Clinical rheumatology
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Clinical rheumatology · Dec 2016
Disease-specific pain and function predict future pain impact in hip and knee osteoarthritis.
The objective of this study is to determine if osteoarthritis (OA) pain and function, persistent low back pain (LBP) and psychosocial factors predict future pain impact (PI) in people with hip and knee OA. In a population-based cohort with hip/knee OA, a standardized telephone questionnaire was used to assess baseline sociodemographics, baseline PI, patient-reported OA severity (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) summary score), psychosocial factors (fatigue, pain catastrophizing (PC), anxiety, social network, and depression), and self-reported persistent LBP. Two years post-baseline, PI was assessed using the Pain Impact Questionnaire. ⋯ In a population-based cohort with hip/knee OA, only the baseline WOMAC summary score was an independent predictor of future PI. This suggests that treatment needs to be focused on limiting pain severity and functional limitations in individuals with hip and knee OA. However, scores for the psychosocial factors are indicative of a healthy cohort and therefore results may not be generalizable to those with poorer psychosocial health.
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Clinical rheumatology · Dec 2016
Observational StudySafety and efficacy of etanercept and adalimumab in children aged 2 to 4 years with juvenile idiopathic arthritis.
The TNF inhibitors etanercept (ETA) and adalimumab (ADA) are approved for treating patients older than 2 years with polyarticular juvenile idiopathic arthritis (JIA). Because long-term experience of treating children younger than 4 years is limited, we evaluated the efficacy and safety of ETA or ADA in patients aged 2-4 years. This prospective, long-term, observational registry study documented baseline demographics, clinical characteristics, disease activity parameters, and safety of patients treated with ETA or ADA. ⋯ Seventy-nine adverse events and four serious adverse events were reported. Administration of ETA and ADA in JIA patients younger than 4 years was efficacious, well tolerated, and safe. Patients younger than 4 years may show marked improvement following anti-TNF-alpha therapy.