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Al Jundi S, Martinez JR, Cresta J, Yousefi F, DeSantis G, Thoonkuzhy M, Rabut E, Mohanraj B, Mauck RL, Dodge GR. Identifying small molecules for protecting chondrocyte function and matrix integrity after controlled compressive injury. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100289. [PMID: 36474951 PMCID: PMC9718264 DOI: 10.1016/j.ocarto.2022.100289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/30/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022] Open
Abstract
Objective Articular cartilage injury is central for the development of post-traumatic osteoarthritis (PTOA). With few disease-modifying therapies successful at offsetting progressive osteoarthritis (OA), our goal is to use a high throughput screening platform of cartilage injury to identify novel chondroprotective compounds. Targeting articular cartilage damage immediately after injury remains a promising therapeutic strategy to overcome irreversible tissue damage. Method We constructed a single impact-cartilage screening method using a multi-platen system that simultaneously impacts 48 samples and makes use of engineered cartilage tissue analogs (known as CTAs). Drug libraries were screened and assessed for their ability to alter two crucial biological responses to impact injuries, namely matrix degradation and cell stress. Results Over 500 small molecules were screened for their ability to alter proteoglycan loss, matrix metalloproteinase activity, and cell stress or death. Fifty-five compounds passed through secondary screening and were from commercial libraries of natural and redox, stem cell related compounds, as well as protease, kinase and phosphatase inhibitors. Through secondary screening, 16 promising candidates exhibited activity on one or more critical function of chondrocytes. While many are mechanistically known compounds, their function in joint diseases is not known. Conclusion This platform was validated for screening drug activity against a tissue engineered model of PTOA. Multiple compounds identified in this manner have potential application as early protective therapy for treating PTOA, and require further study. We propose this screening platform can identify novel molecules that act on early chondrocyte responses to injury and provide an invaluable tool for therapeutic development.
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Affiliation(s)
- Saleh Al Jundi
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
| | - Jerahme R. Martinez
- Translational Musculoskeletal Research Center, Crescenz VA Medical Center, Philadelphia, PA, University of Pennsylvania, Philadelphia, PA, USA
| | - Jake Cresta
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
- Translational Musculoskeletal Research Center, Crescenz VA Medical Center, Philadelphia, PA, University of Pennsylvania, Philadelphia, PA, USA
| | - Farzad Yousefi
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
| | - Gabriel DeSantis
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
| | - Matthew Thoonkuzhy
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
| | - Emilie Rabut
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
- Translational Musculoskeletal Research Center, Crescenz VA Medical Center, Philadelphia, PA, University of Pennsylvania, Philadelphia, PA, USA
| | - Bhavana Mohanraj
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
| | - Robert L. Mauck
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
- Translational Musculoskeletal Research Center, Crescenz VA Medical Center, Philadelphia, PA, University of Pennsylvania, Philadelphia, PA, USA
- Mechano Therapeutics, LLC, Philadelphia, PA, USA
| | - George R. Dodge
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, USA
- Translational Musculoskeletal Research Center, Crescenz VA Medical Center, Philadelphia, PA, University of Pennsylvania, Philadelphia, PA, USA
- Mechano Therapeutics, LLC, Philadelphia, PA, USA
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Endothelial PDGF-BB/PDGFR-β signaling promotes osteoarthritis by enhancing angiogenesis-dependent abnormal subchondral bone formation. Bone Res 2022; 10:58. [PMID: 36031625 PMCID: PMC9420732 DOI: 10.1038/s41413-022-00229-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 06/14/2022] [Accepted: 07/06/2022] [Indexed: 12/11/2022] Open
Abstract
The mechanisms that coordinate the shift from joint homeostasis to osteoarthritis (OA) remain unknown. No pharmacological intervention can currently prevent the progression of osteoarthritis. Accumulating evidence has shown that subchondral bone deterioration is a primary trigger for overlying cartilage degeneration. We previously found that H-type vessels modulate aberrant subchondral bone formation during the pathogenesis of OA. However, the mechanism responsible for the elevation of H-type vessels in OA is still unclear. Here, we found that PDGFR-β expression, predominantly in the CD31hiEmcnhi endothelium, was substantially elevated in subchondral bones from OA patients and rodent OA models. A mouse model of OA with deletion of PDGFR-β in endothelial cells (ECs) exhibited fewer H-type vessels, ameliorated subchondral bone deterioration and alleviated overlying cartilage degeneration. Endothelial PDGFR-β promotes angiogenesis through the formation of the PDGFR-β/talin1/FAK complex. Notably, endothelium-specific inhibition of PDGFR-β by local injection of AAV9 in subchondral bone effectively attenuated the pathogenesis of OA compared with that of the vehicle-treated controls. Based on the results from this study, targeting PDGFR-β is a novel and promising approach for the prevention or early treatment of OA.
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Kemp BR, Ferraro KF, Morton PM, Thomas PA, Mustillo SA, Crimmins EM. Do Early-Life Social, Behavioral, and Health Exposures Increase Later-Life Arthritis Incidence? Res Aging 2022; 44:479-493. [PMID: 34664538 PMCID: PMC9016101 DOI: 10.1177/01640275211044979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES This study investigates direct and indirect influences of childhood social, behavioral, and health exposures on later-life osteoarthritis and rheumatoid arthritis development. METHODS Drawing from cumulative inequality theory and six waves of the Health and Retirement Study (2004-2014), we estimate structural equation modeling-based discrete-time survival analysis of the association between six childhood exposure domains and both osteoarthritis and rheumatoid arthritis incidence for men (n = 2720) and women (n = 2974). Using the delta method to test for mediation, we examine indirect effects via selected health-related risks and resources. RESULTS Risky adolescent behavior is associated with rheumatoid arthritis incidence for women (h.O.R. = 1.883, 95% C.I. [1.016, 3.490]), whereas several types of childhood exposures are associated with later-life osteoarthritis development for both men and women. Experiencing two or more childhood socioeconomic disadvantages is indirectly associated with osteoarthritis (men: coef. = 0.024, 95% C.I. [0.003, 0.045]; women: coef. = 0.111, 95% C.I. [0.071, 0.150]) and rheumatoid arthritis (men: coef. = 0.037, 95% C.I. [0.000, 0.074]; women: coef. = 0.097, 95% C.I. [0.035, 0.159]) development through adult body mass index. DISCUSSION Findings highlight the importance of childhood contexts in understanding the development of later-life osteoarthritis and rheumatoid arthritis.
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Affiliation(s)
- Blakelee R. Kemp
- Department of Sociology, University of Nebraska, Lincoln, NE, USA
| | - Kenneth F. Ferraro
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
- Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Patricia M. Morton
- Department of Sociology, Wayne State University, Detroit, MI, USA
- Department of Public Health, Wayne State University, Detroit, MI, USA
| | - Patricia A. Thomas
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
- Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Sarah A. Mustillo
- Department of Sociology, University of Notre Dame, South Bend, IN, USA
| | - Eileen M. Crimmins
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Awad NB, Axon DR. Characteristics Associated with Good Self-Perceived Mental Health among United States Adults with Arthritis. Behav Sci (Basel) 2022; 12:bs12080256. [PMID: 36004827 PMCID: PMC9405205 DOI: 10.3390/bs12080256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
Mental health disorders are prevalent among United States (US) adults with arthritis. Yet, little is known about characteristics associated with mental health among US adults with arthritis. This retrospective cross-sectional study used 2019 Medical Expenditures Panel Survey data to assess the association between multiple personal characteristics and mental health status among US adults with arthritis. Hierarchical logistic regression models modeled associations between personal characteristics and mental health status. Model 1 included predisposing factors, model 2 included predisposing and enabling factors, while model 3 included predisposing, enabling, and need factors. The a priori alpha level was 0.05. Analyses accounted for the complex survey design and were weighted to produce national estimates. Among 28,512 individuals, 4984 met the inclusion criteria. Of these, 4181 had good mental health (85.5%, 95% confidence interval (CI) = 84.3%, 86.7%). The following characteristics were associated with good mental health status in the final adjusted model: age 18–64 vs. ≥65 (adjusted odds ratio (AOR) = 0.29, 95% CI = 0.12, 0.71), Midwest vs. West census region (AOR = 5.17, 95% CI = 1.63, 16.46), no degree vs. higher than high school education (AOR = 0.34, 95% CI = 0.12, 0.92), and high school diploma vs. higher than high school education (AOR = 0.40, 95% CI = 0.18, 0.86). In conclusion, this study suggests such characteristics may be targeted to help improve mental health among this population. Additional efforts are needed to help satisfy the unmet need for mental healthcare among this population.
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Trends and Racial/Ethnic Differences in Health Care Spending Stratified by Gender among Adults with Arthritis in the United States 2011-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159014. [PMID: 35897384 PMCID: PMC9329708 DOI: 10.3390/ijerph19159014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to determine if there were racial/ethnic differences and patterns for individual office-based visit expenditures by gender among a nationally representative sample of adults with arthritis. We retrospectively analyzed pooled data from the 2011 to 2019 Medical Expenditure Panel Survey of adults who self-reported an arthritis diagnosis, stratified by gender (men = 13,378; women = 33,261). Our dependent variable was office-based visit expenditures. Our independent variables were survey year (categorized as 2011-2013, 2014-2016, 2017-2019) and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian, non-Hispanic other/multiracial). We conducted trends analysis to assess for changes in expenditures over time. We utilized a two-part model to assess differences in office-based expenditures among participants who had any office-based expenditure and then calculated the average marginal effects. The unadjusted office-based visit expenditures increased significantly across the study period for both men and women with arthritis, as well as for some racial and ethnic groups depending on gender. Differing racial and ethnic patterns of expenditures by gender remained after accounting for socio-demographic, healthcare access, and health status factors. Delaying care was an independent driver of higher office-based expenditures for women with arthritis but not men. Our findings reinforce the escalating burden of healthcare costs among U.S. adults with arthritis across genders and certain racial and ethnic groups.
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Huang CH, Yeh ML, Chen FP, Wu D. Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:321-328. [PMID: 35459599 DOI: 10.1016/j.joim.2022.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patients commonly develop postoperative pain after total knee arthroplasty (TKA). Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals. OBJECTIVE To examine the effect of low-level laser acupuncture (LA) in reducing postoperative pain, pain-related interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent TKA. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION A single-blind randomized placebo-controlled trial was conducted. Patients (N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao (SP6), Taixi (KI3), Kunlun (BL60), Fengshi (GB31), Futu (ST32) and Neiguan (PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy output. MAIN OUTCOME MEASURES The primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain, postoperative pain-related interference in daily life and morphine consumption, were measured at hours 24, 48 and 72 after TKA. RESULTS Generalized estimating equations revealed significant between-group differences in pain intensity (P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72 (P < 0.05) and morphine consumption at hours 48 and 72 (P < 0.05). The changes in pain-related interference in daily life were significant (P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood, and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24 (P < 0.05). CONCLUSION Low-level LA gradually reduced older patients' postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-level LA may have benefits as an adjuvant pain management technique for clinical care. TRIAL REGISTRATION ClinicalTrials.gov registration number NCT03995446.
