Clinical rheumatology
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Clinical rheumatology · Oct 2015
Meta AnalysisEffects of home-based exercise intervention on health-related quality of life for patients with ankylosing spondylitis: a meta-analysis.
The objective of this paper was to objectively evaluate the effectiveness of home-based exercise interventions for improving health-related quality of life in patients with ankylosing spondylitis (AS). Databases including PubMed, Web of Science, EMBASE, Ovid-Medline, and The Cochrane Library were electronically searched published from inception through October 2014 involving home-based exercise intervention in AS patients. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), depression and pain as outcomes were included. ⋯ Meta-analyses showed that home-based exercise interventions significantly reduced the BASFI scores (MD = -0.39, 95 % CI -0.57, -0.20, p = 0.001), BASDAI scores (MD = -0.50, 95 % CI -0.99, -0.02, p = 0.04), depression scores (MD = -2.31, 95 % CI -3.33, -1.30, p = 0.001), and for pain scores because of different evaluation methods among these studies; therefore, a subgroup analysis should be conducted for comparison. The results show that home-based exercise interventions can effectively improve the health-related quality of life in patients with AS. The benefit and clinical performance of home-based exercise care requires further investigation by a series of multicenter, large-sample size randomized controlled trails.
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Clinical rheumatology · Oct 2015
Retention of the second-line biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis failing one tumor necrosis factor alpha inhibitor: data from the BioRx.si registry.
This study aimed to investigate the retention of the second-line biologic disease-modifying antirheumatic drugs (bDMARDs) in rheumatoid arthritis patients failing their first tumor necrosis factor alpha inhibitor (TNFi). Data was extracted from the Slovenian registry (BioRx.si) on December 15, 2012. Baseline patient characteristics were compared between second-line TNFi and non-TNFi, and potential confounders were identified by the means of binary logistic regression. ⋯ There appears to be a statistically significant retention advantage of the non-TNFi over the second-line TNFi (log rank test, p = 0.000). This advantage is retained even after taking into account the possible effect of confounders which was tested using the inverse probability-weighted Cox model [hazard ratio (HR) 4.39; 95 % confidence interval (CI) 2.62-8.01, p < 0.001]. After the first-line TNFi's failure, a second-line TNFi is more likely to fail earlier than non-TNFi.