Comparison of health-related quality of life in rheumatoid arthritis, psoriatic arthritis and psoriasis and effects of etanercept treatment Methotrexate improves the health-related quality of life of children with juvenile idiopathic arthritis. Abatacept improves health‐related quality of life, pain, sleep quality, and daily participation in subjects with juvenile idiopathic arthritis The clinical application of etanercept in Chinese patients with rheumatic diseases Efficacy and safety of open-label etanercept on extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis and psoriatic arthritis: part 1 (week 12) of the CLIPPER study Patient-Reported Outcomes and the Association With Clinical Response in Patients With Active Psoriatic Arthritis Treated With Golimumab: Findings Through 2 Years of a Phase III, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial Health-Related Quality of Life, Physical Function, Fatigue, and Disease Activity in Children with Established Polyarticular Juvenile Idiopathic Arthritis A patient-initiated DMARD self-monitoring service for people with rheumatoid or psoriatic arthritis on methotrexate: a randomised controlled trial Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis Self-reported adherence to a home-based exercise program among patients affected by psoriatic arthritis with minimal disease activity.
Objectives To compare health-related quality of life ( HRQoL ) before and after treatment with etanercept in patients with moderate to severe rheumatoid arthritis ( RA ) , psoriatic arthritis ( PsA ) and psoriasis using spydergram representations . Methods Data from r and omised , controlled trials of etanercept in patients with RA , PsA and psoriasis were analysed . HRQoL was assessed by the medical outcomes survey short form 36 ( SF-36 ) physical ( PCS ) and mental ( MCS ) component summary and domain scores . Baseline comparisons with age and gender-matched norms and treatment-associated changes in domain scores were quantified using spydergrams and the health utility SF-6D measure . Results Mean baseline PCS scores were lower than age and gender-matched norms in patients with RA and PsA , but near normative values in patients with psoriasis ; MCS scores at baseline were near normal in PsA and psoriasis but low in RA . Treatment with etanercept result ed in improvements in PCS and MCS scores as well as individual SF-36 domains across all indications . Mean baseline SF-6D scores were higher in psoriasis than in RA or PsA ; clinical ly meaningful improvements in SF-6D were observed in all three patient population s following treatment with etanercept . Conclusions Patients with RA , PsA and psoriasis demonstrated unique HRQoL profiles at baseline . Treatment with etanercept was associated with improvements in PCS and MCS scores as well as individual domain scores in patients with RA , PsA and psoriasis OBJECTIVES To examine the change in health-related quality of life ( HRQOL ) and its determinants in children with juvenile idiopathic arthritis ( JIA ) treated with methotrexate ( MTX ) .  METHODS Patients were extracted from the PRINTO clinical trial which aim ed to evaluate the efficacy and safety profile of MTX administered in st and ard , intermediate or higher doses ( 10 , 15 and 30 mg/m(2)/week respectively ) . Children with polyarticular-course JIA , who were less than 18 years and had a complete HRQOL assessment were included . RESULTS A total of 521 children were included . At baseline , patients with JIA showed poorer HRQOL ( p<0.01 ) than healthy children . In 207/412 ( 50 % ) and 63 ( 15 % ) children , HRQOL values were 2 st and ard deviations below the mean of healthy controls in the physical and psychosocial summary scale , respectively . After 6 months of treatment with st and ard dose MTX , there was a statistically significant improvement in all HRQOL health concepts , particularly the physical ones . Similar improvements were observed in those who did not respond to a st and ard dose of MTX and were subsequently r and omised to a higher dose . The presence of marked disability at baseline was associated with a fivefold increased risk of retaining poor physical health after 6 months of active treatment with st and ard dose MTX . Other less important determinants of retaining poor physical well-being were the baseline level of systemic inflammation , pain intensity and an antinuclear-antibody-negative status . CONCLUSIONS MTX treatment produces a significant improvement across a wide range of HRQOL components , particularly in