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Affiliation(s)
- Chiung-Hui Huang
- Department of Nursing, Taipei Veterans General Hospital, Taipei City 11217, Taiwan, China
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan, China.
| | - Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei City 11217, Taiwan, China; Scool of Nursing, National Taipei University of Nursing and Health Sciences and School of Medicine, Taipei City 11217, Taiwan, China
| | - Daphne Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan, China
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Martorella G, Mathis K, Miao H, Wang D, Park L, Ahn H. Self-administered transcranial direct current stimulation for pain in older adults with knee osteoarthritis: A randomized controlled study. Brain Stimul 2022; 15:902-909. [PMID: 35690388 PMCID: PMC9387776 DOI: 10.1016/j.brs.2022.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a leading cause of pain in older adults. Previous studies indicated clinic-based transcranial direct current stimulation (tDCS) was effective to reduce pain in various populations, but no published studies have reported the efficacy of home-based self-administered tDCS in older adults with knee OA using a randomized clinical study. OBJECTIVE The purpose of this study was to evaluate the efficacy and feasibility of tDCS on clinical pain intensity in adults with knee OA pain. METHODS One hundred twenty participants aged 50-85 years with knee OA pain were randomly assigned to receive fifteen daily sessions of 2 mA tDCS for 20 min (n = 60) or sham tDCS (n = 60) over 3 weeks with remote supervision via telehealth. Clinical pain intensity was measured by the Numeric Rating Scale and Western Ontario and McMaster Universities Osteoarthritis Index. Also, we collected data on the tDCS experience via a questionnaire. RESULTS Participants (68% female) had a mean age of 66 years. Active tDCS significantly reduced pain intensity compared to sham tDCS after completion of the fifteen daily sessions (Cohen's d = 1.20; p-value < 0.0001). Participants showed high levels of satisfaction with their tDCS experience, and there have been no adverse events. CONCLUSION We demonstrated that home-based self-administered tDCS was feasible and reduced clinical pain intensity in older adults with knee OA, which can increase its accessibility. Future studies with multi-site randomized controlled trials are needed to validate our findings. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT04016272.
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Affiliation(s)
| | - Kenneth Mathis
- The University of Texas Health Science Center School of Medicine at Houston, Houston, TX, USA
| | - Hongyu Miao
- Florida State University College of Nursing, Tallahassee, FL, USA
| | - Duo Wang
- Florida State University Department of Statistics, Tallahassee, FL, USA
| | - Lindsey Park
- Florida State University College of Nursing, Tallahassee, FL, USA
| | - Hyochol Ahn
- Florida State University College of Nursing, Tallahassee, FL, USA.
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Poole JL. Beyond the hand and upper extremity: The role of hand therapists in care of people with rheumatic diseases. J Hand Ther 2022; 35:339-345. [PMID: 35985938 DOI: 10.1016/j.jht.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/23/2022] [Accepted: 07/03/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Invited Clinical Commentary BACKGROUND: Arthritis is one of the most frequently reported causes of disability in the United States and the prevalence is expected to increase in the coming decades. While many rheumatic diseases involve hand impairments, most are systemic and involve more than the musculoskeletal system. Functional and work disability are high and people would benefit from the services of occupational and physical therapists. PURPOSE OF STUDY This paper reviews concepts of self-management, and symptoms that contribute to limitations and restrictions to participation in daily life in people with rheumatic diseases and suggests roles for hand therapists beyond the immediate hand impairments. METHODS The impact of selected rheumatic diseases on functional and work disability are reviewed along with strategies for symptom management and self-management. Upper extremity impairments of selected rheumatic diseases are also discussed. RESULTS The role for hand therapists in evaluating and addressing the complex needs of persons with rheumatic diseases, including less common diseases, is discussed. Outcome measures for fatigue, muscle involvement, ergonomics and computer use, and work disability are introduced. Finally, strategies for self-management and prevention of work and functional disability, along with symptom management for fatigue and pain are presented. CONCLUSION Hand therapists can play a vital role in chronic rheumatic disease management to improve self-management and increase participation in meaningful activities. Patients, primary care and rheumatology providers need to be educated about the scope of services occupational and physical therapists provide beyond the hand impairments.
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Affiliation(s)
- Janet L Poole
- Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, NM, USA.
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Cantero-Téllez R, Algar LA, Valdes KA, Naughton N. Clinical effects of proprioceptive thumb exercise for individuals with carpometacarpal joint osteoarthritis: A randomized controlled trial. J Hand Ther 2022; 35:358-366. [PMID: 36008246 DOI: 10.1016/j.jht.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/04/2022] [Accepted: 06/20/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Randomized Control Trial. INTRODUCTION Thumb CMC joint OA is a common diagnosis. Currently there is no evidence available to under if proprioceptive neuromuscular training is an effective intervention for this population. PURPOSE OF THE STUDY To establish the effectiveness of a proprioceptive training program as a complementary therapy for patients with thumb CMC joint OA. METHODS Standard conservative thumb CMC joint OA treatments were received by both the control (n = 26) and experimental groups (n = 26) for a period of 12 weeks. The experimental group received a proprioceptive training program during the same intervention period. Outcome measures included severity of pain with activity according to the numerical rating scale (NRS), QuickDASH, Canadian Occupational Performance Measure (COPM), and proprioception via joint position sense (JPS). RESULTS Fifty-two females participated in the study. Both the experimental and control group made both clinically and statistically significant changes in the mean VAS and COPM scores over time. Only the experimental group achieved a statistically and clinically significant change in JPS error score over time. DISCUSSION Experimental group achieved a statistically significant change in JPS over time in concordance with previous investigations. Changes in pain scores differed from prior investigations and the between-group comparison was not statistically significant. Changes in the Quick DASH was similar to previous findings. CONCLUSION Proprioceptive training in addition to a traditional rehabilitation program decreased error scores on the joint position sense test.
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Affiliation(s)
| | - Lori A Algar
- Outpatient Hand Therapy, Orthopaedic Specialty Group PC, Fairfield, CT, USA
| | - Kristin A Valdes
- Occupational Therapy Department, Touro University, Henderson NV 89014, USA
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The Role of Mitochondrial Metabolism, AMPK-SIRT Mediated Pathway, LncRNA and MicroRNA in Osteoarthritis. Biomedicines 2022; 10:biomedicines10071477. [PMID: 35884782 PMCID: PMC9312479 DOI: 10.3390/biomedicines10071477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/20/2022] Open
Abstract
Osteoarthritis (OA) is the most common joint disease characterized by degeneration of articular cartilage and causes severe joint pain, physical disability, and impaired quality of life. Recently, it was found that mitochondria not only act as a powerhouse of cells that provide energy for cellular metabolism, but are also involved in crucial pathways responsible for maintaining chondrocyte physiology. Therefore, a growing amount of evidence emphasizes that impairment of mitochondrial function is associated with OA pathogenesis; however, the exact mechanism is not well known. Moreover, the AMP-activated protein kinase (AMPK)–Sirtuin (SIRT) signaling pathway, long non-coding RNA (lncRNA), and microRNA (miRNA) are important for regulating the physiological and pathological processes of chondrocytes, indicating that these may be targets for OA treatment. In this review, we first focus on the importance of mitochondria metabolic dysregulation related to OA. Then, we show recent evidence on the AMPK-SIRT mediated pathway associated with OA pathogenesis and potential treatment options. Finally, we discuss current research into the effects of lncRNA and miRNA on OA progression or inhibition.
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111
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Badley EM, Wilfong JM, Chan CH, Canizares M, Perruccio AV. I don’t know what type of arthritis I have: A population-based comparison of people with arthritis who knew their specific type and those who didn’t. PLoS One 2022; 17:e0270029. [PMID: 35727744 PMCID: PMC9212124 DOI: 10.1371/journal.pone.0270029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/02/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To understand differences between people with arthritis who do not know their type (DK) compared to those reporting osteoarthritis (OA) or inflammatory and autoimmune types of arthritis (IAA), including the receipt of appropriate health care, information, and services. Methods Analysis of the Survey on Living with Chronic Disease in Canada–Arthritis Component. Respondents aged ≥20 years with health professional-diagnosed arthritis (n = 4,385) were characterized as reporting DK, OA or IAA. Variables: arthritis characteristics (duration, number and site of joints affected), arthritis impact (current pain and fatigue, difficulty in sleeping and daily activities, impact on life), health (self-rated general and mental health, life stress), arthritis management strategies (seeing health professionals, medication use, assistive devices, receipt of arthritis information, self-management activities). Multinomial logistic and log-Poisson regressions were used, as appropriate, to compare the DK to the OA and IAA groups. Results In this arthritis sample, 44.2% were in the DK group, 38.3% reported OA and 17.5% reported IAA. Those in the DK group were more likely to be younger, have low income, low education, and be of non-white cultural background compared to those with OA. There were no significant differences in arthritis impact, but the DK group was less likely to have received information on, or have used, arthritis management strategies. Conclusions The sociodemographic characteristics of the DK group suggest they likely have lower health literacy. They were less likely to have accessed health care and other support services, indicating this is an important group for health education, both for individuals with arthritis and health care providers.
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Affiliation(s)
- Elizabeth M. Badley
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, University Health Network, Toronto, Canada
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jessica M. Wilfong
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, University Health Network, Toronto, Canada
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada
- * E-mail:
| | - Christina H. Chan
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, University Health Network, Toronto, Canada
| | - Mayilee Canizares
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada
| | - Anthony V. Perruccio
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, University Health Network, Toronto, Canada
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Ekediegwu EC, Akpaenyi CE, Nwosu IB, Onyeso OK. Demographic and disease characteristics associated with pain intensity, kinesiophobia, balance, and fall self-efficacy among people with osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2022; 23:544. [PMID: 35668383 PMCID: PMC9172058 DOI: 10.1186/s12891-022-05486-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a common degenerative joint disease leading to significant pain, mobility limitation, economic burden, reduced quality of life, and disability among adults globally. Psychological factors related to pain intensity (PI), kinesiophobia, fall self-efficacy (FSE), and balance may lead to a poor OA prognosis. This study was designed to explore the association between PI, kinesiophobia, FSE, balance, and age, gender, marital status, site of OA, duration, symmetry, comorbidity, and adaptive behaviours among patients with knee or hip OA. METHODS This cross-sectional study involved 70 purposively selected participants aged 59.91 ± 11.12 years. Numeric pain rating scale, Tampa scale for kinesiophobia, fall-efficacy scale, and timed up and go test were used to measure PI, kinesiophobia, FSE, and balance, respectively. Statistical analyses were completed with the Pearson correlation test, independent samples t-test, and multiple linear regression. RESULTS The participants were mainly women (n = 59, 84.3%). However, there was no gender difference in the reported PI, kinesiophobia, FSE, and balance. There was a significant correlation between FSE and balance (r = 0.422, p<0.001). Kinesiophobia was significantly associated with the presence of comorbidity (β = 0.240, p = 0.001) and knee OA (β = 0.208, p<0.042). There was an association between FSE and the use of a walking aid (β = -0.442, p<0.042), stop-for-rest during walking (β = -0.292, p = 0.002), presence of comorbidity (β = 0.209, p = 0.014), and bilateral lower limb OA (β = 0.167, p = 0.057). Balance was associated with the use of a walking aid (β = -0.421, p<0.001) and stop-for-rest during walking (β = - 0.294, p = 0.006). CONCLUSION Osteoarthritis-related psychological distress affects both men and women. This study support integration of psychological outcomes in the assessment, management, and follow-up of people with lower limb osteoarthritis. Moreover, comorbidity worsened psychological distress among people with osteoarthritis. Therefore, the traditional biomedical management of osteoarthritis can be optimised by timely diagnosis and treatment of comorbidities, and the inclusion of psychotherapy.
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Affiliation(s)
- Ezinne Chika Ekediegwu
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra, Nigeria
| | - Chigbogu Earnest Akpaenyi
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra, Nigeria
| | - Ifeoma Blessing Nwosu
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra, Nigeria
| | - Ogochukwu Kelechi Onyeso
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra, Nigeria.
- Prentice Institute for Global Population and Economy, University of Lethbridge, Lethbridge, Alberta, Canada.
- Population Studies in Health, Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada.
