Rheumatology
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Febuxostat is a new non-purine xanthine oxidase inhibitor that is more potent than allopurinol 300 mg daily. In two Phase III trials, significantly more febuxostat-treated gout patients met the primary endpoint [serum urate (sUA) <6 mg/dl (<360 mumol/l) at the last three visits] (48 and 53% with 80 mg; 65 and 62% with 120 mg), compared with those receiving allopurinol 300 mg (22 and 21%; P < 0.001 in both studies). Febuxostat was more effective than allopurinol in the subset with impaired renal function; no dose adjustment is required in mild-to-moderate renal impairment. ⋯ Co-administration of febuxostat with AZA or 6-mercaptopurine is not recommended. Prophylaxis (colchicine and/or NSAIDs) against acute attacks should be used for at least the first 6 months, since early mobilization flares were observed in the clinical trials. In conclusion, febuxostat is more effective than allopurinol 300 mg daily in reducing sUA levels <6 mg/dl (360 mumol/l), the target recommended by EULAR, and offers a new option for the long-term treatment of gout.
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To adapt the self-administered comorbidity questionnaire (SCQ) into the Early Inflammatory Arthritis-SCQ (EIA-SCQ) and assess its clinimetric properties in EIA. ⋯ The EIA-SCQ is reliable and valid for use in EIA. It has the potential to become a useful measure of comorbidity in outcome studies of EIA when the resources for a full medical chart review are unavailable.
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Multicenter Study
Risk factors for death and the 3-year survival of patients with systemic sclerosis: the French ItinérAIR-Sclérodermie study.
This longitudinal study investigated survival, risk factors and causes of death in the multicentre ItinérAIR-Sclérodermie cohort of patients with SSc without severe pulmonary fibrosis or severe left heart disease at baseline. ⋯ This 3-year study observed survival and mortality estimates that were comparable with previous reports. PAH increased the HR for mortality in patients with SSc, justifying yearly echocardiographic screening.
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To determine the impact of the onset of hand problems on global physical functioning in community-dwelling older adults. ⋯ The development of hand problems has a detrimental effect on global physical functioning even in the absence of concurrent lower limb problems. The assessment and effective treatment of hand problems could prove to be important components of maintaining function in the older adult with joint pain and OA.
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To examine the pattern of scores on self-efficacy, health status and use of self-management techniques among a group of Arthritis Self-Management Programme (ASMP) participants over an 8-yr period, and to describe participants' perspectives of the ASMP and current use of self-management. ⋯ Long-term maintenance of self-efficacy, psychological well-being and self-management techniques may be possible following attendance on the ASMP. The need for additional psychological support for those who are having difficulty adjusting to their condition and its consequences is highlighted.