Rheumatology
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Randomized Controlled Trial
Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis refractory to tumour necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study.
To investigate the effect of tocilizumab on patient-reported outcomes (PROs) in RA patients with inadequate responses to TNF inhibitors (TNFis). ⋯ Tocilizumab treatment in patients with inadequate responses to TNFis resulted in rapid and sustained improvements in multiple PROs that were statistically significant and clinically meaningful, consistent with previous efficacy reports. Trial Registration. ClinicalTrials.gov, http://clinicaltrials.gov/, NCT00106522.
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To identify pre-operative predictors of patient-reported outcomes of primary total knee replacement (TKR) surgery. ⋯ This study identified clinically important predictors of attained pain/function post-TKR. Predictors of pain were not necessarily the same as functional outcomes, which may be important in the context of a patient's expectations of surgery. Other predictive factors need to be identified to improve our ability to recognize patients at risk of poor TKR outcomes.
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To critically review the evidence on the effectiveness of complementary therapies for patients with RA. ⋯ The very limited evidence available indicates that for none of the practitioner-based complementary therapies considered here is there good evidence of efficacy or effectiveness in the management of RA.
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For the purposes of meta-analysis and network meta-analysis, the use of standard outcome measures is ideal. In OA research, the WOMAC was developed as an OA-specific measure of disability. It includes a pain subscale. In 1994 a consensus meeting recommended the use of WOMAC as a primary measure of efficacy in OA. In the context of a review of the efficacy of physical interventions for the relief of the pain of OA of the knee, we investigated the use of WOMAC. ⋯ Poor reporting of both the WOMAC pain subscale and the WOMAC index resulted in significant uncertainty in the interpretation of the results of individual trials and limited their contribution to evidence synthesis. Improved adherence with the standard use of the WOMAC scoring system, with clear reporting of it in trials of OA of the knee should be encouraged.
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To develop evidence-based recommendations for pain management by pharmacotherapy in patients with inflammatory arthritis (IA). ⋯ Eleven evidence-based recommendations on the management of pain by pharmacotherapy in IA were developed. They are supported by a large panel of rheumatologists from 17 countries, thus enhancing their utility in clinical practice.