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Nelson AE, Keefe TH, Schwartz TA, Callahan LF, Loeser RF, Golightly YM, Arbeeva L, Marron JS. Biclustering reveals potential knee OA phenotypes in exploratory analyses: Data from the Osteoarthritis Initiative. PLoS One 2022; 17:e0266964. [PMID: 35609053 PMCID: PMC9129051 DOI: 10.1371/journal.pone.0266964] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/30/2022] [Indexed: 01/11/2023] Open
Abstract
Objective To apply biclustering, a methodology originally developed for analysis of gene expression data, to simultaneously cluster observations and clinical features to explore candidate phenotypes of knee osteoarthritis (KOA) for the first time. Methods Data from the baseline Osteoarthritis Initiative (OAI) visit were cleaned, transformed, and standardized as indicated (leaving 6461 knees with 86 features). Biclustering produced submatrices of the overall data matrix, representing similar observations across a subset of variables. Statistical validation was determined using the novel SigClust procedure. After identifying biclusters, relationships with key outcome measures were assessed, including progression of radiographic KOA, total knee arthroplasty, loss of joint space width, and worsening Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, over 96 months of follow-up. Results The final analytic set included 6461 knees from 3330 individuals (mean age 61 years, mean body mass index 28 kg/m2, 57% women and 86% White). We identified 6 mutually exclusive biclusters characterized by different feature profiles at baseline, particularly related to symptoms and function. Biclusters represented overall better (#1), similar (#2, 3, 6), and poorer (#4, 5) prognosis compared to the overall cohort of knees, respectively. In general, knees in biclusters #4 and 5 had more structural progression (based on Kellgren-Lawrence grade, total knee arthroplasty, and loss of joint space width) but tended to have an improvement in WOMAC pain scores over time. In contrast, knees in bicluster #1 had less incident and progressive KOA, fewer total knee arthroplasties, less loss of joint space width, and stable pain scores compared with the overall cohort. Significance We identified six biclusters within the baseline OAI dataset which have varying relationships with key outcomes in KOA. Such biclusters represent potential phenotypes within the larger cohort and may suggest subgroups at greater or lesser risk of progression over time.
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Affiliation(s)
- Amanda E Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Thomas H Keefe
- Statistics and Operations Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Todd A Schwartz
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.,Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Leigh F Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Richard F Loeser
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Liubov Arbeeva
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - J S Marron
- Statistics and Operations Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Hu BY, Zhao YL, Ma DY, Xiang ML, Zhao LX, Luo XD. Anti-hyperuricemic bioactivity of Alstonia scholaris and its bioactive triterpenoids in vivo and in vitro. JOURNAL OF ETHNOPHARMACOLOGY 2022; 290:115049. [PMID: 35150817 DOI: 10.1016/j.jep.2022.115049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/16/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGY RELEVANCE One folk use of Alstonia scholaris (L.) R. Br. in "Dai" ethno-medicine system is to treat gouty arthritis, which might be caused by hyperuricemia, but anti-hyperuricemic investigation of A. scholaris were rarely reported. AIM OF THE STUDY To verify anti-hyperuricemic property of A. scholaris, and explore its bioactive compounds in vivo and in vitro. MATERIALS AND METHODS The anti-hyperuricemic bioactivity of the non-alkaloids fraction and compounds were evaluated with potassium oxonate (PO) induced hyperuricemia mice model in vivo, and monosodium urate (MSU) induced human renal tubular epithelial cells (HK-2) was selected to test in vitro, respectively, with benzobromarone as the positive control. 11 triterpenoids were isolated by phytochemical methods and their structures were elucidated by spectroscopic analysis and ECD calculation. RESULTS The non-alkaloids fraction of A. scholaris decreased the serum uric acid (UA) level in mice model significantly at the doses of 100 mg/kg and 200 mg/kg, and then nine ursane- and two oleanane-triterpenoids including four new compounds (1-3 and 10) were isolated from the bioactive fraction, in which compounds 1, 4, 5, 6 and 10 exhibited better anti-hyperuricemic tendency in vitro by promoting the excretion of UA in MSU-induced HK-2 cell model at a concentration of 5 μM. Furthermore, compounds 1 and 4 were proved to reduce the serum UA level in mice significantly at 5 mg/kg in vivo. CONCLUSIONS The results supported the traditional use of A. scholaris in treating gouty arthritis, and also provided new bioactive triterpenoids for further chemical and pharmacological investigation.
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Affiliation(s)
- Bin-Yuan Hu
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education, Yunnan Provincial Center for Research & Development of Nature Products, School of Chemical Science and Technology, Yunnan University, Kunming, 650091, PR China
| | - Yun-Li Zhao
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education, Yunnan Provincial Center for Research & Development of Nature Products, School of Chemical Science and Technology, Yunnan University, Kunming, 650091, PR China
| | - Dan-Yu Ma
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education, Yunnan Provincial Center for Research & Development of Nature Products, School of Chemical Science and Technology, Yunnan University, Kunming, 650091, PR China
| | - Mei-Ling Xiang
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education, Yunnan Provincial Center for Research & Development of Nature Products, School of Chemical Science and Technology, Yunnan University, Kunming, 650091, PR China
| | - Li-Xing Zhao
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education, Yunnan Provincial Center for Research & Development of Nature Products, School of Chemical Science and Technology, Yunnan University, Kunming, 650091, PR China
| | - Xiao-Dong Luo
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education, Yunnan Provincial Center for Research & Development of Nature Products, School of Chemical Science and Technology, Yunnan University, Kunming, 650091, PR China; State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, PR China.
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Wan S, Bao D, Li J, Lin K, Huang Q, Li Q, Li L. Extracellular Vesicles from Hypoxic Pretreated Urine-Derived Stem Cells Enhance the Proliferation and Migration of Chondrocytes by Delivering miR-26a-5p. Cartilage 2022; 13:19476035221077401. [PMID: 35548888 PMCID: PMC9137301 DOI: 10.1177/19476035221077401] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Stem-cell therapy is a promising treatment for cartilage defects. The newly identified urine-derived stem cells (USCs), which have multipotency and sufficient proliferative ability, are promising candidates for several tissue engineering therapies. In this study, we investigated the role of USC extracellular vehicles (EVs) in promoting the proliferation and migration of chondrocytes. DESIGN USCs were characterized by measuring induced multipotent differentiation and flow cytometry analysis of surface marker expression. The EVs were isolated from USCs under normoxic conditions (nor-EVs) and hypoxic conditions (hypo-EVs). Transmission electron microscopy and western blot analysis characterized the EVs. The chondrocytes were cultured in the USC-EVs. CCK-8 assay and EdU staining detected the proliferation of chondrocytes, and transwell assay detected their migration. miR-26a-5p expression in EVs was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The target relationship of miR-26a-5p and phosphatase and tensin homolog (PTEN) was predicted and confirmed. The roles of EVs-miR-26a-5p and PTEN on the proliferation and migration of chondrocytes were also investigated. RESULTS Hypo-EVs showed a superior effect in promoting the proliferation and migration of chondrocytes than nor-EVs. Mechanistically, USC-EVs delivered miR-26a-5p into chondrocytes to overexpress miR-26a-5p. PTEN was identified as an miR-26a-5p target in chondrocytes. The effects of EVs-miR-26a-5p on promoting the proliferation and migration of chondrocytes were mediated by its regulation of PTEN. CONCLUSION Our study suggested that hypoxic USC-EVs may represent a promising strategy for osteoarthritis by promoting the proliferation and migration of chondrocytes via miR-26a-5p transfer.
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Affiliation(s)
- Sha Wan
- Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu, China
| | - Dingsu Bao
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Jia Li
- Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu, China
| | - Kefu Lin
- Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu, China
| | - Qi Huang
- Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu, China
| | - Qiang Li
- Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu, China
| | - Lang Li
- Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu, China
- Lang Li, Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, No. 20 Ximianqiao Cross Street, Wuhou District, Chengdu 610041, China.
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Reed M, Rampono B, Turner W, Harsanyi A, Lim A, Paramalingam S, Massasso D, Thakkar V, Mundae M, Rampono E. A multicentre validation study of a smartphone application to screen hand arthritis. BMC Musculoskelet Disord 2022; 23:433. [PMID: 35534813 PMCID: PMC9081322 DOI: 10.1186/s12891-022-05376-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Arthritis is a common condition, and the prompt and accurate assessment of hand arthritis in primary care is an area of unmet clinical need. We have previously developed and tested a screening tool combining machine-learning algorithms, to help primary care physicians assess patients presenting with arthritis affecting the hands. The aim of this study was to assess the validity of the screening tool among a number of different Rheumatologists. METHODS Two hundred and forty-eight consecutive new patients presenting to 7 private Rheumatology practices across Australia were enrolled. Using a smartphone application, each patient had photographs taken of their hands, completed a brief 9-part questionnaire, and had a single examination result (wrist irritability) recorded. The Rheumatologist diagnosis was entered following a 45-minute consultation. Multiple machine learning models were applied to both the photographic and survey/examination results, to generate a screening outcome for the primary diagnoses of osteoarthritis, rheumatoid and psoriatic arthritis. RESULTS The combined algorithms in the application performed well in identifying and discriminating between different forms of hand arthritis. The algorithms were able to predict rheumatoid arthritis with accuracy, precision, recall and specificity of 85.1, 80.0, 88.1 and 82.7% respectively. The corresponding results for psoriatic arthritis were 95.2, 76.9, 90.9 and 95.8%, and for osteoarthritis were 77.4, 78.3, 80.6 and 73.7%. The results were maintained when each contributor was excluded from the analysis. The median time to capture all data across the group was 2 minutes and 59 seconds. CONCLUSIONS This multicentre study confirms the results of the pilot study, and indicates that the performance of the screening tool is maintained across a group of different Rheumatologists. The smartphone application can provide a screening result from a combination of machine-learning algorithms applied to hand images and patient symptom responses. This could be used to assist primary care physicians in the assessment of patients presenting with hand arthritis, and has the potential to improve the clinical assessment and management of such patients.
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Affiliation(s)
- Mark Reed
- , Perth, Australia.
- Hollywood Medical Centre, Suite 41, 85 Monash Avenue, Nedlands, Western Australia, Australia.
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Selig DJ, Kress AT, Horton IM, Livezey JR, Sadik EJ, DeLuca JP. Pharmacokinetics, safety and efficacy of intra-articular non-steroidal anti-inflammatory drug injections for the treatment of osteoarthritis: A narrative review. J Clin Pharm Ther 2022; 47:1122-1133. [PMID: 35505520 PMCID: PMC9542014 DOI: 10.1111/jcpt.13669] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 03/31/2022] [Indexed: 01/07/2023]
Abstract
What is known and Objective Osteoarthritis (OA) is a common cause of joint disease and activity limitation in adults. Common therapies to treat OA‐related pain are oral and topical non‐steroidal anti‐inflammatory drugs (NSAIDs) and intra‐articular (IA) corticosteroids. However, prolonged courses of oral NSAIDs are associated with systemic adverse effects and repeat IA corticosteroid injections may cause cartilage degeneration. IA NSAIDs may be an alternative therapy possibly minimizing systemic side effects while maintaining efficacy. Therefore, we sought to summarize the pharmacokinetics, safety and efficacy of IA NSAIDs to help providers make a more informed decision on the use of IA NSAIDs. Methods We searched the National Library of Medicine Database with terms “intraarticular and nsaid”, yielding 1032 results. Only traditional formulations of NSAIDs were considered for inclusion. Animal studies were included if animals were healthy or if the method of arthritis induction was a reasonable model of osteoarthritis. Human studies were included if humans were healthy or if the primary disease studied was osteoarthritis of a large joint. Of 1032 results, 31 research articles met the inclusion criteria and were summarized in this review. Results and Discussion We found that single doses of IA NSAIDs provided far less total systemic and synovial exposure compared to a one week course of oral NSAIDs, but maximum concentrations to the synovium with IA administration were much higher. IA NSAIDs had an excellent safety profile in small animals, large animals and humans, although these injections were associated with non‐specific cartilage inflammation in healthy animals. In animal models, IA NSAIDs had similar efficacy to PO NSAIDs in treating OA‐related pain. In humans, IA NSAIDs had similar efficacy to PO NSAIDS and IA corticosteroids in treating OA‐related pain; however, many trials did not have a placebo control and outcome measures were heterogeneous. What is new and Conclusion Overall, single doses of IA NSAIDs appear safe and efficacious across animals and humans. The optimal use of IA NSAIDs is still to be determined and further research is needed. However IA NSAIDs may be an additional beneficial therapy to treat OA‐related pain. Potential uses may be to augment IA corticosteroids injections, to interrupt multiple IA corticosteroid injections or as an alternative in patients that are high risk for corticosteroid‐related adverse events.