the physical domains , in patients with JIA To assess health‐related quality of life ( HRQOL ) in abatacept‐treated children/adolescents with juvenile idiopathic arthritis ( JIA ) Over a 2-year period , to evaluate the efficacy and safety of biologic agents , etanercept ( 25 mg twice per week , s.c . ) was used to treat 57 rheumatoid arthritis ( RA ) patients , 9 ankylosing spondylitis ( AS ) patients , 6 psoriatic arthritis ( PSA ) patients , and 4 juvenile rheumatoid arthritis ( JRA ) patients . In addition to inflammatory arthritis , I have used this tumor necrosis factor ( TNF ) blocker in other rheumatic diseases including idiopathic thrombocytopenic purpura ( ITP ) , Behçet 's disease with intractable oral ulcer , fibromyalgia syndrome , and systemic lupus erythematosis with intractable pleural effusion and acute lumbar disc herniation . For RA , after 6 months of etanercept treatment , all the parameters including number of swollen joints , number of tender joints , disease activity score , erythrocyte sedimentation rate , C-reactive protein , and global health status were rapidly improved ( P < 0.001 or P < 0.0001 ) . The anticyclic citrullinated peptide ( anti-CCP ) antibody and rheumatoid factor also significantly declined . For spondyloarthropathy , it also gave a similar effect as to RA . Both Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index also improved . One of the two cases with Behçet 's disease with intractable oral ulcer had a long-term remission after etanercept . The other Behçet 's disease patient with oral ulcer and another with ITP obtained a good response temporarily . The short-term use of etanercept ( <3 months ) did not bring a significant effect for cases of fibromyalgia syndrome , pleural effusion , and lumbar disc herniation . In conclusion , a dramatic and rapid clinical response in different kinds of arthritis patients can be achieved by etanercept . Moreover , the TNF-α inhibitor also can treat other severe rheumatic-related symptoms . In general , except for a few cases with infection and two cases with malignancy , etanercept was safe in our arthritis patients . We need to study a larger number of patients in order to better underst and the efficacy and safety of etanercept Objective To investigate the efficacy and safety of etanercept ( ETN ) in paediatric subjects with extended oligoarticular juvenile idiopathic arthritis ( eoJIA ) , enthesitis-related arthritis ( ERA ) , or psoriatic arthritis ( PsA ) . Methods CLIPPER is an ongoing , Phase 3b , open-label , multicentre study ; the 12-week ( Part 1 ) data are reported here . Subjects with eoJIA ( 2–17 years ) , ERA ( 12–17 years ) , or PsA ( 12–17 years ) received ETN 0.8 mg/kg once weekly ( maximum 50 mg ) . Primary endpoint was the percentage of subjects achieving JIA American College of Rheumatology ( ACR ) 30 criteria at week 12 ; secondary outcomes included JIA ACR 50/70/90 and inactive disease . Results 122/127 ( 96.1 % ) subjects completed the study ( mean age 11.7 years ) . JIA ACR 30 ( 95 % CI ) was achieved by 88.6 % ( 81.6 % to 93.6 % ) of subjects overall ; 89.7 % ( 78.8 % to 96.1 % ) with eoJIA , 83.3 % ( 67.2 % to 93.6 % ) with ERA and 93.1 % ( 77.2 % to 99.2 % ) with PsA. For eoJIA , ERA , or PsA categories , the ORs of ETN vs the historical placebo data were 26.2 , 15.1 and 40.7 , respectively . Overall JIA ACR 50 , 70 , 90 and inactive disease were achieved by 81.1 , 61.5 , 29.8 and 12.1 % , respectively . Treatment-emergent adverse events ( AEs ) , infections , and serious AEs , were reported in 45 ( 35.4 % ) , 58 ( 45.7 % ) , and 4 ( 3.1 % ) , subjects , respectively . Serious AEs were one case each of abdominal pain , bronchopneumonia , gastroenteritis and pyelocystitis . One subject reported herpes zoster and another varicella . No differences in safety were observed across the JIA categories . Conclusions ETN treatment for 12 weeks was effective and well tolerated in paediatric subjects with eoJIA , ERA and PsA , with no unexpected safety findings To evaluate the effect of golimumab on physical function , health‐related quality of life ( HRQOL ) , and productivity in psoriatic arthritis ( PsA ) Objective . To compare child  self-report and parent/proxy report of health-related quality of life ( HRQOL ) , disability , and fatigue in children with active polyarticular juvenile idiopathic arthritis ( JIA ) to that of children with inactive polyarticular JIA and to previous data from healthy controls . Methods . Cross-sectional survey of children with polyarticular JIA