages. The inflammation can also affect people’s internal organs. Patients with rheumatoid arthritis have a higher risk of developing cancer and a shorter lifespan compared to healthy people of the same age. Decreased survival in people with rheumatoid arthritis is still a problem despite the availability of new treatments for the disease. Continue reading Inflammation in rheumatoid arthritis results in shortened lifespan

Economic background can have an impact on patient-reported outcomes

There are differences in outcomes across countries, with worse physician-reported outcomes but better patient reported outcomes in low-income countries.

INTRODUCTION
Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects both men and women. Inequalities in the health of people with rheumatoid arthritis have been reported. Previous studies have noticed that rheumatoid arthritis patients with lower incomes or lower levels of education have higher disease activity than those who are wealthier or have completed higher education. This link also seem to be true at international level, as people in less wealthy countries tend to have worse disease activity than people living in richer countries. Continue reading Economic background can have an impact on patient-reported outcomes