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Affiliation(s)
- Daniel J Selig
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Adrian T Kress
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Isaiah M Horton
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Jeffrey R Livezey
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Eliot J Sadik
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Jesse P DeLuca
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
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Lin X, Tsao CT, Kyomoto M, Zhang M. Injectable Natural Polymer Hydrogels for Treatment of Knee Osteoarthritis. Adv Healthc Mater 2022; 11:e2101479. [PMID: 34535978 DOI: 10.1002/adhm.202101479] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/29/2021] [Indexed: 12/11/2022]
Abstract
Osteoarthritis (OA) is a serious chronic and degenerative disease that increasingly occurs in the aged population. Its current clinical treatments are limited to symptom relief and cannot regenerate cartilage. Although a better understanding of OA pathophysiology has been facilitating the development of novel therapeutic regimen, delivery of therapeutics to target sites with minimal invasiveness, high retention, and minimal side effects remains a challenge. Biocompatible hydrogels have been recognized to be highly promising for controlled delivery and release of therapeutics and biologics for tissue repair. In this review, the current approaches and the challenges in OA treatment, and unique properties of injectable natural polymer hydrogels as delivery system to overcome the challenges are presented. The common methods for fabrication of injectable polysaccharide-based hydrogels and the effects of their composition and properties on the OA treatment are detailed. The strategies of the use of hydrogels for loading and release cargos are also covered. Finally, recent efforts on the development of injectable polysaccharide-based hydrogels for OA treatment are highlighted, and their current limitations are discussed.
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Affiliation(s)
- Xiaojie Lin
- Department of Materials Science and Engineering University of Washington Seattle WA 98195 USA
| | - Ching Ting Tsao
- Department of Materials Science and Engineering University of Washington Seattle WA 98195 USA
| | - Masayuki Kyomoto
- Medical R&D Center Corporate R&D Group KYOCERA Corporation 800 Ichimiyake, Yasu Shiga 520‐2362 Japan
| | - Miqin Zhang
- Department of Materials Science and Engineering University of Washington Seattle WA 98195 USA
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Walsh PJ, Walz DM. Imaging of Osteoarthritis of the Hip. Radiol Clin North Am 2022; 60:617-628. [DOI: 10.1016/j.rcl.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Huang C, Xu Z, Shen Z, Luo T, Li T, Nissman D, Nelson A, Golightly Y, Niethammer M, Zhu H. DADP: Dynamic abnormality detection and progression for longitudinal knee magnetic resonance images from the Osteoarthritis Initiative. Med Image Anal 2022; 77:102343. [PMID: 35026528 PMCID: PMC8901568 DOI: 10.1016/j.media.2021.102343] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/27/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022]
Abstract
Osteoarthritis (OA) is the most common disabling joint disease. Magnetic resonance (MR) imaging has been commonly used to assess knee joint degeneration due to its distinct advantage in detecting morphologic cartilage changes. Although several statistical methods over conventional radiography have been developed to perform quantitative cartilage analyses, little work has been done capturing the development and progression of cartilage lesions (or abnormal regions) and how they naturally progress. There are two major challenges, including (i) the lack of building spatial-temporal correspondences and correlations in cartilage thickness and (ii) the spatio-temporal heterogeneity in abnormal regions. The goal of this work is to propose a dynamic abnormality detection and progression (DADP) framework for quantitative cartilage analysis, while addressing the two challenges. First, spatial correspondences are established on flattened 2D cartilage thickness maps extracted from 3D knee MR images both across time within each subject and across all subjects. Second, a dynamic functional mixed effects model (DFMEM) is proposed to quantify abnormality progression across time points and subjects, while accounting for the spatio-temporal heterogeneity. We systematically evaluate our DADP using simulations and real data from the Osteoarthritis Initiative (OAI). Our results show that DADP not only effectively detects subject-specific dynamic abnormal regions, but also provides population-level statistical disease mapping and subgroup analysis.
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Affiliation(s)
- Chao Huang
- Department of Statistics, Florida State University, Tallahassee, 32304, USA
| | - Zhenlin Xu
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Zhengyang Shen
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Tianyou Luo
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Tengfei Li
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Amanda Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Yvonne Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Marc Niethammer
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA.
| | - Hongtu Zhu
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA.
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Dove AP, Cmelak A, Darrow K, McComas KN, Chowdhary M, Beckta J, Kirschner AN. The Use of Low-Dose Radiotherapy in Osteoarthritis: A Review. Int J Radiat Oncol Biol Phys 2022; 114:203-220. [DOI: 10.1016/j.ijrobp.2022.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/08/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
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Kaufman BG, Allen KD, Coffman CJ, Woolson S, Caves K, Hall K, Hoenig HM, Huffman KM, Morey MC, Hodges NJ, Ramasunder S, van Houtven CH. Cost and Quality of Life Outcomes of the STepped Exercise Program for Patients With Knee OsteoArthritis Trial. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:614-621. [PMID: 35365305 DOI: 10.1016/j.jval.2021.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/31/2021] [Accepted: 09/30/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to evaluate the cost-effectiveness of the randomized clinical trial STEP-KOA (STepped Exercise Program for patients with Knee OsteoArthritis). METHODS The trial included 230 intervention and 115 control participants from 2 Veterans Affairs (VA) medical centers. A decision tree simulated outcomes for cohorts of patients receiving arthritis education (control) or STEP-KOA (intervention), which consisted of an internet-based exercise training program (step 1), phone counseling (step 2), and physical therapy (step 3) according to patient's response. Intervention costs were assessed from the VA perspective. Quality of life (QOL) was measured using 5-level EQ-5D US utility weights. Incremental cost-effectiveness ratios (ICERs) were calculated as the difference in costs divided by the difference in quality-adjusted life-years (QALYs) between arms at 9 months. A Monte Carlo probabilistic sensitivity analysis was used to generate a cost-effectiveness acceptability curve. RESULTS The adjusted model found differential improvement in QOL utility weights of 0.042 (95% confidence interval 0.003-0.080; P=.03) for STEP-KOA versus control at 9 months. In the base case, STEP-KOA resulted in an incremental gain of 0.028 QALYs and an incremental cost of $279 per patient for an ICER of $10 076. One-way sensitivity analyses found the largest sources of variation in the ICER were the impact on QOL and the need for a VA-owned tablet. The probabilistic sensitivity analysis found a 98% probability of cost-effectiveness at $50 000 willingness-to-pay per QALY. CONCLUSIONS STEP-KOA improves QOL and has a high probability of cost-effectiveness. Resources needed to implement the program will decline as ownership of mobile health devices increases.
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Affiliation(s)
- Brystana G Kaufman
- Duke University, Durham, NC, USA; Durham VA Medical Center, Durham, NC, USA.
| | - Kelli D Allen
- Durham VA Medical Center, Durham, NC, USA; University of North Carolina, Chapel Hill, NC
| | - Cynthia J Coffman
- Durham VA Medical Center, Durham, NC, USA; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | | | - Kevin Caves
- Durham VA Medical Center, Durham, NC, USA; Duke Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA
| | - Katherine Hall
- Durham VA Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA; Duke Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA
| | - Helen M Hoenig
- Durham VA Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA; Duke Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA
| | - Kim M Huffman
- Duke University, Durham, NC, USA; Durham VA Medical Center, Durham, NC, USA; Duke Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA
| | - Miriam C Morey
- Durham VA Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA; Duke Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA
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Power JD, Perruccio AV, Paterson JM, Canizares M, Veillette C, Coyte PC, Badley EM, Mahomed NN, Rampersaud YR. Healthcare utilization and costs for musculoskeletal disorders in Ontario, Canada. J Rheumatol Suppl 2022; 49:740-747. [PMID: 35365584 DOI: 10.3899/jrheum.210938] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the magnitude and costs of ambulatory primary and specialist physician care and hospital service use for musculoskeletal disorders (MSDs) in Canada's largest province, Ontario. METHODS Administrative health databases were analyzed for fiscal year 2013-2014 for adults 18+ years, including data on physician services, emergency department (ED) visits and hospitalizations. ICD diagnostic codes were used to identify MSD services. A validated algorithm was used to estimate direct medical costs. Person visit rates and numbers of persons and visits were tabulated by care setting, age and sex, and physician specialty. Data were examined for all MSDs combined as well as specific diagnostic groupings. RESULTS Overall, 3.1 million adult Ontarians (28.5%) made 8 million outpatient physician visits associated with MSDs. These included 5.6 million primary care visits. MSDs accounted for 560,000, 12.3%, of all adult ED visits. Total costs for MSD-related care were $1.6 billion, with 12.6% of costs attributed to primary care, 9.2% to specialist care, 8.6% to ED care, 8.5% to day surgery and 61.2% of total costs associated with inpatient hospitalizations. Costs due to arthritis accounted for 40% of total MSD care costs ($639 million). MSD-related imaging costs were $169 million. Including these costs yields a total estimate of $1.8 billion for all MSDs combined. CONCLUSION MSDs place a significant and costly burden on the health care system. Health system planning needs to consider the large and escalating demand for care to reduce both the individual and population burden.
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Affiliation(s)
- J Denise Power
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - Anthony V Perruccio
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - J Michael Paterson
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - Mayilee Canizares
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - Christian Veillette
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - Peter C Coyte
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - Elizabeth M Badley
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - Nizar N Mahomed
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
| | - Y Raja Rampersaud
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Orthopaedics, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Support: This study was financially supported by the Toronto General & Western Hospital Foundation through the University Health Network Arthritis Program. The funding source had no involvement in study design or manuscript preparation. Conflict of Interest: There are no potential conflicts of interest relevant to this work. Corresponding Author: J. Denise Power, 399 Bathurst Street MP10-326, Toronto, Ontario, Canada, M5T 2S8.
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Dalton B, McDougle J, Alesi M, Pereira D, Feito Y. Blood Flow Restriction Training for Individuals With Osteoarthritis. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rehabilitation of Patients with Moderate Knee Osteoarthritis Using Hyaluronic Acid Viscosupplementation and Physiotherapy. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12063165] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Knee osteoarthritis (KOA) is one of the most common public health problems which cannot be cured and ultimately leads to disability. Current management is largely limited to the treatment of the symptoms. To avoid the late stages of KOA that lead to knee replacement, the key point is to control and reduce destructive processes using efficient pharmacological products combined with physiotherapy (PT). Herein, we perform a monocentric observational study to compare the effect of combining a multi-modal physiotherapy regime and intra-articular (IA) injection with hyaluronic acid (HA) on the non-surgical treatment of KOA. Patients with mild KOA were randomly assigned to two groups to receive an HA injection with PT or an HA injection only. The assessment tools for pain, clinical disease severity, and disability were the total score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (scores range from 0 to 96, with higher scores indicating worse pain, function, and stiffness), knee range of motion (ROM), pain on the visual analog scale (VAS), and muscle strength testing (MST). All tests were evaluated every 3 months up to 1 year from the baseline. The study enrolled 52 patients with ages between 47 and 61 years who were divided into two groups. Thirty-seven (n = 37) patients were randomized in the pilot group (PG) and received IA injections with the viscoelastic hyaluronic acid product (HA) combined with a multi-modal PT regime. The PT program included 10 sessions of transcutaneous electrical nerve stimulation, low-level laser therapy, ultrasound, physical exercise, and cryotherapy. Fifteen patients (n = 15) from the control group (CG) received the IA HA injections only. All patients were confirmed with mild KOA of Kellgren–Lawrence grade 2 on radiographs at the beginning of the treatment. The baseline characteristics, including the severity of pain and level of disability, were similar in the two groups. At baseline, the mean (±SD) WOMAC scores reported were 64.6 ± 4.08 in the CG and 64.5 ± 2.99 in the PG. Notably, at only 3 months into the study, the mean scores were significantly improved to 56.7 ± 5 in the CG and 48.27 ± 2.13 in the PG (mean between-group difference = 16.19 points; 95% confidence interval), finding favor for the combination of HA injections and physiotherapy. At the study’s endpoint (12 months), the scores were improved in both groups, with the mean between-group difference remaining significant (7.08 points, 95% confidence interval). A decrease in pain, as evaluated by the VAS scale, was reported for both groups, with the PG reporting a better VAS score that decreased from 5.7 to 2 when compared to the CG, which decreased from 5.7 to 3. The physical assessment parameters (ROM and MST) followed the same trend, with a rapid improvement in the ROM in the PG, changing from 98° to 115° in the first 3 months, and a slower and more steady evolution in the CG group, changing from 100° to 112° in 9 months. Herein, we report on the combination therapy of an intra-articularly administered HA viscoelastic product and a multi-modal physiotherapy regime, which can play a key role in the non-surgical treatment of KOA, effectively controlling pain, stiffness, and the ROM value and improving patients’ quality of life.