diagnosed and treated between 2000 to 2006 and their parent/proxy . The Childhood Health Assessment Question naire , Pediatric Quality of Life Inventory ( PedsQL ) Generic Core Scales , PedsQL Rheumatology Module , and PedsQL Multidimensional Fatigue Scale were administered . Disease activity data were collected from the physician clinic notes . Comparisons were performed with t tests . Correlations between patient and parent/proxy reports were measured with Pearson correlation coefficients . Results . Sixty children and /or their parents/proxies participated ( 79 % response rate ) . Disease activity status was available for 52 , and 32 met criteria for inactive disease ( 62 % ) . Participants reported lower scores on the PedsQL Generic Core Scales ( range 2.54–9.13 points lower ) and the PedsQL Rheumatology Module ( range 2.46–6.96 points lower ) than those with inactive disease . Participants also reported lower scores on the PedsQL Multidimensional Fatigue Scale than did healthy controls , regardless of disease activity status ( range 0.06–9.2 points lower ) . Conclusion . Although children in this cohort with polyarticular JIA and inactive disease reported HRQOL scores similar to those of healthy controls , children with polyarticular JIA and their parents/proxies tended to report more fatigue than controls , regardless of disease activity . Application of these measures prospect ively to larger cohorts of children with JIA is needed to assess these differences Objective To determine the effectiveness of a patient-initiated disease-modifying antirheumatic drugs ( DMARD ) self-monitoring service for people with rheumatoid ( RA ) or psoriatic arthritis ( PsA ) on methotrexate .  Methods A two-arm , single-centre , r and omised controlled trial assessing superiority in relation to healthcare use , clinical and psychosocial outcomes . Participants were 100 adults with either RA or PsA on a stable dose of methotrexate , r and omly assigned to usual care or the patient-initiated service .  Intervention participants were trained how to underst and and interpret their blood tests and use this information to initiate care from their clinical nurse specialist ( CNS ) . The primary outcome was the number of outpatient visits to the CNS during the trial period . Differences between groups were analysed using Poisson regression models . Secondary outcomes were collected at baseline and after the third and sixth blood tests . Disease activity was measured using either the Disease Activity Score in 28 joints or Psoriatic Arthritis Response Criteria ( PsARC ) , pain and fatigue using a visual numeric scale and the Health Assessment Question -II , Hospital Anxiety and Depression Scale and SF12 were completed to assess disability , mood and quality of life , respectively . Differences between groups over time on secondary outcomes were analysed using multilevel models . Results The patient-initiated DMARD self-monitoring service was associated with 54.55 % fewer visits to the CNS ( p<0.0001 ) , 6.80 % fewer visits to the rheumatologist ( p=0.23 ) and 38.80 % fewer visits to the general practitioner ( p=0.07 ) , compared with control participants . There was no association between trial arm and any of the clinical or psychosocial outcomes . Conclusions The results suggest that a patient-initiated service that incorporates patients ’ self-monitoring DMARD therapy can lead to significant reductions in healthcare use , while maintaining clinical and psychosocial well-being . Trial registration number IS RCT N21613721 Our aim is to assess the prevalence and associated clinical features of  anti-CCP ( cyclic citrullinated peptide )  antibodies for RF ( rheumatoid factor)-positive and RF-negative rheumatoid arthritis ( RA ) and psoriatic arthritis ( PsA ) . In a prospect i ve , cross-sectional , multi-centre study , we determined the titres of anti-CCP antibodies in 208 RA patients ( 129 RF-positive , 79 RF-negative ) , 56 PsA patients and 39 healthy controls ( HC ) . Clinical parameters including disease activity ( disease activity score 28—DAS28 ) , physical disability ( health assessment question naire — HAQ ) , functional capacity ( functional class ) and radiological erosions were investigated in patients with RA . In PsA patients , clinical and radiological features were determined . Anti-CCP2 antibodies were measured using a second-generation anti-CCP enzyme-linked immunosorbent assay ( Euro-Diagnostica , Netherl and s ) . One-hundred four of 129 RF-positive RA ( 81 % ) , 16 of 79 RF-negative RA ( 20 % ) , seven of 56 PsA patients ( 12.5 % ) and none of the HC had anti-CCP antibodies . RA patients with anti-CCP antibodies had significantly higher disease activity , greater loss of function and more frequent erosive disease than anti-CCP antibody-negative group . In subgroup analysis , anti-CCP antibodies in RF-negative patients were also associated with erosive disease . All PsA patients with anti-CCP antibodies had symmetric arthritis with higher number of swollen joints . The prevalence of anti-CCP antibodies in RF-positive RA patients was significantly higher than in RF-negative RA and PsA patients . Anti-CCP antibodies were also associated with erosive disease in RF-negative RA patients . Both anti-CCP and RF tests were negative in 30 % of the patients . Anti-CCP positivity was a frequent finding in PsA and associated with symmetrical polyarthritis Objectives To compare the prevalence , clinical and radiographic characteristics of  psoriatic spondyloarthritis ( PsSpA ) in psoriatic arthritis ( PsA ) , with ankylosing spondylitis ( AS ) . Methods A prospect i ve single-centre cross-sectional observational study recruited consecutive PsA and AS cases . Participants completed outcome measures , and underwent clinical examination , axial radiographic scoring and HLA-sequencing . Multivariable analyses are presented . Results The 402 enrolled cases ( 201 PsA , 201 AS ; fulfilling classification criteria for respective conditions ) were reclassified based upon radiographic axial disease and psoriasis , as : 118 PsSpA , 127 peripheral-only PsA ( pPsA ) , and 157 AS without psoriasis ( AS ) cases . A significant proportion of patients with radiographic axial disease had PsSpA ( 118/275 ; 42.91 % ) , and often had symptomatically silent axial disease ( 30/118 ; 25.42 % ) . Modified New York criteria for AS were fulfilled by 48/201 ( 23.88 % ) PsA cases , and Classification of Psoriatic Arthritis criteria by 49/201 ( 24.38 % ) AS cases . pPsA compared with PsSpA cases had a lower frequency of HLA-B*27 ( OR 0.12 ; 95 % CI 0.05 to 0.25 ) . Disease activity , metrology and disability were comparable in PsSpA and AS . A significant proportion of PsSpA cases had spondylitis without sacroiliitis ( 39/118 ; 33.05 % ) ; they less frequently carried HLA-B*27 ( OR 0.11 ; 95 % CI 0.04 to 0.33 ) . Sacroiliac joint complete ankylosis ( adjusted OR , ORadj 2.96 ; 95 % CI 1.42 to 6.15 ) and bridging syndesmophytes ( ORadj 2.78 ; 95 % CI 1.49 to 5.18 ) were more likely in AS than PsSpA. Radiographic axial disease was more severe in AS than PsSpA ( Psoriatic Arthritis Spondylitis Radiology Index Score : adjusted incidence risk ratio 1.13 ; 95 % CI 1.09 to 1.19 ) . Conclusions In a combined cohort of patients with either PsA or AS from a single centre , 24 % fulfilled classification criteria for both conditions . The pattern of axial disease was influenced significantly by the presence of skin psoriasis and HLA-B*27 More than half of all patients with psoriatic arthritis ( PsA ) exhibit progressive erosive arthritis , associated with severe functional impairment and psychosocial disability .  Biologics have been suggested to be more effective in inducing minimal disease activity " ( MDA ) than disease-modifying antirheumatic drugs ( DMARDs ) . Behavioral patient education appears to be more effective in encouraging patients to increase their physical activity ( PA ) levels . The aim of the study was to evaluate the benefits of home-based exercises program on disease activity and quality of life in MDA-PsA patients treated with an anti-tumor necrosis factor ( TNF ) and DMARD therapy .  We observed a self-reported adherence rate to home-based exercise of 76.6 % and data showed the impact of the exercise program on self-reported health and mental assessment . A positive relationship between patient and therapist is crucial , influencing the quality of the performance , the emotional support , and increasing motivation in PsA patients
There is very limited evidence for the effectiveness of IDIs on PA and HRQoL in RA and JIA and no evidence for their effectiveness in PsA or AS
The aim of this systematic review was to evaluate the evidence from r and omised controlled trials ( RCTs ) evaluating the effectiveness of interactive digital interventions ( IDIs ) for physical activity ( PA )  and  health related quality of life ( HRQoL )  in people with Inflammatory Arthritis [ rheumatoid arthritis ( RA ) , juvenile idiopathic arthritis ( JIA ) axial Spondyloarthritis ( AS ) and psoriatic arthritis ( PsA ) ] .