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Turcotte JJ, King PJ, Patton CM. Lower Extremity Osteoarthritis: A Risk Factor for Mental Health Disorders, Prolonged Opioid Use, and Increased Resource Utilization After Single-Level Lumbar Spinal Fusion. J Am Acad Orthop Surg Glob Res Rev 2022; 6:e21.00280. [PMID: 35303736 PMCID: PMC8932478 DOI: 10.5435/jaaosglobal-d-21-00280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Few studies have examined the effect of hip or knee osteoarthritis, together described as lower extremity osteoarthritis (LEOA) on patient outcomes after lumbar fusion. The purpose of this study was to evaluate the effect of LEOA on postoperative outcomes and resource utilization in patients undergoing single-level lumbar fusion. METHODS Using a national deidentified database, TriNetX, a retrospective observational study of 17,289 patients undergoing single-level lumbar fusion with or without a history of LEOA before September 1, 2019, was conducted. The no-LEOA and LEOA groups were propensity score matched, and 2-year outcomes were compared using univariate statistical analysis. RESULTS After propensity score matching, 2289 patients with no differences in demographics or comorbidities remained in each group. No differences in the rate of repeat lumbar surgery were observed between groups (all P > 0.30). In comparison with patients with no LEOA, patients with LEOA experienced higher rates of overall and new onset depression or anxiety, prolonged opioid use, hospitalizations, emergency department visits, and ambulatory visits over the 2-year postoperative period (all P < 0.02). CONCLUSION Patients with LEOA undergoing single-level lumbar fusion surgery are at higher risk for suboptimal outcomes and increased resource utilization postoperatively. This complex population may benefit from additional individualized education and multidisciplinary management.
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Affiliation(s)
- Justin J Turcotte
- From the Department of Orthopedics, Luminis Health Anne Arundel Medical Center, Annapolis, MD
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The Effect of Proprioception Training on Pain Intensity in Thumb Basal Joint Osteoarthritis: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063592. [PMID: 35329279 PMCID: PMC8955750 DOI: 10.3390/ijerph19063592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 12/15/2022]
Abstract
A randomized controlled trial of forty-five females over 18 years of age with diagnosis of thumb basal osteoarthritis in their dominant hand and with a minimum pain rating of 4/10 on the Visual Analogue Scale (VAS) during activities of daily living (ADLs) were recruited from March to June 2021. The group receiving proprioception training was compared to routine conservative physiotherapy treatment. The main purpose of this clinical trial is to test the effect of proprioception training on pain intensity in subjects with thumb osteoarthritis. Primary outcome was joint position sense (JPS) for the assessment of CMC proprioception and secondary outcomes were Visual Analogue Scale (VAS) and Canadian Occupational Performance Measure (COPM) for the assessment of patient satisfaction and the Quick-DASH which assessed upper limb function. A block randomization was carried out for the control group (n = 22) and experimental group (n = 23). Participants and evaluator were blinded to the group assignment. Proprioception training produced a statistically significant reduction in pain post intervention, but this reduction was small (d = 0.1) at the 3-month follow-up. JPS accuracy demonstrated statistically significant differences between the groups (p = 0.001) post-intervention and at the 3-month follow-up (p < 0.003). Statistically significant differences between means were found in both the Quick-Dash and COPM post intervention (both, p < 0.001), as well as at the 3-month follow-up (both, p < 0.001). There was a significant time factor for the reduction of pain intensity over time but effect sizes between groups was small at the 3-month follow-up period. Proprioceptive training improves thumb JPS accuracy; however, it does not contribute to a reduction in pain intensity in the long term. The inclusion of a proprioceptive program may be beneficial for improving individuals with thumb CMC OA sensorimotor performance. The study was registered at ClinicalTrials.gov NCT04738201. No funding was provided for this study.
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Ryu J, Brittberg M, Nam B, Chae J, Kim M, Colon Iban Y, Magneli M, Takahashi E, Khurana B, Bragdon CR. Evaluation of Three-Dimensional Bioprinted Human Cartilage Powder Combined with Micronized Subcutaneous Adipose Tissues for the Repair of Osteochondral Defects in Beagle Dogs. Int J Mol Sci 2022; 23:ijms23052743. [PMID: 35269885 PMCID: PMC8910734 DOI: 10.3390/ijms23052743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/25/2022] [Indexed: 12/04/2022] Open
Abstract
Cartilage lesions are difficult to repair due to low vascular distribution and may progress into osteoarthritis. Despite numerous attempts in the past, there is no proven method to regenerate hyaline cartilage. The purpose of this study was to investigate the ability to use a 3D printed biomatrix to repair a critical size femoral chondral defect using a canine weight-bearing model. The biomatrix was comprised of human costal-derived cartilage powder, micronized adipose tissue, and fibrin glue. Bilateral femoral condyle defects were treated on 12 mature beagles staged 12 weeks apart. Four groups, one control and three experimental, were used. Animals were euthanized at 32 weeks to collect samples. Significant differences between control and experimental groups were found in both regeneration pattern and tissue composition. In results, we observed that the experimental group with the treatment with cartilage powder and adipose tissue alleviated the inflammatory response. Moreover, it was found that the MOCART score was higher, and cartilage repair was more organized than in the other groups, suggesting that a combination of cartilage powder and adipose tissue has the potential to repair cartilage with a similarity to normal cartilage. Microscopically, there was a well-defined cartilage-like structure in which the mid junction below the surface layer was surrounded by a matrix composed of collagen type I, II, and proteoglycans. MRI examination revealed significant reduction of the inflammation level and progression of a cartilage-like growth in the experimental group. This canine study suggests a promising new surgical treatment for cartilage lesions.
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Affiliation(s)
- Jina Ryu
- ROKIT Healthcare Inc., Seoul 08514, Korea; (J.R.); (B.N.); (J.C.); (M.K.)
| | - Mats Brittberg
- Cartilage Research Unit, Joint Restoration Center, University of Gothenburg, 41345 Gothenburg, Sweden;
- Region Halland Orthopaedics, Kungsbaka Hospital, 43440 Kungsbacka, Sweden
| | - Bomi Nam
- ROKIT Healthcare Inc., Seoul 08514, Korea; (J.R.); (B.N.); (J.C.); (M.K.)
| | - Jinyeong Chae
- ROKIT Healthcare Inc., Seoul 08514, Korea; (J.R.); (B.N.); (J.C.); (M.K.)
| | - Minju Kim
- ROKIT Healthcare Inc., Seoul 08514, Korea; (J.R.); (B.N.); (J.C.); (M.K.)
| | - Yhan Colon Iban
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA 02114, USA; (Y.C.I.); (M.M.); (E.T.)
| | - Martin Magneli
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA 02114, USA; (Y.C.I.); (M.M.); (E.T.)
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02115, USA
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, 18288 Stockholm, Sweden
| | - Eiji Takahashi
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA 02114, USA; (Y.C.I.); (M.M.); (E.T.)
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02115, USA
- Department of Orthopaedic Surgery, Kanazawa Medical University, Ishikawa 920-0293, Japan
| | - Bharti Khurana
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Charles R. Bragdon
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA 02114, USA; (Y.C.I.); (M.M.); (E.T.)
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02115, USA
- Correspondence:
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Tański W, Szalonka A, Tomasiewicz B. Quality of Life and Depression in Rheumatoid Arthritis Patients Treated with Biologics – A Single Centre Experience. Psychol Res Behav Manag 2022; 15:491-501. [PMID: 35264888 PMCID: PMC8901414 DOI: 10.2147/prbm.s352984] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/12/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wojciech Tański
- Department of Internal Medicine, 4th Military Teaching Hospital, Wroclaw, Poland
- Correspondence: Wojciech Tański, Department of Internal Medicine, 4th Military Teaching Hospital, Weigla 5, Wroclaw, 50-981, Poland, Email
| | - Adrianna Szalonka
- Centre for Research and Innovation, 4th Military Teaching Hospital, Wroclaw, Poland
| | - Beata Tomasiewicz
- Department of Internal Medicine, 4th Military Teaching Hospital, Wroclaw, Poland
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Beauchamp T, Arbeeva L, Cleveland RJ, Golightly YM, Hales DP, Hu DG, Allen KD. Accelerometer-Based Physical Activity Patterns and Associations With Outcomes Among Individuals With Osteoarthritis. J Clin Rheumatol 2022; 28:e415-e421. [PMID: 33902099 PMCID: PMC8542057 DOI: 10.1097/rhu.0000000000001750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study examined patterns of physical activity and associations with pain, function, fatigue, and sleep disturbance among individuals with knee or hip osteoarthritis. METHODS Participants (n = 54) were enrolled in a telephone-based physical activity coaching intervention trial; all data were collected at baseline. Self-reported measures of pain and function (WOMAC [Western Ontario and McMaster Universities Osteoarthritis Index] subscales), fatigue (10-point numeric rating scale), and PROMIS (Patient-Reported Outcomes Information System) Sleep Disturbance were collected via telephone. Accelerometers were mailed to participants and were worn for at least 3 days. Proportion of time participants spent in sedentary behavior during the morning (from wake until 12:00 pm), afternoon (12:00 pm until 5:59 pm) and evening (6:00 pm until sleep) each day was averaged across all days of wear. Pearson correlations assessed associations between activity and self-reported measures. RESULTS Participants spent a large proportion of time in sedentary behavior: 65.6% of mornings, 70.0% of afternoons, and 76.6% of evenings. Associations between proportion of time spent in sedentary behavior and reported outcomes were generally strongest in the afternoon, strongest for WOMAC function, and lowest for PROMIS Sleep Disturbance. In the evening hours, sedentary time was most strongly associated with fatigue. CONCLUSIONS Overall, findings stress the importance of reducing sedentary behavior among adults with osteoarthritis and suggest behavioral interventions may be strengthened by considering patients' within-day variation in symptoms and activity.
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Affiliation(s)
- Tyler Beauchamp
- From the Medical College of Georgia at Augusta University, Augusta, GA
| | - Liubov Arbeeva
- Department of Medicine and Thurston Arthritis Research Center
| | | | - Yvonne M Golightly
- Division of Physical Therapy and Thurston Arthritis Research Center, Injury Prevention Research Center, Department of Epidemiology
| | - Derek P Hales
- Department of Nutrition Gillings School of Global Public Health and Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
| | - David G Hu
- Department of Medicine and Thurston Arthritis Research Center
| | - Kelli D Allen
- Department of Medicine and Thurston Arthritis Research Center
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Varghese PP, Chen C, Gordon AM, Magruder ML, Vakharia RM, Erez O, Razi AE. Complications, readmission rates, and in-hospital lengths-of-stay in octogenarian vs. non-octogenarians following total knee arthroplasty: An analysis of over 1.7 million patients. Knee 2022; 35:213-219. [PMID: 35381573 DOI: 10.1016/j.knee.2022.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/10/2022] [Accepted: 03/21/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Studies investigating complications between octogenarians and non-octogenarians undergoing primary total knee arthroplasty (TKA) are limited. Therefore, we investigated whether octogenarians are at greater odds of: (1) in-hospital lengths of stay (LOS) (2) readmission rates, (3) medical complications, and (4) hardware complications compared to non-octogenarians following TKA. METHODS A retrospective query of the PearlDiver database isolated 1,775,460 patients who underwent primary TKA from 2005 to 2014. Patients aged 80 and above represented the study cohort (n = 295,908) and patients 65 to 79 represented the control cohort (n = 1,479,552). Study group patients were matched to controls in a 1:5 ratio according to gender and medical comorbidities. Pearson's Chi Square and logistic regression were used to analyze the primary outcomes of the study which included 90-day medical complications, 90-day readmission rates, 2-year implant-related complications, and in-hospital LOS. A p-value less than 0.001 was statistically significant. RESULTS Octogenarians were found to have significantly higher incidence and odds of 90-day readmission rates (10.59 vs. 9.35%; OR: 1.15, p < 0.0001) and significantly longer in-hospital LOS (3.69 days ± 1.95 vs. 3.23 days ± 1.83, p < 0.0001) compared to controls. Octogenarians also had equal incidence and odds of developing any medical complication (1.26 vs. 1.26%; OR: 0.99, p = 0.99) and lower incidence and odds (1.67 vs. 1.93%; OR: 0.86, p < 0.001) of implant-related complications compared to controls. CONCLUSION Octogenarians undergoing primary TKA have similar odds of medical related complications and lower odds of implant-related complications compared to non-octogenarian patients, whereas readmission rates and in-hospital LOS are greater.
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Affiliation(s)
- Priscilla P Varghese
- Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States; State University of New York (SUNY) Downstate, College of Medicine, Brooklyn, NY, United States
| | - Christine Chen
- Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States; State University of New York (SUNY) Downstate, College of Medicine, Brooklyn, NY, United States
| | - Adam M Gordon
- Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States.
| | - Matthew L Magruder
- Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States
| | - Rushabh M Vakharia
- Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States
| | - Orry Erez
- Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States
| | - Afshin E Razi
- Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States
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Pramipexole treatment attenuates mechanical hypersensitivity in male rats experiencing chronic inflammatory pain. Neuropharmacology 2022; 208:108976. [PMID: 35085583 PMCID: PMC10171400 DOI: 10.1016/j.neuropharm.2022.108976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/14/2022] [Accepted: 01/22/2022] [Indexed: 11/23/2022]
Abstract
Opioids are commonly prescribed for pain despite growing evidence of their low efficacy in the treatment of chronic inflammatory pain and the high potential for misuse. There is a clear need to investigate non-opioid alternatives for the treatment of pain. In the present study, we tested the hypothesis that acute and repeated dopamine agonist treatment would attenuate mechanical hypersensitivity in male Long-Evans rats experiencing chronic inflammatory pain. We used two clinically available therapeutics, l-DOPA (precursor of dopamine biosynthesis) and pramipexole (dopamine D2/3 receptor agonist), to examine the functional role of dopamine signaling on mechanical hypersensitivity using an animal model of chronic inflammatory pain (complete Freund's adjuvant, CFA). We found that both acute and repeated pramipexole treatment attenuated hyperalgesia-like behavior in CFA-treated animals but exhibited no analgesic effects in control animals. In contrast, there was no effect of acute or repeated l-DOPA treatment on mechanical hypersensitivity in either CFA- or saline-treated animals. Notably, we discovered some extended effects of l-DOPA and pramipexole on decreasing pain-like behavior at three days and one week post-drug treatment. We also examined the effects of pramipexole treatment on glutamatergic and presynaptic signaling in pain- and reward-related brain regions including the nucleus accumbens (NAc), dorsal striatum (DS), ventral tegmental area (VTA), cingulate cortex (CC), central amygdala (CeA), and periaqueductal gray (PAG). We found that pramipexole treatment decreased AMPA receptor phosphorylation (pGluR1845) in the NAc and DS but increased pGluR1845 in the CC and CeA. A marker of presynaptic vesicle release, pSynapsin, was also increased in the DS, VTA, CC, CeA, and PAG following pramipexole treatment. Interestingly, pramipexole increased pSynapsin in the NAc of saline-treated animals, but not CFA-treated animals, suggesting blunted presynaptic vesicle release in the NAc of CFA-treated animals following pramipexole treatment. To examine the functional implications of impaired presynaptic signaling in the NAc of CFA animals, we used ex vivo electrophysiology to examine the effects of pramipexole treatment on the intrinsic excitability of NAc neurons in CFA- and saline-treated animals. We found that pramipexole treatment reduced NAc intrinsic excitability in saline-treated animals but produced no change in NAc intrinsic excitability in CFA-treated animals. These findings indicate alterations in dopamine D2/3 receptor signaling in the NAc of animals with a history of chronic pain in association with the anti-hyperalgesic effects of pramipexole treatment.
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Mittinty MM, Elliott JM, Hunter DJ, Nicholas MK, March LM, Mittinty MN. Explaining the gap in the experience of depression among arthritis patients. Clin Rheumatol 2022; 41:1227-1233. [PMID: 34993727 DOI: 10.1007/s10067-021-06010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explain the factors contributing to the gap in depression between employed arthritis patients with and without paid sick leave. METHODS Blinder-Oaxaca decomposition analysis was used to identify factors that explain the gap in the experience of depressive symptoms among arthritis patients with paid and unpaid sick leave. Data from the 2018 National Health Interview Survey, USA, was used. RESULTS A total of 7189 of the NHIS survey participants given the diagnosis of arthritis were identified, of which 39% were male and 61% were female, with mean age of 63.5 years. The decomposition findings suggest patients in the unpaid sick leave group were more likely to report depressive symptoms compared to patients with paid sick leave. The major contributors to the gap in the report of depressive symptoms are sex (female) and annual income (less than 35,000 USD). CONCLUSION Findings suggest that the absence of paid sick leave is a key determinant for experiencing depressive symptoms among individuals with arthritis. The provision of paid sick leave may reduce report of depressive symptoms among employed arthritis patients in the USA. KEY POINTS • Individuals with arthritis are consistently at greater risk of depression and unemployment as compared to individuals without arthritis. • To date greater emphasis is put on determinants of unemployment, while there is no available data on benefits associated with being employed, such as sick leave, and how it affects mental health. • Patients with unpaid sick leave appear to experience more persistent depressive symptoms than patients with access to paid sick leave. • To tackle burden of depression among arthritis patients, provision of paid sick leave may be an effective intervention.
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Affiliation(s)
- Manasi M Mittinty
- Pain Management Research Centre, Royal North Shore Hospital, The University of Sydney, PMRI, St. Leonards, Reserve Road, Sydney, NSW, 2065, Australia.
| | - James M Elliott
- Kolling Research Institute, Faculty of Medicine and Health, The University of Sydney, New South Wales, 2065, Australia
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, NSW, Sydney, 2065, Australia
| | - Michael K Nicholas
- Pain Management Research Centre, Royal North Shore Hospital, The University of Sydney, PMRI, St. Leonards, Reserve Road, Sydney, NSW, 2065, Australia
| | - Lyn M March
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, NSW, Sydney, 2065, Australia
| | - Murthy N Mittinty
- Better Start Group, School of Public Health, The University of Adelaide, Adelaide, SA, 5006, Australia
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Branco J, Branco R, Siqueira T, de Souza L, Dalago K, Andrade A. Clinical applicability of infrared thermography in rheumatic diseases: A systematic review. J Therm Biol 2022; 104:103172. [DOI: 10.1016/j.jtherbio.2021.103172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 01/05/2023]
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135
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Alenzi F, Al-Sheikh H, Alnasser M, Adwani M, Aldhuwayhi R, Algenaim E, Abowadaan M. The level of knowledge about rheumatic diseases in Saudi Arabia: A community-based survey. INTERNATIONAL JOURNAL OF ACADEMIC MEDICINE 2022. [DOI: 10.4103/ijam.ijam_121_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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136
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Borysova I, Potapova T. ASSESSMENT OF FUNCTIONAL ACTIVITY REDUCTION - AS A CRITERION FOR DETERMINING DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2081-2085. [PMID: 36256932 DOI: 10.36740/wlek202209106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim: To analyze the assessment of the decrease in working capacity degree in patients with rheumatoid arthritis in accordance with modern diagnostic disease criteria and social approaches to disability definition in the world (the decline degree of vital activity). PATIENTS AND METHODS Materials and methods: We analyzed the dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020. We analyzed the data of medical and social cases of 433 patients with RA (referral for medical and social examination, Form 088/o). We studied the degree of reduction of their efficiency. Statistical processing was performed using descriptive and variational statistics methods. The results were calculated on a personal computer using the licensed programs STATISTICA 6.1 (StatoftInc., Serial № AGAR909E415822FA). RESULTS Results: It is shown that in Ukraine in 2016-2020 the primary disability had a tendency to increase. The article defines the approaches to medical and social examination of patients with rheumatoid arthritis to determine the ability to work and signs of disability. The article emphasizes the importance of a thorough study of medical data, data on the functional state of the affected joints using functional tests, determining the state of the patient's social activity according to the assessments of questionnaires based on the principles of evidence-based medicine. CONCLUSION Conclusions: The problem of RA is a relevant in the world and in Ukraine. The dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020 shows a growth trend: from 5.8 to 7.1 per 10 thousand population. Carrying out medical and social examination of RA patients to determine the state of working capacity and signs of disability requires careful study of medical data, data on the functional state of the affected joints with functional tests and determining the state of social activity of the patient according to questionnaires. In patients with RA, the most important data for determining violations of vital signs and the presence of functional disability are: disease activity, its course, the presence of lesions of internal organs and the completeness and quality of treatment methods recommended from the standpoint of evidence-based medicine.
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Takura T, Yuasa A, Yonemoto N, Demiya S, Matsuda H, Ebata N, Fujii K, Ishijima M. Cost-Effectiveness Analysis of the Treatment Strategies with or without Opioid Medications in Surgery-Eligible Patients with Osteoarthritis in Japan. PHARMACOECONOMICS - OPEN 2022; 6:33-45. [PMID: 34374962 PMCID: PMC8807819 DOI: 10.1007/s41669-021-00292-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
AIM The aim of this study was to evaluate the cost effectiveness of treatment strategies without opioid medications (non-opioid treatment strategy) versus strategies with opioid medications (opioid treatment strategy) among surgery-eligible patients with osteoarthritis (OA) of the knee or hip in Japan. MATERIALS AND METHODS We built a Markov cohort model to evaluate outcomes for the treatment strategies in surgery-eligible patients aged ≥ 65 years with OA of the knee or hip in Japan. The opioid treatment strategy as an intervention includes a health state with opioid medication in the treatment pathway. On the other hand, for the non-opioid treatment strategy, there is no health state with opioid medication. A targeted literature review and database analysis were conducted to identify and define the values of the variables included in the model. The time horizon was set to 30 years, and a 2% discount was applied for cost and quality-adjusted life-years (QALYs). Sensitivity analysis and scenario analysis were performed in the model. The outcomes were QALYs and the incremental cost-effectiveness ratio (ICER). RESULTS In the base-case analysis, the non-opioid treatment strategy was dominant over the opioid treatment strategy and associated with an incremental cost and QALYs of - 53,878 JPY (- 499 USD) and 0.03 QALYs, respectively, in patients with knee OA, and - 54,129 JPY (- 502 USD) and 0.02 QALYs, respectively, in patients with hip OA. One-way sensitivity analysis showed the ICER was most sensitive to the QALY for opioid monotherapy. Probabilistic sensitivity analyses showed a high degree of uncertainty associated with the results. LIMITATIONS Study limitations included assumptions related to transition probabilities of the health states, and a lack of Japanese-specific data for transition probabilities, incidence of adverse events and utility values. CONCLUSIONS This study suggests that the non-opioid treatment strategy is cost effective compared with the opioid treatment strategy in the management of surgery-eligible patients with OA of the knee or hip. However, this final conclusion may not be accurate as the methodology is heavily reliant on assumptions.
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Affiliation(s)
- Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Yuasa
- Health and Value, Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan.
| | - Naohiro Yonemoto
- Health and Value, Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
| | | | | | | | | | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Hauser RA, Matias D, Woznica D, Rawlings B, Woldin BA. Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil 2022; 35:701-712. [PMID: 34957989 PMCID: PMC9398090 DOI: 10.3233/bmr-210097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low back pain is a significant spinal disorder that affects much of the population at some point during their lives. OBJECTIVE While proper diagnosis is key, diagnosing the underlying cause of low back pain may often be unclear. METHOD In this review article, we discuss lumbar instability as an etiology of low back pain and its treatment by prolotherapy. RESULTS Spinal ligaments may be an underlying culprit in the development of lumbar instability with resultant low back pain and associated disorders. CONCLUSION In these cases, adequate treatment consisting of non-biologic prolotherapy or cellular prolotherapy, including platelet rich plasma (PRP), can be beneficial in restoring spinal stability and resolving chronic low back pain.
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Noh ASM, Chuan TD, Khir NAM, Zin AAM, Ghazali AK, Long I, Ab Aziz CB, Ismail CAN. Effects of different doses of complete Freund's adjuvant on nociceptive behaviour and inflammatory parameters in polyarthritic rat model mimicking rheumatoid arthritis. PLoS One 2021; 16:e0260423. [PMID: 34879087 PMCID: PMC8654228 DOI: 10.1371/journal.pone.0260423] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/14/2021] [Indexed: 12/31/2022] Open
Abstract
Complete Freund's adjuvant (CFA) has been used to develop the arthritic or inflammatory condition in the animal, but there is a lack of information concerning high CFA doses on nociceptive behaviour and inflammatory parameters. This study aimed to compare the effects of different high doses of CFA in rat to closely mimic nociceptive and inflammatory parameters of rheumatoid arthritis (RA) in humans. Twenty-four male Sprague-Dawley rats were randomly divided into four groups (n = 6): Control (C), CFA-induced polyarthritic groups at 5.0 mg/mL (CFA 5.0), 7.5 mg/mL (CFA 7.5) and 10.0mg/mL (CFA 10.0). The rats' right hindpaw was inoculated with CFA intradermally and developed into a polyarthritic state within 20 days. Nociceptive behavioural assessments, including von Frey and hot plate tests and spontaneous activities, were conducted on day 0, 7, 15 and 20. Bilateral ankle joints diameter and circumference, full blood count, joints and paw histological examinations were also conducted throughout the study period. Based on the results, CFA 5.0 and CFA 7.5 groups showed a significant increase in spontaneous activities and development of thermal hyperalgesia but no change in body weight and food intake, no development of tactile allodynia and haematological indices, and no significant morphological changes of joints histology. Meanwhile, CFA 10.0 group demonstrated significant and constant changes in all nociceptive and inflammatory parameters investigated. In conclusion, CFA at the dose of 10mg/mL has the most potential and reliable dosage to develop polyarthritis in a rat model to mimic RA condition in humans.
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Affiliation(s)
- Ain’ Sabreena Mohd Noh
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | - Tan Dai Chuan
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nurul Ajilah Mohamed Khir
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
- International Medical School, Management and Science University, Selangor, Malaysia
| | - Anani Aila Mat Zin
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | - Anis Kausar Ghazali
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | - Idris Long
- Biomedicine Program, School of Health Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | - Che Badariah Ab Aziz
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | - Che Aishah Nazariah Ismail
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
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140
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Perez-Garcia LF, Röder E, Goekoop RJ, Hazes JMW, Kok MR, Smeele HTW, Tchetverikov I, van der Helm-van Mil AHM, van der Kaap JH, Kok P, Krijthe BP, Dolhain RJEM. Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility). Ann Rheum Dis 2021; 80:1545-1552. [PMID: 34373257 PMCID: PMC8600610 DOI: 10.1136/annrheumdis-2021-220709] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/09/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The impact of inflammatory arthritis (IA) on male fertility remains unexplored. Our objective was to evaluate the impact of IA on several male fertility outcomes; fertility rate (number of biological children per man), family planning, childlessness and fertility problems. METHODS We performed a multicentre cross-sectional study (iFAME-Fertility). Men with IA 40 years or older who indicated that their family size was complete were invited to participate. Participants completed a questionnaire that included demographic, medical and fertility-related questions. To analyse the impact of IA on fertility rate, patients were divided into groups according to the age at the time of their diagnosis: ≤30 years (before the peak of reproductive age), between 31 and 40 years (during the peak) and ≥41 years (after the peak). RESULTS In total 628 participants diagnosed with IA were included. Men diagnosed ≤30 years had a lower mean number of children (1.32 (SD 1.14)) than men diagnosed between 31 and 40 years (1.60 (SD 1.35)) and men diagnosed ≥41 years (1.88 (SD 1.14)).This was statistically significant (p=0.0004).The percentages of men diagnosed ≤30 and 31-40 years who were involuntary childless (12.03% vs 10.34% vs 3.98%, p=0.001) and who reported having received medical evaluations for fertility problems (20.61%, 20.69% and 11.36%, p=0.027) were statistically significant higher than men diagnosed ≥41 years. CONCLUSIONS This is the first study that shows that IA can impair male fertility. Men diagnosed with IA before and during the peak of reproductive age had a lower fertility rate, higher childlessness rate and more fertility problems. Increased awareness and more research into the causes behind this association are urgently needed.
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Affiliation(s)
| | - Esther Röder
- Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Johanna M W Hazes
- Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marc R Kok
- Rheumatology and Clinical Immunology, Maasstad Ziekenhuis, Rotterdam, The Netherlands
| | | | - Ilja Tchetverikov
- Rheumatology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Annette H M van der Helm-van Mil
- Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos H van der Kaap
- Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Rheumatology, Admiraal De Ruyter Hospital, Goes, The Netherlands
| | - Petra Kok
- Rheumatology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Bouwe P Krijthe
- Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Rheumatology, Sint Franciscus Vlietland Group, Rotterdam, The Netherlands
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Larrañaga-Vera A, Marco-Bonilla M, Largo R, Herrero-Beaumont G, Mediero A, Cronstein B. ATP transporters in the joints. Purinergic Signal 2021; 17:591-605. [PMID: 34392490 PMCID: PMC8677878 DOI: 10.1007/s11302-021-09810-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/09/2021] [Indexed: 02/08/2023] Open
Abstract
Extracellular adenosine triphosphate (ATP) plays a central role in a wide variety of joint diseases. ATP is generated intracellularly, and the concentration of the extracellular ATP pool is determined by the regulation of its transport out of the cell. A variety of ATP transporters have been described, with connexins and pannexins the most commonly cited. Both form intercellular channels, known as gap junctions, that facilitate the transport of various small molecules between cells and mediate cell-cell communication. Connexins and pannexins also form pores, or hemichannels, that are permeable to certain molecules, including ATP. All joint tissues express one or more connexins and pannexins, and their expression is altered in some pathological conditions, such as osteoarthritis (OA) and rheumatoid arthritis (RA), indicating that they may be involved in the onset and progression of these pathologies. The aging of the global population, along with increases in the prevalence of obesity and metabolic dysfunction, is associated with a rising frequency of joint diseases along with the increased costs and burden of related illness. The modulation of connexins and pannexins represents an attractive therapeutic target in joint disease, but their complex regulation, their combination of gap-junction-dependent and -independent functions, and their interplay between gap junction and hemichannel formation are not yet fully elucidated. In this review, we try to shed light on the regulation of these proteins and their roles in ATP transport to the extracellular space in the context of joint disease, and specifically OA and RA.
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Affiliation(s)
- Ane Larrañaga-Vera
- Department of Medicine, Division of Translational Medicine, NYU Langone Health, New York, NY, USA
| | - Miguel Marco-Bonilla
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, 28040, Madrid, Spain
| | - Raquel Largo
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, 28040, Madrid, Spain
| | | | - Aránzazu Mediero
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, 28040, Madrid, Spain.
| | - Bruce Cronstein
- Department of Medicine, Division of Translational Medicine, NYU Langone Health, New York, NY, USA
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Kelly M, Aja J, Turcotte J, MacDonald J. Effect of a PA-led arthritis center on hip and knee osteoarthritis care. JAAPA 2021; 34:42-48. [PMID: 34772855 DOI: 10.1097/01.jaa.0000800260.99283.d3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effect of an arthritis center on patient care and operational throughput. METHODS A single-institution, retrospective review was conducted of patients with hip or knee osteoarthritis from January 2016 to October 2019. Our physician assistant (PA) led arthritis center opened in November 2017, and manages nonoperative treatment of osteoarthritis by formulating individualized treatment plans. Descriptive and inferential statistics comparing operational measures, treatment patterns, and patient satisfaction pre- and postcenter opening were performed. RESULTS Overall patient volume, new patient volume, and the proportion of new patients seen increased after the arthritis center opened. Encounters per patient and clinicians seen per patient decreased, while the rate of injections and surgery increased. Patient satisfaction improved after opening of the arthritis center. CONCLUSIONS The establishment of a dedicated PA-led arthritis center is associated with improved access to care, operational efficiency, and patient satisfaction in patients with hip and knee osteoarthritis.
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Affiliation(s)
- McKayla Kelly
- At Anne Arundel Medical Center in Annapolis, Md., McKayla Kelly is a research fellow, in the Department of Orthopedics, Jacob Aja practices in the Department of Orthopedics, Justin Turcotte is director of research in the departments of orthopedics and surgery, and James MacDonald is a surgeon in the Department of Orthopedics. Dr. MacDonald discloses that he is a paid consultant or supplier for Smith and Nephew and receives research support from Depuy, Promotus, and Smith and Nephew. The authors have disclosed no other potential conflicts of interest, financial or otherwise
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Gauthier G, Levin R, Vekeman F, Reyes JM, Chiarello E, Ponce de Leon D. Treatment patterns and sequencing in patients with rheumatic diseases: a retrospective claims data analysis. Curr Med Res Opin 2021; 37:2185-2196. [PMID: 34544301 DOI: 10.1080/03007995.2021.1981278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Long-term real-world management of inflammatory rheumatic diseases remains unclear, especially with the advent of new treatment options. This study characterizes the number of advanced treatments used by patients with selected rheumatic diseases (rheumatoid arthritis [RA], psoriatic arthritis [PsA], ankylosing spondylitis, juvenile idiopathic arthritis) and provides a contemporary portrait of treatment patterns and therapeutic sequencing among patients with RA and PsA. METHOD Patients were selected from a large US claims database and classified into disease subsamples based on the latest rheumatic diagnosis recorded before/on the day of initiation of the first advanced treatment (index date). The total number of advanced treatments was assessed within the first 5 years following the index date. Treatment patterns and therapeutic sequencing were assessed over the first 2 years. RESULTS Approximately 20% of patients received ≥2 distinct advanced treatments during the first year following index date - the proportion increased to almost 50% among patients with 5 years of observation. Most patients (RA: 76.8%; PsA: 88.7%) initiated a tumor necrosis factor as the first advanced treatment. Over the first 2 years after the index date, 1/3 of RA and PsA patients switched to another advanced treatment. More than 50% initiated a second treatment with the same mechanism of action (MOA). A small proportion of patients received a biosimilar. CONCLUSION Despite advent of treatments with different MOA, cycling between treatments with the same MOA was common. Further studies with longer data follow-up would be needed to assess the impact of higher adoption of biosimilars on treatment patterns/sequencing.
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144
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Chun DS, Leonard AK, Enchill Z, Suleiman LI. Racial Disparities in Total Joint Arthroplasty. Curr Rev Musculoskelet Med 2021; 14:434-440. [PMID: 34626322 PMCID: PMC8733080 DOI: 10.1007/s12178-021-09718-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW The primary aim of this review was to evaluate recently published total joint arthroplasty (TJA) studies in order to accurately summarize the current concepts regarding racial and ethnic disparities in total joint arthroplasty. RECENT FINDINGS Many studies found that racial and ethnic disparities in TJA are present in all phases of arthroplasty care including access to, utilization of, and postoperative outcomes after TJA. Factors that limit patient access to TJA-increased patient comorbidities, lower socioeconomic status, and Medicaid/uninsured status-are also disproportionately associated with underrepresented patient populations. Minority patients are more likely to require more intensive postoperative rehabilitation and non-home discharge placement. This in turn potentially adds additional concerns regarding hospital/provider reimbursement in light of the current Medicare/Medicaid model for arthroplasty surgeons, thus creating a recurrent cycle in which disparities in TJA reflect the complex interplay of overall health disparities and access inequalities associated with racial and ethnic biases. Literature demonstrating evidenced-based interventions to minimize these disparities is sparse, but the multifactorial cause of disparities in TJA highlights the need for multifaceted solutions on both a systemic and individual level.
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Affiliation(s)
- Danielle S Chun
- Department of Orthopaedic Surgery, Northwestern University, 259 E. Erie St. 13th Floor, Chicago, IL, 60611, USA
| | - Annemarie K Leonard
- Department of Orthopaedic Surgery, Northwestern University, 259 E. Erie St. 13th Floor, Chicago, IL, 60611, USA
| | - Zenaida Enchill
- Department of Orthopaedic Surgery, Northwestern University, 259 E. Erie St. 13th Floor, Chicago, IL, 60611, USA
| | - Linda I Suleiman
- Department of Orthopaedic Surgery, Northwestern University, 259 E. Erie St. 13th Floor, Chicago, IL, 60611, USA.
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Jeong SH, Kim SH, Park M, Kwon J, Lee HJ, Park EC. Arthritis status changes and depressive symptoms among middle-aged and older Koreans: Analysis of data from the Korean Longitudinal Study of Aging survey. J Psychosom Res 2021; 151:110662. [PMID: 34739945 DOI: 10.1016/j.jpsychores.2021.110662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Arthritis can negatively affect physical and mental health, especially among middle-aged and older people. This study investigated the longitudinal association between changes in arthritis status and depressive symptoms among Korean adults aged ≥45 years. METHODS We analyzed data from the Korean Longitudinal Study of Aging 2008-2018, using a generalized estimating equation model to investigate associations between arthritis status change and depressive symptoms, which were assessed using five categories according to measurements based on the Center for Epidemiological Studies Depression Scale (CES-D-10). RESULTS Both men and women whose arthritis status changed to "worse" or remained "same" scored higher for depressive symptoms than those who reported "no symptoms of arthritis" (men, worse = β: 1.07, P ≤ .001, same = β: 0.25 P = .031; women, worse = β: 0.99, P ≤ .001, same = β: 0.13, P = .049). Conversely, men with a "better" arthritis status (β: -0.71, P ≤ .001) and women with a "recovered" arthritis status (β: -0.56, P = .031) scored lower for depressive symptoms than those who reported "no symptoms of arthritis." CONCLUSIONS Arthritis status changes are associated with depressive symptoms in middle-aged and older Koreans. Therefore, mental health evaluation and management interventions are recommended for patients with arthritis and changes in disease status.
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Affiliation(s)
- Sung Hoon Jeong
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Seung Hoon Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minah Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Junhyun Kwon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyeon Ji Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Schminke B, Kauffmann P, Schubert A, Altherr M, Gelis T, Miosge N. SMURF1 and SMURF2 in Progenitor Cells from Articular Cartilage and Meniscus during Late-Stage Osteoarthritis. Cartilage 2021; 13:117S-128S. [PMID: 33090007 PMCID: PMC8721605 DOI: 10.1177/1947603520967069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the roles of SMURF1 and SMURF2 in progenitor cells from the human knee in late-stage osteoarthritis (OA). DESIGN We applied immunohistochemistry, immunocytochemistry, RNAi, lentiviral transfection, and Western blot analysis. We obtained chondrogenic progenitor cells (CPCs) from the articular cartilage and meniscus progenitor cells (MPCs) from the nonvascularized part of the meniscus. RESULTS SMURF1 and SMURF2 appeared in both osteoarthritic tissues. CPCs and MPCs exhibited comparable amounts of these proteins, which influence the balance between RUNX2 and SOX9. The overexpression of SMURF1 reduced the levels of RUNX2, SOX9, and TGFBR1. The overexpression of SMURF2 also reduced the levels of RUNX2 and TGFBR1, while SOX9 levels were not affected. The knockdown of SMURF1 had no effect on RUNX2, SOX9, or TGFBR1. The knockdown of SMURF2 enhanced RUNX2 and SOX9 levels in CPCs. The respective protein levels in MPCs were not affected. CONCLUSIONS This study shows that SMURF1 and SMURF2 are regulatory players for the expression of the major regulator transcription factors RUNX2 and SOX9 in CPCs and MPCs. Our novel findings may help elucidate new treatment strategies for cartilage regeneration.
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Affiliation(s)
- Boris Schminke
- Department of Oral and Maxillofacial
Surgery, University Medical Center Goettingen, Göttingen, Germany,Oral Biology and Tissue Regeneration
Work Group, University Medical Center Goettingen, Göttingen, Germany
| | - Philipp Kauffmann
- Department of Oral and Maxillofacial
Surgery, University Medical Center Goettingen, Göttingen, Germany
| | - Andrea Schubert
- Oral Biology and Tissue Regeneration
Work Group, University Medical Center Goettingen, Göttingen, Germany
| | - Manuel Altherr
- Oral Biology and Tissue Regeneration
Work Group, University Medical Center Goettingen, Göttingen, Germany
| | - Thomas Gelis
- Oral Biology and Tissue Regeneration
Work Group, University Medical Center Goettingen, Göttingen, Germany
| | - Nicolai Miosge
- Oral Biology and Tissue Regeneration
Work Group, University Medical Center Goettingen, Göttingen, Germany,Nicolai Miosge, Oral Biology and Tissue
Regeneration Work Group, University Medical Center Göttingen,
Robert-Koch-Strasse 40, Göttingen, 37075, Germany.
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147
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Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence. Int J Mol Sci 2021; 22:ijms222312920. [PMID: 34884724 PMCID: PMC8658017 DOI: 10.3390/ijms222312920] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 12/30/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative inflammatory condition of the joint cartilage that currently affects approximately 58 million adults in the world. It is characterized by pain, stiffness, and a reduced range of motion with regard to the arthritic joints. These symptoms can cause in the long term a greater risk of overweight/obesity, diabetes mellitus, and falls and fractures. Although the current guidelines for the treatment of OA suggest, as the gold standard for this condition, pharmacological treatment characterized by non-steroidal anti-inflammatory drugs (NSAID), opioids, and cyclooxygenase (COX)-2-specific drugs, a great interest has been applied to nutraceutical supplements, which include a heterogeneous class of molecules with great potential to reduce inflammation, oxidative stress, pain, and joint stiffness and improve cartilage formation. The purpose of this review is to describe the potential application of nutraceuticals in OA, highlighting its molecular mechanisms of actions and data of efficacy and safety (when available).
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148
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Abraham DM, Herman C, Witek L, Cronstein BN, Flores RL, Coelho PG. Self-assembling human skeletal organoids for disease modeling and drug testing. J Biomed Mater Res B Appl Biomater 2021; 110:871-884. [PMID: 34837719 DOI: 10.1002/jbm.b.34968] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/02/2021] [Accepted: 11/13/2021] [Indexed: 01/09/2023]
Abstract
Skeletal conditions represent a considerable challenge to health systems globally. Barriers to effective therapeutic development include a lack of accurate preclinical tissue and disease models. Most recently, work was attempted to present a novel whole organ approach to modeling human bone and cartilage tissues. These self-assembling skeletal organoids mimic the cellular milieu and extracellular organization present in native tissues. Bone organoids demonstrated osteogenesis and micro vessel formation, and cartilage organoids showed evidence of cartilage development and maturation. Skeletal organoids derived from both bone and cartilage tissues yielded spontaneous polarization of their cartilaginous and bone components. Using these hybrid skeletal organoids, we successfully generated "mini joint" cultures, which we used to model inflammatory disease and test Adenosine (A2A ) receptor agonists as a therapeutic agent. The work and respective results indicated that skeletal organoids can be an effective biological model for tissue development and disease as well as to test therapeutic agents.
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Affiliation(s)
- Diana M Abraham
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA
| | - Calvin Herman
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA
| | - Lukasz Witek
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
| | - Bruce N Cronstein
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York, New York, USA
| | - Paulo G Coelho
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York, New York, USA.,Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
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149
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A Collagen-Conducting Polymer Composite with Enhanced Chondrogenic Potential. Cell Mol Bioeng 2021; 14:501-512. [PMID: 34777607 DOI: 10.1007/s12195-021-00702-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022] Open
Abstract
Introduction Conducting polymers (CPs) have demonstrated promise for promoting tissue repair, yet their ability to facilitate cartilage regeneration has yet to be thoroughly investigated. Integrating CPs into common scaffolds for tissue regeneration, such as collagen, would enable mechanistic studies on the potential for CPs to promote cartilage repair. Here, we combine absorbable collagen sponges (ACS) with the CP PEDOT-S and show that the PEDOT-S-collagen composite (PEDOT-ACS) has enhanced chondrogenic potential compared to the collagen sponge alone. Methods PEDOT-S was incorporated through a simple incubation process. Changes to scaffold topography, elastic modulus, swelling ratio, and surface charge were measured to analyze how PEDOT-S affected the material properties of the scaffold. Changes in rat bone marrow mesenchymal stem cell (rBMSC) functionality were assessed with cell viability and glycosaminoglycan production assays. Results Macrostructure and microstructure of the scaffold remained largely unaffected by PEDOT-S modification, as observed through SEM images and quantification of scaffold porosity. Zeta potential, swelling ratio, and dry elastic modulus of the collagen scaffold were significantly changed by the incorporation of PEDOT-S. Seeding cells on PEDOT-ACS improved cell viability and enhanced glycosaminoglycan production. Conclusion We demonstrate a practical approach to generate PEDOT-S composites with comparable physical properties to pristine collagen scaffolds. We show that PEDOT-ACS can influence cell functionality and serve as a promising model system for mechanistic investigations on the roles of bioelectronic signaling in the repair of cartilage and other tissue types.
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150
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Quintana R, Fernández S, Orzuza SM, Silvestre AMR, Bensi A, Goñi M, Iglesias P, Mathern N, García-Bianco V, Honeri A, Pons-Estel BA, Valdata M, Peláez-Ballestas I. «Living with rheumatoid arthritis» in an indigenous qom population in Argentina. A qualitative study. ACTA ACUST UNITED AC 2021; 17:543-548. [PMID: 34756317 DOI: 10.1016/j.reumae.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/22/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a chronic disease which impacts patients' quality of life. The prevalence of RA in the qom population was 2.4% and represented an aggressive and disabling disease. The study goal was to describe the experience of the indigenous qom community individual suffering from RA, along with their experience with the local health care system in the city of Rosario, Santa Fe, Argentina. METHODS Qualitative Study using techniques of participant observation and semi-structured interviews; following a guideline developed by a multidisciplinary research group comprising anthropologists, rheumatologists, nurses, and psychologists. A triangulation strategy was implemented for the analysis. RESULTS A total of 33 interviews were conducted in 29 individuals with RA. The results showed a "normalization" of their symptoms and of their limitations in performing daily tasks. The individuals' relationship with the local health care system was complex and limited in several aspects (e.g. access to health care, continuity of treatment, complexity of medical care pathway and lack of cultural competence). CONCLUSIONS RA is a disease that has a negative impact on the daily lives of the qom people living in Rosario. Improving the relationship between this population and the local health care system as well as the implementation of multidisciplinary work should be priorities.
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Affiliation(s)
- Rosana Quintana
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina.
| | - Sofía Fernández
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Stella M Orzuza
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Adriana M R Silvestre
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Ana Bensi
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Mario Goñi
- Centro de Especialidades Médicas Ambulatorias de Rosario, Secretaría de Salud Pública, Municipalidad de Rosario, Argentina
| | - Paola Iglesias
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Nora Mathern
- Instituto de Reumatología, Ortopedia y Fisiatría, Rosario, Argentina
| | - Vanina García-Bianco
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Andrés Honeri
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Bernardo A Pons-Estel
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Marcela Valdata
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
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